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04-7640 (SFD) IIIIIIIIIIIIIIIIIIIIIIIII 14 .00 1E a, Ot — o`� V O� BUILDING & SAFETY DEPARTMENT v P.O. BOX 1504 (760).777-7012 0F 9 4, ` �ALLE TAMPICO FAX (760) 777-7011 LA-Q� TA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 O BUILDING PERMIT � App lipragonNuAmb 04-0000 764Z-1 Date 12/0.9/04 P ety""Address ' . . . . 80890 CALLE AZUL APN: 762-240-003-57 -300962- Application description DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . . . . MEDIUM DENSITY RES Application valuation . . . . 99599 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 06/12/05 CSLB : 813480 10/31/06 CCC : B ---- ---------------------- Structure Information ------------------------ - 'Construction Type . . . . . TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/CONG <=10 Flood Zone . . . . . . . . NON-AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 CRC # BEDROOMS 2 . 0.0 FIRE SPRINKLERS NO GARAGE SQ FTG 255 . 00 PATIO SQ FTG. 451 . 00 NUMBER OF UNITS 1 . 00 1ST FLOOR SQUARE FOOTAGE 1549 :00 -- ---------------------------------------------------------------------- --- Permit . . . . BUILDING PERMIT v Additional desc Permit Fee 639 . 50 Plan Check Fee 103 . 92 Issue Date Valuation . . . . 99599 Oty Unit Charge Per Extension BASE FEE 414 . 50 50 . 00 4 . 5000 THOU BLDG 50, 001-100, 000 225 . 00 --- --- ----------- ----------------------------------------------------------- Permit . . . . . MECHANICAL Additional desc Permit Fee . . . . 85 . 00 . Plan Check Fee 5 . 31 Issue Date . . . . Valuation . . . . 0 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 R P.O. Box 1504 • ��'� /i • w VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Q4^ 7(040 Date: S Applicant: —Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: No. (2 22 7 BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under f perjury that I am licensed under provision er (cen S ion 7000)of Division 3 of the Business and Professionals Code,and my License II force and effect. icense Class icerise No. Date( y ,2 ntratt ctor / OWNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 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 pennit 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 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 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 1,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 whi ermit is issued. have an II mai aif n workers'compensation insurance,as reBoers i 3700 a Labor C e,f heperfoml@nce of the work for which this permit is issu . My mpensation i nce carrier and poli � j 1 �l �rier olicy NumberOrI /vii I certi hat,in the performance of the work for wh' rMi is issued,I sha n any person in any manner so a% become subject to the workers' c illifipensation laws of California,and a at,if I should become subject to the workers mpensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with t provi ' /bate PPI - / WARNING: FAILURE TO SECURE WO COM ENSATION COVERAGE IS UNLAWFUL,AND SHALL SUBJECT A "MRLOYER TO CRIMINAL PENAL CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAES AND SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. GES AS PROVIDED FOR PENALTIES . 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 t-snbjecricthe� ns and restrictions set forth on this application. 1. Each person upon whose behalf this application is made,ea on at whose request and for whose b t work is performed under or pursuant to any permit issued as a result of this application,the owner,and pplicant,each agrees to,and shall,defend,indemni nd hold harmless the City of La Quinta,its officers,agents and employees for any actor o ' ion related to the work being performed under or following i uance of this permit. 2. Any permit issued as a result of this applica i becomes null and void if work is not commenced within 180 d from date of issuance of such permit,or cessation of work for 180 days will subje permit to cancellation. I certify that I have read this application and state that n is 1 agree to comply with al ' and county ordinances and state laws relating to building construction,and hereby aytheri�e representatives of this county to enter up a e- or inspection purposes. ate�� Signature(Applicant or Agent): Page 2 Application Number . . . . . . 04-00007640 Date 12/09/04 Qty Unit Charge Per Extension. 7 . 00 6 . 5000 EA MECH VENT FAN 45 . 50 1 . 00 6 . 5000 EA MECH EXHAUST HOOD 6 . 50 - - ------------ -- - ------------------------------- - ---------------------------- Permit . . . . . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee . 74 . 32 ' Plan Check Fee 4 . 65 Issue Date . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15 . 00 . 1549 . 00 . 0350 ELEC NEW RES - 1-OR 2 FAMILY 54 . 22 255 . 00 . 0200 ELEC GARAGE OR NON-RESIDENTIAL 5 . 10 -------------------------------- ------------------------- . . . . . . PLUMBING Additional desc Permit Fee 151 . 50 Plan Check Fee 9 . 28 Issue Date . . . . Valuation . . . . 0 Qty ' Unit Charge Per Extension BASE FEE 15 . 00 14 . 00 , 6 . 0000 EA PLB FIXTURE 84 . 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 - - ---- ---------------------------------------------------------------------- Permi�. . . . . . . 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 57 . PLAN 2B, 1549 SF. PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL, SPA OR DRIVEWAY APPROACH. 75 PLAN CHECK. FEE REDUCTION APPLIED FOR MULTIPLE ISSUANCE OF SAME PLAN TYPE. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES-RES . 00 Page 3 Application Number . . . . . 04-000.07640 Date 12/09/04 ----- -------------------------------------------------"----------------------- Other Fees . . . . . . . . . DIF COMMUNITY CENTERS-RES 97 . 00 DIF CIVIC CENTER - RES' 366 . 00 ENERGY REVIEW FEE 10 . 39 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 9 . 95 DIF STREET MAINT FAC-RES 15 . 00 DIF TRANSPORTATION - RES 1098 . 00 Fee summary Charged Paid Credited Due --------------- -- ---------- ---------- - --------- ---------- Permit Fee Total 965 . 32 . 00 . 00 965 . 32 Plan Check Total 123 . 16 . 00 . 00 123 . 16 Other Fee Total 2425 . 34 . 00 . 00 2425 . 34 Grand Total 3513 . 82 . 00 . 00 3513 . 82