07-2233 (RPL)P -.O. BOX 1504,
.78-495 CALL' E TAMPICO
' LA QUINTA, CALIFORNIA 92253 .
Application Number:
07-00002233
Property Address:
61578 TULARE LN
APN:
7.64-280-999-115 -300237-.
Application description:
POOL - RESIDENTIAL
Property Zoning:
MEDIUM HIGH DENSITY RES
Application valuation:
30000
Applicant:
Architect or Engineer:
NIP
BUILDING & SAFETY. DEPARTMENT
BUILDM: 11
Owner:
FOWLER RESIDENCE
61-578 TULARE LANE
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: 8/06/07
AUG ® 6 1tv r
r
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LICENSED CONTRACTOR'S DECLARATION
--------------------------------_
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I licensed under proyisions-of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business a Professionals Code,,and my License is in full force and effect.
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License, ass: C8 C27. C29 License No.: 656128
for by Section 3700 of the Labor. Code, for the performance of the work for which this permit is
Date: �(/� Contractor. I - _ -
.issued.
_ I have and will maintain workers' compensation insurance as required by Section 37001of: the Labor ,
. _
Code, for the performance, of the work for which. this; permit is issued. My workers' compensation
-BUILDER DECLARATION
insurance carrier and po)icy number are:. .
I hereby affirm under penalty. of perjury that I amexempt 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 orcounty that requires a -permit to
_ I certify that, in the•performanc of 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[o file a signed statement that he or she is licensed, pursuant .to the provisions of,the Contractor -s State
- and agreeahat, if I should'bec me subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3:of the Business and Professions Code) or3700
of the Lab comply with those provisions.
that he or she is exempt therefrom and the basis for -the alleged exemption. Any violation of Section 7031.5 by
any a licatit for a permit sub'ects thea Iicant'to a civil enalt of not more than five hundred dollars ($500).: - -
Date: p,Z A lic t
1 _ 11, as.owner ofthe.property,.or,my employees with wages as theivsole compensation, will do the ,work, and
~
the structure is;r`ot intended or offered.for sale'(Sec. 7044, Business and' Professions Code '- he, c
WARNING:. FAILURE SECURER MPENSATION COVERAGE IS UNLAWFUL,,AND SHALL
Contract or`s'-State'License Law does not apply .to an owner of property who Builds or �jmproves thereon,
, SUBJECT'AN EMP,LOYER TO CRIMINAL PENALTIES A..ND'CIVIL FINES'UP TO ONE HUNDREDTHOUSAND
and who does the work -himself or herself through his or her own employees, provided that the
-
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
- improvements are.not intended or offered for sale. If, however, the building -or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.. '
one year ofcompletion,:the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
APPLICANT ACKNOWLEDGEMENT
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and -Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on' this application. .
property-whobuilds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1. Each person upon whose behalf this application is 'made, person at wtiose request and 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,
(_ 1 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 of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMTT
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 nformation is correct. I agree to comply with all
city and county ordinances and state laws relating to builtli ct>}i ruction, and hereby authorize representatives
of this couPty fo enter upon the above-mentioned prope f r i(�p ction.purposes.
Application Number . . . 07-00002233
Permit . . . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
284.50 Plan Check
Fee
184.93
Issue Date . . . .
Valuation
. . .
29600
Expiration Date
2/02/08
Qty Unit Charge
Per
Extension
BASE FEE
252.00
5.00 6.5000
----------------------------------------------------------------------------
THOU BLDG 25,001-50,000
32.50
Permit . . .
MECH POOL
Additional desc .
Permit Fee
26.00 Plan Check
Fee
6.50
Issue Date . . . .
Valuation
0
Expiration Date
2/02/08
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
2/02/08
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
2/02/08
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
LQPERMIT
Application Number . . . . . 07-00002233
" .. Permit . . . WALL/FENCE PERMIT
_. Additional desc..
Permit: Fee 15.00
Plan Check
Fee..
.00
Issue Date
Valuation
400
Expiration Date 2/02/08
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. 48" X
25 L.F CITY',STANDARD.,.EQUIPMENT.WALL.
GAS STUB FOR FUTURE APPLIANCES BY
SEPARATE.PERMIT.
Fee summary Charged Paid
Credited
Due
Permit Fee Total 403.50
.00
00
403.50
Plan Check Total 210.93
.00
.00
210.93
Grand Total 614.43
.00
.00'
614.43
LQPERMiT
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a
Bin #
t
Gty of :La 'Quiril:aa
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 .#
4,
Project Address:' �,
Owner's Name:
A. P. Number:
Address:
Legal Description:
Contractor:
Address:
City, ST, Zip:
Telephone: ,
Project Description:
City, ST, nhAct (A- 9U,_3 %
b
Telephone:
State Lie. # City Lica#:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person::-
Construction Type: Occupancy:
-Project type (circle one).. New • Add'n Alter Repair Demo
Sq. Ft.:
#Stories:
FUnits:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT:.MNOT,WRITE BELOW THIS LIN_ E
#
Submittal
Req'd
Rec'd
TRACKING .
PERMTT 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. plan2""
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
AtI.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
e