04-5905 (SFD)r'
y,
N
T,Vf 4 4 a"
T %;z _7P O. Box 1504
t�9 8-495 CALLS TAMPICO
@A QUINTA, CALIFORNIA 92253
BUILDING PERMIT
Ty OF
tA--�
FA .j--ARcation Number . . .
Property Address . . .
APN:
Application description
.Property Zoning . . . . .
Application valuation . .
BUILDING & SAFETY DEPARTMENT
(760).777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
-4-00005905, Date 8/11/04
43223 BORDEAUX DR
609 -380 -997 -45 -293233 -
DWELLING - SINGLE FAMILY DETACHED
LOW DENSITY RESIDENTIAL
201360
Owner Contractor
PONDEROSA HOMES II, LLC PONDEROSA HOMES II, INC.
400 S. FARRELL DRIVE,
B103 6671 OWENS DRIVE
PALM SPRINGS, CA 92264
PLEASANTON
CA 94588
LA QUINTA
CA 92253 (760) 318-7710
WCC: REPUBLIC
WC: 15671602
10/01/04
CSLB: 752884
08/31/04
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 CRC
# BEDROOMS
5.00
FIRE SPRINKLERS
NO,
GARAGE SQ FTG
502.00
PATIO SQ FTG
500.00
NUMBER OF UNITS
1.00
FIRST FLOOR SQ FTG
3232.00
----------------------------------------------------------------------------
Permit . . . . . .
BUILDING PERMIT
. Additional desc
Permit Fee
996.50 Plan Check Fee
161.93
Issue Date
Valuation . .
. . 201360
Qty Unit Charge
Per
Extension
BASE FEE
639.50
102.00 3.5000
THOU BLDG 100,001-500,000-
357.00
----------------------------------------------------------------7------------
Permit . . . . . ..
MECHANICAL
Additional desc . .
Permit Fee
83.50 Plan Check Fee
5.22
Issue Date
Valuation . .
. . 0
Qty Unit Charge Per
Extension
P.O. Box 1504�� VOICE (760) 777-7012
Tedf
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 041' 1 Date: • 30.044
Applicant:
Applicant's Mailing Address:
—PTchitect or Engineer:
Archi or Engineer's.,
ddress:
A�tJ • ��-c�r�3 S
ic. No. C �Q�33
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
Carl
e, and my License ' full force and effect.
rIce
ise Class Class ` icense No.
,,date et5ntractor
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 corrfpietion, 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:
t 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' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
�d. My w errs' compensationo surance carrier and oficynumber are:
�rier l/,lal / Policy Number /�1o7/(� Z�
_ I comfy 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'
corrigensation 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
7 forttth comply with those provisions.
WARNfNG: 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
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, 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, d h reby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes.
Date Si (Applicant or Agent):
Application Number
. . : . . 04-00005905
Page 2
Date 8/11/04
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
4.00
6.5000
EA MECH VENT FAN
26.00
1.00
6.5000
EA MECH EXHAUST HOOD
6.50
----------------------------------------------------------------------------
Permit .
. . . . . ELEC-NEW RESIDENTIAL
Additional
desc
Permit Fee
138.16 Plan Check Fee
8.47
Issue Date
. . . .
Valuation . . . .
0
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
3232.00
.0350
ELEC NEW RES - 1 OR 2 FAMILY
113.12
502.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
10.04
----------------------------------------------------------------------------
Permit
PLUMBING
Additional
desc
Permit Fee
. . . .
196.50 Plan Check Fee
11.16
Issue Date
Valuation . . . .
0
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
21.00
6.0000
EA. PLB FIXTURE
126.00
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
-------------7--------------------------------------------------------------
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 ," ..'M'-,;4�;.
SFD - LOT
45. PLAN 3AXL+OPTION BEDROOM
Page 3
Application Number
. . . . .
04-00005905 Date
8/11/04
-----------------------------------------------------------------'-----------
Special Notes and
Comments
5/BATH 4(179 SF)
W/2 CAR GARAGE
(GARAGE
502 SF) PERMIT DOES
NOT INCLUDE
BLOCK,
.WALLS, POOL, SPA,
OR DRIVEWAY APPROACH.
75% REDUCTION TO
PLAN CHECK FEE.DUE
TO
MULTIPLE ISSUANCE
OF SAME PLAN
TYPE
----------------------------------------------------------------------------
Other Fees . . .
. . . . . .
ART IN PUBLIC PLACES -RES
20.00
DIF COMMUNITY CENTERS -RES
97.00
DIF -CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
16.19
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
19.46
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
------------------
Charged
----------
Paid Credited
Due
Permit Fee Total
1429.66
---------- ---------- ----------
.00 .00
1429.66
Plan Check Total
186.78
.00 .00
186.78
Other Fee Total
2460.65
.00 .00
2460.65
Grand Total
4077.09
.00 .00
4077.09