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07-2201 (RPL)R.O.-BOX 1504 78=495=CALLE TAMPICOD . LA QUINTA; CALIFORNIA 92253' BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: 07-00002201 78863 VIA CARMEL 646-430-028- - POOL - RESIDENTIAL LOW DENSITY RESIDENTIAL 30000 Architect or Engineer: LICEN ED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I a licensed under provisions of Chapter 9 (commencing with - Section 7000) of Division 3 of the Bus' s and rofessionals Code, and my License is in full force and effect. LicenseCla C8 C27 C29 LicenseNo.: 656128 Pate:D DContractor.) Y-- NER-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).: ( _ 1 1, 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' 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, andwhocontracts for the projects with a-contractorlsl-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: LQPERN11T '' % -1 Owner: NORRED RESIDENCE 78863 VIA CA LA QUINTA, 2253 Contractor- t TESERRA P.O. BOX 1280 COACHELLA, CA (760)398-9222 Lic. No.: 656128 R VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-.7153 Date: 7/27/07 ------------------------------------------------- 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. - 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 aI ' Carrier SEABRIGHT Policer BB1070510 I certify that, in the performanci which this permit is issued, 1 shall not employ any person in any manner so as t to the workers' compensation laws of California, and agree that, if I should bethe workers' compensation provisions of Section 370 of the Labor Code, I ply with those provisions. Date: 7 L7�wtpplicant: WARNING: FAILURE TO SECURE WORKE OMPEN TION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTI D 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 W/_- ssation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that ion is correct. I agree to comply with all city and county ordinances and state laws relating to bn, and hereby authorize representatives of this cou ty to Inter upon the above-mentioned propepurposes. % Date:-t�-/1" nature -(Applicant or -Agent): _- ',Application Number . . . . . 07-00002201 Permit . . . MECH POOL Additional desc . -.- Permit Fee 26.00 Plan Check Fee 6.50 Issue.Date Valuation 0 Expiration Date .' 1/23%08 Qty, Unit Charge Per Extension ;._ BASE FEE 15.00 1.00.'":; 11.0000 EA MECH FURNACE >100K 11.00 Permit . . . MECH POOL • Additional desc '. Permit.Fee 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation . . . . .0 Expiration Date .. 1/23/08 Qty Unit Charge Per Extension BASE FEE 15.00 1.00" 11.0000 EA MECH FURNACE >100K 11.00 Permit BLDG POOL PERMIT Additional desc . Permit Fee . . . . 284.50 Plan Check Fee 184.93 . Issue Dater Valuation 29920 Expiration Date 1/23/08 Qty Unit Charge Per Extension BASE FEE 252'.0.0 5.00 6.5000 ---------------------------------------------------------------------------- THOU BLDG 25,.001-50,000 32.50 Permit ELEC POOL PERMIT -RES Additional desc . Permit Fee . . 45.00 Plan Check Fee 11.25 Issue.Date Valuation 0 Expiration Date 1/23/08 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 LQPERMIT ,.._. 'Application Number 07-00002201 Permit . . . PLUMBING Issue Date' :.. _ Valuation. 0 Expiration Date 1/23/08 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 3.0000 EA PLB --------------- GAS PIPE 1-4 OUTLETS 3.00 _ .. .Permit . . . WALL/FENCE PERMIT Additional desc Permit-Fee . . 15.00 Plan Check Fee .00 _ Issue•'Date: . . . . Valuation ... 80 Expiration Date 1/23/08 Qty Unit Charge Per Extension- BASE FEE 15.00 ----------------------------------------------------- Special Notes and Comments ----------------------- POOL/SPA ALARMS/BARRIERS SHALL BE IN PLACE AT PRE-PLASTER INSPECTION. 48 X5 EQ WALL. Fee summary Charged Paid Credited Due Permit Fee Total 429.50 .00 .00 429. 50 Plan Check Total 217.43 .00 .00 217.43 " Grand-Total 646.93 .00" .00 646.9.3 LQPERAIIT .. . Bin # - �' ' City of La Quinta Building & Safety Division 1 P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: _ A —,AA�&Z— Owner's Name: 6 r / A. P. Number: Address: Legal Description: City, ST, Zip: Contractor:? Address: BOX I Z� . Telephone: Project Description: City, ST,Zip:CM Ch j[ 04—rte„ 3 6 (�+" Telephone: ZZZ State Lie. # : %s ?—On City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: Z- Construction Type: Occupancy: Project type (circle on New Acd'n Alter Repair Demo Sq. FL: #Stories: # Units: Telephone # of Contact Person: Z aS^ 101 Estimated Value of Project: 3� �o APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMTI FEES Plan Sets Plan Check submitted Z 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 Mechani-tal I.Gradiog.plan 2" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted 1.G IN HOUSE:- ''" Review, ready for correctionstissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees