07-0438 (SOTB)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4ht 4 4 Q"
Application Number: 07-00000438 /
Property Address: 58047 CARMONA-_
APN: 764-200-006-4 -316811-
Application description: STRUCTURES OTHER THAN BUILDINGS
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 1000
Applicant:
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
ICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury th t I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busine and Professionals Code, and my License is in full force and effect.
License Class: C8 C27 C29 License No.: 656128
r DateyO-���Convacto i
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I exempt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business and Pro ssions 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 1, 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:
DOWNIE
58047 CARMONA
LA QUINTA, CA 92253
Contractor:
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: 2/21/07
FEB 2 12007
RY OF 1A QUIVIlItA
11110JAMF DEQ
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 performanc6 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 P )icy Number BB1070510
I certify that, in the performance of a work for which this permit is issued, I shall not employ any
person in any manner so as to me subject to the workers' compensation laws of California,
and agree that, if I should co s 'ect to the workers' compensation provisions of Section
3700 of the Labor Code, all o thw comply with those provisions.
Date: ! Applicant:
WARNING: FAILURE TO SECURE WORKERS' qOMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 0100,0001. IN ADDITION TO THE C ST 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 bec mes null and void if work is not commenced
within 180 days from date of issuance of such per iit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that thea in ation is correct. I agree to comply with all
city and county ordinances and state laws relating to buil g co struct n, and hereby authorize representatives
of this county to enter upon the above-mentioned grope for i pection urposes.
nature (Applicant or Agent):
Application Number . . 07-00000438
Permit . .
. BUILDING PERMIT.
Additional desc .
Permit Fee
25.00
Plan Check
Fee
16.25
' Issue Date
Valuation
. . .
. 1000
Expiration Date
8/20/07
Qty Unit Charge. Per
Extension
BASE FEE
15.00
5.00 2.0000 HND -.BLDG 501-2,000
10.00
----------------------------------------------------------------------------
Special Notes and
Comments
CONCRETE FOOT BRIDGE OVER NARROW NECK
OF POOL (8' SPAN)
-
-------------------------------------------------•---------------------------
Other Fees . . .
. . ENERGY
REVIEW FEE
1.63
STRONG
MOTION (SMI)
- RES
.50
Fee summary
Charged Paid
Credited
Due
Permit Fee Total
25.00
.00
.00
25.00
Plan Check Total
16.25
.00
.00
16.25
Other Fee Total
2.13
.00
.00
2.13
Grand Total
43.38•
.00
.00
43.38
LQPERMIT
Bin #
Submittal
City of. La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quints, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Per
Project Address: 09
Owner's Name:
A. P. Number
Address: -5'�76— p 4
Legal Description:
Contractor: 5� Z
City, ST, Zip:
Telephone:
Address: l� Project Description:
City, ST, Zip: C --77--1 V -,L.
U/
Telephone: 39 ! ZZ 2 -
State
State Lic. # : t/p S�D ,2,
Arch., Engr., Designer:
City Lic. #:
•
Address:
City, ST, Zip:
Telephone: Construction Type: Occupancy:
State Lie. #: Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: (� %�0 Sq. Ft.: #StoriIes: Units:
Telephone # of Contact Person: _�j Q—,`� Estimated Value of Project: \r a v U
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACING. PERMIT FEES
Plan Sets
Check submitte
F
Item Amount
Structural Calcs.
Reviewed; ready fo corrections Plan Clieck Deposit
Truss Calfs.
Called Contact Pers ()7 Plan Check Balance
Energy Calcs.
Plans picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading. plan'
2'd Review, ready for correctio issu Electrical
Subcontactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
3rd 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