08-0015 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
'08=00000015
A Property Address:
'81901 RUSTIC CANYON DR
APN:
764-280-999-53 -300237-
Application description:
POOL - RESIDENTIAL
Property Zoninq:
MEDIUM HIGH DENSTTY RES
Application valuation:
26000 ,'
Applicant: Architect or Engineer:
1-1
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: A7C-C8 License No.: 840210
A
..- ate, �� ontracidr
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 thathe 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 _ 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 ISec. 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 imp ent is sold in
one year of completion, the owner -builder will have the burden of proving that he oi id not buil
improve for the purpose of sale.). r
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to con he project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does nc p to an owner of
property who builds or improves thereon, and who contracts for the projects with a tr ctor(s) nARd 1 6 20
pursuant to the Contractors' State License Law.). l
I—) 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: -
LQPER!•11T
2.9
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/03/08
Owner:
MIKE PARSONS
81901 RUSTIC CANYON DRIVE
LA QUINTA, CA 92253
Contractor:
CROCODILE CONSTRUCTION
53080 AVENIDA JUAREZ
LA QUINTA, CA 92253
(760)570-6357
Lic. No.: 840210
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following. declarations:
Lhave'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 STATE FUND Policy Number 1828832
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, 1 shall forthwith comply with those provisions.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
100,0001. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTI 6 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPO Application is hereby made to the Director of Building and Safety for a permit subject to the
`cconditi restrictions set forth on this application. -
JMY ach person upon whose behalf this application is made, each person at whose request and for
hose benefit work is performed under or pursuant to any permit issued as a result of this application,
he owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
dTA f La Quinta, its officers, agents and employees for any act or omission related to the work being
erformed under or following issuance of this permit.
T ny 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 this unt to enter upo he above-mentioned pro rt for inspection purposes.
ate: 3 signature lApplicanror Agent !/ f/�^
7-
Application Number . . . . . 08-00000015
Permit . . . . . BLDG POOL PERMIT
_
Additional desc ".
Permit Fee . . . . 258.50 Plan Check.Fee
168.03
7
Issue Date• . . . . Valuation . .
26000
Expiration Date 7/01/08
�j
k
Qty Unit Charge Per
Extension
BASE FEE
252.00
1 . 00 F . Snnn TT-TnTT BLDG 25,001-50,000
------------------------------------------------------------------------------
G.50
Permit MECH POOL
Additional desc*.
Permit Fee . . . .• . 26.00 Plan Check Fee
6.50
Issue Date . . . . Valuation . . .
. 0
Expiration Date 7/01/08
Qty Unit Charge. Per
Extension
BASE FEE
15.00
1.00 11.0000 EA - MECH FURNACE,1>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 7/01/08
_
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 7/01/08
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
3.00
1.00 3.0000 EA' PLB GAS PIPE 1 -4 -OUTLETS
------------------------------------------------------
3-.00
-----------------------
Special Notes and Comments
POOL/SPA. ALARMS/BARRIERS SHALL BE IN_"
LQPMIIT
Application Number . . . . 08-00000.015
--------------------------------------------------------------
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED '
Fee summary Charged Paid Credited Due
Permit Fee Total 362.50 .00 .00 362.50
Plan Check Total 194.03 00" .00 194.03
Grand Total 556.53 .00 .00 556.53
•i
1
.11 It.
Bill #
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 # ,�•
(�
Project Address: 9/_901 —901 tC AJ
Owner's Name: YS Al S
A. P. Number:
Address:
Legal Description:
Contractor: cmeovde ", t.G_�
City, ST; Zip: ,
Telephone:
Project Description:
Address: ^ 1 1(Ve- J
City; ST, Zip:
OdL
Telephone:
State Lic. # : �.
City Lic: #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person: .�✓1A v�
Construction Type: Occupancy:
Project type (circle one): New . Add'n Alter Repair Demo
Sq. Ft::
# Stories:
# Units:
Telephone # of Contact Person: 6 fy S-1
Estimated Value of Project:
APPLICANT:
DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACIQNG .
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
V Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing n
Grant Deed
Plans picked up
S:M.I.
H.O.A. Approval.
Plans resubmitted
Grading
IN HOUSE:-
1rd Review, ready for correctionslissue
Developer Inpact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr. .
Date of permit issue
School Fees
Total PermitFees