09-0913 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO.
LA QUINTA, CALIFORNIA 92253
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BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:- 09=00000913 _
Property Address: 53620 -VIA STRADA
APN: 772-540-047- -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 45000.
Applicant:i Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of sines nd P essionals Code, and my License is in full force and effect.
License Class: A' B C27, 1 Al I License No.: 133947
ate: ontr tor: _-
WNER UILDER DECLARATION
I hereby affirm under penalty of p t at I a t 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 sale 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.).
(_ I 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. , 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:
VOICE (760) 777-7012
FAX (760) 777-7011.
INSPECTIONS (760) 777-7153
Date: 8/27/09
Owner:
TIM & KATHY STATTON
53-620 VIA STRADA Fro
LA QUINTA, CA 92253
Aub
Contractor:
VALLEYCREST LANDS API
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24151 VENTURA BL af)?0,
:l'+�,{,l nor y tFS�/': 1�;7•
CALABASAS, CA 91302 ✓,.;,.
(818)223-8500�r A
LiC.-No.: 133947
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
sad.
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 ACE AMERICAN Policy Number WLRC45554028
_ 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 become subject to the workers' compensation laws of California,
and agree th i hould come ject to the workers' compensation provisions of Section
3700 of t Labor ode, t ith comply with those provisions.
/Date: pp icant: Al ..
WARNI G AILURE TO S€CURE W 'COM NSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER T CRIM AL PE AL SAND CIVILFINES UP TO ONE HUNDRED THOUSAND '
DOLLARS ($100,000)" IN AD N 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 t e above i formation is correct. I agree to comply with all
city and county ordinances and state laws relating t uil g c s uction, moPereby authorize representatives
ofthi ounty o enter up the above-mentioned apart to ins ec purposes.
ate: ignature (Applicant or
LQPERMIT _�
Application Number .
. . . . 09-00000913
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
382.00 Plan Check
Fee
248.30
Issue Date . . . .
Valuation
. .
45000
Expiration Date
2/23/10
Qty Unit Charge
Per -
Extension
BASE FEE
252.00
20.00 6.5000
----------------------------------------------------------------------------
THOU BLDG 25,001-50,000
130.00
Permit . .. .
MECH POOL
Additional desc .
Permit Fee
26.00 Plan Check
Fee
6.50
Issue Date
Valuation
. .
. 0
Expiration Date
2/23/10
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 . . . .
45.00Plan Check
Fee
-11.25
Issue Date . . .
Valuation
0
Expiration Date..
2/23/10
Qty Unit Charge
Per
Extension
Y
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
2/23/10
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
Permit . . . . . .
WALL/FENCE PERMIT
LQPERMIT
Application Number . . . . . 09-00000913
Permit. . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 15.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
. . .
. 400
Expiration Date 2/23/10
Qty Unit Charge Per
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes and Comments
POOL/SPA, 16 L.F. 6' EQUIPMENT
ENCLOSURE, CITY STANDARD, GAS & ELECTRIC
LINES TO BBQ & FIREPIT. ALARMS/BARRIERS
SHALL BE IN PLACE AT PRE -PLASTER
INSPECTION. 2007 CODES.
Other Fees . . . . . .'. . . BLDG STDS ADMIN (SB1473)
2.00
Fee summary Charged Paid Credited
Due
Permit Fee Total 501.00 .00
.00
501.00
Plan Check Total 274.30 .00
.00 r
274.30
Other Fee Total 2:00 .00
.00
2.00
Grand. Total 777.30 .00
.00
777.30
LQPERMIT
City of La Quinta
Building 8i Safety Division
Permit #
P.O. Box 1504, 78-495 Calle Tampico
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La Quinta, CA 92253 - (760) 777-7012 '
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Building Permit Application and Tracking Sheet
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State Lic. #:
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Arch., Engr., Designer:
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Address:Fe
City., ST, Zip: S.
Telephone:
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:?{ Y Construction Type: Occupancy:
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State Lic. #: Z
:v r"` Pro'ect type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person:_
_ ( Estimated ValxWof Project: ff
APPLICANT: DO NOT WRITE. BELOW THIS LINE
q
Submittal
Req'd
Recd
TRACIMG 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
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up.
S.M.I.
H.b.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''" Review,.ready for correctionsfissue
Developer Impact Fee
Planning Approval
Caped Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees