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07-2403 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Applicant: c&ht 4 4 " BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Architect or Engineer: p1pr- UC SED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Bus' ss nd Professionals Code, and my License is in full force and effect. License LI s: l H Cl7 C' 9 License No.: 656128 ntractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I 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 ($500).: 1 _ 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 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 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: LQPERAfIT Owner: SHEA LA QUINTA C/O JEFF MCQUEEN 8800 N GAINEY CENTER SCOTTSDALE, AZ 85258 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 AUG 28 2007 Date: 8/24/07 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 BB1070510 _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any . person in any manner so a o become subject to the workers' compensation laws of California, and agree that, if I s Id _come subject to the workers' compensation provisions of Section / 3700 of the La orthwith comply with those provisions. Date: 7 b Ap nt WARNING: FAILURE TO SECUR RS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO 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 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 Aabinformation is correct. I agree to comply with all city and county ordinances and state laws relating to buil itruction, and hereby authorize representatives ofthis/coy;+ to enter upon the above-mentioned pro rt ection purposes. _ at�D e: ature (Applicant or Agen J Application Number: kZ�` 07-00002403 Property Address: 81815 LA PAZ -CT APN: 764-280-999-100 -300237- Application description:. POOL - RESIDENTIAL Property Zoning: MEDIUM HIGH DENSITY RES Application valuation: 30000 Applicant: c&ht 4 4 " BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Architect or Engineer: p1pr- UC SED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Bus' ss nd Professionals Code, and my License is in full force and effect. License LI s: l H Cl7 C' 9 License No.: 656128 ntractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I 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 ($500).: 1 _ 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 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 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: LQPERAfIT Owner: SHEA LA QUINTA C/O JEFF MCQUEEN 8800 N GAINEY CENTER SCOTTSDALE, AZ 85258 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 AUG 28 2007 Date: 8/24/07 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 BB1070510 _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any . person in any manner so a o become subject to the workers' compensation laws of California, and agree that, if I s Id _come subject to the workers' compensation provisions of Section / 3700 of the La orthwith comply with those provisions. Date: 7 b Ap nt WARNING: FAILURE TO SECUR RS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO 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 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 Aabinformation is correct. I agree to comply with all city and county ordinances and state laws relating to buil itruction, and hereby authorize representatives ofthis/coy;+ to enter upon the above-mentioned pro rt ection purposes. _ at�D e: ature (Applicant or Agen Application.Number . . . . . 07-00002403 Permit . . BLDG POOL PERMIT Additional desc ... Permit Fee 284.50 Plan Check Fee 184.93 Issue Date . . . . Valuation . . . . 29680 Expiration Date 2/20/08 Qty Unit Charge Per Extension BASE FEE 252.00 5.00 6.5000 --------------------------------------------------------------------------- THOU' BLDG 25,001-50,000 32.50• Permit . . . MECH POOL Additional desc . Permit 26.00 Plan Check Fee 6.50 D Issue ate . . . . Date Valuation . . . . 0 Expiration Date 2/20/08 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 2/20/08. 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- 8.25Issue Date . . Issue-Date Valuation . . . 0 Expiration Date 2/20/08 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 Permit . . . . WALL/FENCE PERMIT. LQPERMIT Application Number . . . . . 07-00002403 L . Permit WALL/FENCE PERMIT Additional desc . Permit Fee 15.00 Plan Check Fee .00 Issue Date ` Valuation , 320 ExpirationDate2/20/08 Qty Unit Charge Per Extension- -BASE FEE 15.00 -------------------------------------------- ------------------------------- Special Notes`and.Comments POOL/SPA, 20 L.F. 4' EQUIPMENT WALL, CITY STANDARD. ALARMS/BARRIERS SHALL BE IN PLACE AT PRE -PLASTER INSPECTION.• Fee summary Charged Paid Credited Due Permit Fee Total 403.50 -.00. .00 403.50 Plan Check Total 210.93 .00 .00 210.93 Grand Total 614.43 -.00 .00 614.43 LQPEINIIT Bin # City ®f La Quinta Building U Safety Division P.O. Box 1504, 78-495 Calle Tampico LaQuinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # A0 Project Address: _9755 Owner's Name: S1Jz-,A, 16` A. P. Number: Address: Legal Description: City, ST, Zip: Contractor:", Telephone:" Address: BoxL z 5, G Project Description: City, ST, Zip: CI CA— 21✓3 to ` Telephone: ED State Lie. # City Lie. #: .S Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lie. #: Name of Contact Person: Construction Type: Occupancy: Project type (circle one): ew Add'n Alter Repair Demo Sq. Fr_:# Stories: # Units: Telephone # of Contact Person: — Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE 11 Submittal .- Req'd Recd TRACEING PERIVIIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cafes. Called Contact Person Plan Check Balance Energy Calcs. 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:- '"' 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