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10-0824 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 10-00000824 Property Address: 60387 LAVENDER CT APN: 764-270-999-160 -300232- Application description: POOL - RESIDENTIAL Property Zoning: MEDIUM HIGH DENSITY RES Application valuation: 27000 Tit�v 4 Xi� Q" Applicant: V ) Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT -------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am I' ensed under provisions of Chapter 9 (commencing with Section 7000) of Div' ion 3 of the Busi ess and ofessionals Code, and my License is in full force and effect. . License Class C 10, 27, 2 License No.: 656128 /ate: PIZel Contractor: 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).: . (_) 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, 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.). Lender's Name: `\ Lender's Address: f y LQPERMIT Owner: WERDANN 60-387 LAVENDER COURT 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: 9/01/10 iD1 SEP ozo,o 3LD CITY OF LA QU114TA F?-.VAW, E T)EPT ----------------------------------------------- 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. K 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 INS Policy Number .BB1100510 _ 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 as to b ome subject to the workers' compensation laws of California, and gree that, if I sho Id beco a subject to the workers' compensation provisions of Section 0 of a Labor Cod I sh forthwith comply with those provisions. 0' Applicant: �ate: ARNI G: FAILURE TO SECURE WORKERS' 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 a ve information is correct. I agree to comply with all city d county finances and state laws relating to buildin construction, and hereby authorize representatives of is county e r upo 'the above-mentioned property f insp coon purposes. Date: r a gnature (Applicant or Agent): Application Number . . . . . 10-00000824 Permit . . . BLDG POOL PERMIT Additional desc . . Permit Fee . . . . 265.00 Plan Check Fee 172.25 Issue Date . . . . Valuation . . . . 27000 Expiration Date 2/28/11 Qty Unit Charge Per Extension BASE FEE 252.00 2.00 6.5000 THOU BLDG 25,001-50,000 13.00 ---------------------------------------------------------------------------- Permit . . . MECH POOL .Additional desc . . Permit Fee . . . 26.00 Plan Check Fee 6.50 Issue Date Valuation . . . . 0 Expiration Date - 2/28/11 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_. 2/28/11 Qty Unit Charge Per r 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 2/28/11 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 LQPERMIT 1 4 LQPERMIT Application Number . . . . . 10700000824. ---------------------------------------------------------------------------- Special Notes and Comments PLACE AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED. 2007 CODES. -----------------7---------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 2.00 Fee summary ------------------ Charged ---------- Paid ---------- Credited -------------------- Due Permit Fee Total 369.00 .00 .00 369.00 Plan Check Total 198.25 .00 .00 198.25 Other Fee.Total 2.00 .00 .00 2.00 Grand Total 569.25 .00 .00 569.25 Bin # City of La Quinta Building & Safety Division Permit #P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 ' Building Permit Application and Tracking Sheet Project Address: a0 3 e �_ AM Owner's Name: A. P: Number: Address: LtJV G—r O Legal Description: � City, ST, Zip: LA v I e! T A Telephone: Contractor: JE S Z Address: 8 6 f 00 ✓ Project Description: City, ST, Zip: At.4►EULA A ZZ3 G C f. SfA Tel hon 8 City Lie. #c State Lie. #: 6 S C 12 8 © - Arch., Engr., Designer,. Address: City, ST, Zip: Telephone: Construction Type: .. e e `, Occupancy: State Lie. #: Project q,pe (circle one). New Add'n Alter Repair Demo Name of Contact Person: Sq. FL: # Stories: # Units: Telephone # of Contact Perso 6p O Z3 i Estimated Value of Project: Z .0 0 0 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal . Req'd Rec'd TRACKUVG PERMIT FEES Plan Sets Plan Check submitted 1 Item Amount Structural Coles Reviewed, ready for corrections Plan Check Deposit Truss Cala. CaUed Contact Person Plan Check: Balance Title 24 Cala. Pians picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for corrcetionstissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.1. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''� Review, ready for correctkonsrssue Developer Impact Fee Planning Approval Called Contact Person A,I,P,P, . Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees