11-0943 (RPL)Tiht 4.4 Q"
P.O. BOX 1504VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 77777153
BUILDING PERMIT,
_ Date: 8
Application Number: - 11-00000943 Owner:
Property Address: `57371 VIA VISTA FELD.
APN: 762-240-003-26 300962 57371 VIA VISTA
Application description: POOL.- RES'IDENTIAL LA QUINTA, CA 92253
Property Zoning: MEDIUM DENSITY RES
Application valuation: 14.000
Contractor:
Applicant: Architect or Engineer: TESERRA
P.O. BOX 1280
LA, CA 92236 .
`COACHEL D
• 9222
Lic.`No
. (760)398
-
• -656128
��. 0
• 2.2011:
------ ----- ----- --- --------7- --- -- --- --- ---- =-----'-----CITYff QUINTA
LICENSED CONTRACTOR'SMECLARATION WORKER'S'COMPENSATION D LARATION FiNA�;CE [?FPT
I hereby affirm under penalty of perjury t t I am licensed under provisions of Chapter (commencing with . I hereby affirm under penalty of perjury one of the following declarations: -
Section 7000) of Divi ion 3 of the Busine and Professionals Code, and. my License is in full force and effect. I have and will maintairi-a certificate of consent to self•insure for workers' compensation, has provdd
License Class: C84'10, 27,2 _ _ License No.: 655128 ". - _ `, - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is -
- issued..
ate:4gontractor. • - - I have and will maintain workers', compensation insurance, asrequiredby Section 3700 of the Labor. '
• - Code, for the performance of the Work for which this permit is issued. My, workers' compensation
_
OWNER-BUILDER DECLARATION - insurances carrier and policy number are::
I hereby affirmunderpenalty of perjury that I am exempt fromtheContractor's State License Law for the _ Carrier EVEREST' NATL INS: - Policy Number . 7600006481111 "
-following reason (Sec. 7031.5:: Business and Professions Code: Any city or county"that requires a permit to _.1 certify that, in the performance of the work for which this permit is issued, I shall not employ any., _
i construct, alter, improve, demolish, or-repair any structure, prior to its issuance,. also requires the applicant forthe `t• - person in any manner, sous to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed-pursuant, to theprovisionsof the Contractor's'State '- .: - ', - and gree that, if I should. atone subject_ to the workers' compensation provisions of Section
-.' License Law:(Chapter 9 (comniencing with Section 70001 of Division of'the Business and Professions Code) or, ";< - - - 3 0 of the bor Code, l ha orthwith comply with those provisions.
PY -
• that he or she is exempt therefrorn'and the basis for the alleged exemption. Any violation of Section 7031.5 by'"any applicant for a permit subjects the applicantto a civil penalty of not more than five hundred dollars (55001::: te:/ icant:
O.I; as owner of the
property, .or-my`employees with-wagesas their sole compensation, will do the work, and
the structure is not intended or.offered for sale (Sec. 7044, Business.and Professions Code: The ,. WAR IN FAI URE. 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 ($100,0001. 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.). APPLICANT ACKNOWLEDGEMENT
I, as owner of the property, am exclusively contracting with licensed-contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the - _ -
• 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application: -
property who builds or improves thereon, and who contracts for projects witha'contractorlsl licensed 1. Each'personupon whose behalf this application is made, each person at whose request and for. ..
' . pursuant to the Contractors'' State License Law.). - •- - whose benefit work is. performed under or pursuant to any permit issued as a result of this application,
(. 1 I am exempt under Sec. B.&P.C. for this reason - _ 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. - -
Date: Owner. - 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 -
CONSTRUCTION LENDING AGENCY - permit to cancellation. -
1 hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the • I certify that I have read this application and state that the ab ve information is correct. 1 agree to comply with all -
work -for which this permit is issued'(Sec. 3097, Civ. C.). .. city and county ordinances and state laws relating to buildin on ction, and hereby authorize representatives _
- - _ - - of .this county a er upon the above-mentioned property f i pection purposes. , - -
Lender's Name:
�ure (Applicant or Agent): •
-Lender's Address: '
Application Number . . . 11-00000943
Permit . . . BLDG POOL PERMIT'
• Additional desc .
