08-1707 (RPL)P.
in
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: -08-00001707
Property Address:
81438 MOONSTONE CT
APN:
764-280-999-106 -300236-
Application description:
POOL - RESIDENTIAL
Property Zoning:
MEDIUM HIGH DENSITY RES
Application valuation:
17000
T414t 4 4 Q"
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
-------------------------------------------- -----
LICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) ofDivision 3 of the Business and Professionals Code, and my License is in full force and effect.
License Clas/s: ABC -8 License No.: 890415
�te: ti ractar: /�/ .-,
OWNER -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 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
Owner:
BYRON BERRY
81438 MOONSTONE COURT
LA QUINTA, CA 92253
Contractor:
CROCODILE CONSTRUCTION
53080 AVENIDA JUAREZ
LA QUINTA, CA 92253
(760)574-6357 j
Lic. No.: 890415 CT 1003
CIOF QUIN-------------------------
T,
FIN�4NC� ®l��p
WORKER'S COMPENSATION DECLARATION
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/14/08
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 EXEMPT Policy Number EXEMPT
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 that, if I should become subject to the workers' compensation provisions of Section
3700 of the Labor /Code, I shall forthwith comply with those provisions.
at, Q 4)01- scant: !�T
T
WARNING: FAI URE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,0001. 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 information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of t/his/bounty t/o enter upon th above-mentioned property for inspection purposes.
tHa e: i ! G ature (Applicant or Agent);/zz/ 'i—
Application Number .
. . . . 08-00001707
Permit . . .
ELEC POOL PERMIT -RES
Additional desc .
Permit Fee . . .
45.00 Plan Check Fee
11.25'
Issue Date
Valuation
0
Expiration Date
4/12/09
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 30.0000
-----------------------------------------------------------------------------
EA ELEC PRIVATE SWIMMING POOL
30.00
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee
180.00 Plan Check Fee
117.00
Issue Date . . . .
Valuation . . .
. 17000
Expiration Date
4/12/09
Qty Unit Charge
Per
Extension
BASE FEE
45.00
15.00 9.0000
THOU BLDG 2,001-25,000
135.00
Permit . . .
PLUMBING
Additional desc .
Permit Fee
24.00' Plan Check Fee
6.00
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
4/12/09
Qty Unit Chargee
Per
Extension
BASE FEE
15.00
1.00 6.0000
EA PLB FIXTURE
6.00
1.00 3.0000
-------------=-----------7---------------------------------------------------
EA PLB WATER INST/ALT/REP
-3.00
Special Notes and Comments
POOL. ALARMS/BARRIERS
SHALL BE IN PLACE
AT PRE -PLASTER INSPECTION. EQUIPMENT
ENCLOSURE NOT INCLUDED
Fee summary Charged Paid Credited
Due
---------------------------
Permit Fee Total
------------------------------
249.00 .00 .00
249.00
Plan Check Total
134.25 .00 .00
134.25
Grand Total
383.25 .00 .00
383.25
LQPERMIT
CITY OF LA QUINTA SUB -CONTRACTOR LIST
JOB ADDRESS_ }�1-RL4 0 tot IC..w i�. v, PERMIT NUMBER OWNER�AV4-A vdEE Tim {�(,t�I +�J BUILDER. � � (� GM S% �
This form shall be posted on the _job with the Building nlnl spection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work
on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply.will result in a stoppage of work and/or the voidance
of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response.
Trade C a sification
!
Cont ctor :.;. ::.:::.:.::::
:.:
::::>::;::::;:;•:;:> :.......:. ...:;
..:..::::..::..:::. State::Contractot.s, license.... •;.::.:.::.;:.
•.
::.: ::.:: :.W..or�ec.Corri ensat!on;Insuranoe:.': .. ;>:::: ;•:::.:
City Biisines License:
.
Company Name
Classification
(e.g. A, B, C-8)
License NumberExp.
(xxxxxx)
Date
(xx/xx/xx)
(e. . SExp.
ta�Fund,IComp)
Policy Number
(Format Varies)
Exp. Date
(xx/icx/xx1
License Number
(xxxx)
Date
(xx/xx/xx)
EARTHWORK (C712)
A �- S `
l `C7
D�1
..7
0(Q (�qd
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(S
CONCRETE (C-8)*:-
C (.
t.l
(
1 I
+4 0.
-6 l8
FRAMING .40-5) '..:;'
STRUCT. `STEEL jC-51)
MASONRY 16.29)
PLUMBING (C-36)
LATH; PLASTER jCr.35)
C-9) ..---
DRYWALL (C-9)..---
HVAC-
ELECTRICAL. (C-10)' ; .. .
ROOFING" (C=391;;
SHE . �kAETAL (043)`
GLAZING (C-17);.'
INSULATION: -(P72).'
SEWAGE DISP - (6-42)
PAINTING (C=33) -
CERAMIC TILE (C-54)
CABINETS (C-6)
31
C.lir CL l -41
LANDSCAPING
POOL (C-53)
NOV
mmaull sera _
copied ortansrel. Many*mor.mtur
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w� hatmem w} intim t firy�stto,o�b/�bdning Oxpress
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Bin#
City. of La Quinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle. Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit .# O
Project Address:'
Ooris tops C
Owner's Name: s \
A. P. Number:
Address:
Legal Description:
Contractor: �10ST . —LJ\j C ,
City, ST, Zip: A 0 A, QZZG 3
Telephone: E f "
Address: 5 Z — M � k7l .L L. M -p rL-G --,T.
Project Description:
City, ST, Zip:
Telephone: (, q S
State Lic. # City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: �J IGIL O(L
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Perso : -7 (o C ,alS
Estimated Value of Project: $11,60 C)
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 Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"d 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