08-1147 (RPL)Ot
- P.O. BOX 1504 VOICE (760) 777-7012'
78-495 CALLE TAMPICO FAX (760) 777 7011
LA QUINTA, CALIFORNIA 92253 BUILDING &SAFETY DEPARTMENT, INSPECTIONS (760) 777 7153 '
BUILDING PERMIT
Date: 7/09/08
Application Number. 08-00001147 Owner.
-Property -Address:-- -- 81213 VICTORIA? LN O HENDERSON RESIDENCE
APN: 764'7270-999-128.-300234- 81213 VICTORIA LANE
Application description: POOL 7 RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: MEDIUM HIGH DENSITY RES Q® ;
Application valuation: 9200
0
Contractor:
Applicant: Archjt ngineei - 0���' CROCODILE CONSTRUCTION INC
,>� P 53080 AVENIDA JUAREZ
LA QUINTA, CA 92253 "
N'
(760)574 -6357
Lic. .No.-: 890415
..........
_________ _ _ _ _ _ — _ _ _ — _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - _ _ _ — — — — _ _ _ _ _ _ _ _ _ _ _ _-_ _ — — _ _ - _ -----—------
• - - u ED CO TRACTOR'S DECLARATION - - WORKER'S COMPENSATION DECLARATION - ..
I hereby. affirm under penalty of per' ur th I a licens d under. provisions of Chapter,9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 70001 of Division 3 of the B ne n P fe ionals/ ode, and my License is in fullforce and effect. - _ - I have and will maintain a. certificate of consent to self -insure for workers' compensation, as provided
License Class: ABC -8 L,1` nse No.:. 890415 - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
- Date: tl rContractor: 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
OWNS BUILD R DECLARATION insurance. carrier and policy number are: -
I hereby affirm under penalty of perjury that I am exemp from a Contractor's State License Law for the - - Carrier EXEMPT Policy Number _EXEMPT _
following reason (Sec. 7031 .5, Business and Professions ode: Any city or county that requires a permit to I certify that, in the performance of the work fo hich this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prio to its issuance; also requires the applicant for the person in any manner so as to ecome sub- ct to tale workers' 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, if I should be a su ject o the w rkers' 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 Labor o e, I forth ith omply h those provisions. -
thatheor she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5- by • /�j
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (-Date`: '�O , Applicant: -
(-_ 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 _ —WARNING: FAILURE TO SECURE W KER'SCOMPENSATI N 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 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 _ 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,
(_) I am exempt under Sec. BAP.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 is not commenced
within 180 days from date of issuance of such permit es void o ork for 1.80 days will subject ,
CONSTRUCTION LENDING AGENCY - permit to cancellation. - - -
I hereby affirm under penalty of perjury that there is a construction lending agency. for the. performance of the I certify that I have read this applicationandstate that th a ov rfiDr t n is rrr . I agree to, comply with all
work for which this permit is issued (Sec. 3097, Civ. C.1. ,. . city and county ordinances and state laws relating to bu' din c stru w d ET�eb uthorize representatives
- of this county to enter upon the above -,mention ed y f r spa io p p es. -
Lender's Name: -
Date: _w ignaw (Applicant or Ag'entl >
-. Lender's Address:
•LQPERMIT
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Application'Numbers '08-000-01147
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Permit BLDG POOL PERMIT
Additional desc a
Permi.t Fee 117 `00 '' Plan Check Fee
96.05,-
`L
Issue Date _ Valuation'. • t
9200
,..
Expiration Date ' 1/05/09
y •R
Qty ,Unit .Charge, JPer_
��Extension}
BASE FEE ''
,.45.00,
8.00 9.0000 THOU, BLDG- 2,001-25,000 `,
72.00
t ,•
s
------------------------------------.--------------------------
------------
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Permit MECH POOL,
y'.
Additional desc
�.
Permit Feb 26.00 - Plan Check Fee,---.
6 .50
-Issue Date Valuation
0
_Expiration Date 1/05/09
�..
"
Qty Unit Charge Per
Extension
r
_
BASE FEE,
15.00.
---
1.00 11.0000 EA MECH FURNACE >100K
--------- - - - -------- - - - - -------- - --- - - -- -- ------ ---
-
11.00
--------`----
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Permit . . ... ELEC POOL PERMIT -RES
Additional desc
;
r
Permit Fee 45.00' Plan Check Fee
11.25
Issue Date Valuation
0
Expiration Date 1/05/09
Qty' Unit Charge Per,
Extension
BASE' FEE
- 15.00
4:
1.00 30.0000 EA ELEC PRIVATE SWIMMING POOL
30.00
-.
CITY' OF LA QUINTA'SUB-CONTRACTOR• LIST. n/ '
JOB ADDRESS - ga' TLI W PERMIT NUMBER ..OWNER erl�,JmP S BUILDER 0&6_ -g 57 �.
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.
Trade / Classification-
Contractor' :. :.
.:....::.,. .
>::::>:::::: ::::::.::;>State:::Contractor License.... ;:..:.; ::;; . • ::. Workers.Com ensation..Irisurerice `.::" :''<;: ':.<"i :..' Cit .. euslneys Ueense'::>
'
Company Name.
Classification
(e.g. A, B, C-8)
License Number
(xxxxxx)
Exp. Date
(xx/xx/xx) (e.(State Fund, (Comp)
Policy Number
(Format Varies)
Exp. Date License Number
(xx/xx/xx) (xxxx)
Exp. Date
(xx/xx/xx)
EARTHWORK IC 12l
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-7(8 1 1
-3190
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C.ONCRffE lC 81
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FRAMING IC 51 '.:'
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77 STRUCT:rSTEEL (C,51)
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MASONRY (C•29) ;....
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PLUMBINOIC-361 ...
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LATH:
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DRYWALL (C-91, ..:
------------
HVAC. IC -20Y:.::
ELECTRICAL (C 1o1 ..
SHE ETAL
hOIRRINd.015)
GLAzING (C;17);.`
INSULATION `(C,2) . ...: .
SEWAGE DISP; (G 421 -
PAINTING (G33)' '' r
CERAMIC TILE (C-54) '
CABINETS I0-61 .{
FENCING (C-13)
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LANDSCAPING W47)::;;
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POOL IC -53) .
Bin #
City of La Quinta.
Building U Safety Division
Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #P.O.
�/j
1
Project Address: rQ _ r2 k , Iowot
'vj
Lope
A. P. Number:
Legal Description:
Contractor: CY'® CO e �S ^�'
Owner's Nae:
m
`.0 A HewJersov
Address:.8l -at 3
City, ST, Zip: Giti �,� y,
tD 6V
Telephone:
Address. S'�_ ( l' &tote r
Project Description:
City, ST, Zip:
o� ISOA
Telephone: 3— ,iO
State Lic. # : DLI O a City Lic. #:
Arch., Engr., Designer:
_42r ;
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:1.,CK.o LIft f%ra
Construction Type: Occupancy:
P cY:
Project type (circle one): New. Add'n Alter Repair Demo
Sq. Ft.: . 2 O
# Stories:
T# Units:
Telephone # of Contact Person: ;05 -- Cf tf Q7
Estimated Value of Project: U \
APPLICANT:
DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd ::
Ree'd
TRACMG .
PERMIT FEES
Plan Sets
Plan Check submittedItem
Amount
Structural Calcs.
Reviewed, ready tor+1 . actions
{.
Plan Check Deposit
Truss Cates.
Called Contact Person ;
Plan Check Balance
Energy Cates.
Plans ticked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading, plan
2'' Review, ready for corrections/issue
Electrical
Subcoutactor 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. correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
M