12-1268 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
12-00001268
Property Address:
52465 VIA CASTILE
APN:
772-410-998-24 -32453 -
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
1 22000
Tit!t44Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
WOODS
52465 VIA CASTILE
LA QUINTA, CA 92253
Contractor:
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/24/12
O
OCT 25 2011
I
Applicant: Architect or Engineer:
TESERRA
P.O. BOX 1280
CITY OF LA QUINTA
COACHELLA, CA 92236
FINANCE DEPT.
(760)398-9222
Lic. No.: 656128
CENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury th I am licensed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Divisi3 of the Busine and Professionals Code, and my License is in full force and effect.
on
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
•
License Class: 8 , 1 , 27 2 License No.: 656128
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
Date: l0 / ontractor:
�/ issued.
I` 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
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that 1 am exempt from the Contractor's State License Law for the
Carrier EVEREST NATL IN Policy Number 7600006481121
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
person in any manner so as 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 b _me subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
00 the Labor Code, 1/)pff 1/)forthwith 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
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
ate: L /t plicant:
(_ 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
WARNING: FAILURE TO SECURE WORKERS' 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 ONE 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.).
(_ 1 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 I am exempt under Sec. , BAP.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
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 suckstr
ation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the n is correct. I agree to comply with all
city and county ordinanc s and state laws relating to buildiand hereby authorize representatives
of thi - unty t nter pon eabove-mentioned propertyrposes.
ate: f / nature (Applicant or Agent):
Application Number . . . . . 12-00001268
Permit . . .
ELEC POOL PERMIT -RES
Additional desc . .
Permit Fee . . . .
45.00 Plan Check Fee
11.25
Issue Date . . . .
Valuation . . . .
0
Expiration Date . .
4/22/13
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 30.0000
----------------------------------------------------------------------------
EA ELEC PRIVATE SWIMMING POOL
30.00
Permit . . .
BLDG POOL PERMIT
Additional desc . .
Permit Fee . . . .
225.00 Plan Check Fee
146.25
Issue Date . . . .
Valuation . . . .
22000
Expiration Date . .
4/22/13
Qty Unit Charge
Per
Extension
BASE FEE
45.00
20.00 9.0000
----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
180.00
Permit . . .
PLUMBING
Additional desc . .
Permit Fee . . . .
27.00 Plan Check Fee
6.75
Issue Date . . . .
Valuation . . . .
0
Expiration Date
4/22/13
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 6.0000
EA PLB FIXTURE
6.00
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
Additional desc . .
Permit Fee . . . .
54.00 Plan Check Fee
.00
Issue Date . . . .
Valuation . . . .
2250
Expiration Date . .
4/22/13
Qty Unit Charge
Per
Extension
BASE FEE
45.00
1.00 9.0000
THOU BLDG 2,001-25,000
9.00
----------------------------------------------------------------------------
Special Notes and Comments
ADD NEW POOL TO EXISTING
SPA, 90 L.F. 6'
LQPERMIT
Application Number . . . . . 12-00001268
----------------------------------------------------------------------------
Special Notes and Comments
BLOCK WALL, CITY STANDARD. EXISTING SPA
PLUMBING TO BE USED. ALARMS/BARRIERS
SHALL BE IN PLACE AT PRE -PLASTER
INSPECTION. 2010 CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00
Fee summary Charged
Permit Fee Total 351.00
Plan Check Total 164.25
Other Fee Total 1.00
Grand Total 516.25
LQPERMIT
Paid Credited Due
.00 .00 351.00
.00 .00 164.25
.00 .00 1.00
.00 .00 516.25
Bin.#
City, �f Ld QUll1ta
Bidwipg u Safety Division
P.O. Box 1504,78-495 Calle Tampico
1.a.Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # / \�
Project Address: C4,5—rILL,
Owner's Name:. O
A. P. Number.
Address: /
Legal Description:
City, ST, Zip:- s
Contractor. 2
Telephone:
Address: /OOA vl!� SY
Project Description:
City, ST, Zip:Z
10 �L p Lf moi.
Telephone: L7
City Lia #;
S7 DAwkf—
State Lic. #: / Z
S'/')�
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone: ) �1`
State Lic. #: ' s
Construction Type: . Occupancy:
Project type (circle one): Ne Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Name of Contact Person: y ^
Telephone # of Contact Person: Q. 2S0 -2-31,9
Estimated Value of Project: Z 000
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACMG
PERMIT FEES
Plan Sets
Plan Check submitted
tem Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
SALL
H.O.A. Approval
Pians resubmitted
Grading
IN HOUSE:
'^' Review, ready for correetionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees