07-2841 (SOTB)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 07-00002841
Property Address: 54250 CANANERO CIR
APN: 767-320-999-295 -32879 -
Application description: STRUCTURES OTHER THAN BUILDINGS
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 500
Applicant:
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I a licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business an Professionals Code, and my License is in full force and effect.
LT-
License/16&f/
CClas�sl:: C8 C27 C29 LicenseNo.: 656128
Date: 16 P7 0 Contractor: �-
EWBUILDER DECLARATION
I hereby affirm under penalty of perjury that I am 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:
LQPE%NI IT
A
Owner:
AHEARN
54-250 CANANERO CIR
LA QUINTA, CA 92253
Contractor: D
TESERRA
P.O. BOX 1280
COACHELLA, CA 9 3
(760)398-9222
Lic. No.:,65612
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Od 3 01001
CITY OF LA QUINTA
Date: 10/29/07
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 policy number are:
Carrier SEABRIGHT Policy Number BB1070510
I certify that, in the performance of the rk for which this permit is issued, I shall not employ any
person in any manner so as to bec a subject to the workers' compensation laws of California,
and agree that, if I should b me bject to the workers' compensation provisions of Section
3700 of the Labor Code, b2
f with comply with those provisions..
Date: opplicant:
r '
WARNING: FAILURE TO SECURE WOR PENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMIN ES 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 of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or Lonis
f work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above informrect. I agree to comply with all
city and county ordinances and state laws relating to building tru Ieby authorize representatives
of thiscou/pty toenter upon the above-mentioned property or in
Date{ �( Z�! Q ignature (Applicant or Agent):
f
LQPERMIT
Application Number . . . . . 07-00002841
Permit . . . BUILDING PERMIT
Additional desc .
Permit Fee . . . .
15.00
Plan Check Fee
9.75
Issue Date . . . .
Valuation
500
Expiration Date
4/26/08
Qty Unit Charge
Per
Extension
----------------------------------------------------------------------------
BASE
FEE
15.00
Permit . . . ELEC-MISCELLANEOUS
Additional desc
Permit Fee . . . .
17.25
Plan Check Fee
4.31
Issue Date . . .
Valuation . .
. 0
Expiration Date
4/26/08
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
3.00 .7500
PER ELEC
DEVICE/FIXTURE 1ST 20
2.25
----------------------------------------------------------
Special Notes and Comments
------------------
BBQ ONLY PER APPROVED
PLANS
Fee summary Charged
----------------- ---------- ----------
Paid Credited
------ - --- ----------
Due
Permit Fee Total
32.25
.00 .00
32.25
Plan Check Total
14.06
.00 .00
14.06
Grand Total
46.31
.00 .00
46.31
Bin # City of La Quinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
Permit # ® La Quinta, CA 92253 - (760) 777-7012
.a� H Building Permit Application and Tracking Sheet
Project Address: _ 'c� 04 j 9YZO Owner's Name:
A. P. Number: Address:
Legal Description: City, ST, Zip:
Contractor: "r Telephone:
Address: 'Q ;� 0 Project Description:
City, ST, Zip: !a L L Lr� C i Z z- 8Q nk)
Telephone: .;39 �— C -1Z,. z, z-- r9/vi/ /
State Lic. # : 65 61 i •
Arch., Engr_, Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Telephone # of Contact Person
It I Submittal
Plan Sets
Structural Calcs.
Truss Calcs.
Energy Calcs.
Flood plain plan
Grading plan
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
School Fees
City Lic. #:
Construction Type:
Project type (circle one):
Sq. Ft.: #
Estimated Value of Projec
APPLICANT: DO NOT WRITE BELOW THIS LINE
Rec'd TRACKING
Plan Check submitted
Reviewed, ready for correctionsee
Called Contact Person
Plans picked up
Plans resubmitted
2"d Review, ready for corrections/issue
Called Contact Person
Plans picked up
Plans resubmitted
Review, ready for corrections/issue
Called Contacl
' ' ' >rto 1
Date of permit
Occupancy:
New Add'n Alter Repair Demo
Stories: # Units:
.500
PERMIT FEES
Item
Plan Check Deposit
Plan Check Balance
Construction
Mechanical
Electrical
Plumbing
S.M.I.
Grading
Developer Impact Fee
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• CONSTR
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Amount
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SPECIFICATIONS
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DECK
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TYPE Qm x
SURFACE AREA Or POOL
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SPA EC JOATION
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SPA DAM WALL WIDTH �,�. �
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SPECIAL NDTES _ ._._.�-
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EXCAVATION TE
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rd
6AER TO' (1) QETTRMM 114E APPROMIMATe ELFVATICK OF POOL Dq 5 A AT LAYWI uN PAY pE EKCA`JATICIN
. (2) TAKE+lNOME THAT POOL AND EQUV16 NT I.00Ai1(1N5 ARE SUR6CCT TID AcaRFTANC,E OF
LO(X BUILD04G UPAJ[itsIENT AT NME OF IBSIJ4 DF PERPAT
.(3) 4Er iiGm CCWORETE 5i♦ AT LEAs7 Tom imLy FQR sEw" 4+l*S AMR iHE3_L VS INSTA3JFT)
(4) ADREE THAT IFSIERiiA IS NOT PPSP045113LE ra� U445Fjt JM CONIIITTs7N5 arI 9@JECrS.
ITNI] ANY DAMPO_ is CUI 51QEWALK8, DRIVE AYEL LAWN% OR OTHER [T V$ IN THE ACCESS AREA
(5) 9PF' THAT ALL FE<114G, GATES, AM GARAGE UOMS MEFT UICAL DODC5 FOR A POOL ENCL,OSLIRF
PRIOR 1T) PREPLIETER IN;PEC CIN
(6j fRUt AFTER I LOSIER, (FOLMW INSFP.00TIONS -- )n W017 USE RLnRnt l4h51]
(7) TAXE NQTICE THAT THLS IWAWNID IS TFIE SOLE PROPETtT'r OF TESeE"A AND THAT AW
tME WITHOUT WFdTTE++ PEFMIssIaN OF TESERRA IS PRROA811I:P B7 LAW,
�ANEIP APFq iOvE5 PLAN. POl11. A.ND EaJIPM04T LOCATIONS AND HAS READ TFIE RES°'>31JSIIALi Ks AND 161PUM AEU E
S-WIh M 14G POOL PLAN FOR: y
ar~i E R I RESIDENCE
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