08-1508 (RPL)P.O. BOX 1504
T-vy
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING.& SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 08-00001508 Owner: ...1
Property Address: 54155 CANANERO CIR WISE
APN: 767-320-999-284 -32879 - 54155 CANANERO C
Application description: POOL - RESIDENTIAL LA QUINTA, CA 3
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 25000
Contractor: �d
Applicant: Architect or Engineer: TESERRA 4
P.O. BOX 1280
COACHELLA, CA 92236
� (760)398-9222
Lic. No.: 656128
I hereby affirm under penalty of rrjury that I am licens u r pr i ' of Chapter 9 (commencing with
Section 70%) of Division 3 of he Business and Profes ' Is an License is in full force and effect.
License -�8 C27 C2 6'6128
O ER- ILDER DECLARATION
1 hereby affirm under penalty of perjury tend
I am xem from the Contractor's State License Law for the
following reason (Sec. 7031. Business Pr fes ' ns Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair y ucture, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or s ' licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
(_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sate. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
1 _ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
I _ 1 I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
0,7
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/03/08
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and poli�tumber are:
Carrier SEABRIGHT \-,-,PolicvNumbeL�BB1080510
I certify that, in the performanc of th or r ermit is issued, I shall not employ any
person in any manner so as to ecom bje o orkers' compensation laws of California,
and agree that, if I should beco a jec rs' compensation provisions of Section
f% �P00 of the Labor Code, I shall rthw' c ' h those provisions.
WARNING: FAILURE TO SECURE WORKS OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. -
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1 . Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
2. Any permit issued as a result oft s app ion becomes null and void if work is not commenced
within 180 days from date of is once of s permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state t the ab ve info n is ect. ee to comply with all
city and county ordinances and state laws relating to bu on ion, er rize representatives
of this coury+y� gnror upon the above-mentioned property fo ection
(Applicant or Agent):
Application Number . . . . . 08-00001508
Permit . . . BLDG POOL PERMIT
Additional desc . .
Permit Fee . . . . 252.00 Plan Check Fee - 163.80
Issue Date . . Valuation 25000
Expiration Date . . 3/02/09
J Qty Unit Charge Per Extension
BASE FEE 45.00
23.00 9.0000 THOU BLDG 2,001-25,000 207.00
----------------------------------------------------------------------------
Permit . . . MECH POOL
Additional desc . .
Permit Fee 26.00 Plan Check Fee 6.50
Issue Date Valuation . . . . 0
Expiration Date 3/02/09
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 11.0000 EA MECH FURNACE >100K 11.00
----------------------------------------------------------------------------
Permit . . . . . ELEC POOL PERMIT -RES
Additional desc .
Permit Fee . . . . 45.00 Plan Check Fee 11.25
Issue Date Valuation . . . . 0
Expiration Date 3/02/09
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 30.0000 EA ELEC PRIVATE SWIMMING POOL 30.00
------------------------------------------------ ---------------------------
Permit . . . PLUMBING
Additional desc . .
Permit Fee . . . . 33.00 Plan Check Fee 8.25
Issue Date Valuation 0
Expiration Date 3/02/09
Qty Unit Charge Per Extension
BASE FEE 15.00
2.00 6.0000 EA PLB FIXTURE 12.00
1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00
1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00
------------------------------------=---------------------------------------
Special Notes and Comments
POOL/SPA. ALARMS/BARRIERS SHALL BE IN
LQPERA1IT
Application Number . . . . . 08-00001508
----------------------------------------------------------------------------
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
Fee summary Charged
----------------- ----------
Permit Fee Total 356.00
Plan Check Total 189.80
Grand Total 545.80
LQPERMIT
Paid Credited Due
---------- ---------- ----------
.00 .00 356.00
.00 .00 189.80
.00 .00 545.80
Bin # ...
City of. La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # V�
\�V
Project Address:
Owner's Name: ls�,
A. P. Number:'
Address: ��✓�S
Legal Description:
City, ST, Zip: QU;4
Contractor:e
Telephone: �
Address: Sb—
��
Project Description. S ()
City, ST, Zip:
e,
Telephone:
State Lic. # :
Arch., Engr., Designer:
la Lic. #:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project type(circle one) Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: (760
v— UZ $
Estimated Value of Project: 2-0 2 S K
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal Req'd Rec'd TRACIQNG PERMIT FEES
Plan Sets
Plan Check submitted Item Amount
Structural Calcs.
Reviewed, ready for corrections Plan Check Deposit
Truss Cates.
Called Contact Person Plan Check Balance
Energy Calcs.
Plans picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
2'" Review, ready for correctionsliissue Electrical
Subcontactor List
Called Contact Person Plumbing
- -- - - ------
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VntOUSE:-
-damningApproval-
Approval=Pub.
Pub.Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
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