08-1264 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
08-00001264
Property Address:
52768 VIA DONA
APN:
772-410-999-6 -298944-
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
JUUUU
T4ht 4 XP Q"
Applicant: Architect or Engineer:
d1
I hereby affirm under penalty of
Section 7000) of Division 3 of I
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
"OR'S DECLARATION
provisions of Chapter 9 (commencing with
ode, a9d my License is in full force and effect.
.se N6.: 656128
patir O < ' L` ractor:
/ OWNER -BUILDER DECLARATI R
I hereby affirm under penalty of perjury t 1 am exempt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, B i s 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, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
(_ 1 1 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:
WOODARD
52768 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: 8/15/08
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
k issued.
I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of t e rk for which this permit is issued. My workers' compensation
insurance carrier and policy nu er a,q:
Carrier SEABRIGHT P y umber BB1080510
I certify that, in the performance of the or hich this pe mit is issued, I shall not employ any
person in any manner so as to eco s ' t e w ers' compensation laws of California,
and agree t if 13pould beco subje to or ' comp9ltsation provisions of Section
Date:N/� Applicant:
WARNING: FAILURE TO SECURE WORKE OMP ATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINA ENAL AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN AD
DITIO 0 OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR COD , TEREST, 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
2. Any permit issued as a result of this applicatio%in'
nd void if work is not commenced
within 180 days from date of issuance of sucsation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the n is gree tomply with all
city and county ordinances andtate laws relating to buildie thori representatives
of t,Vig�&unty to�fer a above-mentioned propertyur
(Applicant or Agent):
Application Number . . . . . 08-00001264
Permit . . . BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
284.50
Plan Check
Fee
184.93
Issue Date . . . .
Valuation
. . .
. 29750
Expiration Date
2/11/09
Qty Unit Charge
Per
Extension
BASE
FEE
252.00
5.00 6.5000
-----------------------------------
THOU BLDG
25,001-50,000
32.50
Permit . . . MECH POOL
Additional desc-. .
Permit Fee . . . .
37.00
Plan Check
Fee
9.25
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date . .
2/11/09
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
2.00 11.0000
----------------------------------------------------------------------------
EA MECH
FURNACE >100K
22.00
Permit . . .
ELEC POOL PERMIT
-RES
Additional desc . .
Permit Fee . . . .
75.00
Plan Check
Fee
18.75
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date
2/11/09
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
2.00 30.0000
----------------------------------------------------------------------------
EA ELEC
PRIVATE SWIMMING
POOL
60.00
Permit . . .
PLUMBING
Additional dcoc , ,
Permit Fee . . . .
72.00
Plan Check
Fee
18.75
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date . .
2/11/09
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
8.00 6.0000
EA PLB
FIXTURE
48.00
2.00 3.0000
EA PLB
WATER INST/ALT/REP
6.00
1.00 3.0000
----------------------------------------------------------------------------
EA PLB
GAS PIPE 1-4 OUTLETS
3.00
Permit . . . . . . WALL/FENCE PERMIT
LQPERMIT
i
LQPERMIT
Application Number
Permit
Additional desc .
Permit Fee . . .
Issue Date . . .
Expiration Date .
. . . . . 08-00001264
WALL/FENCE PERMIT
15.00 Plan Check Fee .
Valuation . . .
2/11/09
.00
250
Qty Unit Charge Per Extension
BASE FEE 15.00
----------------------------------------------------------------------------
Special Notes and Comments
POOL,SPA, WATER FEATURE, 2 POUNTAINC,
FIREPIT & 10 L.F. 6' BLOCK WALL, CITY
STANDARD. ALARMS/BARRIERS SHALL BE IN
PLACE AT PRE -PLASTER INSPECTION.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . HOURLY PLAN CHECK 105.00
Fee summary
-----------------
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
Charged Paid
483.50 .00
231.68 .00
105.00 .00
820.18 .00
Credited Due
.00 483.50
.00 231.68
.00 105.00
.00 820.18
Bin # City of. La Quinta
Building a Safety Division
Permit #IVA
P.O. Box 1504, 78-495 Calle Tampico
1 La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: �Q jz� Owner's Name: 21'
A. P. Number: 661 �� Address: '0 //
Legal Description: r 4��4City, ST, Zip:
Contractor: e Telephone:
Address: b--AveiE�U Project Description: vil� S
H.OA-.-Approval -
---- HOUSF--- -
Pub. Wks. Appr
School Fees
Plans resubmitted- Grading
Flij
-
— ---
Called Contact Person A.i.P.P.
Date of permit issue
Total Permit Fees
City, ST, Zip: n e t `1 LZ -361
Telephone: "I Z�Z
t` �/ Z �i! /1 / 7 r /lid
lU L F 1560 Z'(14117
LV40
State Lic. # :
City Lie. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:�j�
#Stories:
#Units:
Telephone # of Contact Person:(7 v— c27 -g Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal Req'd Rec'd TRACKING PERMIT FEES
Plan Sets Plan Check submitted?, -----,,,Item Amount
Structural Calcs. Reviewed, ready for Corrections Plan Check Deposit
Truss Cales. Called Contact Person Plan Check Balance
Energy Calcs. Plans bicked up / Construction
Flood plain plan Plans resubmitted Mechani-al
Grading plan 2" Review, ready for corrcetions/issue Electrical
Subeontactor List Called Contact Person Plumbing
H.OA-.-Approval -
---- HOUSF--- -
Pub. Wks. Appr
School Fees
Plans resubmitted- Grading
Flij
-
— ---
Called Contact Person A.i.P.P.
Date of permit issue
Total Permit Fees
r