05-1866 (RPL)P.O. BO)( 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
L05-_000_01866.
Property Address:
48000 BIG HORN DR
APN:
658-140-999-21 -29436 -
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW' DENSITY RESIDENTIAL
Application valuation:
19000
Tiht 4 4 Q"
Applicant: mr—&—L—ant hitect
or Engineer:
MAY 2 5 2005
CITY OF LA QUINTA
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
ection 7000) of D�ivisinfthe Business and Professionals Code,and Licens is i full fore and effect.
/License Class: % License N .
atontractor.
OWNER -BUILDER DECLARATI
I hereby affirm under penalty of perjury that I am exempt from the Contractor's a cense 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 1$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 (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 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.).
I_ 1 I am exempt under Sec. , B.&P.C. for this reason
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: _
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/23/05
Owner:
BUONO, JR. GEORGE
48-000 BIG HORN DRIVE
LA QUINTA, CA 92253
Contractor:
CROCODILE CONSTRUCTION
WCC: STATE FUND
WC: 1795231 09/01/05
CSLB: 840210 06/30/06
----------------------------------------------—
WORKER'S COMPENSATION DECLARATION
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
TTX`/ issued.
X I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for th performance of the work for which this permit is issued. My workers' compensation
arrier I sur ce c rri ran cy nunber are:
147 -Policy Number
-' I cbrfifythff, 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
370Vo 4he Labor Code. all forthwith comply with tho a ions.
Date!F� Applicant
WARNING: FAILURE TO SECURE WORK' ' COMPENSATION COVERAGE IS UNL FUL, NO SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE ND THOUSAND
DOLLARS ($100,000). 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 wo `k 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 relatinAbuill onstruction, andhereby authorize representatives
of thiiss/coynty to enter upon the above-mentionedn pec ion purpDate: ��_OSi nature (Applicant or Age
Application Number 05-00001866
Permit . . .
BLDG POOL PERMIT
Additional desc .
Permit'Fee . . . .
198.00 Plan Check Fee
128.70
Issue Date . . . .
Valuation . . .
. 19000
Expiration Date
11/12/05
Qty Unit Charge
Per
Extension
BASE FEE
45.00
17.00 9.0000
----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
153.00
Permit . . .
MECH POOL
Additional desc .
Permit Fee . . . .
26.00 Plan Check Fee
6.50
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
11/12/05
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
11/12/05
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
11/12/05
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
LQPERMYr
Application Number . . . . . 05-00001866
----------------------------------------------------------------------------
Special Notes and Comments
BE IN PLACE PRIOR TO PRE -PLASTER
INSPECTION. EQUIPMENTE ENCLOSURE NOT
INCLUDED IN PERMIT.
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 302.00 .00 .00 302.00
Plan Check Total 154.70 .00 .00 154.70
Grand Total 456.70 .00 .00 456.70
LQPERMIT
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