07-1710 (RPL)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: 6/13/07
Application Number: 07-00001710 T Owner:
Property Address: 53188 VIA PALACIO PARKER RESIDENCE
APN: 772-550-050- - - 53-'188 VIA PALACIO
Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 3000 e ^�
Contractor: D 4 !
Applicant: Architect or Engineer: TESERRA 2001 J'
P.O. BOX 1280
COACHELLA, CA 92236
(760)398-9222 �IiXaLAQU1M1�
Lic. No.: 656128
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury thatI am icerise d under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and rofessionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: C8 C27 C29 - License No.: 656128 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
Y
? Date: } / 0%- (✓Contract - _ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor. -
t— ti- ---- -Code, for the performance of the work for which this permit is issued. My workers' compensation
OWNER -BUILDER DECLARATION insurance carrier and policy number are: -
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier SEABRIGHT Policy Number BB1070510
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to - _ I certify that, in the performance of the work for which this'permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the personin any manner so as t become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State - and agree that, if I should bec me subject to the workers' compensation provisions of Section
License Law YChapter 9 (commencing with Section 7000) of Division *3 of the Business and Professions Code) or 3700 of the Labor Co 1 sh 'th comply with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by -� 7 "
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ate: ,r1 Applicant ! _
1 _ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and 11 - the structure is not intended or offered for sale (Sec. 7044,'Business and Professions Code: The WARNING: FAILURE TO SECURE W KERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License'Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL, PENALTIES AND CIVIL FINES UP TO 014E HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION,3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S. FEES. '
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.). APPLICANT ACKNOWLEDGEMENT
( 1 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does'not apply to an owner of conditions and restrictions set forth on this application.
property who builds or improves thereon,and who contracts for the projects with a contractor(s) licensed 1 . Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law3. whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_) I am exempt under Sec. , B.&P.C. for this reason 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.
Date: Owner: .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
CONSTRUCTION LENDING AGENCY permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all
Work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to building co struction, and hereby authorize representatives
of this county to enter upon the above-mentioned grope r in ection purposes.
Lender's Name:
• _3,rDate: �b "Signature (Applicant or Agent):
Lender's Address: `
LQPERMIT
Application Number ... . . . 07
7-00001710Permit.
-00001710 -
Permit .. . . . BLDG POOL PERMIT
Additional desc .
Permit -Fee `54.00
Plan Check
Fee
35.10
Issue Date
Valuation
. . .
3000
Expiration Date 12/10/07
Qty Unit Charge Per
Extension
BASE :FEE
45.00
1.00 9.0000 THOU BLDG
2,001-25,000
9.00
Permit . . ELEC POOL PERMIT
-.RES
Additional desc..
Permit Fee 45.00
Plan Check
Fee ..
11.25
Issue Date
Valuation
0
Expiration Date... 12/10/07
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 21.00
Plan.Check
Fee..
5".25
Issue Date
Valuation
0
Expiration Date 12/10/07
Qty Unit Charge Per
Extension
_ BASE
FEE
15.00
1,.00> 6.0000 EA PLB FIXTURE.'
6.00
-- -- - - ------ - - -
Special Notes and Comments
- --
--
FOUNTAIN PER APPROVED PLAN
Fee summary Charged
Paid .Credited
Due.
Permit 'Fee Total 120.00
.00
.00
120.00..
Plan Check Total 51.60
.00
.00
51.60
Grand Total 171.60
.00
.00
171.60
LQPERMIT
Bin #
City of La. Quihta
Building 8L Safety Division
P.O. Box 1'504 78-495 Calle Tampico
La Quinta, CA 92253 - (760)-777-7012.
Building Permit Application and Tracking Sheet
Permit #;
Project Address: _ laa ' Awao
Owner's Name:
A. P. Number:
Address:
Legal Description:
Contractor:
City, ST, Zip:
Telephone: '
Address: 0.. 0 • (P
Project Description:
City, ST, Zip: L O/i CI ^1-1-14 CA - ZS (,o
u � 4-1 `. ok)
Tele hone:
State Lic. # : (2 _ City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
p
(` : �
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
S Ft.:
# Stories:
# Units:
Telephone # of Contact Person:(O Z --C) .
Estimated Value of Project:. 3
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd •
Rec'd
TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitted
I I
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
9a L
Flood plain plan
Plans resubmitted
Mechanical
Grading. plan
2"d Review, ready for correctio issu
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
d7