08-1665 (RPL)P.O. BOX 1504
78-495 CALLE`TAMPICO
LA QUINTA,.CALIFORNIA 92253
Application Number: 08-00001665,
Property Address: 55186 SOUTHERN HILLS
APN: 775-190-048-. - -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 25000
Tityl 4 4- Q"
Applicant: Architect or Engineer:
r
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CO ACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am lice un provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busine s sio ;,C -ode, and my License is in full force and effect.
ONJNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury hat I -allp Oempt from'the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business and PrbPessions 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 MOO).:
(_) 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 thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.). -
1 _) 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.I.
Lender's Name:
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner: D
KIDWILER
55186 SOUTHERN HILLS
LA QUINTA, CA 92253 7
Contractor:
..TESERRA
P.O. BOX 1280
COACHELLA, CA 92236
(760)398-9222
Lic. No.: 656128
Date: 10/06/08
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 an olicy number are: ,
Carrier SEABRIGHT Policy Numb r BB1080510
_ I certify, that, in the pe or nce of the which this permit -is issued, I shall not employ any
person in any manner s to be e s I t to the workers' compensation laws of California,
and agree that, if I should esu e o he workers' compensation provisions of Section
�00 of the Labor Code. I a ply with those Provisions.
D A ant:
WARNING: FAI E TO SECURE ORK 'COMPENSATION COVE C -IS I-NNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINA ENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION 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 fora 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 actor omission related to the work being
performed under or follow . uance of this permit.
2. Any permit issued as a rsuit of thi plication becomes null and void if work is not commenced
within 180 days from ate of issuance f such permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this applicatio nd st a �,ection
rmation is correct. I agree to comply with all
city and county ordinances and state laws tin ction, and hereby authorize representatives
of this counUto, eplM upon thSvebove- nt' �purposes.
Application Number .
. . . . 08-00001665
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee
252.00 Plan Check Fee
163.80
Issue Date
Valuation . . .
. 24783
Expiration Date
4/04/09
Qty Unit Charge
Per
Extension
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
4/04/09
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
4/04/09
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
4/04/09
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 . . . . . 08-00001665
Permit .. . . WALL/FENCE PERMIT
Additional desc .
•Permit -Fee .-. . . 15.00
Plan Check
Fee
.00
Issue Date,..
Valuation
. . .
. 217
Expiration'Date 4/04/09
j Qty Unit Charge Per
Extension
BASE FEE
15.00
--------------------------------------------------------
Special Notes and Comments
--------------------
POOL/SPA, 10 L.F. 5' EQUIPMENT WALL,
CITY STANDARD, 139 L.F. 2" GAS RUN FOR
FUTURE APPROVED APPLIANCE.
ALARMS/BARRIERS SHALL BE IN PLACE AT -
PRE -PLASTER INSPECTION.
Fee summary Charged Paid
.Credited
Due
Permit Fee total 371.00
.00
.00
371.00
Plan Check Total 189.80
.00
.00
189.80
Grand Total 560.80
.00
.00
560.80
r
LQPERMIT
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Bin #
City of. La Quinita
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
1�Quinta,
Project Address: S-�lu/ '
Owner's Name:ul� L
A. P. Number:
Address: ��1 __1;0a- h 0 AWS
Legal Description:
City, ST, Zip: G -�
Contractor: <f sicr raTelephone:
Address: b::
Project Descriptioq: L �' nn nnIIww
City, ST, Zip: 4a b L
Telephone: —g22_Z¢
State Lic. # : 2
CQ '7 L 2
City Lic. #:
,Om� �� % 1��Yi� [�/1 L✓�i
Arch., Engr., Designer:
<7 '
f
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): e Add'n Alter Repair Demo
Ft.: �2 # Stories: # Units:
Name of Contact Person:
re-ipajSq.
Telephone # of Contact Person:(766?—G0-07—%J
Estimated Value of Project: 3100L-2-5 K
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal Req'd Rec'd TRACKING. PERMIT FEES
Plan Sets
Plan Check submitted D 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
Z"' Review, ready for corrections/issue Electrical
Subcontactor List
Called Contact Person Plumbing
-A0AA—Appcoval-------- ----
-PlansresuUmiffe----------- - - Grading------------
-
�$lIDIISL[SS-�_
-fanning=Approval-- -
=''Called`ContacFPFrson
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
ON g