04-6987 (SFD) � IIIIIIIIIIIIIIIIIIIIIIIII 17
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BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760).777-7012
OF r4 9 78=496 CALLE TAMPICO FAX (760) 777-7011
LAQUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
..
;9 - BUILDING PERMIT
Application-Number . . . . . 04--0-0;0-0.69Date 10/27/04
Property Address . . . . . . 80x7-77 CALLE AZUL
APN: 76-2-240-003-38 -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: WC298892004 06/12/05
CSLB: 813480 10/31/06
CCC: B
-------------------------- Structure Information --.-----------------------
Construction Type . . . . . TYPE V - N014 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
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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
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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 4INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 041- Ay 187 Date: •4
Applicant: --Architect or Engineer:
,&,WW,4,
Applicant's Mailing Address: Architect or Engineer"sddr s:
Lic. No.: C 2,`�>-77�
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 o7imencing with Section 7000)of Division 3 of the Business and Professionals
ode,and my License full force and effect.
License Class �nse No.
Bate "� a ontractorL
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 1,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 ha a an will main a certificate of consent to self-insure for workers'compensation,as provided for by Section 3700 of the Labor Code,for the performance
f the ork for ich his permit is issued.
I ve a will m intain work 'compensation insurance,as required b Section 3,790 of the Labor Code,for thperformance of t work for which this permit is
is e y ri �i �lrsation insu a carriescan o icy number a �jG;v� L/
mer // icy N m et>'r l �J
I e fy at,in the performance of the for which �Pp rmied all not employ any person in any manner so a Kobecome subject to the workers'
compensation laws of California d agree th ,if I tfould fectt he 'orkers'compensation provisions of S ction 3700 of the Labor Code,I shall
forthwith comply wit ose p visions.
/ Date Applicant
WARNING: FAILURE TO SECURE WORK COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
AN
CIVIL FINES UP TO ONE HUNDRED THOU D 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
Lender's Address 0 1A
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 Quinta,its
officers,agents and employees for any act or omission related to the work beg p ru
ined under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null an f woAI m ithin 180 days from date of issuance-of such permit,or
cessation of work for 180 days will subject permit to aeetla
I certify that I have read th' application and state that ove info ion is core ee mply all city and county ordinances and state laws relating to building
construction,and�jhereb uthorize representati o this cou o o erty for inspection purposes.
Date L y _ Signature(Applicant or Agen .
Page 2
Application Number 04-00006987 Date 10/27/04
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
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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
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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 91. 00
5 . 00 . 7500 EA PLB GAS PIPE >=5 3 . 75
5 . 00- 1 . 00 15 . 0000 EA PLB GAS METER 15 . 00 -
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Permit
----------.-----------=-----------------------------------------------------
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-----------7------------------- - -------------------- --
Special Notes and Comments
SFD - LOT 38 . PLAN 4A. PERMIT DOES NOT
INCLUDE BLOCK WALLS, POOL, SPA OR
DRIVEWAY APPROACH. 75% PLAN CHECK FEE
REDUCTION APPLIED FOR MULTIPLE ISSUANCE
OF SAME PLAN TYPE.
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Other Fees . . . . . . . ART IN PUBLIC PLACES-RES . 00
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Page 3
Application Number . . . . . 04-00006987 Date 10/27/04
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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 24.27 . 39
Grand Total 3563 .46 . 00 . 00 3563 .46