07-2615 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
0
I I�
07-00002615
52425 VIA DONA
772-480-028- - -
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
30000
c&ht 4 XP Q"
Architect ori eer:
-----------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that I am 'tensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and P ofessionals Code, and my License is in full force and effect.
License Class: CB C27 C29 License No.: 656128
Date: 10 Contractor:
ER -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 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.). .
1 _ 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, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
I—) 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:
HEIKKALA RESIDENCE
52-425 VIA DONA
LA QUINTA, CA 92253
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: 9/27/07
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 are:
Carrier SEABRIGHT Pol y Number BB1070510
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 beco a ject to the workers' compensation laws of California,
and agree that, if I should ecome s jectsubto the workers' compensation provisions of Section
3700 of the Labor Code, all forth ith comply with those provisions.
Date: Applicant:
WARNING: FAILURE TO SECURE WOR S COM NSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PEN SAND CIVIL FINES UR 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 such permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above i formation is correct. I agree to comply with all
city and county ordinances and state laws relating to building con ruction, and hereby authorize representatives
of this cou%% ty to enter upon the above-mentioned propert r insp tion purposes.
Date: gnature (Applicant or Agent):
Application Number . . . . 07-00002615
Permit . . . BLDG POOL PERMIT
Additional desc . .
Permit Fee . . . . 284.50 Plan Check Fee 184.93
Issue Date . . . . Valuation . . . . 30000
Expiration Date . . 3/25/08
Qty Unit Charge Per Extension
BASE FEE 252.00
5.00 6.5000 THOU BLDG 25,001-50,000 32.50
----------------------------------------------------------------------------
Permit . . . MDCII POOL
Additional desc .
Permit Fee . . . . 26.00 Plan Check Fee 6.50
Issue Date . . . . Valuation . . . . 0
Expiration Date 3/25/08
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 11.0000 EA MECH FURNACE >100K 11.00
----------------------------------------------------------------------------
Permit . . . ELEC POOL PERMIT -RES
Additional desc .
Permit Fee 45.00 Plan Check Fee 11.25
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 3/25/08
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
Issue Date . . . . Valuation . . . . 0
Expiration Date 3/25/08
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
1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00
----------------------------------------------------------------------------
Special Notes and Comments
POOL, SPA, ALARMS/BARRIERS SHALL BE IN
LQPERMIT
Application Number . . . 07-00002615
----------------------------------------------------------------------------
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
Fee summary Charged Paid Credited Due
=--------------------------------------------------------
Permit Fee Total 388.50 .00 .00 388.50
Plan Check Total 210.93 .00 .00 210.93
Grand Total 599.43 .00 .00 599.43
LQPERMIT
Bin #
City of La Quointa
Building u Safety Division
Permit # P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking ng Sheet
Project Address: Owner's Name:
L4 P -Gs .
A. P. Number: Address:
Legal Description: City, ST, Zip:
Cont ractor:?-R
Address: P- ®aoi(
City, ST, Zip:
Telephone: -Uzz-
State Lie. # : (O.S
Arch., Eng -r., Designer:
Address:
City, ST, Zip:
Telephone:
State Lie. #:
Name of Contact Person:
Telephone # of Contact Person:
# Submittal Req'd
Plan Sets
Structural Cales.
Truss Cales.
Energy Calcs.
Flood plain plan
Grading.plan"
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
School Fees
5
City Lie. #:
I
Project Description:
Total Permit Fees
Q
Construction Type:
Occupancy:
Project j type (circle one):
e Add'n Alter Repair Demo
s �.
Sq. Ft.:
ies: # Stor
# Units:
6" a
Estimated Value of Project:
9,3O DD 0
APPLICANT: DO NOT WRIYE BELOW THIS LINE
MEMOMMM
Recd TRACKING ,
PERMIT FEES
Plan Check submitted
Item
Amount
Reviewed, ready for corrections
Plan Check Deposit
Called Contact Person
Plan Check Balance
Plans picked up
Construction
Plans resubmitted
Mechanical
2nd Review, ready for corrections/issue
Electrical
Called Contact Person
Plumbing
Plans picked up
S.M.T.
Plans resubmitted
Grading.
ird Review, ready for corrections/issue
Developer Impact Fee
Called Contact Person
A.I.P.P.
Date of permit issue
Total Permit Fees