04-7630 (SFD) ` I IIIIIII VIII III VIII IIII 57
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BUILDING & SAFETY DEPARTMENT
P.O. Box lso (760).777-7012
OF -49 CALL I MPICO FAX (760) 777-7011
A QUINTA-, G �LIFORNIA 92253 INSPECTION.REQUESTS (760) 777-7153
JAN 46 2005 BUILDING PERMIT
CITY OF u QUINTA
FINAt4CE DEPT.
Appl o umber 04-00007630 Date 12/09/04
Property Address., .. 80848 CALL AZUL
APN: 762-240-003-64 -300962-
Application description . . . DWELLING - SINGLE FAMILY DETACHED
Property Zoning . . . . . . . MEDIUM DENSITY RES
Application valuation . . 85886
Owner Contractor
- yo-•
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
r
P.O. Box 1504 • /� .
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: 64-3(03o Date:
Applicant: ---Architect or Engineer:
Applicant's Mailing Address: chitect or Engineer's Address:
ic. No.: C 2331
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 my License ull�c and effect. �
License Class Tcense No.
IF
/Date 0� Contrector
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 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 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.
4 have anoAvIll'Iftntain workers'compensation insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is
iss ers'compensation i�n uaRce came A ��L�M �
artier olid y N (� `�7"
_Ice ' that in the performance of the for whic is permit i rl'shall not em oy any person in an anner so a o become subject to the workers'
mpensation laws of Califomi nd agree t should ubject the wo rs'compensation provisions of Section 3700 of the Labor Code,I shall
forthwith comply with thos rovisions.
Date �(/ —✓ Applicant
WARNING: FAILURE TO SECURE WORK S'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.).
Lenders Name
Lenders Address kMr:
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.
alf 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 appli
1. Each person upon whose beF
cation,the owner,and the applicant, d shall,defend,indemnify and hold harmless the City of La t]uinta,its
officers,agents and employees for any act or omission rel o the work being perform nder or following issuance of this permit.
2. Any permit issued as a result of this application bec null and void if work is not c2de
d within 180 days from date of issuance of such permit,or
cessation of work for 180 days will subject perm' cancellation.
I certify that I have read this application and state that th bove inform is me ree toith all city and county ordinances and state laws relating to building
construction,and hereby aut rize representatives of is county to upon t e-me rty for inspection purposes.
Date f:�A Si�(Applicant or Agen .
Page 2
Application Number . . . . . 04-00007630 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 . 0.0 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 64 . PLAN 1B, 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.
--------------------------------------------------------------------------- -
Other Fees . . . . . . . . . ART IN PUBLIC PLACES-RES . 00
l
Page 3
Application Number . . . . . 04-00007630 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 Total 3412 .20 . 00 . 00 3412 . 20