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04-8117 (SFD)0 U - BUILDING & SAFETY DEPARTMENT w� Box 1504 (760).777-7012 -4 CALLE TAMPICO FAX (760) 777-7011 �•� �PLn UJNTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Appl •cation Number . . . . 040=0_0'08117 Date 2/02/05 erty Address . . . 81355 NATIONAL DR APN: 767-570-002- - - Application description . . . DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . . LOW DENSITY RESIDENTIAL Application valuation . . . . 323904 Owner Contractor ------------------------ ---------------- NORMAN ------- NORMAN ESTATES II EHLINE COMPANY C/O MEDALLIST, GOLF DEVELOPMENT 55375 MEDALLIST DR 50.1 NORTH AlA LA QUINTA CA 92253 JUPITER FL 33477 (760) 771-8130 WCC: STATE FUND WC: 2290006783 01/01/06 CSLB: 482086 11/30/05 CCC: B. -------------------------- Structure Information ------------------------- Construction Type . . . . . TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/CONG <=10 Flood Zone . . . . . . . . NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 CRC # BEDROOMS 4.00 FIRE SPRINKLERS NO GARAGE SQ FTG 646.00 PATIO °SQ ;FTG '729.00 NUMBER OF UNITS 1.00 1ST FLOOR SQUARE FOOTAGE 3732.00 Permit ELEC-NEW RESIDENTIAL Additional desc . . Permit.Fee . . . . 158.54 Plan Check Fee 39.64 Issue Date . . . . Valuation 0 Qty Unit Charge Per Extension . BASE FEE 15.00 3732.00 .0350 ELEC'NEW RES - 1 OR 2 FAMILY 130.62 646.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 12.92 ----------------------------------------------------- ------------------- ----------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc Permit Fee . . . . 1423.50 Plan Check Fee 925.28 Issue Date . . . . Valuation . . . . 323904 Qty Unit Charge Per,, Extension .- :__' :.BASE ; FEE �.: ,�;, � ,.. ; � • •6.39.50 224.00 3.5000 THOU BLDG 100,00'1'500,000 784.00 41 _1411111 P.O. BOX 1504• �� VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 4INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Date: 3 • as Applicant: Applicant's Mailing Address: �,,( -T-e 4 r chltect or Engine r: � u eLS+-k&+e(As l y - -alfa Architect or Engineer's A rens: AIIA Lic. No.: u y09 BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION /I hereby affirm under penalty of perjury that I am licensed u der provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License .gn full force and effect. r �O License Class n License No. !� 8to / Date3 of ContractKr ''VII�I�I� l O 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).): 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 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. ]c 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 �,i sued My wo�jers' compensation insurance carrier n p licy� tuber are:8 Carrier 5-4 -e %UNIT Policy Number = (Aa 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, 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. Date 3 qL4a Applicarrt 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. 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 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 wit"ll 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 fqr inspection purposes. Kate** Signature (Applicant or Agent):./// Page 2 Application Number . . . . . 04-00008117 Date 2/,02/05 ---------------------------------------------------------------------------- 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 ----------------------------------------------------------------------------- Permit . . . . . . MECHANICAL Additional desc Permit Fee . . . . 109.50 Plan Check Fee 27.38 Issue Date . . . . Valuation . . . . 0 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 8.00 6.5000 EA MECH VENT FAN 52.00 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 ----------------------------- Permit . ... . . . ----------------- ---------------------------- PLUMBING Additional desc Permit Fee . . . . 203.25 Plan Check Fee 50.81 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 22.00 6.0000 EA PLB FIXTURE 132.00 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 9.00 .7500 EA PLB GAS PIPE >=5 6.75 1.00 15-0000 EA PLB GAS METER 15.00 ---------------------------------------------------------------------------- Special Not and Comments SFD - LOT 1. PLAN 3A. PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL, SPA OR DRIVEWAY APPROACH. --------------------------------- Other Fees . . . . . --------------------------- ----------------- . . . . ART IN PUBLIC PLACES -RES 309.76 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00. ENERGY REVIEW FEE 92.53 DIF FIRE PROTECTION-RIES 97.00 Page 3 Application Number -------------------------- 04-00008117 Date 2/02/05 Other Fees . . . ------------- . . ... . . ------------------------------------- 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 32.39 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary ----------------- Charged Paid Credited Due Permit Fee Total ----- - ---- 1909.79 ---------- ---------- .00 ---------- .00 1909.79 Plan Check Total 1043.11 .00 ..00 1043.11 Other Fee Total 2839.68 .00 .00 2839.68 Grand Total 5792.58 .00 .00 5792.58