04-4103 (SFD) ..r IIIIIIIIIIIIIIIIIIIIIIIII �1
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BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760).777-7012
0F_ 9 78-495 CALLE TAMPICO FAX (760) 777-7011
1-7,}. y,��;�- LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number X04-00004103 } Date 5/17/04
Px--operty Address . . . . . . . 80885 CALLE AZUL
APN: 762-240-003-35 -300961-
Application description . . . DWELLING - SINGLE FAMILY DETACHED
Property Zoning . . . . . . . MEDIUM DENSITY RES
Application valuation . . . . 85886
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/CONG <=10
Flood Zone . . . . . . . . NON-AO FLOOD ZONE
Other struct info . . . . . CODE EDITION 2001 CBC
. # BEDROOMS 2 . 00
FIRE SPRINKLERS NO
GARAGE SQ .FTG 24"4 . 00
PATIO SQ' FTG 163 .00
NUMBER OF UNITS 1 . 00
FIRST FLOOR SQ FTG 1380 . 00
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Permit BUILDING PERMIT '
Additional desc
Permit Fee . . . . 576 . 50 Plan Check Fee 93 . 68
Issue Date . . . . Valuation 85886
Qty Unit Charge Per Extension
BASE FEE 414 . 50
36 . 00 4 . 5000 THOU BLDG 50, 001-100, 000 162 . 00
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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 • 1��� �j
rV 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: Date: (O^41^0 R
Applicant: ch' t or iiJEngineer:
Applicant's Mailing Address: Architect or En sneer's Addres :
-Fe-I ler- A S
I�ew Rc-� Qeacc\ CC..,
Ic. No.: C
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
e,and my LiGP�sg is in full force and effect.
License Class 151 N L— icense No. �� �
Date 'lJ1 ontractor 1 X6,\3 LS `Cl��`O'f1S Lkk
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 basls 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 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. ,B.&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.
1 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
iss ed. )Qy��wo�r�kers'compensatio urance carrier and !,1j numb a�@
�arier- 43�%G ^�*Hca.^ Policy Number (a�C.`i`80 �Z,AC�'3
_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
1 forthwith comply with those provisions.
Date L�-tA-VLk p icant
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.).
Lender's Name
Lender's 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 etrpersprt 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 a applicant,each agrees to,and shall,defend,indemnity and hold harmless the City of La Quinta,its
officers,agents and employees for any r omission related to the work being performed under or following issuance of this permit.
2. Any permit issued as a result of thi plication becomes null and void,#work is not commenced within 180 days.from date of issuance of such permit,or
cessation of work for 180 day ill subject permit to cancellation.
I certify that I have read t is applicatio and state that the ab i ati is agree to comply with all city and county ordinances and state laws relating to building
construction,an here authorize repre ve-mentioned property for inspection purposes.
Date nature(Applican
24
Page 2
Application Number 04-00004103 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 . . . . 68 . 18 Plan Check Fee 4 . 26
Issue Date Valuation . . . . 0
Qty Unit Charge Per Extension
BASE FEE 15 . 00
1380 . 00 . 0350 ELEC NEW RES - 1 OR 2 FAMILY 48 . 30
244 . 00 . 0200 ELEC GARAGE OR NON-RESIDENTIAL 4 . 88
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Permit . . . . . . PLUMBING
Additional desc
Permit Fee . . . . 139 . 50 Plan Check Fee 8 . 72
Issue Date . . . . Valuation . . . . 0
Qty Unit Charge Per Extension
BASE FEE 15 . 00
12 . 00 6 . 0000 EA PLB FIXTURE 72 . 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
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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
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` Special Notes and Comments
SFD - LOT 35 . PLAN 1B. PERMIT DOES NOT
Page 3
Application Number . . . . 04-00004103 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.
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Other Fees . . . . . . . . . ART IN PUBLIC PLACES-RES . 00
DIF COMMUNITY CENTERS-RES 97 . 00
DIF CIVIC CENTER - RES 366 . 00
ENERGY- REVIEW FEE 9 . 37
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 8 . 58
DIF STREET MAINT FAC-RES 15 . 00
DIF TRANSPORTATION - RES 1098 . 00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 877 . 68 . 00 . 00 877 . 68
Plan Check Total 111 . 57 . 00 . 00 111 . 57
Other Fee Total 2422 . 95 . 00 . 00 2422 . 95
Grand Total 3412 . 20 . 00 . 00 3412 . 20
Certificate of Occupancy
— 5c&t,, 4
tG�itrrit/
G� OF T1��9wJ 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- 80-885 CALLE AZUL
Use classification: SINGLE FAMILY DWELLING Building Permit No.: 04-4103
Occupancy Group: R-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
By: GARY HARTMAN
Date: 8-30-2005
Building Official
POST INA CONSPICUOUS PLACE