08-0005 (RPL)I-
P.O. BOX 1504 ^'
78-495 CALLE TAN.PICO
LA QUINTR; CALIFORNIA 92253` BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 08-06000005 i� i Owner:
I Property Address: 51755 VIA BENDITA HARVEY RESIDENCE
APN: 772-270-010-5 311231- 51-755 VIA BENDITA
Application description: POOL - RESIDENTIAli LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 25000
t
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Contractor:
Applicant: Architect or Engineer: TESERRA q
P.O. BOX 1280
COACHELLA, 9 236pao 1Vt(760)398-92 2
Lic. No.: 65 8 ��� ��`•
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LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am ens ed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and P fessionals Code, and my License is in full force and effect.
License Cass: C8 C27 C29 license No.: 656128
Date: Contractor:
/ OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 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 ($5001.:
(_) 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.).
(_) 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 _ 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 ISec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
v �1
LQPERn1IT
Date: 1/03/08
-- ------- - - - - - -
WORKER'S COMPENSATION DEC -
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' c6mpensation 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 Policy Number BB1070510
certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to ecome subject to the workers' compensation laws of California,
and agree that, if I should bec a subject to the workers' compensation provisions of Section
3700 of the Labor Cod I shal forthwith comply with those provisions.
Date:. Applicant:
WARNING: FAILURE TO SECURE W C MBENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND-EIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$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 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 in rmation is correct. I agree to comply with all
city and county ordinances and state laws relating to building const ction, and hereby authorize representatives
of this cc my to enter upon the above-mentioned propert inspe ion purposes.
Date: Signature (Applicant or Agent):
Application Number .
. . . . .08-00000005
Permit . . . . . .
BLDG POOL PERMIT
Additional desc
Permi-t..Fee
252.00 Plan Check Fee
163.80..
Issue Date . . . .
Valuation . . .
. 25000
Expiration Date
7/01/08
Qty Unit Charge
Per
Extension
BASE FEE
4S.010
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
7/01/08
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
7/01/08
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
Expirati.on Date
7/01/08
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, ALARMS/BARRIERS
SHALL BE IN
LQPER.NIIT
Application Number . . . . 08-00000005
Special Notes and Comments
PLACE AT PRE: --PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT_INCLUDED.
Fee summary, Charged Paid Credited Due
_----------------=----------------------------------------
Permit Fee Total 356.00 00 .00 356.00
Plan Check Total 189.80 .00 .00 189.80
Grand Total 545.80 .00 .00 545.80
f
LQPERAI IT
Bin #
City of La Quinta
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:S r&KAJ
Owner's Name: U -
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor:: P. P, A-
Telephone:
Address: ' M 0
Project Description:
City, ST, Zip: Cl'i� (L�k ct`, q zz
Od t��
Telephone:
State Lic. # : , 5 i
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:`
State Lic. #:
•s
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: �L`�(-�
Sq. Ft.:
#Stories:
# Units:
Telephone # of Contact Person: � ��--t� 'y�
Estimated Value of Project: a&0 1
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING I I
PERMIT FEES
Plan Sets
Plan Check submitted
I 7
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Cales.
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:-
Jrd 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