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SFD (10-0830)50580 Mandarina 10-0830 4 P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA_CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 9/07/10 Application Number: 10-00000830 _ Owner: Property Address: 50580 MANDARINA CITRUS 18 GROUP, LLC APN: 776-200-002- - - 30-875 DATE PALM DRIVE Application description: DWELLING - SINGLE FAMILY DETACHED CATHEDRAL CITY, CA 92234 Property Zoning:, LOW DENSITY RESIDENTIAL Application valuation: 277754 Q Contractor: Applicant: Architect or Engineer- GHA ENTERPRISE, INC j 30875 DATE PALM DRI SUFC2 '1 'O I i CATHEDRAL CITY, CA 22 4 (760) 969-1400 CITY LA Lic. No.. 750957 rr ; ,. ' vl rA ---------------------------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professionals Code, and my.License is in full force and effect._ I have and will maintain a certificate of consent to self -insure for workers' compensation,. as provided ' License Class: B License No.: 750957 for by Section 3700 oftheLabor Code, for the performance of the workforwhich this permit is issued. ate: tractor: .+y—' I 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 issued. My workers' compensation OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 719000223 following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, 1 shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code rthwith comply with those provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by w any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: te: I/N/(OApplicant- 1, 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 WARNING: FAILletE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or"improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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.). (_ 1 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.). (_ 1 I am exempt under Sec. , BAP.C. for this reason Date: Owner: 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.I. - Lender's Name: 1 L Lender's Address:' { ` LQPERMIT 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 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. I 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 f • spection purposes. I te: r ( / O Signat (Applicant or Agentl: LQPERMIT Application Number . . . 10-00000830 Permit . .. . ELEC-NEW RESIDENTIAL Additional desc . Permit Fee 136.97 Plan Check Fee ". 34.24 Issue Date . . . Valuation . . . . 0 Expiration Date 3/06/11 Qty Unit Charge Per Extension BASE FEE 15.00 .3115.00 .0350 ELEC NEW RES -•1 OR 2 FAMILY .169.03 647.00 .0200" ---------------------------------------------------------------------------- ELEC GARAGE OR NON-RESIDENTIAL 12.94 Permit . . . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 1262.50 Plan Check Fee 820.63 Issue Date Valuation 277754 Expiration Date 3/06/11 Qty Unit Charge Per Extension BASE FEE 639.50 178.00 3.5000 ---------------------------------------------------------------------------- THOU BLDG 100,001-500,000 623.00 Permit . . . GRADING PERMIT Additional desc . Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 .Expiration Date 3/06/11 Qty Unit Charge Per Extension BASE FEE 15.00 Permit . . . MECHANICAL' Additional. desc . Permit Fee . . . . 118.00 Plan Check Fee 29.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 3/06/11 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 9.0000 EA MECH FURNACE <=100K 18.00 2.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 33.00 7.00 6.5000 EA MECH VENT FAN. 45.50 1.00 6.5000 ---------------=---------------------------------------------------- EA MECH EXHAUST HOOD 6.50 -------- Permit . . . . . . PLUMBING LQPERMIT Application Number . . . . 10-00000830' Permit . . . PLUMBING Additional desc . Permit Fee . . . . 201.75 Plan Check Fee .. 50.63 Issue Date . . . . Valuation 0" Expiration Date 3/06/11 Qty Unit Charge Per Extension BASE FEE 15.00 22.00 6.0000 EA PLB FIXTURE 132.00 1.00 15.0000 EA A 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 7.00 .7500 EA PLB GAS PIPE >=5 5.25 1.00 15.0000 EA PLB GAS METER 15.00 Special Notes and Comments SFD - LOT 2, PLAN 1C, 3115 SF. PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS OR DRIVEWAY APPROACH. 2007 CBC, 2008 ENERGY CODES THIS PERMIT WAS PREVIOUSLY ISSUED (#06-2581) BUT WAS NEVER COMPLETED & - 'ALLOWED TO EXPIRE. NEW OWNERS SUBMITTED UPDATED PLANS ENCOMPASSING CURRENT BUILDING & ENERGY CODES AS WELL AS THE SLAB FIX FOR THIS LOT. PREVIOUS INSPECTIONS WILL BE TRANSFERRED TO THE UPDATED JOB,CARD. --------=------------------------------------------------------------------- Other"Fees . . . . BLDG STDS ADMIN (SB1473) 12.00 ENERGY REVIEW FEE 82.06 GRADING PLAN CHECK FEE .00 Fee summary Charged Paid Credited ---------------------------------------- Due ----------------- Permit Fee Total 1734.22 .00 .00 1734.22 Plan Check Total 935.00 .00 .00 935.00 Other Fee Total 94.06 .00- .00 94.06 Grand Total 2763.28 .00 .00 2763.28 LQPERMIT