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04-4129 (SFD) III II IIID III VIII IIII 75 IE _ 4 o ' � oz U BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012 c�MOF1 ._78-495_CAL.LE TAMPICO FAX (760) 777-7011 LA"-,QUINTA,�I CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number r . X04_-0000.4.1-2.9- Date 5/17/04 Property Address.. ` , 80939 CALLE AZUL APN: 762-240-003-44 -300961- Application description . . . DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . . . . MEDIUM DENSITY RES Application valuation . . . . 102629 Owner Contractor PUERTA AZUL PARTNERS DAVIS/REEDICONSTRUCTION INC 17700 SW UPPER BOONES FERRY RD 169 SAXONY ROAD, STE #105 SUITE 100 ENCINITAS CA 92024 PORTLAND OR 97224 (760) 634-2350 WCC: STATE FUND WC: WC298892003 06/12/04 CSLB: 813480 10/31/04 CCC: B -------------------------- Structure Information ------------------------- Construction Type . . . . .. TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/LONG <=10 Flood Zone . . . . . . . . NON-AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 CRC # BEDROOMS 2 . 00 - FIRE SPRINKLERS NO GARAGE SQ FTG 437 . 00 PATIO SQ FTG 316 00 NUMBER OF UNITS 1 . 00 FIRST FLOOR SQ FTG 1571 . 00 --------------------------------------7------------------------------------- Permit . . . . . . BUILDING PERMIT ` Additional desc Permit Fee . . . . 650 . 00 Plan Check Fee 422 . 50 Issue Date Valuation . . . . 102629 Qty Unit Charge Per Extension BASE FEE 639 . 50 3 . 00 3 . 5000 THOU BLDG 100, 001-500, 000 10 . 50 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL Additional desc Permit Fee . . . . 78 . 50 Plan Check Fee 19 . 63 Issue Date Valuation . . . . 0 Qty Unit Charge Per Extension P.O. Box 1504 • �� VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 TINSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 4 ( 02 Date: (o -4-oO Applicant: chitect r Engineer: M V-S AsON Applicant's Mailing Address: Architect or Engineer's Address: L1(vk1 I&Ales Q.3 t Pork (:-, _ g'Z6✓ru c. No.: C- Z b 7-7 Ci BUILDING PERMIT DECLARATIONS 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 �de,and ss Lic�e�i;jp fLll force and effect. / s k2 1 4 SO License Class i'��- /License No. { -7�•{ v Dateb�`� Cont �V \� �Q�COC�,Sk1�-k. a d� OWNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors'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 Contractors'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($500).): U I,as owner of the property,or my employees with wages as their stile 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 or 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.). U 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.). U I am/exempt under Sec. ,BA P.C.for this reason Date Owner WORKERS'COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certifica(e 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 work for which this permit is issued. fvly workers'compensation mnsupance carrier and policy umber Cartier UC\G t�gnco.� policy Number 6_3C_ XCid ZdV _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. WARNING: FAILURE 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. 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.). Lendefs Name Lenders Address 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,indemnity and hold harmless the City of La Quinta,its officers,agents and employees for any act or omission related toldework- a nng perforned under or following issuance of this permit. 2. Any permit issued as a result of this application become 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 ncellation. I certify that I have read this application and state that thea ve information is cor ,� mply witp all city and county ordinances and state laws relating to building construction and reby;.uthorize representatives of thi ounty to enter on ro y for inspection purposes. ( ignature(Applicant or Agent): lk. Page 2 Application Number . . . . . 04-00004129 Date 5/17/04 Qty Unit Charge Per Extension BASE FEE r 15 . 00 1 . 00 9 . 0000 EA MECH FURNACE <=100K 9 . 00 1 . 00 9 . 0000 EA MECH B/C <=3HP/100K BTU 9 . 00 6 . 00 6 . 5000 EA MECH VENT FAN 39 . 00 1 . 00 6 . 5000 EA MECH EXHAUST HOOD 6 . 50 ----------------------------------------w . . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee . . . 78 . 73 Plan Check Fee 19 . 68 Issue Date Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15 . 00 1571 . 00 . 0350 ELEC NEW RES - 1 OR 2 FAMILY 54 . 99 437 . 00 . 0200 ELEC GARAGE OR NON-RESIDENTIAL 8 . 74 ------------7------------------------------------------------------7-7------ Permit . . . PLUMBING Additional desc Permit Fee 145 . 50 Plan Check Fee 36 . 38 Issue Date Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15 . 00 13 . 00 6 . 0000 EA PLB FIXTURE 78 . 00 1 . 00 15 . 0000 EA PLB BUILDING SEWER 15 . 00 1 . 00 7.. 5000 EA PLB WATER HEATER/VENT 7 . 50 1 . 00 3 . 0000 EA PLB WATER INST/ALT/REP 3 . 00 1 . 00 9 . 0000 EA PLB LAWN SPRINKLER SYSTEM 9 . 00 1 . 00 3 . 0000 EA PLB GAS PIPE 1-4 OUTLETS 3 . 00 1 . 00 15 . 0000 EA PLB GAS METER 15 . 00 ---------------------------------------------------------------------------- Permit . . . . . . GRADING PERMIT Additional desc Permit Fee 15 . 00 Plan Check Fee . 00 Issue Date Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15 . 00 ---------------=------------------------------------------------------=----- Special Notes and Comments SFD .- LOT 44 . PLAN 3AAR. PERMIT DOES NOT Page 3 Application Number . . . 04-00004129 Date 5/17/04 . 7----------------------------------------------------------------------- Special Notes and Comments . INCLUDE BLOCK WALL, POOL, SPA OR DRIVEWAY APPROACH. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES-RES . 00 DIF COMMUNITY CENTERS-RES 97 . 00 DIF CIVIC CENTER - RES 366 . 00 ENERGY REVIEW FEE 42 . 25 DIF. FIRE PROTECTION-RES 97 . 00 GRADING PLAN CHECK FEE . 00 DIF LIBRARIES - RES 225 . 00 DIF PARK MAINT FAC - RES 5 . 00 DIF PARKS/REC - RES 502 . 00 STRONG MOTION (SMI) - RES 10 . 26 DIF STREET MAINT FAC-RES 15 . 00 DIF TRANSPORTATION - RES 1098 .00 Fee summary Charged Paid Credited Due ----------------- ------ --- ---------- ---------- ---------- Permit Fee Total 967 . 73 . 00 . 00 967 . 73 Plan Check Total 498 . 19 . 00 . 00 498 . 19 Other Fee Total 2457 . 51 . 00 . 00 2457 . 51 Grand Total 3923 .43 . 00 . 00 3923 .43 1111111 M R1111111 77 IE �f Certificate of Occupancy � � tG�it�riV G� OF9� Building & Safety Department This Certificate is issued pursuant to the requirements of Section 109 of the California Building Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 80-939 CALLE AZUL Use classification: SINGLE FAMILY DWELLING Building Permit No.: 04-4129 Occupancy Group: R3 Type of Construction: VN Land Use Zone: RM Owner of Building: PUERTA AZUL PARTNERS, LLC Address: 17700 SW UPPER BOONES FERRY City, ST, ZIP: PORTLAND, OR By: GARY HARTMAN (� Date: JUNE 16, 2005 Building Official POST IN A CONSPICUOUS PLACE 0*1_ _