07-1626 (RPL). P.O. BOX 1504 . -(T, -.
.s.
78-495 CALLE TAMPICO
LA QUINTA; CALIFORNIA 92253 BUILDING 8c SAFETY DEPARTMENT
BUILDING -PERMIT . _
F •Application Number: 07-0.0001626 ( -"� Owner
Property.Address: 61589. TORO CANYON WY i SCHMID RESIDENCE
APN: 764.-280-9997120=300237- 61-589 TORO CANYON WY -
Application description: POOL - RESIDENTIAL — �,r;—� LA QUINTA, CA 92253
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 20000
Applicant: Architect or Engineer
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am r ensed 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 Class: 8 C27 C29 license No.: 656128
., i
Date: ' ,Contractor:
'OWNER -BUILDER DECLARATION
1 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 (S500).: '
(_ 1 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 havethe 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 thereon, and who contracts for the projects with a contractor(s) 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:
LQPERDIIT - f
' 11.
2001
Contractor:
III TESERRA
P -.O. BOX 1280
COACHELLA,. CA 92236
(760)398-9222
Lic. No.:. 656128
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 [icy Number BB1070510
'I certify that, in the performance of a work for which this permit is issued, I shall not employ any
person in any manner so as to be omesubject to the workers' compensation laws of California,
and agree that, if I should becom subject to the'workers' compensation provisions of Section
3700 of the labor C e, I shall fo thwith comply with those provisions.
Date: E - Applicant:
WARNING: FAILURE TO SECURE W RK ENSATION 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
N-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 Deco es 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 info ation is correct. I agree to comply with all
city and county ordinances and state laws relating to bu' ' g construc ' n, and hereby authorize representatives
of this county to enter upon the above-mentioned pro rty o�inspectio urposes. _
Date:/ ignature (Applicant or Agent):
VOICE (76,0) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/04/07
Application Number .
. . . .. 07-00001626' .
•. Permit.
BLDG POOL PERMIT
Additional desc
Permit -Fee—
207.00. Plan Check Fee
134:55
Issue Date
Valuation : . .
19600
Expiration Date.
12/01/07
Qty Unit Charge.'
Per
Extension'
BASE FEE _
45.00:-:
:18.00 9.0000
THOU BLDG 2.,001-25,000
162.00
Permit . .
MECH POOL
Additional desc .
- Permit Fee ':
26.00 Plan Check Fee ..
6.50
Issue Date- . . . .
-Valuation
0
Expiration Date
12/01/07 .
-Qty Unit Charge.
Per
Extension
BASE FEE
15.00.
1.00 11:0.000
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
1.2/01/07
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 P1an�Check Fee
8.25
Issue Date
Valuation
0
_Expiration Date
12/01/,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
.1.00 3.0000
EA PLB GAS PIPE.1-4 OUTLETS
3.00'
Permit . . . . . ,.WALL/FENCE PERMIT
LQPERDIIT-
-
- -.
- Application Number . . . . . 07700001626
-'Permit WALL/FENCE .PERMIT"
Additional desc .
• Permit -Feer o 15.00, Check
Fee
.00
_Plan
Issue .Date ` s: Valuation
400 _
: 12/01/07
Expiration Date
Qty Unit Charge. Per,
Extension
t BASE'FEE':
--
.15.00
-----------------------------------------
r Special Notes and Comments
-------
--------------
ry POOL, SPA,.ALARMS/BARRIERS SHALL BE.IN
;
PLACE AT PRE -PLASTER INSPECTION. 25'
'. L.F X 48" EQUIPMENT WALL CITY STANDARD.
Fee summary Charged Paid Credited
------------------ ---------- -------------------- ---------
.: -
----------
Due
Permit Fee Total 326.00 .00 `'
00
326.00 `
Plan Check Total 160.55 .00
.00
.160.55'
Grand Total 486.55 .00
.00
486.55• -
' LQPERMIT
.
Bin #
City of La. Q uinta,"
Building & Safety Division
P.O.Box 1504, 78-495•Calle Tampico ``s
'
# `
Permit „ r „
ta' CA 92253-
La Quin (760) 777-7012 -• • ; ;,'
-Building Permit Application and Tracking Sheet'
Project Address: !'
Owner's Name: ,
.-5
A. P. Number: '
Address:
Legal Description~a
r ,'
City, ST, Zip_MIZE
Contractor:
Telephone' • rk
M
Address:P. �.^(p
Project Description:
City, S_ T, zip: e o1.4-c'i z;-L C 4
,i
Telephone:
+,GC i�V-L U/'
State Lic. # : Z
City Lic. #:
l
s^
Arch:' Engr., Designer - ' r
Address: r
City, ST, Zip:
s
Telephone: y
Construction Type: Occupancy: ,
Project type (circle one): ' New Add'n ' Alter Repair . Demo
State Lic. #:
Name of Contact Person: JS =, N�� pCZ,
s.
Sq. Ft.: # Stories: �� #Units:
Telephone # of Contact Person: • ' D Z• —C�).
[Esti—mated Value of Project: ZO 0,0 Z,)
' APPLICANT: DO NOT WRITE BELOW THIS LINE
# .
Submittal
Req'd
Recd3
TRACKING . -
PERMIT FEES
Plan Sets.
w
Plan Check submitted
Item !Amount
t
Structural Calcs.
Reviewed, ready for corrections a ' - •
Plan Check Deposit
,
Truss Calcs.
t
Called Contact Person
Plan Check Balance A .
Energy Calcs.
<,; •
Plans picked up
' Construction
Flood plain plan
-
Plans resubmitted ^
'Mechanical
"
Grading.plan
2"d Review, ready for correctionsrssue
'Electrical.,,.'
Subcontactor List
'
Called Contact Person
t
Plumbing
-
Grant Deed
+' '
.'Plans picked up
S.M.I. ,
H.O.A. Approval
-
Plans resubmitted w ,
Grading r,
,
1�
INHOUSE:-
''d 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
S
-
-•Total Permit Fees
IOU