04-7627 (SFD) IIIIIII VIII III VIII IIII 06
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BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760).777-7012
c�MpFi49 78-495 CALLE TAMPICO FAX (760) 777-7011
1A QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
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2005 BUILDING PERMIT
JAS 0 6
pR Girc-at on�-,umber . . . . 04-00007627 Date 12/09/04
"I text°address . . . . . . 80879 CALL AZUL
°P Y
N: 762-240-003-55 -300962-
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: WC298892004 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 CBC
# BEDROOMS 2 . 00
FIRE SPRINKLERS NO-
GARAGE SQ FTG 244 . 00
PATIO SQ FTG 163 . 00
NUMBER OF UNITS 1 . 00
1ST FLOOR SQUARE FOOTAGE 1380 . 00
----- ------------------ ------------------------------------------ -----------
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
-- ------------------------------------------------------------------------- -
Permit . . . . . . MECHANICAL
Additional desc
Permit Fee . . . . 78 . 50 Plan Check Fee 4 . 91
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
T
P.O. Box 1504 /i •
w 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- Date: /• .3 oar
Applicant: ---Architect or Engineer: / 04
Applicant's Mailing Address: Architect or Engineer's Address:
ic. No. ��� 722
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATI N
I hereby affirm under3in'
aler. ry that I am licensed under provisions o pte c en ection 7000)of Division 3 of the Business and Professionals
,Code,and my Licensr and effect.
/ License Class ��?;�Pmor
cense No.
Date%2
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 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. ,BA P.C.for this reason
Date Owner
WORKERS'COMPENSATION DECLARATION
I hereby affirm under penalty of pedury 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 MrWfTIVNhis permit is issued.
I have will aintain workers'compensation insurance,as re luir�r d n 3700 a Labor ode,ior�hg,perf�ce the work for which this permit is�� issu compensation in�tuance carrier and poi'r r r . Gy G/I(�J
,-- er �licy Number `
I ce y that,in the performance of the work of employ any person in any manner so as to become subject to the workers'
compensation laws of Califomia that,if I should beco subject to t workers'compensation provisions of Section 3700 of the Labor Code,1 shall
forthwith co h thos ovisi s.
/t pplicant
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 3708 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 (�
A CKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director ng and Safety for a perms to the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this anon is made,each person at whose request bftdfor whose benefit work is performed under or pursuant to any permit
issued as a result of this applicaf ,the owner,and the applicant,each agrees to,and shall,d nd,indemnify and hold harmless the City of La Quinta,its
officers,agents and employe for any act or omission related to the work being performed under following issuance of this permit.
2. Any permit issued as a res t of this application becomes null and void if work is not commenced wit in 180 days from date of issuance of such permit,or
cessation of work for 180 ftXs will subject permit to cancellati
I certify that I have read this application an e a ove info i s corre a wit II city and county ordinances and state laws relating to building
construction,and hereby aut ' representative7orAg
his county a upon t v - oned pr y for inspection purposes.
ate�^ y -- S�re(Applicant
Page 2
Application Number . . . . . 04-00007627 Date 12/09/04
Qty Unit Charge Per Extension
6 . 00 6 . 5000 EA MECH VENT .FAN 39 . 00
1 . 00 6 . 5000 EA MECH EXHAUST HOOD 6 . 50
- -- --- ------- -------------- ------------------------------------------------ -
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
----------------------------------------------------------------------------
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
- - --- ------------------------------------------------------------------- ----
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 55 . PLAN 1RA, 1380 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.
-_----------------------------------------------------------------7------- ---
Other Fees . . . . . . . . . ART IN PUBLIC PLACES-RES . 00
1
Page 3
Application Number . . . . . 04-00007627 Date 12/09/04
- ----------------------- --------------------------------------------------- -
Other Fees . . . . . . . . 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 To 3412 . 20 . 00 . 00 3412 . 20