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SFD (12-1281)50880 Mandarina 12-1281 s P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 • VINW BUILDING & SAFETY DEPARTMENT BUILDING PERMIT VOICE (760 7 7 01 FAX (760) 1 INSPECTIONS (760) 777-7153 Application Number: 12 - 00001281 Owner: Property Address: 50880 MANDARINA CITRUS 18 GROUP, LLC APN: .. 776-210-006- - - 30-875 DATE PALM DRIVE,_STE. C Application description: DWELLING - SINGLE FAMILY DETACHED CATHEDRAL CITY, CA 92.234 Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: .290871 Contractor: Applicant: Architect -or Engineer: GHA ENTERPRISE, INC. 30875 DATE PALM DRIVE, SUIT CATHEDRAL CITY, CA 92234 (760)969-1400 D -----' ^ Lic. No.: 750957 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, aV my License is in full force and effect. Li nse Class: B e N 750957 Date: , 'ontractor. OWNER -BUILDER DECLARATION - I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 Contractor's 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).: (_) 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 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.). (_ 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. , 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 Date: 10/26/12 NOV O 11011 ------=------------------------UuxOF WORKER'S COMPENSATION Tlonf MANCE DEPT. 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_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 insurance carrier and policy number are: Carrier STATE FUND Policy Number 71922311 I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensationlaws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of e Labor Code, 1 hall forthwith comp withJthonse_provisions. Date: / /C7 Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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 1 have read this application and state that the above information is correct. I agree to comply with all city an county ordinances and state laws relating to building construction, and hereby au horize representatives oft coun y to enter upon the above-mentioned property for inspection purpos ate: Sig ure (Applicant or Agent): Application Number . . 12-00001281 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 1308.00 Plan Check Fee 850.20 Issue Date . . . . Valuation . . . . 290871 Expiration Date 4/24/13 Qty Unit Charge Per Extension BASE FEE 639.50 191.00 3.5000 THOU BLDG 100,001-500,000 668.50 Permit MECHANICAL Additional desc . Permit Fee . . . . 118.00, Plan Check Fee 25.75 Issue Date . . . . Valuation .. 0 Expiration Date 4/24/13 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 34.97 Issue Date . . . . Valuation . . . . 0 Expiration Date 4/24/13 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 52.88 Issue Date . . Valuation . . . . 0 Expiration Date 4/24/13 Qty Unit Charge Per Extension BASE FEE 15.00 22.00 6.0000 EA PLB FIXTURE. 132.00 LQPERMIT LQPERMIT Application Number . . 12-00001281 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 4/24/13 Qty Unit Charge Per Extension BASE FEE 15.00 Special Notes and Comments SFD - LOT 12, PLAN 2B, 3198 SF. PERMIT DOES NOT INCLUDE POOL, SPA.,,BLOCK WALLS OR DRIVEWAY APPROACH. 2010 CODES. y Other Fees . . . . . . . ART IN PUBLIC PLACES -RES 227.18 BLDG STDS ADMIN (SB1473) 12.00 DIF COMMUNITY CENTERS -RES 104.00 DIF CIVIC CENTER - RES 1089.00 ENERGY REVIEW FEE 85.02 DIF FIRE PROTECTION -RES 612.00 DIF LIBRARIES - RES 334.00 MULTI -SPECIES (MSHCP) FEE 1254.00 DIF PARK MAINT FAC - RES 51.00 DIF PARKS/REC - RES 1773.00 i STRONG MOTION (SMI) - RES 29.09 " DIF STREET.MAINT FAC -RES 158.00 DIF TRANSPORTATION - RES 3592.0.0 Fee summary Charged Paid Credited Due' Permit Fee Total 1792.39 .00 .00 1792-.39 Plan Check Total 963.80. .00 .00 963.80 Other Fee Total 9320.29 .00 .00 9320.29 Grand Total 12076.48 .00 .00 12076.48 LQPERMIT