04-4740 (SFD)P.O. Box 1504
7=8r -495 -CAL -LE TAMPICO
L QU,I.N.TPI!CALIFORNIA 92253
NOY 10 2004 I'L.')l BUILDING PERMIT
Applioat^ronpl umber I . . .
Property Address . . . .
APN:
Application description
Property Zoning . . . .
Application valuation
Owner
LENNAR HOMES OF CALIFORNIA
78401 HIGHWAY 111, STE C
LA QUINTA, CA
LA QUINTA CA 92253
BUILDING & SAFETY DEPARTMENT
(760).777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
-=�&47760.0.0474A . 'Date 7/09/04
43496 BORDEAUX DR 5` }
609-380-997-55 -293233-
DWELLING - SINGLE FAMILY DETACHED
LOW DENSITY RESIDENTIAL
143155
Contractor
LENNAR HOMES OF CALIFORNIA INC
78401 HIGHWAY 111, SUITE C
LA QUINTA CA 92253
WCC: OLD REPUBLIC IN
WC:' MWC10877600 11/01/04
CSLB: 728102 09/30/04
CCC: B
------ Structure Information SFD -----
Construction Type . . . . TYPE V - NON RATED
Occupancy Type . . . . . DWELLG/LODGING/CONG <=10
Flood Zone . . . . . NON -AO FLOOD ZONE
Other struct info . . . . . CODE EDITION 2001 CBC
# BEDROOMS 5.00
FIRE SPRINKLERS NO
GARAGE SQ FTG 418.00
PATIO SQ FTG 45.00
NUMBER OF UNITS 1.00
FIRST FLOOR SQ FTG 2349.00.
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Permit . . . . . . BUILDING PERMIT
Additional desc
Permit Fee . . . . 793.50 Plan Check Fee.. 515.78
Issue Date . . . . Valuation . . . . 143155
.Qty Unit Charge Per Extension
BASE FEE 639.50
44.00 3.5000 THOU BLDG 100,001-500,000 !`�1�` 154.00
----------------------------------------------------- -----------------------
Permit., . . . . . . MECHANICAL
Additional desc
Permit Fee . . . . 47.00 Plan Check Fee 6.00
Issue Date . . . . Valuation . . . . 0
Qty Unit Charge Per Extension
P.O. BOX 1504 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: 0:774746 Date:
Applicant:
Applicant's Mailing Address:
or Engineer:
Arci ect or Engineer's Address:
&f Of q1;1_7a/
No. 3a3 Ys
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
C , and my LiM is in full force and effect. �
icenseClass e5censeNo. -7215i02-
D- % i ✓ V4d,&<<4
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. Arry 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 1, 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
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' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
is ue . M worl er' corn ensation insyfa�e came nd policy
/Carrier � � %r_ p iPtSf"cy Number , �i��pli1 &0th
_ 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 become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Dateant
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.).
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, and hereby authorize representatives of this countyytto�enter upon the above-mentioned property for inspection purposes.
_,Z�te � r Sig�plicant or Agent):
J
v
Application Number
T
Page 2
. . . 04-00004740 Date 7/09/04
Qty Unit
Charge
Per.
Extension
.BASE FEE
15.00
1.00
9.0000
EA MECH FURNACE <=100K
9.00
1.00
16.5000
EA MECH,B/C >3-15HP/>100K-500KBTU
16.50
1.00
6.5000
EA MECH EXHAUST HOOD
6.50
-------------------
Permit . . .
---------------------------------------------------------
. . .
ELEC-NEW RESIDENTIAL
Additional desc
Permit Fee .
. . .
105.58 Plan Check Fee
26.40
Issue Date .
. . .
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
'
BASE FEE
15.00
2349.00
.0350
oELEC NEW RES -1 OR 2 FAMILY
82.22
418.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
8.36
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Permit . . .
. . .
PLUMBING
Additional desc
Permit Fee .
. . .
164.25 Plan Check Fee
41.06
Issue Date .
. . .
Valuation . . . .
0
Qty 'Unit
Charge
Per
Extension
BASE FEE
15.00
16.00
6.0000
EA PLB FIXTURE
96.00
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
5.00
.7500
EA PLB GAS.PIPE >=5
3.75
1.00
15.0000
EA PLB GAS METER
15.00
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Permit . . .
. . .
GRADING PERMIT
Additional desc
Permit Fee .
. . .
15.00 Plan Check Fee
.00
Issue Date .
. . .
Valuation . . . .
01
Qty - Unit
Charge
Per
Extension
BASE FEE
-
15.00
-------------------
Special Notes
--------------------------------------------
and Comments
------------
SFD - LOT 55.
PLAN 2Y.'PERMIT
t
DOES NOT_;
4
:"
Fee summary Charged
Permit Fee Total 1125.33
Plan Check Total 589.24
Other Fee Total 2470.89
Grand Total 4185.46
Paid Credited Due
---------- ---------- ----------
.00, .00 1125:33
.00 .00 589.24
.00 .00 2470.89
.00 .00 4185.46
Page
3
Application Number . . . . .
04-00004740 Date
7/09/04
--------=-------------------------------------------------------------------
Special Notes and Comments
INCLUDE BLOCK WALL, POOL, SPA
OR
DRIVEWAY APPROACH.
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Other Fees . . . . . . . . .
ART IN PUBLIC PLACES -RES
.00
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
51.58
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
14.31
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary Charged
Permit Fee Total 1125.33
Plan Check Total 589.24
Other Fee Total 2470.89
Grand Total 4185.46
Paid Credited Due
---------- ---------- ----------
.00, .00 1125:33
.00 .00 589.24
.00 .00 2470.89
.00 .00 4185.46