04-7634 (SFD) IIIIIIIIIIIIIIIIIIIIIIIII 35
°
BUILDING & SAFETY DEPARTMENT
c �v4 P.O. Box 1504 (760).777-7012
OF iY�9 78-495 CALLE TAMPICO FAX (760) 777-7011
o QUIFF TA, CORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
SAN o 6 2005
Appli aon' umy tiTA 04-00007634 Date 12/09/.04
Prope ty 1' . . . . . 80819 CALLE AZUL
APN: 762-240-003-45 -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 . 00
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
Additional 'desc . .
Permit Fee . . . . 639 . 50 Plan Check Fee 103 . 92
Issue Date Valuation . . . . 99599
Qty 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
P.O. Box 15044
VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 TOt INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: Z-4- �. �'•pl—
ate:
Applicant: --Architect or Engineer: rf /�
.Applicant's Mailing Address: Architect or Engineer's Address: �'v
No.
BUILDING PERMIT DECLARATIONS
LICENSED CONT,ACTOR'S DECLA ONN��
I hereby affirm undo alty of rjury that I am licensed under provisions of C r 7irIn 7000)of Division 3 of the Business and Professionals
Code,and my Licens ' full rce and effect.
cense Class -1-15cense No.
c� Sart *-- v ract�r
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
-K,�,,// of the work for which this perrrri sissued.
I have an will air n w rkers'compensation insurance,as required on 3700 of the abo C e or the performance of the work for which this permit is
iss y s'c n i nce carrier and policy
merpolicy Number (��G���J
I c ,m the pe rmance of the work for whic shall empl any perso any manner s�o become subject to the workers'
co ensation laws of California,and at,if I d b me subject to workers'compensation provisions of Section 3700 of the Labor Code,I shall
hwith comply w' ns.
,-,11'ate2(� plicant
WARNING: FAILURE TO SECUR ORKE MPENSATION COVERAGE IS UNLAWFUL,AND SHALL SUBJECT AN -PL-0YF�R TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HU ED THO ND DOLLARS($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS-ASFOR IN
SECTION 3706 OF THE LA OR CODE,I TEREST,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)
APPLICANT ACKI�WL-EDt,EIpl
IMPORTANT Application is hereby made to the Director of Building and Safet permit subject to the conditions an strictions set forth on this application.
1. Each person upon whose behalf this application is made,a person at whose request and for whose benefit A is performed under or pursuant to any permit
issued as a result of this application,the owner,and th pplicant,each agrees to,and shall,defend,indemnify a hold harmless the City of La Quinta,its
officers,agents and employees for any act or omi ' n related to the work bein ormed under or following iss nce of this permit.
2. Any permit issued as a result of this applicatio ecomes null and void if w not commenced within 180 from date of issuance of such permit,or
cessation of work�representatives
will subject it to cancellation.
I certify that I have read this ad state that(he above information' rre a ances and state laws relating to building
construction,an of ount ove-m o property for inspection purposes.
Dateloo-7f' �/ Sie(Applicant or Agent):
1
r
Page 2
Application. Number . . . . . 04-00007634 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
------ ------ ----------- -----------------------------------------------------
Permit . . . . . . 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
-
----------------------------------------------------------------------- ----
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 45 . PLAN 2A, 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 . . . . . 04-00007634 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