07-2112 (RPL)N
� r
P.O. BOX 1504
.78-495 CALL(~ TAMPICO
LA QUINTA, CALIFORNIA 92253
e-i&t
BUILDING & SAFETY DEPARTMENT
. BUILDING PERMIT
Application Number:
0,7-00002112
Property Address:
78611 TALKING 'ROCK TURN
APN:
770-300-030'- - -
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
30000
Owner:
VAN DEN BERG
78611 TALKING ROCK TURN
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) ,777-7011
INSPECTIONS (760) 777-7.153
Date: 8/07/07
CONSTRUCTION LENDING AGENCY '
I hereby affirm under penalty of perjury that thereis 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
within 1,80 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
certify that I have read this application and state thjZ
on is correct. 1 agree to comply with all.
city and county ordinances and state laws relating to and hereby_ authorize representatives _
of this count to enter upon the above-mentioned-prurposes. '
_
Date• �:Argnat (Applicant or _Agent):
Contractor: •
I
pai,p
08 997
Applicant: Architect or Engineer:
TESERRA
Ai
-P.O. BOX -1280
COACHELLA, CA 922jE
CITY 01' AA
(760) 398-9222
Lic. No.: 656128
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION -
I hereby affirm underpenalty of perjury that.I a licensed under provisions of Chapter 9 (commencing with
.1 hereby affirm uhder penalty of perjury one of the following declarations:
xSect ion 7000) of Division 3 of the Business an 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 CksC 8 C27 - C29 License No.: 656128 -
_
for by Section 3700 of the Labor Code, for the performance of the -work for which this permit is
ate:�' 0ntractor:
issuedi
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:
I hereby affirmunderpenalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier SEABRIGHT olicy 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 a 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 bec me 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 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
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
,700 of the La or Code shall fort ith comply with those provisions.
.•y -
91%�
- any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
ate:. / pplicant• i
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
WARNING: FAILURE TO SECURE WOR CE NSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License 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 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,.ANDATTORNEY'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.).
APPLICANT ACKNOWLEDGEMENT
(_ 1 1, 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 who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1. • Each person upon whose behalf this application is made, each person at whose 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,
(_) 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
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.
Date: - Owner: - _
-2. Any permit issued as a result of this application becomes null and void if work is not commenced
CONSTRUCTION LENDING AGENCY '
I hereby affirm under penalty of perjury that thereis 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
within 1,80 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
certify that I have read this application and state thjZ
on is correct. 1 agree to comply with all.
city and county ordinances and state laws relating to and hereby_ authorize representatives _
of this count to enter upon the above-mentioned-prurposes. '
_
Date• �:Argnat (Applicant or _Agent):
Application Number .
. . . . 0.7-00002112
Permit .
BLDG POOL.PERMIT .
Additional desc .
Permit Fee
284.50 Plan Check Fee
184.93
Issue.Date
Valuation
30000
Expiration Date -
2/03/08
Qty Unit Charge
Per
Extension
BASE FEE
252.00
5.00 6.5000
-----------------------------------------------------------------------------
THOU BLDG'25,001-50;000
32.5.0
Permit . . .
MECH POOL
Additional desc .
Permit Fee . .". .
26.00 Plan Check Fee,.
6.50
- Issue Date : . .
Valuation
0
Expiration Date
2/03/08
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 11.0000
-----------------------------------------------------------------------------
EA MECH •FURNACE >100K
11.00
Permit
ELEC.POOL PERMIT -RES'
i
Additional desc .
Permit Fee
45.00 Plan Check Fee
11.25
Issue DateValuation
. .
0
— Expiration Date
2/03/08"
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
2/03/08.
-
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
Special Notes and Comments
POOL/SPA, WATER FEATURE WITH 4 GUNITE"
LQPERA11T
Bin #
- t
City 'of La Quints-
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico F
La Quinta; CA 92253 - (760) 777-7012
Building Permit Application and Tracking'Sheet
Permit # . ` �
Project Address: –
Owner's Name: VkV.
A. P. Number:
Address-
Legal Description:. r •
City, ST, Zip:.
Contractor: LP,
Telephone:
O , I
Address: . D i213LP..
Project ,
City, ST, Zip: 't t`,64–�'ZL��
)Description:
C. �—S
Tele hone:_
State Lic, #: ? b City Lic. #:
Arch., Engr., Designer: ;
i
Address:
,
City, ST, Zip: .,
Telephone:.
'"
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:J G L. -�•
w Sq. Ft.:.' • .
# Stories:
#Units:
Telephone # of Contact Person: c) 2Li listimated
Valtie of Project: 'COtf ,
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
,Req'd
Recd
TRACKING .
PERMIT FEES
Plan Sets
Plan Check submitted. ,
QQ
7 IV
Item, .
_ .Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
\
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
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
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
,
School Fees
Total Permit Fees
?//9 7/ z6.