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04-7118 (SFD)y T-Vf °F:wQUAtw BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760),777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number . . . Dat.e 11/08/04 Property Address . . . . . . 57565 BALLYBUNION APN: •762-330-015- - - Application description . . . DWELLING - SINGLE FAMILY DETACHED Property Zoning LOW DENSITY RESIDENTIAL Application valuation . . . . 335607 Owner Contractor - ------------------------ WEISKOPF PARTNERS 1, ------------------------ LLC SOUTHERN HILLS DEVELOPMENT INC 55161 SOUTHERN HILLS 81070 CHANTICLEER DR LA QUINTA CA 92253 LA QUINTA CA 92253 (760) 771-3497 WCC: EXEMPT WC: EXEMPT 05/31/05 CSLB: 838041 05/31/06 CCC: B --------------------------- Structure Information ------------------------- Construction Type . . . . . TYPE V - NON RATED ,Occupancy Type . . . . . . DWELLG/LODGING/CONG <=10 -Flod'd 2,one NON -AO FLOOD ZONE Other-_-sUruct info . . . . . CODE EDITION 2001 CBC BEDROOMS 4.00 FIRE -SPRINKLERS NO GARAGE SQ FTG 826.00 PATIO SQ FTG 803.00 NUMBER OF UNITS 1.00 >�=� FIRST FLOOR SQ FTG, 382.1. 0;0 ----- - -------------- Permit BUILDING PERMIT Addi-tional desc Permit Fee . . . . 1465.50 Plan Check Fee 238.15 Issue Date Valuation . . . . 335607 Qty Unit Charge Per Extension BASE FEE 639.50 236.00 3.5000 THOU BLDG 100,001-500,000 826.00 --------------------------------------------------------- Permit . . . . . . ------------------- MECHANICAL Additional desc Permit Fee . . . . 126.00 Plan Check Fee 7.86 Issue Date Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 4.00 9.0000 EA MECH FURNACE <=100K 36.00 4.00 9.0000 EA MECH B/C <=3HP/100K BTU 36.00 5.00 6.5000 EA MECH VENT FAN 32.50 P.O. Box 1504I4 CE VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: tom' 71 i8 Date: 4(, 4G� Applicant: c Itect or En (neer: Applicant's Mailing Address: architect or Engineer's Address: _—.ic. 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 Code, and my Li a is in full force and effect. ) cense Class 1`7License No. 1 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 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 of the work for which this permit is issued. _ I have and will maintain workers' compInsation 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 pisurance carrier and policy number are: Carrier Wolicy Number, I certify that, in the performance of compensationlaws of Califomi forthwith comply with those pr y ant � WARNING: FAILURE TO SECURE WORKERS' CIVIL FINES UP TO ONE HUNDRED THOUSAP SECTION 3706 OF THE LABOR CODE, INTERE work foryffiich this rmit is issued, I shall not employ any person in any manner so as to become subject to the workers' J agree at, if l sho ld bJesorae-s4ect to the workers' compensation provisions of Section 3700 of the Labor Code, I shall ISATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND ,RS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN 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.). Lenders Name Lender's 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, ch 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 af licant, 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 rel ted to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application beco"I'� is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cI certify that I have read this applicationand state that the aboveagree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county -men an rpperty for inspection purposes. -01 ignature (Applicant or Agent): Application Number 04-00007118 Page 2 Date 11/08/04 Qty Unit Charge Per Extension 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 ---------------------------------------------------------------------------- Permit . . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee . . . . 165.26 Plan Check Fee 10.33 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 3821.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 133.74 826.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 16.52 ---------------------7------------------------------------------------------ Permit . . . . . . PLUMBING Additional desc Permit Fee . . 182.25 Plan Check Fee 11.39 Issue Date Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 17.00 .6.0000 EA PLB FIXTURE 102.00 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 11.00 .7500 EA PLB GAS PIPE >=5 8.25 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 - LOT 43, PLAN 7REVERSED. PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL, SPA OR DRIVEWAY APPROACH. 750-8 REDUCTION TO PLAN CHECK FEE DUE TO MULTIPLE ISSUANCE OF SAME PLAN TYPE ------------------------=------------- Other Fees . . . . . -------------------------------- . . ... ART IN PUBLIC PLACES -RES ------ 339.01 DIF COMMUNITY CENTERS -RES 97.00 Page 3 Application Number . . . . . 04-00007118 Date 11/08/04 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 23.82 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. 33.56 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Permit Fee Total 1954.01 Plan Check Total -267:73 Other Fee Total 2801.39 Grand Total 5023.13 Paid Credited Due ---------- ---------- ---------- .00 .00 195.4..01 .00 .00 267.73 .00 .00 2801.39 .00 .00 5023.13 JOB ADDRESS CITY OF LA QUINTA PERMIT NUMBER SUB -CONTRACTOR LIT I \ OWNER,\ e► 1C� � C.r ,�C.v BUILDER �D This form shall bel2osted on the job with the Building Inspection Card at all times in a conspicuous lace. Only persons appearing on this list or their employees are authorized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance