07-1495 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINT'A, CALIFORNIA 92253.
Application Number:
0_7=0.0-0-0.1495
Property Address:
56768 PALMS DR
APN:
764 -020 -001 -
64-020-001-Applicationdescription:
Application description:
POOL - RES,IDENTIAL.
Property Zoning:.
LOW, DENSITY RESIDENTIAL
Application valuation:
30000
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SHERMAN RESIDENCE
56-768 PALMS DR
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/21/07
Contractor: /O
Applicants Architect or.Engineer: TESERRA
P.O. BOx.1280_ 4
COACHELLA, CA 92236 - n
(760) 398-9222
Lic. No.: 656128
i` � 9�e
- t�
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION-DECLARA
I he
rebyleffirrn under penalty of penury that 5:.'alicensed under provisions:of Chapter 9:Ic6mmencing with •=1 hereby affirm under penalty of perjury one of the following declarat dons .: -
`Sec`tion:7000) of Division 3 of the B4ne and rofessionals Code, and my license is in full force and effect. _ I have'and will maintain a certificate of consent to self -insure for workers' compen 'tion, as provided
License Cla s: C8 C27 'C29 License 'No.: 656128 for by Section 3700of the Labor Code, for the performanceof the work for which this permit is
issued.:
Date:
Contract,"�' _ 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
OWNER -BUILDER DECLARATION .insurance carrier and policy "number -are:
I hereby :affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the - Carrier SEABRIGHT -Policy Number BB1070510
-following. reason (Sec. 7031.5, Business and Professions Code:. Any city or county that requires a permit to _ I certify that, in the performance f the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as t become subject to the workers' compensation laws of California,
permit tofile a signed statement that he or she,is licensed pursuant to the provisions of the Contractor's State and agree that, if I should bec rte subject to the workers' compensationprovisions of Section
License,L3 aw (Chapter.9'(commencing with Section. 7000) of Division 3 of'the Business. and Professions Code) or 00 Of the Labor ' , 1 s all orthwith comply with those provisions.
that,heo"r
she is exempt therefrom and the basis,for the alleged exemptiow-Any violation of Section 7031.5 by +� ]n2,�
any applicant for a permit subjects the applicant'to a civil penalty of not more.than five hundred dollars ($500).: Dater W' Applican f .-
(_ b
1; as ownerof the property, ormy employees with wages as their sole compensation, will do the work, and +,^,
the structure isnot intended or offered.for sale ISec. 7044, Business and Professions Code: The- WARNING: FAILURE To SECURE ORKERS' COMPENSATION' COVERAGE IS UNLAWFUL, AND SHALL
ContractoFs"State License Law does not apply tojan owner of property who builds or improves thereon, SUBJECT.ANEMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDREE,THOUSAND:
and who'does'the work himself or herself through'his or her own employees, provided that.the DOLLARS. ($100,000). IN ADDITION TO'THPCOST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within • SECTION3706.OF THE"LABOR.CODE, INTEREST, AND ATTORNEY'S FEES.
one year of completion, the owner -builder will have the burden of proving that he or shedid not build or ..
'improve for the purpose of sale.). APPLICANT ACKNOWLEDGEMENT
1—) 1, as owner of the property; am exclusiyelycontracting with licensed contractors to construct the project ISec. IMPORTANT Application is hereby made to the Director of*ilding and. Safety for a permit subject to the
7044, Business and Professions Coder The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. .
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1 . Each person upon whose behalf this application is made, each person at whose requesvand for
pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_) I am exempt under Sec. , B.&P.C. for this reason the owner, and the applicant, each agrees to,"and shall defend, indemnify and hold harmless the City
Date: Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance ofthe
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
of La Quetta, 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 1.80 days will subject
permit to cancellation.
I certify that I have read this application and state that the above inform tion is correct. I agree to comply with all
city and county ordinances and state laws relating to building constructs n, and hereby authorize representatives
of this counjy to enter upon the above-mentioned propeio urposes.
