10-1341 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 1-0-0000134i--.,
Property Address: 78375 VIA .SEVILLA
APN: 604-202-002-66 -23971
Application description: POOL - RESIDENTIAL ...
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 9500
Applicant: v Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
. LIC SED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I m licensed under provisions of Chapter 9 (commencing with -
Section 7000) of bivision,3of the Business a d Professionals Code,•andmy License is in full force and. effect.
Li ense Class: 8 29-53 License No.: 656128
Date: �Z /Xnlactor:
- -
OWNER -BUILDER DECLARATION
Lhereby affirm under penalty of perjury that 1 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).:
(_) 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, 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 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
,. r
Owner:
HARTIGAN .
78-375 VIA SEVILLA'
LA QUINTA, CA 92,253
VOICE (760) 777-7012
. FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/08/10
Contractor:
TESERRA
P.O. BOX 1280 [1M� I Nu 10
COACHELLA, CA 92236
(760) 398-9222 GlT`!.� QUINTA
Lic. ,No..: 656128 +�I�n,:,^ n;FT
------------------
WORKER'S COMPENSATION DECLARATION
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 INS Policy Number BB1100510 '
_ I certify that, in the performan a of the work for which this permit is issued, I shall not employ any
person in any manner so as o become subject to the workers' compensation laws of California,
and agree that, if I should b come V bject to the workers' compensation provisions of Section
--yC0 f the Labor Code, I s all f hwith comply with those provisions.
plicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO.CRIMINAL PENALTIES'AND 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 such permit, or cessation of woik for 180 days will subject
permit to cancellation. '
I certify that I- have read this application and state that the abov information is correct. I agree to comply with all
city and county ordinances and state laws relating to building c nstruction, and hereby authorize representatives
of this county t nt upon the above-mentioned property for ns ction purposes.
Date: 9' Si ature (Applicant or Agent): '
Application. Number. 10-00001341
Permit •POOL PERMIT .
Additional desc .
Permit Fee 117.00 Plan' Check Fee
76.05
Issue Date Valuation
9500
Expiration Date 6/06/11
Qty 'Unit Charge Per
Extension
BASE FEE
45.00
`8.00 " 9.0000 THOU. BLDG' 2'; 001-,25; 000
72.00
Permit ELEC`POOL PERMIT -RES
Additional desc .
Permit Fee . . . ..45.0.0 Plan Check Fee
11.25
Issue Date . . . . Valuation
0
Expiration Date 6/06/11
Qty Unit'Charge Per.
Extension
BASE FEE
15.00
1.00 30.0000.EA ELEC PRIVATE.SWIMMING POOL
30.00
Special Notes and Comments
POOL REMODEL - ADD RAISED BOND BEAN AND
' GUNITE.PAD FOR NEW BOULDER WATERFALL.
ALARMS/BARIERS SHALL BE IN PLACE AT
PRE-PLASTER'INSPECTION. 2007 CODES:.
-------------------_--- ---------------- -
Other Fees . . . . . BLDG STDS ADMIN (SB1473)•
1.00
Fee summary Charged Paid Credited
Due
Permit Fee Total 162.00 .00 .00
162.00
• Plan Check Total 87.30 .00 .00
8.7.30
Other.Fee Total. .1.00 .00 .00•
1.00
Grand Total 250.30 00' .00
250.30
LQPERMIT .. .. .. ..
-
Bin #
City of La Quinta
Building 8t Safety Division
P.O. Box 1504, 78-495 Calle Tamplco -
La Quinta, CA.92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address:S
Owner's Name:
HA a -t'lGA^/
A. P. Number:
Address: 8 S'F_'v t_ A -
Legal Description:
Contractor: �R
City, ST, Zip: jACqu,, j _rA 4 Z Z S 3
Telephone:
Address:
Project Description:
City, ST, Zip:
Telephon 6 p g Z Z -L
D A , E -D D c!54 M
State Lic. #.: S l Z H City Lic. #;
. D r) ...rUJ)Tr�D re New
.
Arch., Engr., Designer
UL.D6iL- '9T'Cr7'L
Address:
City., ST, Zip:
Telephone: V
State Lic. #: r
Name of Contact Person: v(A o Z .
Construction Type: E� Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:.
# Stories:
#Units:
Telephone # of Contact Person 0Co 3 /
Estimated Value of Project: Jc S o p
APPLICANT: DO NOT WRITE BELOW THIS UNE.
#
Submittal
Plan Sete
Req'd .
Rec'd
TRACKING
Plan Check submitted
PERMIT FEES
Item Amount
Structural Calcs
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Cala.
Plans picked up
Construction
Flood plain plan
+
Plans resubmitted
Mechanical
Grading plan
2`! Review, ready for correctionvissue
Electrical
Subcoutactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:
3.d Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees