04-4110 (SFD) IIIIIIIIIIIIIIIIIIIIIIIII 36
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B BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760).777-7012
C� OFT9`' 78-495 CALLE TAMPICO FAX (760) 777-7011
LA INSPECTION CALIiFO�p NIA 92253 INSPECTION REQUESTS (760) 777-7153
�� • _ �; I', BUILDING PERMIT
Applicat ionNumber .� '0-4-000-0411-0 Date 5/17/04
Property Addre'sse9 ':�': 80909 CALLE AZUL
APN: 762-240-003-39 -300961-
Application description . . . DWELLING - SINGLE FAMILY DETACHED
Property Zoning . . . . . . . MEDIUM DENSITY RES
Application valuation 1.12634
Owner Contractor
------------------------ ------------------------
PUERTA AZUL PARTNERS DAVIS/REED CONSTRUCTION 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 1 . 00
FIRE SPRINKLERS NO
GARAGE SQ FTG 250 . 00
PATIO SQ FTG 617 . 00
NUMBER OF UNITS 1 . 00
FIRST FLOOR SQ FTG 1740. 00
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Permit . . . . . . BUILDING PERMIT
Additional desc
Permit Fee 685 . 00 Plan Check Fee 111 . 31
Issue Date . . . . Valuation . . . 112634
Qty Unit Charge Per Extension
BASE FEE 639 . 50
13 . 00 3 . 5000 THOU BLDG 100, 001-500 , 000 45 . 50
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Permit . . . . . . MECHANICAL
Additional desc
Permit Fee . . . . 78 . 50. Plan Check Fee 4 . 91
Issue Date . . . . Valuation 0
Qty Unit Charge Per Extension
P.O. BOX 1504 •
VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 04- 4110 Date: &—4 0
Applicant: i hilje„c o En 'neer:
Applicant's MailingAddress Architect ojrEin
ee 's ddress-
Al J
C/11
Ic. No.: C4
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9(commencipg-with Section 7000)of Division 3 of the Business and Professionals
Code,and my Licens is i full force and effect.
/License Class icense No.
ate ontractor
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 1,as owner of the property,or my employees with wages as their sdle 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 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 work for which this permit is
issueo. y coo rs' ompensaf Iism7rance cam n polic .n be r re .�
rtier _hi�Yrl "t� �F ol�rf 1r Number 11p_ d � l, `fjt�
_I certify that,i he performance of the work for which this permi is issued,1 shelf 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' mpensation provisions of Section 3700 of the Labor Code,I shall
forthh mply with those provisions.
/Dater
WAR NG: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FIN SUP 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.).
Lender's 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 a dsball,defend,indemnity and hold harmless the City of La Quinta,its
officers,agents and employees for any act or omissionrelated t ork being performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes an
cessation of work for 180 days will subject permit to ca ellation.d void if work is not commenced within 180 days from date of issuance of such permit,or
1 certify that 1 have read this application and state that the above' formation is . I ag with all city and county ordinances and state laws relating to building
construction,(`ann/d he y authorize representatives of this county nter up o above n property for inspection purposes.
/bate / Signature(Applicant or Agent):
Page 2 _
Application Number . . 04-00004110 Date 5/17/04
Qty Unit Charge Per Extension
BASE FEE 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
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Permit . . . . . ELEC-NEW RESIDENTIAL
Additional desc
Permit Fee . . . . 80 . 90 Plan Check Fee 5 . 06
Issue Date . . Valuation 0
Qty Unit Charge Per Extension
BASE FEE 15 . 00
1740 . 00 . 0350 ELEC NEW RES - 1 OR 2 FAMILY 60 . 90
250 . 00 . 0200 ELEC GARAGE OR NON-RESIDENTIAL 5 . 00
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Permit . . . . . PLUMBING
Additional desc
Permit Fee . . . . 146 .25 Plan Check' Fee 9 . 14
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
5 . 00 . 7500 EA PLB GAS PIPE >=5 3 . 75
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 39 . PLAN 4A. PERMIT DOES NOT
Page 3
Application Number . . . . . 04-00004110 Date 5/17/04
-----=----------------------------------------------------------------------
Special Notes and Comments
INCLUDE BLOCK WALLS, POOL, SPA OR
DRIVEWAY APPROACH. 75% PERMIT FEE
REDUCTION APPLIED FOR MULTIPLE ISSUANCE
OF SAME PLAN TYPE.
---------------------------------------------------=------------------------
Other Fees . . . . . . ART IN PUBLIC PLACES-RES . 00
DIF COMMUNITY CENTERS-RES 97 . 00
DIF CIVIC CENTER - RES 366 . 00
ENERGY REVIEW FEE 11 . 13
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 11 .26
DIF STREET MAINT FAC-RES 15 . 00
DIF TRANSPORTATION - RES 1098 . 00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 1005 . 65 . 00 . 00 1005 . 65
Plan Check Total 130 .42 . 00 . 00 130 . 42
Other Fee Total 2427 . 39 . 00 . 00 2427 . 39
Grand Total 3563 .46 . 00 . 00 3563 . 46
f, IIIIIIIIIIIIIIIIIIIIIIIII 38
IE '
� ��. Certificate of Occupancyo �- o
QUb(rC4V
G� OF 9w BuRdin & Safety Department
t
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: 80-909 CALLE AZUL
Use classification: SINGLE FAMILY DWELLING Building Permit No.: 04-4110
Occupancy Group- RR=3 _ Type of Construction: VN Land Use Zone: RL,
Owner of Building- PUERTA AZUL PARTNERS L.L.C. Address: 17700 SW UPPER BOONES FERRY
City, ST, ZIP: PORTLAND, OR. 97224
��d'1rl By: GARY HARTMAN
Date- 8-30-2005
Building Official
POST IN A CONSPICUOUS PLACE