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04-6988 (SFD) IIIIIII VIIIIII VIII IIII 26 v � 4 BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012 �cF 9 OF 7,8-495 jCALLE TAMPICO FAX (760) 777-7011 ii -LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT U-Appli=cation Number . . . . . . 04-0000619-8-8,— Date 10/27/04 Property Address ZQ -?Q:J. CALLE AZUL i APN: 762=240-003-4341 -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 10/31/04 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 FIRST FLOOR SQ FTG 1740 . 00 --------------------------------------------------------------------------- - Permit . . . . . . 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 ---------------------------------------------------------------------------- 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 • VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 04- 6 988' Date: it .3 Applicant: hitect or Engineer: 1 t U ZI J- 4_ . Applicant's Mailing Address: Architect o ngineer's Addr ts' : e_ic mac. on A L�2wVoA Secx_� h Ccs 9?_(c,(-0 c: No.: C°L3 77 cl 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 Code,and License is in ull force and effect. ! cerise Classss License No. ,Date f — � ontractor� - 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 work for which this permit is issued. have and will maintain w rs'compensation insurance,as required by Section 370 of the Labor Code,for the performance o e work for which this permit is is led. y wp� rs' ensation-tpsurance carrier and policy number are: amer — olicy N --� Z('� ertify t1rat,in the p rformance of t for which this rmit is id,I shall not employ any person in any manner so s to become subject to the workers' compensation laws of Cali ia,and agr at,if comeu inject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comp y with se provision /Date �L p icant WARNING: FAILURE TO SECURE KERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRE 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 Lenders 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,defend,indemnify and hold harmless the City of La Ouinta,its officers,agents and employees for any act or omission re e�vorirb ' rued under or following issuance of this permit. 2. Any permit issued as a result of this application es null and void if work's not com ed within 180 days from date of issuance of such permit,or cessation of work for 180 days will subject rmit to cancellati I certify that I have read this a ication and state th the above info n is re agr comply w3h all city and county ordinances and state laws relating to building construction,and hereby au ze pre les o is county t n u n t o entioned pr rty for inspection purposes. e 0 7 gnat3i lure(Applicant or Age =t j Page 2 Application Number . . . . . 04-00006988 Date 10/27/04 Qty Unit Charge Per Extension 6 . 00 6 . 5000 EA MECH VENT FAN 3.9 . 00 1 . 00 6 . 5000 EA MECH EXHAUST HOOD 6 . 50 -----------------------------'----------------------------------------------- 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 ------------------------------------------------------------------------ -- -- 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 FIXTURE78 . 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 --------------------------'------------------------------------------------- - Special Notes and Comments SFD - LOT 41 . PLAN 4R-B. 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 04-00006988 Date 10/27/04 . ---------------------------------------------------------------------------- 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 DI.F 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 427 . 39Grand Total 3563 .46 . 00' . 00 3563 . 46 i