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