09-1030 (RPL)4
P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 9/24/09
Application Number: 09-00001030 Owner:
Property Address: 78915 DESCANSO IN AMUNDSON
APN: 646-350-011- - I- 78915 DESCANSO LANE
Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 23000
o r1Contractor: o -
Applicant: Architect or Engineer: TESERRA
n
P.O. BOX 1280 b1J�
COACHELLA, CA 92236
(760)398-9222
LiC. No. 656128 Gl��t1F"A"Z )NiA
— — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — —
I hereby affirm under penalty of perjur that
Section 7000) of Division 3 of the Busin
License Cl a s: C8 , 10 , 27 2
ate: ontractor:
O -BUILDER DECLARATION
I hereby affirm under nal f perjury that I a t from the Contractor's Stat License Law for th
e win u de penalty o pe lu y e s o e
following reason (Sec. 7031.5, Business and P Bions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair 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.).
(_ 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 contractorls) licensed
pursuant to the Contractors' State License Law.).
(_ 1 I am exempt under Sec. , BAP.C. for this reason
ED CONTRACTOR'S DECLARATION
I am lice d under provisions of Chapter 9 (commencing with
and Professi aIs e, and my License is in full force and effect.
nse No.: 656128
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: ',
LQPERMIT
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.
1 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 NumberBB1080510
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 become subject to the workers' compensation laws of California,
and agree
aagree that, if I should become sublW to the workers' compensation provisions of Section
of the Labor CodeXfo omply with those Provisions.
Date: plicant:
WARNING: FAIL RETOSECURE WORTION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINA FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPE A.T,ION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPUCANT 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 information is correct. I agree to comply with all
city and county ordinances and state laws relating to g construc ' nd hereby authorize representatives
oft is c to en/yupoe above-mentioned pro ins n purposes.
�Si
(Applicant or Agent):
Application Number . . . . . 09-00001030
Permit . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
234.00 Plan Check Fee
152.10
Issue Date . . . .
Valuation . . . .
23000
Expiration Date
3/23/10
Qty Unit Charge
Per
Extension
BASE FEE
45.00
21.00 9.0000
----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
189.00
Permit . . .
MECH POOL
Additional desc .
Permit Fee . . . .
26.00 Plan Check Fee
6.50
Issue Date . . . .
Valuation . . . .
0
Expiration Date
3/23/10
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
3/23/10
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 . . . .
33.00 Plan Check Fee
8.25
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
3/23/10
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
L----------------------------------------------------------------------------
Permit . . . . . . WALL/FENCE PERMIT
LQPERMIT
Application Number . . . . . 09-.00001030
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee 15.00
Plan Check Fee
.00
Issue Date
Valuation . . .
. 325
Expiration Date 3/23/10
Qty Unit. Charge Per
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes and Comments .
POOL/SPA, BBQ, 15 L.F. 5' EQUIPMENT
ENCLOSURE, CITY STANDARD.
ALARMS/BARRIERS SHALL BE IN PLACE AT
PRE -PLASTER INSPECTION.2007 CODES.
----------------------------------------------------------------7-----------
Other Fees . . . . . . . . . BLDG STDS
ADMIN (SB1473)
1.00
Fee summary Charged Paid
----------
Credited
----------
Due
---------------------------
Permit Fee Total 353.00
----------
.00 .00
353.00
Plan Check Total 178.10
.00 .00
178.10
Other Fee Total 1.00
.00 .00
1.00
.Grand Total 532.10
.00 .00
532.10
LQPERMIT
#
City of a, Quinta
Building. a Safety Division
P.O.. Box 1504, 78-495 Calle Tampico .
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # O,},O
pa' f
Project Address: 20415OV S V
Owner's Name: 2q M 14 A / ID-)
A. P. Number:
Address: ���� SCJ C S-7)
Legal Description:
City, ST, Zip:
Contractor: 7 �,� aft• '
Telephone:
Address: g(�— (,0 A V ,
Project Description:L c
City, ST, Zip: r L Cj¢ 7—Z3
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: E&M&
Telephone # of Contact Person:. -
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal.
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted .
Mechanical
Grading plan
2" Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval.
Plans resubmitted
Grading
IN HOUSE:-
''' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P,
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees