07-0697 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4ht °f 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 07-00000697
Property Address: 57551 BARRISTO CIR
APN: 762-240-015-2 -32225 -
Application description: DWELLING - SINGLE FAMILY DETACHED
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 199592
Applicant: cc rchitect or Engineer:
.�tyt;'t✓ �l^� M t
3s�c1
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/06/07
Owner:
G5 ENTERPRISES, INC.
6347 DI VITA WAY
CARLSBAD, CA 92009
D°
Fm
AY 012007 tri
E
2240
CITY OF LA QUINTA EN I
— FINANCE DEPT. (7 60
-r L>_C .
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 Pro essionals Code, and my License is in full force and effect.
License Class: 11337 License No.: 854569
Date: S ( 1c \ ntractor:
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 _ 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 contractors) 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
Ictor: .
CONSTRUCTION, INC.
ENCINITAS BLVD, STE D-485
VITAS, CA 92024
)594-2282
No.: 854569
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
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 issued. My workers' compensation
insurance carrier and policy number are:
Carrier STATE FUND Policy Number 1848754
_ 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 bec a subject to the workers' compensation provisions of Section
13700 of the LaborvCod�e,7ss,p orthwith comply with those provisions.
;)Me: 511 `�1 plicam:
WARNING: FAIL RE 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 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' formation is correct. I agree to comply with all
city and county ordinances a state laws relating to building cans ruction, and hereby authorize representatives
oft ' county to enter up the above-mentioned property fo insp tion purposes.
ate: J 1 Z gnature (Applicant or Agent"
Application Number . . . 07-00000697
Permit
. . .
BUILDING PERMIT
Additional
desc . .
Permit Fee
. . . .
989.50
Plan Check Fee
643.18
Issue Date
. . . .
Valuation . . . .
199592
Expiration
Date
10/03/07
Qty. Unit Charge
Per
Extension
BASE
FEE
639.50
100.00
----------------------------------------------------------------------------
3.5000
THOU BLDG
100,001-500,000
350.00
Permit
MECHANICAL
Additional
desc .
Permit Fee
. . . .
129.50
Plan Check Fee
32.38
Issue Date
. .
Valuation . . . .
0
Expiration
Date
10/03/07
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
3.00
9.0000
EA MECH
FURNACE <=100K
27.00
1.00
9.0000
EA MECH
B/C <=3HP/100K BTU
9.00
2.00
16.5000
EA MECH
B/C >3-15HP/>100K-500KBTU
33.00
6.00
6.5000
EA MECH
VENT FAN
39.00
1.00
---------------------------------------------------------------------•-------
6.5000
EA MECH
EXHAUST HOOD
.6.50
Permit
. . .
ELEC-NEW RESIDENTIAL
Additional
desc .
Permit Fee
. . . .
140.81
Plan Check Fee
3.5.20
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date
10/03/07
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
3222.00
.0350
ELEC
NEW RES - 1 OR 2 FAMILY
112.77
652.00 •
----------------------------------------------------------------------------
.0200
ELEC
GARAGE OR NON-RESIDENTIAL
13.04
Permit . . . PLUMBING
Additional desc . .
Permit Fee . . . . 193.50
Issue Date . . . .
Expiration Date.. . 10/03/07
Qty • Unit Charge Per
BASE FEE
20.00 6.0000 EA PLB FIXTURE
LQPERMTT
Plan Check Fee . . 78.38
Valuation . . . . 0
Extension
15.00
120.00
Application Number . . . . . 07-00000697
Permit . . . . . . PLUMBING
Qty
Unit Charge
Per
BASE FEE
Extension
1.00
15.0000
EA
PLB
BUILDING SEWER
15.00
.00
6.0000
EA
PLB
ROOF DRAIN
.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
Issue Date . . . .
Expiration Date . . 10/03/07
Plan Check Fee
Valuation . .
Qty Unit Charge Per
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes and Comments
SFD - LOT 2, PLAN 4A, 3222
SF. PERMIT
DOES NOT INCLUDE POOL, SPA,
BLOCK WALLS
OR DRIVEWAY APPROACH
2001 CBC, CMC, CPC, 2004 CEC,
2005
ENERGY CODES
----------------------------
Other Fees . . . . . . . .
-----------------------------------------
. ART IN PUBLIC PLACES -RES
20.00
DIF COMMUNITY CENTERS -RES
74.00
DIF CIVIC CENTER - RES
995.00
ENERGY REVIEW FEE
64.32
DIF FIRE PROTECTION -RES
140.00
GRADING PLAN CHECK FEE
.00
DIF LIBRARIES - RES
355.00
DIF PARK MAINT FAC - RES
22.00
DIF PARKS/REC - RES
892.00
STRONG MOTION (SMI) - RES
19.95
DIF STREET MAINT FAC -RES
67.00
DIF TRANSPORTATION - RES
1930.00
Fee summary
-----------------
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
LQPERMIT
Charged Paid
1468.31 .00
789.14 .00
4579.27 .00
6836.72 .00
Credited Due
.00 1468.31
.00 789.14
.00 4579.27
.00 6836.72