08-1662 (SOTB)P.O. BOX 1504
78-495 CALLE TAMPICO
!s. LA QUINTA, CALIFORNIA 92253
T -,&t'4 4 Q"
Application Number: 08-00001662
Property Address: 61620 FIRE BARREL DR
APN: 764-280-999-2 .-30023S-
Application description: STRUCTURES OTHER THAN BUILDINGS
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 3000
Applicant:
Architect or Engineer:
iia
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I sed under rovisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business nd Profes ' de d my License is in full force and effect.
License CIa • C8 C27 C29 a 656128
ate: el- ntractor:
I hereby affirm under penalty of perjury that I amgScempt from the Contractor's State Lic aw for the
following reason (Sec. 7031.5, Business and P fessions Code: Any city or county that requires rmit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicZlrntJor 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.). -
(_) 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 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 forr which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
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
Date: 10/06/08
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.
pL 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
T` Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier SEA13RIGHT Policy Number BB1080510
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 ome subject to the workers' compensation laws of California,
and agree that, if I shoul ecome s j the the
compensation provisions of Section
�0 of the Labor Code I shall fo i ply with those provisions.
ft-t'e licant:
WARNING: FAILURE TO SECURE WO COMP ION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMI L IL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 15100,0001. IN ADDITIO 0 THE T OF COMPENSATION, DAMAGES�IS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, A ATTORNEY'S FEES.
APPLICANT ACK"EDGEMENT
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 tate tha ab nformation is correct. I agree to comply with all
city and cou ty ordinances and state laws rela to bui constr tion, and hereby authorize representatives
of thi un^� ent®up�the above-mentioned:p or ' coon purposes.
0
Application Number 08-00001662
It's Permit . . . BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 54.00
Plan Check
Fee
35.10
Issue Date . . . .
Valuation
3000
Expiration Date 4/04/09
Qty Unit Charge Per
Extension
BASE FEE
45.00
1.00 9.0000 THOU BLDG 2,001-25,000
----------------------------------------------------------------------------
9.00
Permit . . . PLUMBING
Additional desc . .
Permit Fee . . . . 18.00
Plan Check
Fee
4.50
Issue Date . .
Valuation
. . .
. 0
' Expiration Date.. 4/04/09
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 3.0000 EA PLB GAS PIPE,1-4
OUTLETS
3.00
----------------------------------------------------------
Special Notes and Comments
------------------
FIREPIT (ANSI Z223.1), 90 L.F. 1 1/2"
_
GAS LINE.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . ENERGY
REVIEW FEE
3.51
STRONG
MOTION (SMI)
- RES
.50
Fee summary, Charged Paid'..
----------
Credited
--------------------
Due ,.
---------------------------
Permit Fee Total 72.00
.00
.0.0
72.00
Plan Check Total 39.60
.00
.00
39.60
Other Fee Total 4.01
.00
.00
4.01
Grand Total _115.61
.00
.00
115.61
0
LQPERMIT
Total Permit Fees`
t
Bin # ` L
City of. La Quints
Building 8L 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:��
Owner's Name: '` i/,� SZ
A. P. Number: 6G� L
6-d
Address: 6 /— �Z > v
Legal Description:
City, ST, Zip:
Contractor: i se `/
Telephone:
Address: b--
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Project Description:
City, ST, Zip:
`� qZ--2
-
Telephone: �" l� L.Z
�j •� (� r �/-�•
State Lie. # :
City Lie. #:
J C)2 1
Arch., Engr., Designer:
/
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project type (circle o Ne Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.: dt/14,—
# Stories:
# Units:
Telephone # of Contact Person: (
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal Req'd
Rec'd TRACMG PERMIT FEES
Plan Sets
Plan Check submitted O 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
Flood plain plan
Plans resubmitted Mechanical
Grading plan
2" Review, ready for correctionstissue El
Subcontactor List
Called Contact Person lum rng (y As
H:OA.-Approval-- - —
-- — - - -
- '-- - -Plans—resubmiflea - — �- - -- - - —Grading
-
--
Ianning-Approval--
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees`
t
Property of Teserra. Unauthorized use is prohibited.