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07-2814 (RPL),• it � � �� e - - - '� - P.O. 86x-1'5104. ..' ✓' VOICE (760) 777-7012 78-495 CALLETAMPICO FAX (760) 777-7011 LA QUINTA; CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 y - BUILDING PERMIT Date: ' 10/24/07 Application Number:'67-0000281,4 Owner: Property Address. 61619-,TOPAZ DR _ BOB & 'PATTY HEITZMAN ' APN: 764-280'999-21 -3.00237 61619 _TOPAZ DRIVE Application description: POOL - RESIDENTIAL ; LA QUINTA, CA 92253 Property Zoning: MEDIUM HIGH DENSITY RES O Application valuation: 25000 Contractor: Applicant: Architect or Engineer CROCODILE CONSTRUCT ON /� O 50660 EISENHOWER.D 14 LA QUINTA, CA.922. 3 C�rY 4249 (760)360-5895 ` 1 ! Lic. No... 8402100Q&��Tq LICENSED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION 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 a Professional de, 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 ass: A-C-CS ce se o.: 840210 for by Section 3700 of the Labor Code, for .the performance of the work for which this permit is issued. ate: fl ntractor: - - u 1 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 CLARATION - .. 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 (Sec. 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 sub'ect to the workers' compensation laws of California, permit to file a signed statement that he or she is licensedpursuantto. the provisions of the Contractor's State and agree that, if I should be me ubje t th . orkers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Lab C , I Il fo wit y.with chose 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 ($500).: e: 0 �j plicant: - - 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 WO CERS' COMPENSATIO 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 cir her own employees, provided that the- DOLLARS 1$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 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, (_) I 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 affirni.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 abov 'nformation is rrect. I agree to comply with all f work for-which this permit is issued (Sec. 3097, Civ. C.). - city and county ordinances and state laws relating to in n tr an h authorize representatives of this�nton'e above-mentioned ert for n ecti ur eLender's Name:D (Applicant or Agent): Lender's Address: LQPERAIIT - Application Number 07-00002814 Permit BLDG POOL PERMIT - Additional desc - Permit, Fee -252.00, Plan Check Fee.. 163.80 Issue Date . . . . Valuation 25000 Expiration -Date 4/21/08 Qty Unit Charge Per Extension BASE FEE '45.00 23.00 9.0000 THOU BLDG'2,001-25;000' 207.00 Permit . . MECH POOL Additionaldesc Permit Fee 26.00 Plan Check Fee : 6.50 Issue Date Valuation 0 Expiration Date 4/21/08 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 _ 4/21/08 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 ._ '. A_ Expiration.Date 4/21/08 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 i-4.OUTLETS 3.00 Special Notes and Comments -POOL/SPA. ALARMS./BARRIERS..SHALL BE IN LQPERAIIT Application Number 07-00002814 -- - - - - - - - ------- - - - - -- - - - - ------ Y' Special Notes'and Comments -- - - - - -- - - - - - - - - - - - . -- - - - - - - - - - - - - - - - - -_'PLACE'"AT "PRE -PLASTER INSPECTION. - r - EQUIPMENT.ENCLOSURE,NOT INCLUDED f, , Fee summary Charged Paid fCredited' - Due Permit Fee Total 356.00 00 .00 356.00' ` Plan Total 18,9".80. .00 -.00 189.80 _Check Grand Total 54.5.80 .00 .00 545.80 . - LQPERMTT • Bin # CiOf La . tY Quinta Building ex Safety Division P.O. Box 1504, 78-49S Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address:' (OP- b Z Owner's Name: b • �" A. P. Number. Address:. — ( A Z Legal Description. Contractor. e ' f •� � City, ST, Zip:LCL e Telephone: Address: G 1-0 Q Project Description: City, ST, Zip: O 1 a L N Telephone: - 0? State Lic. # : p City Lic. #: Arch., Engr., Designer Address: City, ST, Zip: Telephone: State Lie. #: Construction Type: Occupancy. Project type (circle one): New. Add'n Alter Repair Demo Name of Contact Person:A I C D ote ma-Q Sq- FL: # Stories: - # Units: Telephone # of Contact Person: '76o — DDs — v Estimated Value of Project: SI •®o O APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Plan Sets Structural Calcs. Req'd _ Reed TRACKING plan"Check submitted - Reviewed, ready for 1[rectioas PERMIT FEES It.. Amount Plan Check Deposit Truss Cala. Called Contact Person Plan Check Balance, Enemy Cala. Plans ticked up Construction Flood plain plan Pians resubmitted Mechanical Grad1ng pli° 2•' Review, ready for correcdoneLvae Electrical Subcoutactor List Called Contact Person • Plumbing Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading IN ROUSE:- '^' Review, ready for,corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue . School Fees Total Permit Fees