07-2600 (RPL)P.O. BOX 1504.
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: ll�—_0'_7=0A 0 600 -
Property Address: 6•]'63.5=TUI.P:RE LN
APN: 764-280-999.-92 -300237-
Application description: POOL - RESIDENTIAL
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 15000
Applicant: Architect or, Engineer
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I licensed under rovlsions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Bus ss' rofessionals o -and my License is in full force and effect.
License •ClaW:C8=L ens N 840210
toractor:
OWNER -BUILD RATION
-!.hereby affirm underpenalty of perjury that I am exDempt from the Contractor's State License Law for the,
following reason '(Sec: 7031.5, Business and Professioms Code: Any city or county that requires a permit to
construct, alter,: improve demolish, of repair any structure':prior to its issuance, also regdire's the applicant for the'
permit •to*file a signed stasement"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 thealleged exemption. Any violationof Section 7031:5 by
any-applibant fora permit subjects the -applicant to a civil penalty of not more than five: hundred dollars ($500).::. .
(_ 1. 1; as ownerof 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 Profession Code: The
Contractors' State License Law.dOes not apply to an owner of p(operty 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.).
(_) 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 aconstruction 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
Owner:
STEVE STERNBERGER
61635 TULARE LANE
LA QUINTA, CA 92253
Contractor:
CROCODILE CONSTRUCTION
50660 EISENHOWER DR, #914
LA QUINTA, CA 92253
(760)360-5895
Lic- No.: 8.40210
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/27/07
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
issued. -
. I have, and willmaintain.woil.ers' compensationlnsurance, 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 carrierand.policy number are:.: -
Carrier STATE. FUND . Policy Number' 828832
_ I -certify that; in the performance of fte:work'forty ch t 'S permit is issued, 1' shall. not employany
person in any, manner so as to orr subjects t ` oikers' compensation laws of.California,
and.agree that; itsho bec s b' c_t to wo rs':compensation provisions of•Section
. 3700. of the Lab1 sh If rth t om _w those provisions. -
ate. an
R
WARNING: FAILURE TO'SECURE WO • ERS' j M 'ENSATIO O RAGE,IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDREDTHOUSAND
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 employeesforany act or omission related to the work being
performed under or following issuance of this permit.
2. Any permii 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 essation of wor 1 B days will subject
permit to cancellation. 4ato
I certify that I have read this application and state that the ove in ion s orre comply with all
city and unty ordinances and state laws relating to buil n cons ucti , a fererepresentatives
of this c nt to enter upon the above-mentioned pro fo ,ins ecti pur es.
(Applicant or Agent):
Application Number . . . . . 07-00002600 .
Permit . . . BLDG POOL PERMIT
Additional desc .
Permit Fee 162.00 Plan Check
Fee
105.30
Issue Date. - Valuation
. .
15000
Expiration Date _ 3/25/08
Qty Unit Charge Per
Extension
BASE FEE
45.00
13.00 9.0000 THOU BLDG 2;001-25,000
117.00
Permit . . - MECH'POOL
Additional desc .
.-Permit. Fee . . . . 26.00 Plan Check
Fee
6.50.
Issue Date Valuation
0
Expiration Date 3/25/08
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' 3/25/08
a
.Qty' .Unit Charge" Per
Extension
BASE FEE;.
15".00.
1".00.- 30.00,00"EA- '.ELEC>PRIVATE SWIMMING
------------------------------------------
POOL
30.0`0
Permit PLUMBING
Additional desc M:
Permit,,Fee 27.00 Plan Check
Fee ..
6.75
Issue -Date. Valuation
0
Expiration Date •. 3/25/08
Qty Unit Charge Per
Extension
BASE:_FEE
i5.00
.1.0:0 6..0000 EA PLB FIXTURE
6.00
1.00 31A000 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. ALARMS/BARRIERS SHALL BE IN PLACE
LQPERMIT
Application Number . . . . . 07-00002600
----------------------------------------------------------------------------
Special Notes and Comments
AT PRE -PLASTER INSPECTION. EQUIPMENT
ENCLOSURE NOT INCLUDED
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 260.00 .00 .00 260.00
Plan Check Total 129.80 .00 .00 129.80
Grand Total 389.80 00 .00 389.80
LQPERAIIT
-f Vi ' Y-,
Bin #
City of La Quinta
Building a Safety Division -
P.O..Box 1'504; 78 495 .Calle Tampico
La QWhta, CA 92253 - (760)'77,7-7012
Building Permit Application and Tracking Sheet
C4
Permit #
Project Address: s-%�
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-Oer'
awns Name'. fu S, e e .
A. P. Number:
o.�,.Address:
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Legal Description -
Contractor: LV—O
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City, ST Zip ±hkd je
Telephone
ProjectDesc.4ow-
Address: Ir 2-- —
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'.City, ST, Zip:4�z
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Telephone:
State Lic. # :
City Lic. #:
Arch., Engr., Designer:
Address:
;City, ST, Zip:
Telephone:
.State Lic. #::Project
Construction Type:, Occupancy:
« .•;
type (cgcleone): New. Add'n Alter Repair Demo
Name of Contact Person:
!?�dt
Sq. Ft.:
`# Stories:
# Units:
Telephone # of Contact Person:
a' .
Estiinated'Value,of Project: 9d C)
APPLICANT
DO NOT.WRtTE;BELOW THIS LINE .
#
Submittal
Req'd .'
Ree'd
TRACKING .'j
PERMIT FEES
Plan Sets
Plan Check submitted
�'a5
Item
Amount
Structural Cities.
Reviewed, ready foriirecdons
plan Check Deposit
Truss Calcs.
Called Coutact Person r
Plan Check Balance
Energy Calcs.
Plans picked up .
Construction
Flood plain plan
Plans resubmitted'
Mechanical
Grading. plan
Vie view, ready for corrections/ sue
Electrical
Subcoutactor List.
Called Contact PersonPlumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Review, ready for.correctionsrssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
_
Total Permit Fees