04-3753 (SFD)1
v .
of �'°ie�•
FAN BUILDING & SAFETY DEPARTMENT
.O. Box 1504 (760).777-7012
78-495 CALLE TAMPICo FAX (760) 777-7011
LA QUINT -A, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT r
Application Number .
. . . . 04-00003753 Date 4/29/04
Property Address.
48252 BIG HORN DR
APN:
658-140-999-12 -29436 -
Application description DWELLING - SINGLE FAMILY DETACHED
Property Zoning . . :
. . . . LOW DENS. ITY'RESIDENTIAL
Application valuation
197485
Owner
Contractor
IVANHOE LA QUINTA COVE TRANS WEST. HOUSING,
INC.
C/O R BARRY MCCOMIC
9968 HIBERT STREET,
STE #102
7979 IVANHOE AVE STE
550'' SAN DIEGO
CA 92131
LA JOLLA
CA 92037 (858) 653 -3003 -
WCC: STATE FUND
WC: 1648813,
10/01/04
CSLB: 701039
01/31/05
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 CBC
FIRE SPRINKLERS NO
GARAGE SQ FTG
672.00
PATIO SQ FTG
814.00
NUMBER OF UNITS
1.00
FIRST FLOOR SQ FTG
3033.00
---------- --------------------
Permit . . . . . .
----------------------------------------------
BUILDING PERMIT
Additional desc . .
Permit Fee
982.50 Plan Check Fee
159..66
Issue Date
Valuation
197485
Qty Unit Charge
Per
Extension
BASE FEE
639.50
98.00 3.5000
THOU BLDG 1.00,001-500,000
343.00
Permit . . . . . .
ELEC-NEW RESIDENTIAL
.Additional desc
Permit Fee
181.82 Plan Check Fee
.94
Issue Date
Valuation
0
Qty Unit Charge Per
Extension
P.O. Box 1504�� VOICE (760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA_ 92253 444' '. ,� INSPECTIONS (760) 777-7153
BUILDING Bt: SAFETY DEPARTMENT
Application Number:
Applicant:
Applicant's Mailing Address:
Date:
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
Code, and my License i full force and effect. 2 OIT_
License Class License No.
Date ' Q Contractor
OWNER -BUILDER DEC TION
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 1, 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.).
.0 I am exempt under Sec. , B.8 P.C. for this reason
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.
_ 1 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
is u d y w c pensation insurance caner an Ipo i ngtL9
Cartier � Policy Number 1 ("�—�c2 L*3
-
- I certify that, in the performance of the work for which this sigpermit' issued, l 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 - �/ 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.
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
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 with all 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 for inspection purposes.
Date �� Signature (Applicant or Agent):
Page
2
Application Number
.
. .
. . 04-00003753
Date
4/29/04
Qty Unit
Charge
Per
Extension
BASE
FEE
15.00'
3033.00
.0350
ELEC
NEW RES - 1 OR 2 FAMILY
106.16
3033.00
.0200
ELEC
GARAGE OR NON-RESIDENTIAL
60.66
----------------------------------------------------------------------------
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 .
.
79.00
Plan Check Fee
4.94
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
16.5000
EA
MECH
B/C >3-15HP/>100K-500KBTU-
33.00
1:.00
6.5000
EA
MECH
VENT -FAN
6.50
1.00
6.5000
EA
MECH
EXHAUST HOOD
6.50
-----------------7----------------------------------------------------------
Permit . . .
. . .
PLUMBING
Additional desc-.
Permit Fee .
. . .
190.50
Plan Check Fee
11.91
Issue Date .
. . .
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
BASE
FEE
15.00
20.00_
6.0000
EA
PLB
FIXTURE
120.00
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
8.00
.7500
EA
PLB
GAS PIPE >=5
6.00
1.00
15.0000
EA
PLB
GAS METER
15.00
-----------------------`----------------------------------------------------
Special Notes
and Comments
SFD, LOT 12, PLAN 3C.
PERMIT
DOES
NOT
Page 3
Application Number
. . . . .
04-00003753 Date
4/29/04
----------------------------------------------------------------------------
Special Notes and Comments
INCLUDE BLOCK WALL,
POOL, SPA,
OR
DRIVEWAY APPROACH.75% PLAN CHECK
FEE
REDUCTION FOR MULTIPLE
ISSUANCE
OF SAME
PERMIT TYPE.
----------------------------------------------------------------------------
Other Fees . . . .
. . . . .
ART IN PUBLIC PLACES-RES
.00
DIF COMMUNITY CENTERS-RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
15.97
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
19.74
DIF STREET MAINT FAC-RES
15.00
DIF TRANSPORTATION - RES
1098.00
' Fee summary.
--'--------------
Charged
----------
Paid Credited
------------------------------
Due
Permit Fee Total
1448.82
.00 .00
1448.82
Plan Check Total
177.45
.00 .00
177.45
Other Fee Total
2440.71
.00 .00
2440.71
Grand Total
4066.98
.00 .00
4066.98