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08-1574 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: 08-00001574 81490 JOSHUA TREE CT 764-280-999-127 -300236- POOL - RESIDENTIAL MEDIUM HIGH DENSITY RES 25000 Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICE"ED CONTRACTOR'S DECLARATION I hereby affirm under penalty of pe ' ry that I am a un pr io of hapter 9 (commencing with Section 7000) of Division 3 of the B ess and P e io of m icense is in full force and effect. Licenses: C27 C29 t 56128 Date: tractor. BUILDER DECLARATION I hereby affirm under penalty of perjury that I empt from the Contractor's State License Law for the following reason (Sec. 7031 .5, Business a ofessions 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 ($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.). (_) 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 (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT Owner: CHASKA 81490 JOSHUA TREE Q LA QUINTA, CA 92253 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: 9/17/08 �- 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 and policy number are: Carrier SEABRIGHT Policy Number BB1080510 I certify that, in the perfor ce of the work for which this permit is issued, I shall not employ any person in any manner so ecome the workers' compensation laws of California, and agree that, if I should beco o e wor mpensation provisions of Section ,en ,-Q700 of the Labor Code, I shall mpl th ose provisions. WARNING: FAILURE TO SECURE WORK E ' COMPENSATION COVERAGE IS -UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 0100,000). 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 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 p mrt. 2. Any permit issued as a result of this application ecomes II and void if work is not commenced within 180 days from date of issuance of such mit, or ssation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above in s corre I agree to comply with all city and county ordinances and state laws relating to building const reb ze representatives of this cpVPt7%to eyte on the above-mentioned property for i - e ' n (Applicant or. Agent): Application Number . . . . . 08-00001574 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 252.00 Plan Check Fee 163.80 Issue Date . . . . Valuation . . . . 25000 Expiration Date 3/16/09 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 3/16/09 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 - 3/16/09 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 3/16/09 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 - ----------------------------- ------------------------------------------------ Special Notes and Comments POOL/SPA, FIREPIT (496 AGAL), 100 L.F. LQPERMIT LQPERMIT - Application Number . . . . .. 08-00001574 ---------------------------------------------------------------------------- Special Notes and Comments OF1 1/2" DIAMETER GAS LINE. ALARMS/BARRIERS SHALL BE IN 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 LQPERMIT - Bin # - City of. La Quino Building a Safety Division Permit # �j� P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address: q� �J C. Owner's Name: Address:��-- A. P. Number: 2 Legal Description: City, ST, Zip: zw Contractor: e Telephone: �~ Address: b-- Project Description: G City, ST, Zip: e ` CZ-36 li Aee Telephone: 11111M - State Lic. #: 2 City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: Construction Type: li� Occupancy: State Lic. #: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: # Stories: T# Units: Telephone # of Contact Person:(76 v- 07- -9 1 Estimated Value of Project: 2-Q..- 2 5 K APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plau Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan' 2" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing oom and s resubmitted Grading – aaAnrng-Apppoval_ .._ —–__.... :;eWUeaWoo a`v - rstmz CTP`-Pr Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees Rags At -0 WITH -tCrt�t 1 eo[7�tpP 7 w �g'I fly Tµrxcur S Guy - ... tQPItIC, . FIfl.EF17 .#T tit' •.4�I fW,. ]'ifl�r.� c ..-wm ALL DECKING EXPANS[ON XINTS FOR RE PR ESE VAT ION ONLY, FIELD LAYOUT WILL VARY. 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