07-2091 (RPL)I
P.O: BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING &SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
J BUILDING PERMIT
Date: 7/18/07'
Application Number: 07-'-00002091 Owner:
Property Address: 48611 STILLWATER DR 'READ
APN: 658-140-99 -129 729436 - 48611 STILLWATER DRIVE
Application description: POOL _ RESIDENTIAL LA QUINTA, CA 9
Property Zoning: LOW DENSITY RESIDENTIAL D
Application valuation: 30000 A
Contractor: JULApplicant: Architect or Engineer: TESERRA JU
1 P.0% BOX_ .128
COACHELLA, 922OF
(760) 398-9222 �QU
Lic. No.: 656128��
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' LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions 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 afd 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 Class: C8 C27 C2 License No.: 656128 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
.� �•� ��ntractor: - _ y 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: -
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 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 to beco a subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become s bject to the,workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3 00 of the abor Code shall f ' ith 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 applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:- ate: plicant:
(_) I, as ownerofthe 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 WARNING: FAIL RENO SECURE WORR ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State Li6ense Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND.
and who does the work himself or herself through his or herownemployees, 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 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 'l, 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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
(_) 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
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 180 days will subject
permit to cancellation. '
I certify that I have read this application and state that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building constru tion, and hereby authorize representatives
.oA;this t�y toenter upon the above-mentioned property f 'ns e t n purposes"��'— 9ature IApplica_nt or Agent
l:
Application Number . . . . . 07-00002091
Permit . . . BLDG POOL PERMIT
-Additional desc ..
Permit Fee 284.50 Plan Check Fee
184.93
Issue.Date . .' . . Valuation . . .
. 29350
. Expiration Date 1/14/08
Qty Unit. Charge Per
Extension
BASE FEE
25200,
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 1/14/08
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 1/14/08
Qty Unit Chargee 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 1/14/08
-Qty Unit Charge Per
Extension
BASE. FEE
15.00
2.00 6:_0000 EA. PLB FIXTURE
12.00.
1.00 X3.0000 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
"
LQPERPIIT
Application -Number . . . . . . 07-00002091
Permit WALL/FENCE PERMIT
Additional desc
"
- - Permit -Fee -19.00 Plan Check•
Fee
.00
Issue Date . . . Valuation
650
Expiration Date'. 1/14/08
,Qty Unit Charge Per
Extension
BASE FEE
15.00
2.00 2.0000 HND BLDG 501-2,000
4.00
Special Notes and Comments
POOL/SPA, WATER FEATURE, 30..L.F. 6'
EQUIPMENT ENCLOSURE, CITY STANDARD.
ALARMS/BARRIERS SHALL BE'IN PLACE -AT
PRE_PLASTER INSPECTION.
Fee summary Charged Paid Credited
Due
Permit Fee Total 407.50 .00
.00.
407.50
Plan Check Total 210.93 .00
00
210.93
"Grand Total 618.43 .00
.00.
618.43
LQPERMIT
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'QN
Bin #
City of La Quinn.
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 .#
Project Address: 6� 5
Owner's Name:
A. P. Number: a,
Address:
Legal Description:
Contractor:
City, ST, Zip:
Telephone:
Address: 2 o
Project Description:
City, ST, Zip: Ca lif CA- q ZZ310
S
Telephone:3 ZZZ
t'
Wkt.t_ A30
'
State Lie. # : 69 2
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): Add 'n Alter Repair Demo
Sq. Ft.:
#Stories:
#Units:
Telephone # of Contact Person: 2 - 02
Estimated Value of Project: COO
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' Review, ready for correctionsfissue
Electrical
Subcoutactor 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
r