Permit Fee 153.00 Plan Check
Fee
99.45
Issue'Date . . . . Valuation
14000 .,
• Expiration Date 2/27/12
?.
Qty Unit Charge Per
Extension
BASE . FEE
45 :.00
12..00 9.0000 THOU BLDG 2,001-25,000108.00.'
Permit MECH POOL
_
Additional desc
Permit Fee . . 2.6.00. Plan Check
Fee
6.50
Issue.Date Valuation
0
Expiration -Date 2/27/12
Qty .. Unit Charge Per
Extension'.
BASE FEE -
15.00
1.00. 11.0000 EA MECH'FURNACE >100K
11.00
Permits ..'.ELEC POOL PERMIT -RES
Additional desc
Permit Fee 45. 00' Plana Check
Fee..,_
11 .25 .J
Issue Date• Valuation
= Expiration.Date'2/27/12
Qty Unit Charge Per. _
Extension.'.
BASE FEE ,'
:.
15.00 ,
1.00 30.0000 EA `" ELEC'PRIVATE ,SWIMMING
POOL
30.00
:. Permit PLUMBING>
t
Additional desc '.
•
Permit Fee 27:00 Plan Check
Fee
6.75
Issue Date Valuation
0
Expration_Date2/27/12 '
Qty Unit Charge Per''
Extension.
BASE FEE
15.00 .. '
1.00 6.0000 EA PLB FIXTURE6A0•
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
SPA ONLY. ALARMS/BARRIERS SHALL BE IN-•
LQPERMIT
-
Application Number 11-00000943
-----Special
Notes and Comments
PLACE .AT PRE -PLASTER INSPECTION.
•
EQUIPMENT ENCLOSURE NOT INCLUDED. 2010
c
,
'
CODES.
---------------------------------------------
• -
Other Fees . . . . . BLDG STDS ADMIN
(SB1473)
1.'00
Fee summary .- Charged Paid Credited
Due
i
----------------- -----------------------------
'Permit Fee Total-. 251.00 .00
----------
.00
251.00'
Plan Check Total 123.95•- .00
.00
123.95
Other Fee Total 1.00 •.00
.00
1.00
Grand Total 375.95 .00
.00
375.95• {
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LQPERMIT
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City ot. LaQuinta.
Building & Safety. Division
Permit # P.O. Box .1504, 78-495 Calle Tampico -
La Quinta, CA 92253 - (760) 777-7012.
Building Permit Application and Tracking Sheet
Project Address: S 3Owner's Name:
A. P. Number:
Address:
S
Legal Description:
City, ST, Zip; L-& 0 U ^rFA C -A, 9ZZ 5 3
Contractor:7ESC__kR'_�A
Telephone: MIMAM �'M- ='*�'.
M
Address: PC, /20 4-7
Project Description:
City, ST, Zip:
Telephone: 0 3 7 8
M..
City Lic.
State Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic-
..... . . . . . . . . .....
^
Construction Type: Occupancy:
Project type (circle one) Add'n Alter Repair Demo
Name ofContact Person:
C_ z
Sq. FL:
# Stories: # Units:
Telephone # of Contact Person:
0 2_�� C) Z-73 Aq Estimated Value of Project: 0 0 0
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec"d
'TRACKING PERMIT FEES
Platt Sets
Plan Check submitted I It. Amount
Structural CaIcs.
Reviewed, ready for corrections Plan Check Deposit
Truss Cates.
Called Contact Person Plan Check Balance
Title 24 Cales.
Plans picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
Review, ready for corrections/issue Electrical
Subcontactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval
Plans resubmitted- Grading
IN HOUSE:-
Review, ready for corrections/issue Developer Impact Fee
Planning Approval
Called Contact Person A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees