07-1769 (RPL)P.O. BOX 1504'
78-495 CALLE TAMPICO
LA QUJNTA; CALIFORNIA 92253
Application Number: -
Property Address:
APN: '
Application description
Property Zoning:
Application valuation:
Applicant:
TOhl
I -Y 4
BUILDING &. SAFETY DEPARTMENT
_ - BUILDING -PERMIT-
Own
ERMIT- -
07-00001769 Owner:
61787 TORO CANYON,WY.. SHEA.LA QUINTA
764-280-999-129 -300237- C/O JEFF MCQUEEN
POOL'- RESIDENTIAL..' 8800 N GAINEY CENTER
MEDIUM HIGH DENSITY RES SCOTTSDALE, AZ 85258
25000
Architect orEngineer:
01A
---------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
Licens�,b Cl
27 C29 License No.: 656128
.Date:ontractor:
1110741�
OWNER-BUILDER DECLARATION
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 acivil penalty of not more than five hundred dollars ($500).:
(_ 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 yearofcompletion, 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 licensedcontractors 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.). - - -
1 _ 1 I am exempt under Sec. B.&P.C. for this reason
Date: Owner: T
CONSTRUCTION LENDING AGENCY -
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:
LQPERA11T
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: 6/18/07
' 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 permii is issued. My workers' compensation
insurance carrier -and policy number are:
Carrier SEABRIGHT Policy Number BB1070510
I certify that, in the performa4ofwork for which this permit is issued, I shall not employ any
person in any mannerso ae subject to the workers' compensation laws of California,
and agree that, if I shouldbject to the workers' compensation provisions of Section
3,7800 of the Labor C e comply with those, provisions.
Date: .ttr pplicant: .
WARNING: FAILURE TO SECURE W RKERS' 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 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 Ouinta, 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 tion is correct. I agree to comply with all
city and county ordinances and state laws relating to building construct n, and hereby authorize representatives
of this count to enter upon the above-mentioned property o inspectio purposes.
Date:nature (Applicant or Agent):
y '
BASE FEE'
45.00
23.00 9.0000
THOU BLDG 2,001-25,000
207.00 .
Permit . .
MECH POOL
Additional desc :.
Permit Fee
26.00.. Plan Check Fee
6.50
Issue Date,
Valuation
0
Expiration.Date
12/15%07
Qty, Unit Charge
Per
Extension
BASE FEE
15.00
1.00' 11.0000
EA MECH :FURNACE >100K
11.00.'.
J •Permit • . .
ELEC POOL PERMIT -RES
Additionalidesc
`
Permit Fee
45.00 Plan Check Fee
11.25
Issue Date.
Valuation . . .
. 0
Expiration Date
12/15/07
Qty Unit Chargee
Per
Extension
-
BASE FEE
15.00
1.00'' 30.0000
----------------------------------------------------------------------
EA ELEC PRIVATE SWIMMING POOL
.30.00
Permit . . .
PL_UMBING
Additional desc .
Permit Fee
33.00 Plan Check Fee
8.25
Issue Date
Valuation
0
Expiration Date ...
12/15/07
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
LQPERMIT _ .
.Application Number 07:00001769
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee w 15.00 Plan Check Feer
- .00
_.Y _
Issue Date Valuation _ . . .
-400"
r Expiration Date 12/15/07`
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. 25LF X'
4811'CITY STANDARD BLOCK WALL.
7,
• _ Fee summary Charged Paid Credited
Due
• Permit Fee'Total 371.00 .00 .00 *"371.00'
Plan Check Total 1.89.80 .00' 00
189.80.
Grand Total560.80 00.• .00
560.80_
. LQPERMIT
,. ,
� � w
Birt
-. City of to Qui n-ta
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 # 1
Project Address:
Owner's Name:
A. P. Number:
Address: >
Legal Description:
City, ST, Zip: '
Contractor:
Telephone:
r:
Address: �._ O � .C_5,e�-
Project. Description: >
City, ST, Zip:qC, 611- f' -L� Z,S Co • .
PCO y -• c�— 5
Telephone: / L Z Z
State Lic. # : (2 City Lica #:
Arch., Engr., Designer:
Address:. f
City, ST, Zip:
,
Telephone: a r
State Lic. #: �" t
Name of Contact Person: `1'
J5�= / Nn�DGZ
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
S Ft.: # Stories: - # Units'.
Sq..Ft.:
Telephone # of Contact Person: < O 2 —(� .
Estimated Value of Project 00
APPLICANT: DO NOT WRITE BELOW•THIS LINE
#
Submittal
Req'd
Rec'd
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
2nd 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:-
3H Review, ready for corrections/issue
Developer Impact Fee
`
Planning Approval
Called Contact Person
Pub. Wks. Appr
r'
Date of permit issue
School Fees
Total Permit Fees