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05-4605 (SFD)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T,&t 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: C_05-000046 5 Owner: Property Address: 5'21 -4 -6 -ROSEWOOD LN _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided HOMES - CODORNIZ APN: 772-410-997-36 -32070 - U U BOX 810 Application description: DWELLING - SINGLE FAMILY DETACHED insurance carrier and policy number are: • CA 92253 . Property Zoning: MEDIUM HIGH DENSITY RES OCTQUINTA, UQUINTA lCntractor: Application valuation: 100157 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 CITY any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars 1$5001.: Applicant: �rchitect or Engineer: FINA HOMES LLC 5 E. UNIVERSITY DRIVE PHOENIX, AZ 85034 (760)123-4567 Lic. No.: 690645 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/14/05 -------------------'------------------------------- - 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 Professions 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: A -B License No.: 690645 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is ater� ntractor: issued. 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 0014793-2005 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, 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 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 La or Code, I shall forthwith ith those provisions. 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 1$5001.: D�tE�O-A ' 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 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.). (_ I 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 ry irritant to the Gats Liaonaa Lo.. ). I _ I 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 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. 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 thio aggllGatlgn is mar1P, rash narsnn at whnse rarlimrt 2nd fnr 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 ouinta, 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 lawsrelating to building con . ' n, and hereby authorize representatives of this c my toenterupon the ove-mentioned property spection S. A_ 5 ature (Applicant or Agent): Application Number 05-00004605 Permit . . . BUILDING PERMIT Additional desc . Permit Fee 643.00 Plan Check Fee 104.49 Issue Date . . . . _ Valuation . . . . 100157, Expiration Date 4/12/06 Qty Unit Charge Per Extension BASE FEE 639.50 1.00 3.5000 ---------------------------------------------------------------------------- THOU BLDG 100,001-500;000 3.50 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 52.50 P1an.Check Fee 3.28 Issue Date Valuation . . . . 0 Expiration Date 4/12/06 Qty. Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 .1.00 9.0000 EA. MECH B/C <=3HP/100K BTU 9.00 2.00. 6.5000 EA. MECH VENT FAN 13.•00 1.00 6.5000 ------------------------------------------------------------------------------- EA MECH EXHAUST HOOD 6.,50 Permit . . . ELEC-NEW RESIDENTIAL Additional desc . Permit Fee . . . . 79.66 Plan Check Fee 4.98 Issue Date . . . . Valuation .. . . .. 0 Expiration Date 4/12/06 Qty Unit Charge Per Extension BASE FEE 15.00 1592.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 55.72 447.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 8.94 Permit . . . PLUMBING Additional desc . Permit Fee 140.25 Plan Check Fee 7.83 Issue Date Valuation . . 0 - Expiration Date 4/12/06 Qty Unit Charge Per 'Extension BASE FEE 15.00 "12.00 6.0000 EA PLB FIXTURE 72.00. 1.00 15.0000 EA PLB BUILDING SEWER 15.00 LQPERMIT Application Number. . . . . . 05-00004605 Permit . . . . . . PLUMBING BASE FEE Qty Unit Charge Per' Extension 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 5.00 .7500 EA PLB GAS PIPE >=5 3.75 1.00 ---------------------------------------------------------------------------- 15.0000 EA PLB GAS METER 15.00 Permit . ... . . . GRADING PERMIT Additional desc 366.00 Permit Fee . . . . . .15.00 Plan Check Fee .00 Issue Date . . . . Valuation 0 Expiration Date. . 4/12/06 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments ---------------- SFD - LOT 36, PLAN SF3A,.1592 SF. PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS ORBLDG.:Mq P/ 04 CECf05'ENERGV.11 DRIVEWAY APPROACH. 75% REDUCTION TO 77 PLAN CHECK FEES DUE TO MULTIPLE ISSUANCE OF SAME PLAN TYPE ---------------------------------------------------------------------------- Other Fees . . . . . . . . . DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE - 10.45 DIF FIRE PROTECTION -RES 97.00 DIF LIBRARIES - RES 22�5.00 DIF PARK MAINT FAC RES 5.00 DIF PARKS/kEC - RES .502.00 STRONG MOTION (SMI) RES 10.01 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 109.8.00 Fee summary Charged ----------------- ----------- Paid Credited ---------- --- ---- ---------- Due Permit Fee Total 930.41 7-7 .00 .00 930.41 Plan Check Total 120.58 .00 .00 120.58 Other Fee Total 2425.46 .00 .00 2425.46 urand 'roral 34/6.45 . ou, . 00 3476.46 LQPERMIT l IN Own ��. Certificate of ccupancy ti z Noaar_,aInn Ccs C� OFBuilding & Safety Department This Certificate is issued pursuant to the requirements of Section 109 of the California Building Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. - --.-BUILDING ADDRESS: 52-146 ROSEWOOD LANE Use classification: SFD Building Permit No.: 05-4605 Occupancy Group: R3 Type of Construction: VN Land Use Zone: RMH Owner of Building: RJT-CODORNIZ Address: P.O. BOX 810 City, ST, ZIP: LA QUINTA, CA 92253 By: DAVID GATICA Date: AUGUST 25, 2006 Building Official POST IN A CONSPICUOUS PLACE {