08-1740 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4 -ht 4 Xi& Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: ' 08-00001740 .
Property Address: 54185 CANANERO CIR
APN: 767-320-999-283--32879 -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 28000
Applicant:
e Q
I hereby affirm urider penalty of perjury that
Section 70001 of Division 3 of the Business
License Class: ,29 C27 C29
�• � //`/ .off
/te: ` V ontractor.
Architect or Engineer:
'OR'S DECLARATION
provisions of Chapter 9 (commencing with
)de, and my License is in full force and effect.
91WNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I mag exempt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is 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 sale. 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 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.).
(_ 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
Owner:
GILBERT
54185 CANANERO CIRCLE
LA QUINTA, CA 92253
Contractor: D
TESERRA
P.O. BOX 1280
COACHELLA, CA 92236
(760)398-9222
Lic. No.: 656128
-VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/21/08
OCT 212000
ryOFLA
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.
r I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performan of the rk for which this permit is issued. My workers' compensation
insurance carrier and polic ' umber a
Carrier SEABRIGHT )icy umber BB1080510
I certify that, in the performance of the for whi h this ermit is issued, I shall not employ any
person in any manner so as to become s bl e r ers' compensation laws of California,
and agree that, if I should become subje o ' compensation provisions of Section
/ 700 of t e Labor Code, I shall fort rt se provisions.
s
Dat pplicant:
WARNING: FAILURE TO SECURE WORT �IES
ATION COVERAGE IS UNLAWFUL, A D -SHALL
SUBJECT AN EMPLOYER TO CRIMINALD 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 of this application becomes null and void if work is not commenced
within 180 days from date of issuanrl,4
perm , cessation of wor Ij-da i subject
permit to cancellation.
I certify that I have read this application and stateboy9.i rma on is gree to comply with all
city and county ordinances and state laws relatingcon ttructio d e uthorize representatives
of tFya cpuntylo_enter upgn'the above-mentioned s
(Applicant or Agent):
Application Number . . . . . 08-00001740
Permit . . . BLDG POOL PERMIT
Additional desc . .
Permit Fee . . . . 271.50 Plan Check Fee 176.48
Issue Date . . . . Valuation 28000
Expiration Date 4/19/09
Qty Unit Charge Per Extension
BASE FEE 252.00
3.00 6.5000 THOU BLDG 25',001-50,000 19.50
----------------------------------------------------------------------------
Permit . . . MECH POOL
Additional desc .
Permit Fee• 26.00 Plan Check Fee 6.50 -
Issue Date . . . . Valuation . . . . 0
Expiration Date 4/19/09
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 4/19/09
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 . . 4/19/09
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, WATER FEATURE. ALARMS/BARRIERS
LQPERMIT
1
LQPERMIT
Application Number . . . . . 08-00001740
----------------------------------------------------------------------------
Special Notes and
Comments
SHALL BE IN
PLACE
AT PRE -PLASTER
INSPECTION.
EQUIPMENT ENCLOSURE NOT
INCLUDED.
Fee summary
-----------------
Charged Paid
--------------------
Credited
--------------------
Due
Permit Fee
Total
375.50 .00
.00
375.50
Plan Check
Total
202.48 .00
.00
202.48
Grand Total
577.98 .00
.00
577.98
3
Bin #
City of. La Quinta
Building a Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit# ,� j�
V�'
��
Project Address:
Owner's Name: L T
A. P. Number: f;cr/,�v �� 64I ZT3
Address: . � —/g5 -
Legal Description: !�
Legal
City, ST, ZipL '
Contractor: e r r
Telephone:
Address: b--
Project Description:
City, ST, Zip:
Telephone: 3?t—
StateLic.4: 5
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
t
s
Construction Type: Occupancy:
State Lic. #:
Project type (circle one) New Add'n Alter. Repair Demo
Name of Contact Person:
Sq. Ft.: S�7
# Stories:
# Units:
Telephone # of Contact Person: (760) 0-- UZ -9 1
Estimated Value of Project: -- Z K
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACMG .
PERMIT FEES
Plan Sets
Plan Check submitted
Ju ILO
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
«
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person.
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
'`" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
lf1
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