08-0377 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINT'A, CALIFORNIA 92253. BUILDING & SAFETY DEPARTMENT..
BUILDING PERMIT
VOICE (760) 777=7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/03/08
Application Number: '-08-00000377 Owner:
Property Address: 81868 RUSTIC CANYON DR. DAN & NICOLE OHANIAN
AP.N: 764-280-999-73 -300237- 81868 RUSTIC CANYON DRIVE
Application description: POOL - RESIDENTIAL SCOTTSDALE, AZ 85258
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 28000
Contractor:
Applicant: Architect or Engineer:, . ' CROCODILE CONSTRUCTION o
53080 AVENIDA JUAREZ p
LA QUINTA, CA 92253 n
^ (.760)570-6357D n}� iz eM
LiC. No.: 840210 10 O
f" QUIP1'f A
CI FNA.NCE DEpT'
-----——----————-
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENS ION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under,provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals Code, and 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 License No.: 840210 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
� iy �+� � issued.
e: 3 U`� i edi racwr: /r d� �ry 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
OWNER -BUILDER DECLARATION 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 ISec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to_ I certify that, in the performance of the work for which this 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 become subject to the workers' 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 should become subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions Code) or 3700 of the L or Code, I shall forthwith comply with those 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 (55001.: ate: plicant: / ��z
I _ 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 WARNING: FAILURE 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 ($100,000). 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
(_) 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 the projects with a contractor(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 any permit issued as a result of this application,_
(_) 1 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.
I 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 above information is correct. I 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 building construction, and hereby authorize representatives
- of this aunty to enter upon the above-mentioned property for inspection purposes.
lender's Name:
tet 4ignature (Applicant or Agent):
Lender's Address:
LQPERMIT
`:, ;;: Application Number .
. . . . 08-00000377
'.•Permit- . . .
BLDG POOL PERMIT
Additional desc .
Permi-t. Fee:
271:50 Plan Check
Fee
176.48
- Issue Date :
'Valuation
. .
28000
Expiration Date
8/30/08
Qty Unit Charge
Per.
Extension
BASE FEE
252.00
3_00 ,.� 6 . 5nnn
------------------------------------------------------------------------------
THOTT TiTd1f; 2S; nni -sn, nnn
_ _19.50. .
Permit
MECH POOL
Additional desc .
Permit -Fee'
26.00 Plan Check
Fee..
6.50
Issue.Date
Valuation
. . .
. 0
Expiration Date
8/30/08
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
8/30/08
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
33.00 Plan Check
Fee
8.25
" Issue Date . .
Valuation
0
Expiration Date
8/36/08
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'A0
1.00 3.0000
EA PLB GAS PIPE -1-4 OUTLETS
3.00
Special,Notes and Comments
POOL/SPA. ALARMS/BARRIERS
SHALL BE IN '
LQPERMIT
Application Number . . . . 08-00000377
-----------------------------------------
-Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
Fee summary. Charged Paid Credited Due
-- --- -- ---- - ----------
Permit Fee Total 375.50 .00 .00 375.50
Plan Check Total 202.48 .00 .00 202.48
Grand Total 577.98 nn _nn 577-,gg
Bin#
City of La Quino.
Building & Safety Division
P.Q. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253- (760) 777-7012
(PQj Building Permit Application and Tracking Sheet
Permit # (`
Project Address: ..g V
Owner's Name: ,
A. P. Number:
Address:, _ S P ,
C4 Ajun,.l
Legal Description:
City, ST; Zip: R W fi , 10 6 le
Contractor: y C.0 L R w
Telephone:
Address: _ 0'96• Ar Z
Project Description:
City, ST, Zip: L 4. CA 2 2
Telephone: 760 (�/- cjSO 3 afi
State Lic. # : p.0 City Lic: #:
Arch., 'Engr., Designer:
-
Address:
City, ST, Zip:
`
Telephone:
State Lic. #:
Name of Contact Person: 2Z OZ
Construction Type: Occupancy:
Project.type (circle one): New . Add'h Alter Repair Demo
Sq. Ft:: #Stories: #Units:
Telephone # of Contact Person:
Estimated Value of Project: O v�"
APPLICANT:
DO NOT WRITE BELOW THIS LINE 4
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
aftern
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan CheckBalance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical!
Grading plan
2" Review, ready for correcti sfissue
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 Lnpact Fee '
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
J
Total Perm& Fees
..o .ar•ww.w; cnangeo, copba•or [renaterred In
any (ornl•or rnahnef Whgtapeyer without flfat
otitalning the express, written perrhisslon of CC-
r
OF LA QUINTA
G & SAFETYbEPT.
PROVED
FOR CONSTRUCTION
DATF3- 5C'6 BY ---PT-