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04-4623 (SFD)Property Address . . . . APN: Application description Property Zoning Application valuation Owner BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 2253 INSPECTION REQUESTS (760) 777-7153 ING PERMIT NORMAN ESTATES II C/O MEDALLIST GOLF DEVELOPMENT 501 NORTH AIA JUPITER FL 33477 a ' X04_0.00046.23 Date 5/27/04 81075 NATIONAL DR 767-500-003- - - DWELLING - SINGLE FAMILY DETACHED LOW DENSITY RESIDENTIAL 342299 Contractor ---------------- EHLINE COMPANY 55375 MEDALLIST DR LA QUINTA CA 92253 (760) 7.71-8130 WCC: STATE FUND WC: 2290006783 01/01/05 CSLB: 482086 11/30/05 CCC: B --------------------------- Structure'Information------------------= 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 4.00 FIRE SPRINKLERS NO GARAGE SQ FTG 843.00 PATIO SQ FTG 698.00 NUMBER OF UNITS 1.00 FIRST FLOOR SQ FTG 3917.00 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc Permit Fee 1490.00 Plan Check Fee 242.13 Issue Date Valuation'. 342299 Qty Unit Charge Per Extension BASE FEE 639.50 243.00 3.5000 THOU BLDG 100,001-500,000 850.50 -------=-------------------------------------------------------------------- Permit . . . . . . MECHANICAL Additional desc Permit Fee . . . . 109.50 Plan Check Fee 6.85 Issue Date . . . . Valuation 0 Qty Unit Charge Per Extension t Page 2 Application Number 04-00004623 Date 5/27/04 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 18.0.0 8.00 6.5000 EA MECH VENT FAN 52.'00 1.00 ---.------------------------------------------------------------------------- 6.5000 EA MECH EXHAUST'HOOD 6.50 Permit . . . . . . .ELEC -NEW RESIDENTIAL Additional desc Permit Fee I. . . 168.96 Plan Check Fee 10.56 Issue Date. Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 3917.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 137.10 843.00 ---------------------------.------------------------------------------------- .0200 ELEC GARAGE OR NON-RESIDENTIAL 16.86 Permit . . . . . . PLUMBING Additional desc Permit Fee 187.50 Plan Check Fee 11.72 Issue Date, Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 19.00 6.0000 EA PLB FIXTURE 114.00 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 12.00 .7500 EA PLB GAS PIPE >=5 9.00 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 Qty Unit Charge Per Extension -------------------------------------------------------- BASE FEE 15.00 . Special Notes and Comments -------------------- SFD - TR 29657, LOT 17. PLAN 4A..PERMIT. v Page 3 Application Number ------------------------------------------------ . . . . . 04-0.0004623 Date 5/27/04 Special Notes and Comments ---------------------------- DOES NOT INCLUDE BLOCK WALLS, POOL, SPA OR DRIVEWAY APPROACH. 75% REDUCTION TO. PLAN CHECK -FEE DUE TO MULTIPLE ISSUANCE OF SAME PLAN TYPE ---------------------------------------------------'------------------------- Other Fees . ... . . . . . . ART IN PUBLIC PLACES -RES 355.74 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 24.21 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 34.22 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Paid Credited Due Permit Fee Total 1970.96 .00 .00. 1970.96 Plan Check Total 271.26 .00 .00 271.26 Other Fee Total 2819.17 .00 .00 2819.17 Grand Total 5061.39 .00 .00 5061.39 P.O. BOX 1504 T--af 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Applicant: Hppllcanus Mailing Address: BUILDING & SAFETY DEPARTMENT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: "Architect or Engineer: IArchitect 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 Cade, and my Licena is icen in full force and effect. '� , `RZ� �6 ">icense Class se No. C.1 rDate — Comractor_ 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).): ( j 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 16an 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 iof the work for which this permit is issued. I have and will maintain workers' compens insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is l � ds,Sued. My w com ensati surance cameLand of y number �arier = t AA-- j o.�Policy Number J � C> _ 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' compensation laws of California agree that, if I should become subject to the workeirs' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pro isio s. ate a �"'- 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 ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I herebyaffirm under y perjury CONSTRUCTION LENDING AGENCY penalty of a 'u that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lenders Name Lender's Address IMPORTANT APPLICANT ACKNOWLEDGEMENT 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, indemnity and hold harmless the City of Le 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 dayt 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 info tion 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 toWnbruthe above- mentioned property for inspection purposes. —194 ignaS lure (Applicant or Agent)•