SFD (12-0568)50790 Mandarina
12-0568
4
P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO 4FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 5/24/12
Application Number: 12-0 0 000568 Owner:
Property Address: 50790 MANDARINA CITRUS 18 GROUP, LLC
APN: 776-210-003- - - 30-875 DATE PALM DRIVE, STE. C
Application description: DWELLING.- SINGLE FAMILY DETACHED CATHEDRAL CITY, CA 92234 n
Property Zoning: LOW DENSITY RESIDENTIAL D fie, . (j
Application valuation: 289770 !1
Contractor: t JUN 0 5 2019
Applicant: Architect or Engineer: GHA ENTERPRISE, INC. j
' 30875 DATE PALM DRIVE, SUITE CmQ 1
CATHEDRAL CITY, CA 92234 j !.AQP INTA
(`+ (760) 969-1400 FINP.. CE ERT.
Lic. No.: 750957
-----------------------------------------------------------.-----------------------------------
. 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 nd Professionals Code, nd 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: 13 ' a se ado.: 750957 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
/Date ontractor: VS I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
s 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 71922311'
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to , _ 1 certify that, in the performance of the work for which this permit is issued, I 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 beco a subject to the worker ' compensation provisions of Section .
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 oft Labor Code, I s I forthwith mply 'tl hose provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by j
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)•: Date: plicant:
(_ 1 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 WARNING: FAILURE 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.).
(_) 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.).
( _) I am exempt under Sec. , B.&P.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.).
Lender's Name:
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 ordinance nd state laws relating to building construction, and hereby uthorize representatives
pf this county to nter u n the above-mentioned. property for i ection
Date, 'gnature (Applicant or Agent):
Application Number 12-00000568'
Permit
. . .
BUILDING PERMIT•
Additional
desc .
Permit Fee
. . . .
1304.50
Plan Check Fee
.211.98
Issue Date
. . . .
Valuation . . . .
28"9770
Expiration
Date
11/20/12
Qty Unit Charge
Per
Extension
BASE
FEE
639.50
190.00
3.5000
THOU BLDG
100,001-500,000•
665.00
Permit
. . . MECHANICAL
Additional'desc
.
Permit Fee
. . . .
118.00
Plan Check Fee-.
6.43
Issue Date
. .
Valuation
0
Expiration
Date
11/20/12
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
2.00
9.0000
EA MECH
FURNACE <=100K
18.00
.00
9.0000
EA MECH
B/C <=3HP/100K BTU
.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
. . ELEC-NEW RESIDENTIAL
Additional
desc ..
Permit Fee
. . . .
139.89
Plan Check Fee..
8.74
Issue Date
Valuation
0
Expiration
Date
11/20/12
.Qty Unit Charge
Per
Extension
BASE
FEE
15.00
3198.00
.0350
ELEC
NEW RES - 1 OR 2 FAMILY
111.93
648.00
.0200
ELEC
GARAGE OR NON-RESIDENTIAL
12.96
Permit
. ... PLUMBING
Additional
desc .
Permit Fee
. . . .
211.50
Plan Check Fee
13.22
Issue Date
. . . .
Valuation
0
Expiration
Date ".
11/20/12
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
22.00
6.0000
EA PLB FIXTURE
132.00
LQPERMIT
LQPERMIT
Application Number .
. . .12-00000568
Permit . . . . . . PLUMBING
Qty Unit Charge
Per
Extension
1.00 .15.0000
EA PLB BUILDING SEWER
15.00
2.00 7.5000
EA PLB WATER HEATER/VENT
15.00
1.00 3.0000
EA PLB WATER INST/ALT/REP
3.00
1.00 9.0000
EA PLB LAWN SPRINKLER SYSTEM
9.00
10.00 .7500
EA PLB GAS PIPE'>=5
7.50
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.
Expiration Date
11/20/12
Qty Unit Charge
Per
-Extension
BASE FEE
15.00.
Special Notes and Comments
SFD - LOT 9, PLAN 2C,
3198 SF. PERMIT
DOES NOT.INCLUDE POOL,
SPA, BLOCK WALLS
OR DRIVEWAY APPROACH.
EXISTING SLAB TO
2001 CODES. 2010 CODES.
75t.REDUCTION TO
PLAN CHECK FEES DUE TO
MULTIPLE ISSUANCE
OF SAME PLAN TYPE.
----------------------------------------------------------------------------
Other Fees . . . . .
. ART IN PUBLIC PLACES -RES
224.43
BLDG STDS ADMIN (SB1473)
11.00
ENERGY REVIEW FEE
21.20
MULTI -SPECIES (MSHCP) FEE
1254.00
STRONG MOTION (SMI) - RES
28.98
Fee summary Charged
Paid Credited
-- ---------- ----------
Due
----------------- ---
Permit Fee Total
- --------------
1788.89 .00 .00
1788.89
Plan Check Total
240.37 .00 .00
240.37
Other Fee Total
1539.61 .00 .00
1539.61
Grand Total
3568.87 .00-. .00
3568.87
LQPERMIT