08-0168 (SOTB)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
0-8-00.0.00.1,6:8
Property Address:
61676 TULARE LN
.APN:
764-280-999-108 -300237-
Application description:
STRUCTURES OTHER THAN BUILDINGS
Property Zoning:
MEDIUM HIGH DENSITY RES
Application valuation:
500
Applicant: �✓ Architect or Engineer:
-----------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am Icensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and P ofessionals Code, and my License is in full force and effect.
License% lass: 8 C27 C29 License No.: 656128
=Date,
.a.Contractor.:� `
O NER-BUILDER'DECLARATION
I hereby affirm under penalty of perjury that am exempt from the Contractor's State License Law for the
following reason (Sec. 703.1.5, Business and Professions Code: Any city or. county that requires apermit to
construct, atter, improve, demolish, or repair. any structure, prior to itsissuence, also requires the applicant for the
permit to file assigned statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing withSection 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).:
(_) 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 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 [hereon, and who contracts for the projects with a contractors) licensed
pursuant to the Contractors' State License Law.).
I—) 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:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/18/08
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY C
SCOTTSDALE, AZ
Contractor:
TESERRA
P.O. BOX 1280
COACHELLA, CA 92236
(760)398-9222
LiC- No.: 656128
350
a
------------------
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 " Policy Number BB1080510
1 certify that, in the performance of the work for which this permit is issued, I shall not employ' any
person in any manner so as t become sec' to the. workers' compensation laws of California,
and agree that, if I should be m_ a subjeubjct to the workers' compensation provisions of Section -
370g of the Labor Cid, I shad forthwith comply with those provisions.
WARNING: FAILURE TO SECURE TOGRA 9W 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
IMPORTANT Application is hereby made to the Director of Building and. Safety for a permitsubject to the
conditions and restrictions set forth on this application.
1.. Each person upon whose behalf this application is made, each person at whoserequest 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 infor ation is correct. I agree to comply with all
city and county ordinances and state laws relating to buildin nstruc ion, and he
authorize representatives
of this cou y [o enter u on the above-mentioned property or specti purposes.
Date: (/ nature (Applicant.oc.Agent):
Application Number .
. . . . 08-00000168
Permit . . .
BUILDING PERMIT
Additional desc .
Permit Fee . . . .
15.00
Plan Check
Fee
9.75
Issue Date . . . .
Valuation
. . .
. 500
Expiration Date
7/16/08
Qty Unit Charge
Per
Extension
----------------------------------------------------------------------------
BASE FEE
15.00
Permit . . . . . .
PLUMBING
Additional desc . .
Permit Fee . . . .
18.00
Plan Check
Fee
4.50
Issue Date . . . .
Valuation
0
Expiration Date
7/16/08
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 .3.0000
EA PLB GAS PIPE 1-4 OUTLETS
3.00
----------------------------------------------------------------------------
Special Notes and Comments
FIREPIT ONLY
Fee summary Charged
---------------------------
Paid
----------
Credited
--------------------
Due
Permit Fee Total
33.00
.00
.00
33.00
Plan Check Total
14.25
.00
.00
14.25
Grand Total
47.25
.00
.00
47.25
LQPERMIT
Bin #
Permit #
'
Project Address: _- 6
City ®f La Qu'nta
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
Owner's Name: 5/ 6o7— /06
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor: '"'=
Telephone:
Ig
3��'P'`�g3�*�
t a k
of,>ara/r: P
Address:0 9119
0
Project Description:
City, ST, Zip:CClAc Ll.k
ok, q Zz•� �,
,
C1
Telephone: b " �Z l--
Mc
State Lic. # : I
Arch., Engr., Designer:
City Lic. #:
Address:
City, ST, Zip:
Telephone:
{ rr ,
Construction Type: Occupancy:
'Project type (circle one): New Add'n Alter Repair Demo
State Lic. #:
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: j� —tai y�
Estimated Value of Project: X00
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING PERMIT FEES
Plan Sets
Plan Check submitted (8 Item
Amount
Structural Calcs.
Reviewed, ready for corrections Plan Check Deposit
Truss Cales.
Called Contact Person Plan Check Balance
Energy Calcs.
Plans picked up Construction
�A(.
Flood plain plan
Plans resubmitted Mechanical
Grading plan
2"' Review, ready for correctio ssu 1 Electrical
Subcontactor List
Called Contact Person Plumbing (�;Arj
(—Y 007(f j
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
''' Review, ready for corrections/issue Developer Im a e
Planning Approval
Called Contact PersonUINTA
Pub. Wks. Appr
Date of permit issue� � SAFE DEPT.
mi tit nit'School
Fees
.VtLi
wir i CON
GAS SHUTOFF
VALVE GRAVEL
LOCATED
WITHIN 36" GAS LOG
OF UNIT LIGHTER
(TYP.) .
0
F.S.
METAL GAS RISER
2" 0 DRAIN OR PROVIDE 12" DIAM
OPENING IN FOOTING -
GAS LINES. SHALL BE INSTALLED
PER CPC FOR DEPTH,
COURSE COVERAGE, AND PLACEMENT.
SAND 4MEMB.RANE WATER PROOF
STONE CAP
#4 TIE STEEL#4 BAR VERT. AT32" O.C.
8x8x8 CMU,; SOLID GROUT
FS.
CLR
GRAVEL SUMP
3 CU. FT.
CRUSHED ROCK
n OUTDOOR FIRE RING -STONE CAP
11
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HEADER BOARD
HYBRID BERMUDA
SOD
NATURAL GRAY BROOM
F!NISH CONCRETE WITH
6" CALIFORNIA EDGE
FIRE PIT:
+12" QUARTZITE CAP
WITH CANTILEVER, EL
• DORADO LEDGE STONE
SIDES. QUARTZITE PINE
MOUNTAIN GOLD.
ANNUAL COLOR
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APPROVED
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