SFD (04-5516)78060 Lost Elk Tr
04-5516
4
T44f 4 4 Q"
P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number '. .
Property Address . . .
APN:
Application description
Property Zoning . . . .
Application valuation .
BUILDING PERMIT
BUILDING & SAFETY DEPARTMENT
(760.).777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
__04 =00,00.5516 -_ Date 7/15/04
. 78060 LOS T ELK TR
658-140-999-48 -29436 -
. . . DWELLING - SINGLE FAMILY DETACHED
. . . LOW DENSITY RESIDENTIAL
199884
Owner Contractor
IVANHOE LA QUINTA COVE TRANS -WEST HOUSING, INC.
C/O R BARRY MCCOMIC ` 9968 HIBERT STREET, STE #102
7979 IVANHOE AVE— STE-550 SAN DIEGO CA 92131
LA JOLLA IlJ C 29A 037 (858) 653-3003
U NAV 1 6 2004 191 WCC: STATE FUND
WC: 1648813 10/01/04
clr CSLB: 701039 01/31/05
0'4dAf C ' 9 G Tj
8 ® T CCC: B
-------------------------- Structure Information--------------------------
Construction
-----------------------=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 3.00
FIRE SPRINKLERS NO
GARAGE SQ FTG 704.00
PATIO SQ FTG 315.00
NUMBER. OF UNITS 1.00
FIRST FLOOR SQ FTG 3180.00
----------------------------------------------------------------------------
Permit . . . . . . BUILDING PERMIT
Additional desc .
Permit Fee '989.50 Plan Check Fee 160.80
Issue Date Valuation 199884
Qty Unit Charge Per Extension
BASE FEE 639.50
.100.00 3.5000 THOU BLDG 100,001-500,000 f'. 350.00
Permit . . . . . . MECHANICAL
Additional desc .
Permit Fee 90.00 Plan,Check Fee 5.63
Issue Date . . . . Valuation 0
Qty Unit Charge Per Extension
P.O. Box 1504 1
VOICE (760) 777-7012
78-495 CALLE O FAX (760) 777-7011
LA QUINTA, CALIFORNIAFOR 9225344 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: Jrs o Date:
Applicant:. --Architect or Engineer:
&&L
eld,
Applicant's Mailing Address: Architect or Engineer's Address:
Lic. No.:
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 my License i .n full force and effect''
n
nse Class license No. !/ I 103q
Date - Contractor_ r'
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State Lioense 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. 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.
1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issuad. My wd&ers' c mpensat[on i 5txance carrier and pJ y nu r are:
Cartier policy Number _ /
_ i is sued, s a not employ any person in any manner so as to become subject to the workers'
I certify that, in the performance of the work for which this pe
92 913
compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
6ate G cant
WARNI F [LURE TO SECURE WORKERS' 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.).
Lender's Name
Lenders Address
IMPORTANT Application is hereby made to the Director of BuildingAPPLICANT
C
Safety ACKNOWLEDGEMENT
set forth on this
1. Each person upon whose behalf this application is made, each person at wh slesrequest a d for whose benefit work sto the andnperformed under or pulrsuant to any permit
issued as a result of this application, the owner, and the applicant, each agrees to, and shall, defend, indemnity and hold harmless the City of La Quinta, its
officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or
cessation of work for 180 days will subject permit to cancellation.
1 certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building
construction and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes.
,,-,Date l U
Sig (Applicant or Agent):
4
Page
2
Application Number .
. .
. . 04-00005516 Date
7/15/04
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
2.00
9.0000
EA
MECH FURNACE <=100K
18.00
2.00
9.0000
EA
MECH B/C <=3HP/100K BTU
18.00
5.00
6.5000
EA
MECH VENT FAN
32.50
1.00
6.5000
EA
MECH EXHAUST HOOD
6.50
----------------------------------------------------------------------------
Permit . . .
. . .
ELEC-NEW RESIDENTIAL
Additional desc
Permit Fee .
. . .
140:38 Plan Check Fee
8.78
Issue Date .
. . .
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
3180.00
.0350
ELEC NEW RES - 1 OR 2 FAMILY
111.30
704.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
14.08
----------------------------------------------------------------------------
Permit . . .
. . .
PLUMBING
Additional desc
. .
,
Permit Fee
178.5'0 Plan Check Fee
11.16
Issue Date .
. . .
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
18.00
6.0000
EA
PLB FIXTURE
108.00
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
8.00
.7500
EA
PLB GAS PIPE >=5
6.00
1.00
15.0000
EA
PLB GAS METER
15.00
--------------------------------------------------------------7-------------
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 -48 PLAN
1CR
3180
SF. PERMIT
5
Page 3
Application Number
. . . . .
04-00005516 Date
7/15/04
----------------------------------------------------------------------------
Special Notes and
Comments
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
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
16.08
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
19.98
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
-----------------
Charged
Paid Credited
Due
Permit Fee Total
----------
1413.38
------------------------------
.00 .00
1413.38
Plan Check Total
186.37
.00 .00
186.37
Other Fee Total
2441.06
.00 .00
2441.06
Grand Total.
4040.81
.00 .00
4040.81