07-2815 (RPL)r r•
P.O. BOX. 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:_
07-0000.2815
81793 RUSTIC CANYON DR
764-280-999-44 -300237-
POOL - RESIDENTIAL
MEDIUM HIGH DENSITY RES
14000
Architect or Engineer:
M
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760),777-7153
Date: 10/24/07
Owner:
KEVIN & MONICA WZGNER
81793 RUSTIC CANYON DRIVE
LA QUINTA, CA 92253
Contractor: D
CROCODILE CONSTRUCTION OCT 24 2007
50660 EISENHOWER DR, # 4
LA QUINTA, CA 92253
(760) 360-5895 CITY OF LA QUINTA
Lic.. No.: 840210 GiNeNCEDEPT.
LICE ED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION '
I hereby affirm under penalty of perjury that I licensed under visions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:,
. Section 7000) of Division 3 of the Busy ss a fes
ionals od an my License is in full force and effect.
_ I have and will•maintain a certificate of consent to self -insure for workers' compensation, as provided.
license Class: A -C -C8.
Li rise 840210
for by Section 3706 of the Labor Code, for the performance of the work for which this permit is
�issued..
�t��,9�
.
ate: jj1l�
adff[ractor:
1;,e
R 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
V OWNER-BUILDE RATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier STATE FUND Policy Number 1828832
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance of a work for w is permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
'
person in any manner so as to b c me compensation laws of California,
permit to file a signed statement that he or she is Licensed pursuant to the provisions of the Contractor's State
and agree that, if I sh Id beco ubj compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
Mt7thkers'
700 of the Lab d , shall fo hwise provisions.
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).:
ate: icant:
( 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structureis not intended or offered for sale (Sec. 7044, Business and Professions Code: The
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION V RAGE 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 ($100,000). 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
(_ 1 1, 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 the projects with a contracfor(s) licensed
1 . Each person upon 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 anypermitissued as a result of this application,
(_ 1 I am exempt under Sec. , BAP.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 bein
Date:
Owner:
CONSTRUCTION LENDING AGENCY
1 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: A
Lender's Address: 1/ ,
LQPERMIT
9
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 bove i ormation is cc ec . 1 agree to comply with all
city and'county ordinances and state laws relating to buil g co uctio .and h reb thorize representatives
of this coif Y oo enter upon the above-mentioned p ori echo rpos
ate: �L Y ture (Applicant or Age t):
I
LQPERA11T
Application Number
07-00002815
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit Fee
153.00 Plan Check
Fee
99.45
Issue Date
Valuation
14000
Expiration Date
4/21/08
Qty Unit Charge
Per
Extension
BASE FEE
45.00
12,00 9.0000
-------------------------------
THOU RTT)h12,001-25,nnn
--------------------------------=
inR nn
------------
Permit
MECH POOL
Additional desc .
Permit Fee
26.00 Plan -Check
Fee
6.50
Issue Date
Valuation
0
Expiration Date..
4/21/08
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 . .'. .
45.00 Plan Check
Fee,
11.25
Issue Date
Valuation
0
Expiration Date
.4/21/08'
,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 . . . .
27.00 Plan Check
Fee
6.75
Issue Date
Valuation
. . . .
0
Expiration Date
4/21/08
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 6.0000
.EA PLB FIXTURE
6.00
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
SPA. ALARMS/BARRIERS
SHALL BE IN PLACE
Sin #
Ci of La '
City Qu►nta
Building u Safety Division
Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #P.O.
P1 PS 1
0""
Project Address: 121 —7 3 FuS-fl-( eA
Owner's Name: yn u
A. P. Number:
Address:C
N
Legal Description:
City, ST, Zip:
Contractor: ch/igl-Tom:
Address: .-.r e
Project Description:
ip:
City, ST, Z62
`
A
Telephone: .?6(i _ 2 S— o
NO=
State Lic. # : If
City Lic.
•
Arch., Engr., Designer:
Address:
City,'ST, Zip:
Telephone:
State Lic. #:
Construction Type: Occupancy:
P cY:
Project type (circle one): New. Add'n Alter Repair Demo
Name of Contact Person:
s
Sq. Ft.:
�T O .
# Stories: ,.
#Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPUCANT:
DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd :.
RWd
TRACIMG
PERMIT FEES
Plan Sets
Plan Check submitted',
10.
(�
Item
Amount
Structural Cities.
Reviewed, ready foctt�,'0 ections
; �
Plan Check De Posit
Truss Cities.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans Picked up
Construction
Flood plain pian
Plans resubmitted
Mechanical
Grading, plau'
2" Review, ready for correctionstissue
Electrical
Subcoutactor 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. correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue .
School Fees
Total PermitFees
iN Qlt
0 ;,. ��' O
O
• • t o
•
4
09 �0��2
o 'AOS
Cj
Chuck Cooper
Environmental'Planning + Design
81720 Daniel Drive 1a Quinta CA 92253
R.
..
a0sLANDSCAPE PLAN + DESIGN
alShuckCgoper EnWFonmentaYDeelgnl CC-� d° KEVIN & MONICA WEGNER
ED reserves all Aghts in antl to�fhle landscape + fi, �' •.� v'
plan andtl6elgn The plan eneiAeefgntare RjLOGY- LOT 44 (7044) ..
De reproduced changed copied or tranefeiraA In
ELC any loan oPmanner whatsoever, Without flrai s� Y� 81793 FUSTIC CANYON DR.
:= .the esprese wAttempermfssion ot'CC-
OCT 19,2007
ey