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07-0740 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 07-00000740 Property Address: 81420 GOLF VIEW DR APN: 762-410-019- - - Application description: POOL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 29200 Applicant: I hereby affirm under penalty of perjury thaf I ar Section 7000)-ot Division 3 of the Busine s and T41�p 4 4v Q" Architect or Engineer: P / BUILDING & SAFETY DEPARTMENT BUILDING PERMIT - ----------------------------- CONTRACTOR'S DECLARATION en8ed under provisions of Chapter 9 (commencing with fess', nals Code, and my License is in full force and effect. License No.: 656128 ��/� O NER-BUILDER DECLARATION I hereby a firm under penalty of perjury that I am a mpt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Profes 'ons Code: Any city or county that requires a permit to construct, alter, improve, demolish, or•repair any slw ure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is license 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.). (_) 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.). 1 _ 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: LQPERMIT Owner: BLOESSER 81420 GOLF VIEW DRIVE LA QUINTA, CA 92253 Contractor: TESERRA P.O. BOX 1280 COACHELLA, CA 92236 (760)398-9222 Lic. No.: 656128 c VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/12/07 ----------------------------------------------- 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. y 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 olicy Number BB1070510 certify that, in the performance of a work for which this permit is issued, I shall not employ any person in any manner so a ome subject to the workers' compensation laws of California, and agree that, if I shoul eco a bject to the workers' compensation provisions of Section /3' 7�00�of/the/Lager Code*f shat f h ith comply with those provisions. Da� l IiAoolicant: WARNI : FAILURE TO SECURE WORKERS COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJEC AN EMPLOYER TO CRIMINAL PEN LTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO TH 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 applicatio becomes null and void if work is not commenced within 180 days from date of issuance of su permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read is application and stat4the ove rmation is correct. I agree to comply with all city and coup ordinan es a tate laws relaticonstruc 'on, and hereby authorize representatives f s t to enter th bove-mentioner inspectio purposes.Date: t, atur (Applicant or Age Application Number . . . . . 07-00000740 Permit . . . MECH POOL Additional desc . . Permit Fee . . . . 37.00 Plan Check Fee 9.25 Issue Date . . . . Valuation . . . . 0 Expiration Date -9/08/07 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 11.0000 ----------------------7----------------------------------------------------- EA MECH FURNACE >100K 22.00 Permit . . . ELEC.-MISCELLANEOUS Additional desc . . Permit Fee . . . . 18.75 Plan Check Fee 4.69 Issue Date . . Valuation . . . . 0 Expiration Date 9/08/07 Qty Unit Charge Per Extension BASE FEE 15.00 5.00 .7500 ---------------------------------------------------------------------------- PER ELEC DEVICE/FIXTURE 1ST -20 3.75 Permit . . . BLDG POOL PERMIT Additional desc . . Permit Fee . . . . 284.50 Plan Check Fee 184.93 Issue Date Valuation . . . . 29200 Expiration Date 9/08/07 Qty Unit Charge Per Extension BASE FEE 252.00 5.00 6.5000 ----------------------------------------------------------------------------- THOU BLDG 25,001-50,000 32.50 Permit . . . PLUMBING Additional desc . Permit Fee . . . . 33.00 Plan Check Fee 8.25 Issue Date . . . . Valuation 0 Expiration.Date 9/08/07 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 .; v; Application Number . . . . . 07-00000740 1, Permit . . . .WALL/FENCE PERMIT' Additional desc .. . Permit Fee . . . . 21.00 Plan Check Fee .00 Issue Date . . . . Valuation 800 Expiration Date 9/.08/07 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 2.0000 HND BLDG 501-2,000 =------------ 6.00 ------------------------------------------- Special Notes and Comments -------------------- POOL/SPA, WATER FEATURE, (2) A/C BLIND WALLS (20' X 41HIGH) , - 30 L.F. 4' EQUIPMENT ENCLOSURE ALL CITY STANDARD. GAS & ELECTRIC STUBS FOR FUTURE APPROVED AND SEPARATELY PERMITTED APPLIANCES. ALARMS/BARRIERS SHALL BE IN PLACE AT PRE -PLASTER INSPECTION. Fee summary Charged Paid Credited. Due ----------------------------------------------- Permit Fee Total 394.25 .00 ---------- .00 394.25 Plan Check Total •207.12 00 .00 207.12 Grand Total 601.37: .00 .00 601.37 LQPERMTT Bin # City Qf • La QUinta Building a Safety Division P.O. Box 1504, 78-495 Calle Tampico Permit #� La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project AddressF>k_Lt2-c) C.oL v \,CV3 ;i.. Owner's Name: \ A. P. Number: Address:'s 1--L42,0 Vvs w A(Z— Legal Description: City, ST, Zip: �C;J Contractor: (� 5� -�� ly Telephone: Pub. Wks. Appr Date of permit issue Address: (� Project Description: City, ST, Zip:4f-0P:t:-C Ll.C.1- Z23 `P Telephone: !:)07 ZZ2— Total Permit Fees VA State Lic. # City Lic. #:�� ,O Arch., Engr., Designer: 'L llj�- LL C.►J K rC L Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Perso77 Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Telephone -# of Contact Person: Estimated Value o.fProject: JK 'vGeCDC) C3 APPLICANT: DO NOT WRITE BELOW THIS LINE to Submittal Req'd Recd TR.ACKNG • PERMIT FEES Plan Sets Plan.Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2"d Review, ready for corrections/issue V.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 i Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees W6, a -g, Zoo