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08-1518 (RPL)Ilk P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: . Application valuation: A --I; .­. 0800001518 81442 GOLDEN POPPY WY 764-280-999-98 -300236- POOL - RESIDENTIAL MEDIUM HIGH DENSITY RES 22000 T-it4t 4 4 Q" Architect or Engineer: a6P BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 ss:'ABC-8 LicenseNo.: 890415 ate: Utractor: %' J, 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 1$500).: (_ I 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.). (_) 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 contractorls) 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: Lender's Address: LQPERMIT Owner: DAYTON & KRISTY PIERSON 81442 GOLDEN POPPY WAY LA QUINTA, CA 92253 Contractor: CROCODILE CONSTRUCTION INC 53080 AVENIDA JUAREZ LA QUINTA, CA 92253 (760)574-6357 Lic. No.: 890415 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/10/08 a q 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 will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the worklfor 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. We: `'` WARNING: FAIL 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 ($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 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 th' ou/n'tyy toenterupon the above-mentioned property for inspection purposes. ate: ^�� 61 Sign re (Applicant or Agent): Application Number . . . . . 08-00001518 Permit . . . . . BLDG POOL PERMIT Additional desc . Permit Fee 225.00 Plan Check Fee 146.25 Issue Date . . . . Valuation . . . . 22000 Expiration Date . . 3/04/09 Qty Unit Charge Per Extension BASE FEE 45.00 20.00 9.0000 ---------------------------------------------------------------------------- THOU .BLDG 2,001-25,000 180.00 Permit . . . MECH POOL Additional desc . Permit Fee . . . . '26.00 Plan Check•Fee 6.50 Issue Date . . . . Valuation 0 Expiration Date 3/04/09 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 3/04/09 .Qty Unit Charge Per r-- 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 3/04/'09 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. ALARMS/BARRIERS SHALL BE IN LQPERMIT Application Number 08-00001518 Special Notes and Comments PLACE AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED. Fee summary Charged Paid Credited Due ----------------------------------------------------------- Permit Fee Total 329.00 .00 .00 329.00 Plan Check Total 172.25 .00 .00 172.25 Grand Total 501.25 .00 .00 501.25 LQPERMIT CITY OF LA QUINTA SUB-CONTRNCTOR LIST JOB ADDRESS �'_L4l�I�i J ��o i� Lv PERMIT NUMBER OWNER -fQ KiZ15T i, BUILDER. This form shall be posted on the job with the Build ng 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, all information requested below must be completed by applicant. "On File" is not an acceptable response. Tra Clas Contractor >::'r:><::::::::'::::State'.::Contrac Licerf : for .s. se... :.: :.: Wgikes.Compensation;lrisurance:° ::'^:" . ::.. ::::::;:.: Cit .Bus nets y Lice nse.:: Company Name Classification (e.g. A, B, C-8) License Number (xxxxxx) Exp. DatePolicy (xx/xx/xx) (e. - State Fund, IComp) Number (Format Varies) Exp. Date (xx/xx/xx) License Number (xxxx) Exp. Date (xx/xx/xx) EARTHWORK 1C7121 :'.; l lLtc�C� IAM1) [�- �`C7 I �!% C � �Q I7 ` d 7 �1 4-1-6 'J l ( 11 30 CONCRETE (C-8) c. J� �G ' o O FRAMING :1G-5) STRUCT.:STEEL'IC-51) ���� t �c g C �G l -440 O D MASONRY (C-29) PLUMBING (C-36) LATH. PLASTER (0=35) (,fir -�.� R—Lk- S DRYWALL (C-9) ..::..: HVAC. (C720)~ ELECTRICAL. R00\FING'(G39) ::.`•:>'.:`.`: . SHEE'� METAL (C43) FLOO�RINGiC'.:T5):. GLAZING (C-17}: INSULATION (G-21: SEWAGE DISP ' IC -42) '-': PAINTING (C=33) CERAMIC TILE (C-54) CABINETS (C-6) FENCING (C-13) L LANDSCAPING IC=27.) . POOL (C-53) Bin # City of " La Quin a Building 8Z Safety Division P.O. Box 1504,78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 I Building Permit Application and Tracking Sheet Permit # c� Project Address: Z 0 7v O Owner's Name:a>p, YJ � �� S P1l—:. p—svo A. P. Number: Address: �.1-qqz C, O lLt`-1�J WA,-( [City, Legal Description: ST, Zip: QuIriTk Ovvct ZZS Contractor: C(Z p co 6 1 - Co ,_S 'T Telephone: Address: CE, 'Z_ (2-1 LLKol2.U- Ste- Project Description: �)pn1 City, ST, Zip:"Tkke2ttilA t_ , q 22-1 Telephon Lop a -IS d State Lic. # : Q City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: ; 45 OT p 2 Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person. - Estimated Value of Project: a p O Q APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING. PERMIT FEES Plan Sets Plan Check submitted S Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading,planlou Review, ready for corrections/issue Electrical S6bcontactor List Called Contact Person Plumbing . Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review, ready foe corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees