08-0183 (RPL)P.O. BOX 1504 .
78-495 CALLE TAMPICO
LA QUINTA,•CALIFORNIA 92253
r
Application Number: 1 08-00000183 �-
T1 Property, Address: 81907 SEABISCUIT WY '
APN: 767 -200 -999 -39 -312023 -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL ,
Application valuation: 30000'
Applicant:
Architect or Engineer:
P IA -
c'7
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of peigR-BUILDER
nder provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the ls Code, and my License is in full force and effect.
Lic�en
License No.: 656128
r. -
DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec.`031 .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.1$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 1, 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 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: N
LQPERA1rT
VOICE (760) 777-7012
FAX (760) 77777011
INSPECTIONS (760) 777-7153
Owner:
GREENBERG
81907 SEABIS
LA QUINTA, C 253 Q
(760)777-992
Contractor: JAN 2 3 2008
TESERRA
P.O. Box i 2 o CITY OF LA QUINTA
COACHELLA, INANCEDEpr
(760)398-9222
Lic. No.: 656128 '
Date: 1/23/08
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 policy number are:
Carrier SEABRIGHT P licy Number BB1080510
I certify that, in the performance of t e work for which this permit is issued, I shall not employ any
person in any manner so as to beme subject to the workers' compensation laws of California,
arid agree that, if I should become ubiect to the workers' compensation provisions of Section
3"90 of the Labor Cod/_1I III fo hwith comply with those provisions.
cant:
WARNING: FAILURE TO SECURE WMAKER PENSATION 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 of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation. /
I certify that I have read this application and state that the above inforhtation is correct. I agree to comply with all
city and county ordinances and state laws relating to buitdin construyl{toion,
and hereby authorize representatives
;.�t
his cou ty to enter upon the above-mentioned properto inspect n purposes.
a: ture (Applicant or Agent):
Application Number.'.
. . . . 08-00000183,-
0000183-Permit
Permit. .
BLDG POOL PERMIT
Additional desc .
Permit Fee284:50
Plan Check Fee
184.93
Issue Date . . . .
Expiration Date
; Valuation . . . .
7/21/08
'29567"
Qty Unit Charge
Per
Extension
BASE FEE
252.00
5.00 6.5000
THOU BLDG 25,001750,000
32.50
Permit
MECH POOL
Additional desc .
Permit Fee . .
26.00 Plan Check Fee
6.50
Issue Date
Valuation
0
Expiration Date
7/21/08
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
7/21/08
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
7/21/08 '
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
Permit . . WALL/FENCE PERMIT
-
r
LQPERA1IT
,. Application Number 08-00000183
!'
Permit . . . WALL/FENCE PERMIT
_ Additional desc..
Permit Fee 15.00
Plan Check
Fee
.00
Issue Date.
Valuation
. . .
., 433
f Expiration Date 7/21/08
Qty Unit Charge Per
Extension
BASE FEE
15.00,
---------------------------------------- -----------------------------------
Special Notes and Comments
r POOL/SPA; 20 L.F. 54" EQUIPMENT WALL,.
CITY STANDARD. ALARMS/BARRIERS SHALL BE
IN PLACE AT PRE -PLASTER INSPECTION
r
Fee summary Charged Paid
Credited
Due.
Permit Fee Total 403.50
.00
.00
403.50
-Plan Check Total 210.9.3
.00
.00
210.93
Grand Total 614.43
.00
.00
614.43
LQPERDIIT _
Bid #
City of La .Quinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit A lication and Tracking- ng Sheet
Permit #
Project Address: V-9637— Pm I` 1i,
Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST; Zip:
Contractor: "7_L= -'5L. _/Zs
Telephone:
[Project
Address:-' �U(� (/(; S
Descripttiion:
City, ST, Zip: l Q`j�G ��`( &4-
Telephone: '3k�. u�
State Lic. # : „
City Lic: #:
wry L L �- s '' a o'`
f
Arch., Engr., Designer:
Address: 1
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #: •
Name of Contact Pers on:SSC
Project.type (circle one): New . Add'n Alter Repair Demo
Sq. Ft::
#Stories:
# Units:
Telephone # of Contact Person:�.
Estimated Value of Project: 30
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd 1
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted .
I$
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. Approvil.
Plans resubmitted
Grading
IN HOUSE:-
7rd 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
Soy 3 3
2.95