Dare: L/ U It -+fig nature (Applicant or Agent):
,,:... Application Number
07-00001495
'Permit . . . . .
BLDG POOL'PERMIT
Additional desc .
Permit Fee.
284.50 Plan Check Fee
184.93
Issue'. Date: Z.
Valuation . . .
. 29567
Expiration Date
11%17/07 -
Qty Unit Charge
Per
Extension
BASE •. FEE.:
252..00
:.. '. .5`00.• 6.5000
}
THOU BLDG 25„0'01-50,000
32.50
-Permit.. . . . . . .
MECH. POOL-
` 'Addstional desc .
Permit_._Fee_ _ '.. ._-_ . _.-
26'.00 P1an_ Check Fee_
6.5.0
- Issue,Date
Valuation
0
' Expiration Date
..
11/17/07
Qty• Unit.Charge
Per
Extension
c
.BASE. FEE
15.00
1:00 11.0'.0,00
-EA': MECH' FURNACE >TOOK
1.1. 00
Permit,
ELEC P.00L,PERMIT-RES
Additional desc .
-Perm Fee' . . .
45.00 Plan, Check Fee .
11::25:
-Issue Date
Valuation:.
0-:-.
Expiration -Date :.
11/17/07.
Qty Unit Charge
.Per
Extension
BASE FEE..
1.00 30.0000'.EA
ELEC PRIVATE SWIMMING POOL
30.00
Permit . . .
PLUMBING
' Additional desc-'-.
Perin"it Fee
.39:0:0 Plan Check Fee
9-7'5'.
Issue Date . . .
Valuation
0
'>E- irati'on Date
11/17/07 _
a Qty Unit Charge-
Per
Extension,
BASE.FEE
15.00
3.00 6.0000
EA PLB FIXTURE
18.00
• 1.00, 3.0000
EA PLB .WATER INST/ALT/REP
3.0.0
.1.00 3.0000
-------------------------------------------------------------------
EA PLB GAS PIPE 1=4.OUTLETS
3.00
Permit . . . . . .
WALL/FENCE PERMIT.
LQPERMIT
. Application Number . . . . . 07-0000149.5
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee 15.00
Plan Check
Fee
.00
Issue:Date
Valuation
. . .
. 433
Expiration Date 11/17/07
1
Qty Unit Charge Per
Extension
BASE FEE
15.00
-- -- -----------------
Special. Notes and.Comments .
------------
------
---------------
POOL_SPA, ALARMS/BARRIERS _SHALL BE IN
,:, , ...,,: .... :.:.: ..• —PLACE ..AT.:.PRE-PLASTER; INSPECTION:
WATERFEATURE_,PER• APPROVED PLAN:., 5' X
'20' --EQUIPMENT _WALL CITY STANDARD.
Fee summary, t.0harged Paid
Credited
--
Due :.
---
----------------- -- --------- ----------
Permit Fee Total" . 4.09:50`
--------
.00`
00~
409..50
Plan Check: ,Total'' 212,.43
.00
.0.0..
2T2;. 43.
Grand.Toaal 621.93
00
00
621.93
LQPERMIT
Bin #
Permit #
(
Project Address: _ Z L
City ®f La Quints
Building & Safety Division
P.O. Box 1504, 78=495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
S _ v Owner's Name: ,
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor:
Telephone:
-
Address: 0 .. 90X I 2319
Project Description:
City, ST, Zip: COl:�C.I ;LL4
7 z Z-3
Poo L,4 S
Telephone: V— 2-2-2- L k �.
State Lic. # : j/L' City Lic. #:
Arch., Engr., Designer:
D 115' i
Address:
City, ST, Zip:
Telephone:
Construction Type:Occu anc
NL-�J p y:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
State Lic. #:
Name of Contact Person:J � L ,
NI4.NDGZ
Telephone # of Contact Person:(O Z
—(� .
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd Rec'd TRACKING . PERMIT FEES
Plan Sets
Plan Check submitted
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"d 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 HOUSE:-
3'd 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
e )