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07-1673 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 07-00001673 Property Address: 54832 TANGLEWOOD APN: 775-052=009- - - Application description: POOL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 25000 Applicant:, Architect or, Engineer: 4. BUILDING & SAFETY DEPARTMENT BUILDING PERMIT - LICENSED CONTRACTOR'SDECLARATION I hereby affirm under penalty of perjury that I am li ensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Pr Fessionals Code, and my License is in full force and effect. License Class: C8 C27 C29 LicenseNo.: 656128 Date: 610 'Contractor: _ OWNER -BUILDER 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 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 buildor improve for the purpose of sale.). ( ) 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 build3 or improves thereon, and who contracts for the projects with a contiautui(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: LQPERNIIT VOICE (760) 777=7012 FAX (760) 777-7011 INSPECTIONS (760) 77.7-7153 Date: 6/08/0,7 Owner: .BURCH RESIDENCE , 54-832 TANGLEWOOD LA QUINTA,,CA LA QUINTA,-'CA 92253 Contractor: D TESERRA d P.O. BOX 1280 COACHELLA, C 2 36 !' (760)398-922 JUN Lic. No.: 65 12 _ -—————————-———————--— — — =- —————— — — — — — — WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 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 requited 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 t e work for which this permit is issued, I shall not employ any person in any manner so as to be me subject to the workers' compensation laws of California, and agree that, if I should. become subject to the workers' compensation provisions of Section /�`//X�Pyy � 3700 of the Labor Cod , with comply with those provisions. �' .,Dat � pplicant: r WARNING: FAILURE TO SECURE W KERS' COMPENSATION 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 . IMPORTANTApplication 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'inf mation is correct. I agree to comply with all city and county ordinances and -state laws relating to building constiu tion, and hereby authorize representatives of thist cou y7 enter upon the above-mentioned property c on purposes. bat( �0 Aignature (Applicant. or Agent)' i / r Application Number . . 07-00001673 Permit . . . . . MECH POOL, Additional.desc . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation 0 Expiration Date 12/04/07 Qty. Unit Charge Per Extension BASE FEE 15.00 1.00 11.0000 ---------------------------------------------------------------------------- EA MECH FURNACE >100K 11.00 Permit . . . BLDG POOL PERMIT Additional desc Permit Fee 252.00 Plan Check Fee 163.8.0 Issue Date Valuation . . . 24500 ' Expiration Date 12/04/07 Qty Unit Charge Per Extension ' : BASE FEE 45.00 23.00 9.0000 THOU BLDG 2,001-25,000 .207.00 Permit . . . ELEC POOL PERMIT -RES Additional desc . Permit Fee . . . 45.00 Plan Check Fee 11.25 Issue Date Valuation . . . . 0 Expiration Date 12/04/07 ury unit unayge Ljer Extension BASE FEE 15.00 1.00 30.0000 EA ELEC PRIVATE SWIMMING POOL . 30.00 Permit PLUMBING: Additional desc . Permit Fee . . . . 36.00 Plan Check Fee 8.25 Issue Date Valuation 0 Expiration Date 12/04/07 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 .2.00 3•.0000 EA PLB GAS PIPE 1-4`OUTLETS 6.00 Permit . . . : .. . WALL/FENCE PERMIT LQPERDIIT - . Application Number . . . . . 07-00001670 Permit WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 15.00 Plan Check Fee.. .00 Issue Date Valuation . . . . 500 Expiration Date 12/04/07 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. 20' j L.F. X.60" CITY.STANDARD BLOCK WALL. '• Fee summary Charged Paid Credited Due. , Permit Fee Total 374.00 .00 .00, 374.00 Plan Check Total 189.80. 00 .00 189.80 Grand Total 563.80 ..•00 .00' 563.80 _ T i '� � '� t,,... _,..._.....�,�.,...W...,..3 Bin # City of La Quinta Building 8T Safety Division P.O. Box 1504,78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # n �� Project Address: SG ,_ Z-- 0 Z2 Owner's Name: A. P. Number: Address: Legal Description: City, ST, Zip: Contractor: Telephone: Address: E. 0. Project Description: City, ST, Zip: C OIl-Cl — C4 Z,S L Telephone: 3 — Z Z �Ag S State Lic. # : f 2 _ City Lic. #: Arch., Engr., Designer: t L ©� f Address: City, ST, Zip: Telephone: Construction Type: Occupancy: State Lic. #: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: `` J ��� � - N1�NDGZ- Ft.: S Ft.: Sq.. # Stories: # Units: # of Contact Person: • 6 O Z7,1— —0 Estimated Value of Project: �—J 0O i APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd 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"u 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:- '"' 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