06-2391 (RPL)P.O. BOX 1504 .
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
06-00002391
79963 PARKWAY ESPLANADE N
609-380-999-14 -293234-
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
29000
C&tyl 4
BUILDING & SAFETY 'DEPARTMENT
BUILDING PERMIT
Architect or Engineer:
Owner:
KOSTELECKY
79-963 PARKWAY ESPLANADE
LA QUINTA, CA
LA QUINTA, CA 92253 I
Contractor:
CROCODILE CONSTRUCTION
52121 "F.ILLMORE STREET
THERMAL,.CA 92274
(760)360-5895
Lic. No.: 840210
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/15/06
JUN 5 2006
®UIMi/1
:IiY OF L.�► _.�
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LICENSED CONTRACTO ECLARATION
-------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am I' nsed under pr visi ns of Chapter 9 Icommencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Busi es and ss' - Is Cod 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 Class: A -C -CS , Licens o . 840210 -
_
for by Section 3700 of. the Labor Code, for the performance of the work for which this permit is
Date:
issued. :. ..
_ I have and will maintain workers' compensation insurance, as required by Section 3700 of the:Labor
JContractor
Code, for theperformance of the work for which this permit is issued. My workers' compensation
- OWNER-BUILDER,DE RATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury thJ am exempt from the Contractor's State License Law forthe
Carrier STATE FUND Policy Number 231-2005
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance the work for whi thipermit 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 as t come sub'ect to - kers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, ' o d be o esu
c o the rker ' compensation provisions, of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
700 of the L bor o Is al .forth' i
amply ith ose.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 1$500).:
Date: i�
Applicant:
1 11, as owner of the property, or my employees with wages as their sole compensation; will do the work, and
_
the structure isnot intended or offeredfor sale (Sec. 7044, Business and Professions Code: The
WARNIN FA
LURE TO SECUREWORI ERS COMPENSATION C ERAGE 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 ENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($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
(_ 1 I, 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,
( 1 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
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:
LQPERMIT
of La Quints, its officers, agents and employees for any act or omission related to th ork 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 i orcom enced
within 180.days from date of issuance of suc rmit, or c s tion ork fo '180 day bject
permit to cancellation.
I certify that I have read this application and state that t e abo infor do is co ct. I a ree to co ly with all
city and count ordinances and state laws relating b Iding c struct n, nd he y aut rize rep r Ives
of this co my o enter upon the above-mentioned prop for i specti rpos s
Date' ; Sign Applicant or Agent): '
Application Number . . . . . 06-00002391
Permit
BLDG POOL PERMIT
Additional desc . .
Permit Fee . . . .
278.00
Plan Check Fee
.180.70
Issue Date . . . .
Valuation . . .
. 29000
Expiration Date
12/12/06.
Qty Unit Charge
Per
Extension
BASE FEE
252.00
4.00 - 6.5000
THOU. BLDG 2.5,001-50,000
26.00
Permit
MECH POOL
Additional desc..
Permit...Fee
,24.00
Plan Check Fee
6.00
Issue -Date
Valuation . . .
. 0
Expiration Date..
12/12/06
Qty, Unit Charge
Per.
Extension
BASE FEE
15.00
1.00 9.0000
EA MECH FURNACE
<=10.OK
9.00
Permit . . .
ELEC POOL PERMIT -RES
Additional desc .
Permit `Fee;...
45.00 `Plan
Check Fee
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
12/12/06
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 .'
12/12/06
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 WITH GAS LINE
FOR FUTURE
LQPERMIT
Application Number
. . . . .
06-00002391
---------------------------------------------
Special Notes and
Comments
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------------------------
PRE -BUILT FIREPIT
AND BBQ. PER
APPROVED
PLAN
Fee summary
Charged_
Paid
----------
Credited
--------------------
Due
-----------------
Permit Fee Total
----------
380.00
.00
.00
380.00
Plan Check. -Total
206.20°=
.'00
.00
206.20
Grand.Total
586.20
.00
.00
586.20
LQPERDIIIT .
Bin #
City of La .Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet ,
Permit #
06-
Project Address: �j f.l( �5 SI
Owner's Name: I b� es 1 e h C
A. P. Number:
Address: w-6, �s 4t
Legal Description:
City, ST, Zip:
Contractor:
+� D(L f S �'��`� f d N
Telephone:
Telephone:
Address: 5 -t'� � ��rQ ST
Project Description:. �L Z M NI
City, ST, Zip:'l hQiM4-L Co " 91Z? 4
(,l OSi�
I! T
q
Telephone: �b a-75= (
b0 pr ,
State Lie. # City Lic. #:
Arch., Engr., Designer:
^
Address:
( &.45, LINt
City, ST, Zip:ieE.eln
y SF�A¢-L� (e.n iz tsz�
Telephone:
Construction Type: ,' o� Occupancy:
State Lic. #:
Project type (circle one): New Add -'n Alter Repair Demo
Name of Contact Person:
Sq- Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: -1 QD O
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING .
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
2°" Review, ready for corrections/issue
Electrical
Subcontactor. List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
ILO.A. Approval:
Plans resubmitted
Grading
INHOUSE:-
'"' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue I
1 i
Q 111
OF tA QUINFA
A r
.
School Fees
I
�y
rry SAFE
� � �� i i r: r
F01t
CONSTRucTinI
1
Total Permit Fees
5'
SOD
5'
raised 18"
3019,,
in
16'x31' Ounite
pool tyical
colored,salt finish concrete
desert tan color - typical
natural rock waterfall PLANTER
raised 12" typical
KOSTELECKY RESIDENCE
79963 PARKWAY ESPLANADE N.
LAQUINTA,CA
Masonry fire pit +12" SOD
"GrandEffects"
as i ated fire system
32' 6"
Patio cover - 10' x 17'
"Alumiwood" typical
_1.5.04 ON4y wlaW' A11V6
,*A A✓swe6 axz
54,"U7E 06WWr �C32u�eD.
C
t
y C
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE 6' !:L 0C- gy217`
5'
le: 1/8 in