09-1197 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: r- , 09-00001197
Property Address: 81295 JASMINE CT
APN: 764-280-999-34 -300236-
Application description: POOL - RESIDENTIAL
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 10000
Applicant:
----------------
I hereby affirm under penalty of perjury am
Section 70 0) o iv' ' n 3 of the Business a
License s3;. 27,2
i
/ate: ntractar:
T,&t 4 4 Q"
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
r 9 (commencing with
is in full force and effect.
�NER- ILDER DECLARATION
I hereby affirm under penalty of perjury that I am exe from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business and I fes . Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any s u ure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is is sed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Secti 000) 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 ($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 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 _ 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 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:
LQPERMIT
Owner:
BOWERS
81295 JASMINE
LA QUINTA, CA
Contractor:
TESERRA
P.O. BOX 1280
COACHELLA, CA
(760)398-9222
ii C. NO.: 65610
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
11/19/09
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 Policy Number BB1080510
_ I certify that, in the performance of the wor ich this permit is issued; I shall not employ any
person in any manner so as to becom )e o the workers' compensation laws of California,
and agree that, iqO
me c e workers' compensation provisions of Section
7Qq'�f the Labwith those provisions.
�(/
date: plicant-
WARNING:. FAIL RE TO SECURMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRLTIES AND CIVIL FINES UPTO 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 Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issua of this permit.
2. Any permit issued as a result of this Iication becomes null and void if work is not commenced
within 180 days from date of issueI
h permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and stata ve i ation is correct. I agree to comply with all
city and county ordinances state laws relating uction, and hereby authorize representatives
of thi ount eVnureeabove-mentiones ses.
te: (Applicant or Age
1. J
Application Number . . . . . 09-00001197
PermitBLDG
POOL PERMIT
Additional desc .
Permit Fee . . . .
117.00
Plan Check Fee
76.05
Issue Date . . . .
Valuation
10000
Expiration Date
5/18/10
Qty Unit Charge
Per
Extension
BASE
FEE
45.00
8.00 9.0000
----------------------------------------------------------------------------
THOU BLDG
2,001=25,000
72.00,
Permit. . .
MECH POOL
Additional desc .
Permit Fee . . . .
26.00
Plan Check Fee
6.50
Issue Date . . . .
Valuation . . . .
0
Expiration Date
5/18/10
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
•5/18/10
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
27.00
Plan,Check Fee
6.75
Issue Date . . . .
Valuation
0
Expiration Date
5/18/10
Qty Unit Charge
Per
Extension ~
BASE
FEE
15.00 _
1.00 6.0000
EA PLB.FIXTURE
6.00
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
'
SPA: ALARMS/BARRIERS
SHALL BE IN
PLACE
LQPERMIT
4
LQPERMIT
Application Number . . . . .
09-00001197
----------------------------------------------------------------------------
Special Notes and Comments
AT PRE -PLASTER INSPECTION. EQUIPMENT
ENCLOSURE NOT INCLUDED. 2007
CODES.
-------------------------------------=--------------------------------------
Other Fees . . . . . . . . .
BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged
Paid
----------
Credited
--------------------
Due
---------------------------
Permit Fee Total- 215.00
.00
.00'
215.00
Plan Check Total 100.55
.00
.00
100.55
Other Fee Total 1.00
.00
.00
1.00
Grand Total 316.55
.00
.00
316.55
4
LQPERMIT
Bi" #
City of La Quints
Building 8T Safety Division
P.O. Box 1504, 78-495 Calle Tampico .
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #1nn
Project Address: s /�- &
Owner's Name:
A. P. Number: Z6-1 2�,-Igga
Address:
Legal Description: Q`/f l
Contractor:720---5E
City, ST, Zip:
Telephone:
Address: 8:(, -ICO AVE 5-q
Project Description: S /
City, ST, Zip: (20 = L Z7-.3 to
Telephone:
State Lic. # : City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Construction Type: Occupancy:
Project type (circle one): New• Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Name of Contact Person:
Telephone # of Contact Person:. ti"
Estimated Value of Project: v
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACIOIYYG
PERMIT FEES
Plan Sets
Plan Check submitted
IC
Item
Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cafes.
Called Contact Person
Plan Check Balance
Energy Cafes.
Plans picked up
Construction
Flood plain plan
Plans resubmitted .
Mechanical
Grading plan
tad Review, ready for correctionsAssae
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval:
Plans resubmitted
Grading
IN ROUSE:-
'n° 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