09-0624 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Tity/ 4.,4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 09-00000624 1
Property Address: 53840 DEL GATO DR
APN: 770-370-012- -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 15000
Applicant:
I hereby affirm under penalty of perjury that I ZI
Section 7 00) f Di i 3 of the Business and
Licens la 0 , 2 7 , 2
at tractor:
OW BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am pt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business and Pr Bions Code: Any city or county that requires a permit to
construct, alter, improve; demolish, or repair y 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 (5500).:
(_) 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 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 contractors) licensed
pursuant to the Contractors' State License Law.).
1 _ 1 I am exempt under Sec. B.&P.C. for this reason
Architect or Engineer:
of Chapter 9 (commencing with
y License is in full force and effect.
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:
DELLA PENTA
53840 DEL GATO DRIVE
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/17/09
Contractor:
TESERRA D d
P.O. BOX 1280 1�
COACHELLA, CA 92236 l n
(760) 398-9222 JUN
Lic. No.: 656128
cry `
-------------------------------------- ---
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
—.J.paveand-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 BB1080510
I certify that, in the pe formance he work for which this permit is issued, I shall not employ any
person in any manne o as to bec a subje o the workers' compensation laws of California,
and agree that, if I shou ome su o e workers' compensation provisions of Section
0�¢the bor Code, I shal with those provisions.
ate: / I7 .p(plicant:
WARNING: FAILURE TO SECURE WORKERS' CO PE ATION COVERAGE IS UNLAWF SAND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIE AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 0100,0001. 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 780 days will subject
permit to cancellation.
�ateM:ignature
d this application and ate tha the above inform 'e cot agree to comply with all
nce tate laws rel g to b ilding constr roanb authorize representatives
on the above-mentioned or i ion e
ignature (Applicant or Agent):
Application Number . . . . . 09-00000624
Permit . . .
ELEC POOL PERMIT -RES
Additional desc .
Permit.Fee . . . .
45.00 Plan Check Fee
11.25
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
12/14/09
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 30.0000
----------------------------------------------------------------------------
EA ELEC PRIVATE SWIMMING POOL
30.00
Permit . . .
BLDG POOL PERMIT
Additional-desc .
Permit Fee . . . .
162.00 Plan Check Fee
105.30
Issue Date . . . .
Valuation
15000
Expiration Date
12/14/09
Qty Unit Charge
Per
Extension
BASE FEE
45.00
13.00 9.0000
------------------------------------------
THOU BLDG 2,001-25,000
---------------------------------
117.00
Permit . . .
PLUMBING
Additional desc .
Permit Fee . . . .
33.00 Plan Check Fee
8.25
Issue Date
Valuation . . .
. 0
Expiration Date
12/14/09
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
WATER FOUNTAIN AT ENTRY 18" DEEP
----------------------------------------------------------------------------
Other Fees . . .
BLDG STDS ADMIN (SB1473) .
1.00
Fee summary Charged
•---------------------------
Paid Credited
------------------------------
Due
Permit Fee Total
240.00 .00 .00
.240.00
Plan Check Total
124.80 00 .00
124.80
Other Fee Total
1.00 .00 .00
1.00
Grand Total
365.80 .00 .00
365.80
LQPERMIT
Bin #
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 Application and Tracking Sheet
Permit #
Un
"1
Project Address:. .- (�
Owner's Name:
A
A. P. Number: r
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Address: tsr70 n
Legal Description:
Contractor: ser
rTelephone:
City, ST, Zip: l
Address: b--
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Project Description: 11
City, ST, Zip:
�Q �Z
f
Telephone:
State Lic. It : 5 2
Arch., Engr., Designer:
City Lic. #:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): ew Add'n Alter. Repair Demo
Sq. FL: 'Z # Stories: # Units:
Telephone # of Contact Person:
P
Estimated Value of Project:
�S
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACIJIYG .
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°" Review, ready for correctionsfissue
Electrical
•SE/rt(/�(�
Subcontactor List
Called Contact Person
PlumbingZ
>/1A /e-1
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''" 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