08-1277 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
1
Application Number: X08-00001277 _
Property Address: 61437 SAPPHIRE LN
APN: 764-280-999-103 -300236-
Application description: POOL - RESIDENTIAL
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 12500
T '40
4t�p 4
Architect or Engineer:
aim
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 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 _ 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 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: I P4
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/28'/08
Owner:
HARVEY & JUDY GEDDES
61437 SAPPHIRE LANE
LA QUINTA, CA 92253 `D
e 4 Q
Contractor: AV
n
CROCODILE CONSTRU I NC `' �110pg
53080 AVENIDA JU EZ CITY
LA QUINTA, CA 92253 F gOFLA
AulA T
(760)574-63S7
CF���T
LiC. No.: 890415 .
------------------
WORKER'S COMPENSATION DECLARATION
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
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 EXEMPT Policy Number EXEMPT
I 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, I shall forthwith comply with those provisions.
o�6 �0/�,/
cant: cif
WARNING: FAI RE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,0001. 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 work 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 relating to building construction, and hereby authorize representatives
of thzl
is cou y to en r upon the above --/mentioned prop rty for inspection purposes.
Pere: i% G (j0 ,� lure (AppligCiJtt or Agent)'
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: A13C-8
LicenseNo.: 890415
�O
tractor:
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 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 _ 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 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: I P4
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/28'/08
Owner:
HARVEY & JUDY GEDDES
61437 SAPPHIRE LANE
LA QUINTA, CA 92253 `D
e 4 Q
Contractor: AV
n
CROCODILE CONSTRU I NC `' �110pg
53080 AVENIDA JU EZ CITY
LA QUINTA, CA 92253 F gOFLA
AulA T
(760)574-63S7
CF���T
LiC. No.: 890415 .
------------------
WORKER'S COMPENSATION DECLARATION
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
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 EXEMPT Policy Number EXEMPT
I 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, I shall forthwith comply with those provisions.
o�6 �0/�,/
cant: cif
WARNING: FAI RE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,0001. 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 work 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 relating to building construction, and hereby authorize representatives
of thzl
is cou y to en r upon the above --/mentioned prop rty for inspection purposes.
Pere: i% G (j0 ,� lure (AppligCiJtt or Agent)'
Application Number . . . 08-00001277
Permit . . ..
BLDG POOL PERMIT
Additional desc .
Permit Fee
144.00 Plan Check Fee
93.60
Issue Date . .
Valuation
12500
Expiration Date
1/24/09
Qty Unit Charge
Per
Extension
BASE FEE
45.00
11.00 9.0000
------------------------------------------
THOU BLDG 2,001-25,000
----------------------------------
99.00
Permit . . .
MECH POOL
Additional desc .
Permit Fee . . . .
26.00 P1an.Check Fee
6.50
Issue Date . . . .
Valuation
0
Expiration Date
1/24/09
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
1/24/09
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 . .
1/24/09
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
LQPERMIT
Application Number . . . . 08-00001277
Special Notes and Comments
AT PRE -PLASTER INSPECTION.. EQUIPMENT
ENCLOSURE NOT INCLUDED.
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 242.00 .00 .00 242.00
Plan Check Total 118.10 .00 .00 118.10
Grand Total 360.10 .00 .00 360.10
LQPERMIT
Bin #
City .of La `Quints f
` Building 8L Safety Division
P.O. Box
1504, 78-495 Calle Tampico La Quinta, CA 92253- = (760) 777-7012
Building Permit Application and Tracking Sheet
Permit .#
11
0'
Project Address:'���
Owner's Name:
A. P. Number:
Address: _
Legal Description:
City, ST, Zip: k U IN . C.A.
Contractor: C
Address: • Z - j o sI-
Telephone:
Project Description:
City, ST, Zip:
S iPr
Telephon , d
1
State Lic. #
City Lic. #:
Arch., Engr., Designer:.
Address:
'City, ST, Zip:
Telephone: IniffsMConstiLiotion
State Lic. #:
Name of Contact Person:
Type: Occupancy:
Project type (circle one): New Add'n_ Alter Repair Dem_ o
Sq. Ft..: Stories: #Units:
Telephone # of Contact Perso (
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE ~
#
Submittal
Req'd -
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submittedItem
Amount
Structural Calcs.
Reviewed, ready for corrections,
Plan Check Deposit
Truss Calcs.
Called Contact Person "
Plan Check'Balanee
Energy Calcs.
Plans picked up ,:'. `
Construction
Flood plain plan
Plans resubmitted +
Mechanical
*.
Grading plan'
2." Review, ready for corrections/issue', ••
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 Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue t �.
School Fees
i
,. _ d -
Total Permit Fees
CITY OF LA QUINTA SUB-CONTRACTOR LIST
(� T
JOB ADDRESS I LA cS — % PERMIT NUMBER OWNER �f ''� BUILDER. S
This form shall be posted on the job with the Build no Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work
on this job. Any-changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply.will result in a stoppage of work and/or the voidance
of building permit. For each applicable trade, ail information requested below must be completed by applicant. "On File" is not an acceptable response.
catio
Trade (Classdi n
Cont ractor,
late. ::.:::>
t te..Contracto�.s. L�certse .. ;..... :.:.:..
::`° :.' Workeis.Com erlsation;Irisurance:' :' " ::...:::;:.::
p.
Cit .. Biisrje s Ut ens•-
Y
Company Name
Classification
(e.g. A, B, C-8)
License Number
(xxxxxx)
Exp. Date
(xx/xx/xx)
(e. .State Fund, IComp)
Policy Number
(Format Varies)
Exp. Date
(xx/xx/xx)
License Number
(xxxx)
Exp. Date
(xx/xx/xx)
EARTHWORK (C712)STATE.
FU rel D-13002
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CONCRETE :
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FRAMING
STRUCT.'STEEL (C-51)
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C -�/—D
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111
MASONRY (C-29) `
PLUMBING (C-36)
(ATH; PLASTER (C=35)
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L (
L (_
L 1
DRYWALL (C-9)..-.' :
HVAC. (C-20p.:.::::<.::>
ELECTRICAL. (C-10) :... ,
ROOFING'
SHED METAL (C43)
INSULATION' (C-2)::
•
SEWAGE DISP (0-421'
PAINTING (C=33)
CERAMIC TILE (C-54)
CABINETS (C-6)
FENCING (C-13) ' ' . • :.
t { l(. w/
Q t7 7
4 cYJ'O2
LANDSCAPING (C=27.).'.:.°°:
POOL (C-53)