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05-2602 (RPL)P.O. BOX 1504 • ���ININ� 78-495 CALLE TAMPICO 4 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: L05--00002602\ 78055 RED HAWK LN 658-140-999-25 -29436 POOL - RESIDENTIAL LOW DENSITY RESIDENTIAL 35000 Architect or Engineer: t1ull-) ------------------ LICENSED CONTRACTOR'S DECLARATION VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: STOLLE 78-055 RED HAWK LANE n LA QUINTA, CA 92253 SEP 2 9 2005 Contractor: CROCODILE CONSTRUCTION CV pp LA QUINTA WCC: STATE FUND FINANCE DEPT. WC: 1795231-2005 09/01/06 CSLB; 840210 06/30/06 I hereby affirm under penalty of perjury that I am nsed under pr i ions of Chapter 9 (commencing with Section 7000) of Division 3 of the Busine and roe Is Cod , a d my License is in full force and effect. License Class: icen Date: Contractor: O ER -BUILDER D LA TION I hereby affirm under penalty of perjury that I am exempt from the Co a or 's State License Law for the following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires apermit 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, 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 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: LQPERMIT Date: 9/29/05 ----------------------------------------------- WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ['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 A Poli umber ---- -- - - - - -- I certify that, in the perfor ce of th w k for 'ch this()- person issued, I shall not employ any in any manner as bec ubje t the wopensation laws of California, and agree that, if I s Id be me ub' ct to he orkersnation provisions of Section 700 of the Labor Co I sh Ifo ith co pl with thisions. We- / Applicant. WARNIN F LURE TO SECURE WORKERS' OMP SATION VERA E IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENA IES AND CIVIL FINES UP ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE OST 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 hol armless the City of La Quinta, its officers, agents and employees for any a or omission related o the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application become nul and of ipthhg ommenced within 180 days from date of issuance of su rmit, r ce sati n days will subject permit to cancellation. I certify that I have read this application and state that ov inf rma ion i c rcomply with all city and c unty ordinances and state laws relating to buil in o sti cti , an R eepresentatives of this c my o 'a, upon the above-mentioned prope n e io purp Dat Signature (Applicant or Agent): Application Number . . . . . 05-00002602 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 317.00 Plan Check Fee 206.05 Issue Date . . . . Valuation . . . . 35000 Expiration Date 12/24/05 Qty Unit Charge Per Extension BASE FEE 252.00 10.00 ---------------------------------------------------------------------------- 6.5000 THOU BLDG 25,001-50,000 65.00 Permit . . . MECH POOL Additional desc . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 12/24/05 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 ----------7----------------------------------------------------------------- 11.0000 EA MECH FURNACE >100K 11.00 Permit . . . ELEC POOL PERMIT -RES Additional desc . . Permit Fee . . . . 45.00 Plan Check Fee 11.25 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 12/24/05 Qty Unit Charge Per Extension 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 . . 12/24/05 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 ---------------------------------------------------------------------------- Special Notes and Comments POOL & SPA ONLY. ALARMS/BARRIERS SHALL LQPERMIT Application Number . . . . . 05-00002602 ; ---------------------------------------------------------------------------- Special Notes and Comments BE IN PLACE PRIOR TO PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT. Fee summary Charged Paid ------------------------------------- Credited Due Permit Fee Total 421.00 .00 -------------------- .00 421.00 Plan Check Total 232.05 .00 .00 232.05 Grand Total 653.05 .00 .00 653.05 LQPERMIT # Permit # 0.5 0.� Project Address: A. P. Number: . .Legal Description: Contractor: Coc� t Address: Ll Cit)', ST, -.Zip: Telephone:-—� o State Lic. # :'940 a.1© Arch., Engr., Designer: . ---------------- Address: City, ST, Zip:. Telephone: State Lic. #• Name of Contact Person: Telephone # of Contact Person: # Submittal Req Plan Sets Structural Calcs. Truss Calcs. Title 24 Calcs: Flood plain plan Grading plan Subcontactor List Grant Deed H.O.A. Approval IN HOUSE: - Planning Approval Pub. Wks. Appr School Fees t City of Ia. Qulnta Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet bot Owner's Name: I I Address: V _rni 2 T� City, ST, Zip: `S t Telephone: `---T 642 S Project Description: t � Lic. #: 1 f LN n Total Permit Fees Con s truct ' ton Type: Oec u p a n c• . Pr •. • e J 0 circle ct type ( one):. NewAdd'n Alter -Repair Demo Sq. Ft.: # Stories: # Units:. Estimated Value of Project: d C> 0 `D APPLICANT: DO NOT WRITE BELOW THIS LINE d Rec'd TRACKING PERMIT FEES Plan Check submitted �O/ A Item Amount Reviewed, ready for corrections Plan Check Deposit .Called Contact Person Plan Check Balance Plans picked up Construction Plans resubmitted . NLechanical 2" Review, ready for corrections/issue Electrical Called Contact Person Plunibink Plans picked up 5.N1.[. Plans resubmitted Grading '°° Review, ready for corrections/issue . Developer Impact Fee Called Contact Person A.I.P.P. Date of permit issue Total Permit Fees