04-7656 (SFD) .� IIIIIIIIIIIIIIIIIIIIIIIII 46
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BUILDING & SAFETY DEPARTMENT
c, w4 P.O. Box 1504 (760).777-7012
OFTi '9 -8=49 \A' r,E AM iGp FAX (760) 777-7011
D eer.N A-.; &A-H-i~o1111IA 92253 INSPECTION REQUESTS (760) 777-7153
JAN 0 6 2005 B. ILDING PERMIT
CITY OF LA®UINTA
Applicat 'on Nus "°er���P?! 04-00007656 Date 12/0.9/04
Property -Address. • . . . . . 80836 CALLE AZUL
APN: 762-240-003-66 -300962-
Application description DWELLING - SINGLE FAMILY DETACHED
Property Zoning . . . . . . . MEDIUM DENSITY RES
Application valuation . . . . 112634
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/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
1ST FLOOR SQUARE FOOTAGE 1740 . 00
---------------------------- -----------------------------------------
. . . . . . 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
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
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: Qq- 7(p5(o Date: /• S-O
Applicant: .—Architect or Engineer:
Applicant's Mailing Address: _.Architect or Engineer's Address:
No.:—O-- 233 ? �
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provis ons oft apter 9(commencing with Section 7000)of Division 3 of the Business and Professionals
Code,and my License isull force nd effect.
cense Class 0— _ cense No. 0 W
/Dat r oontractor
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. ,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 w for ich this permit is issued.
I have an will ntai vers'compensation insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is
issue rkers' om io ' urance carrier and mbar are Z Q
�rrier Policy Nu �Q �'L�Q3
_I c t,i h erfrman f the w r which this permit is issued,I ha not employ any person in any manner so as to become subject to the workers'
compensation laws of California agr a,if I should b ome a to the workers'compensation provisions of Section 3700 of the Labor Code,I shall
forthwith co h those vision
DateAppli
WARNING: FAILURE TO SECURE RKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL-PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,00),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,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 agrees to,and shall - and hold harmless the City of La Ouinta,its
officers,agents and employees for any act or omission related to the work bei. a under or following issua f this permit.
2. Any permit issued as a result of this application becomes null and void' s not commenced within 180 days from da f issuance of such permit,or
cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information s 1 agre with all city and county ordin ces and state laws relating to building
construction,and hereby authgpse representatives of this county to enter bove- pr for inspection pu S.
ate �� Signature(Applicant or Agent):
z
Page 2
Application Number . . . . . 04-00007656 Date 12/09/04-
Qty .
2/09/04Qty _ Unit Charge Per Extension
6 . 00 6 . 5000 EA MECH VENT FAN 39 . 00
1 . 00 6 . 5000 EA MECH EXHAUST HOOD 6 . 50
- ----------------7--------------------7-------------------------------------
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
-----------------7----------------------------------------------------------
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
--------------------------------------7----------------------------------- - -
Special Notes and Comments
SFD - LOT 66 . PLAN 4B, 1740 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 . . . . . 04-00007656 Date 12/09/04
----------------------------------------------------------------------------
Other Fees . . . . . . . . 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