04-6373 (SFD)s
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BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760).777-7012
c��►tpp 9 ; 78 495 CAj- - TAMPICo FAX (760) 777-7011
e LA' QUINTA, ,CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
1 � � BUILDING PERMIT
App-1_i_-atiorn'�Num_ber__; . . . . . 0=4=00.000637 Date, 9/21/04
Property Address . . . . . 181.6_7-5—BROWN DEER PARK
APN: 767-540-004- - -
Application description . . . DWELLING - SINGLE FAMILY DETACHED
Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL
Application valuation . . . . 370077
Owner Contractor
CALIFORNIA COVE @LA QUINTA LLC CALIFORNIA COVE COMMUNITIE INC
8105 IRVINE CENTER DRIVE #800 8105 IRVINE CENTER DR
IRVINE CA 92618 SUITE 800
IRVINE CA 92618
(949) 453-1775
WCC: STATE FUND
WC: 1659679 05/03/05
CSLB: 811053 07/31/06
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 670.00
PATIO SQ FTG 496.00
NUMBER OF UNITS 1.00
FIRST FLOOR SQ FTG 4336.00
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Permit . . . . . . BUILDING PERMIT
Additional desc
Permit Fee . . . . 1588.00 Plan Check"Fee 258.05
Issue Date . . . . Valuation . . . . 370077
Qty 'Unit Charge Per Extension
BASE FEE 63'9.50
271.00 3.5000 THOU BLDG 100,001-500,000 948.50
----------------------------------------------------------------•------------
Permit . . . . . . MECHANICAL
Additional desc . .
Permit Fee . . . . 96.50 Plan Check Fee 6.03
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 4INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 04-63-73 Date: 12
Applicant: itect or Engine r
42�A hr
Applicant's Mailing Address: -,Architect or Engin er'sAddress:
Cir L4wyf,
Lic. No.. if-- / 2, 174
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licen under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
Cie, and my Licen in full force and effect.
//license Class <icense No.
_--Date 2 ontractor eo.QL, /-0
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of pe a hat 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 permi 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 fora 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
1 of the work for which this permit is issued.
I have and will maintain workers' compensation ins a ce, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
�C' iss y wo ers' compensation i nce . r a d olic pu r are:
gamer �T�1 #--Lt olicy Nu b 110 �G�(D
I certify that, in the performance of the work r ich 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, a that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those pro i ro
WARNING: FAILURE TO SECURE W RS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED USAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR COCIE, 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 aFbingo�erfomn.a
tdshll, defend, indemnify and hold harmless the City of La Quinta, its
officers, agents and employees for any actor omission related to the wo under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void' is not commenced within 180 days from date of issuance of such pernit, or
cessation of work for 180 days will subject permit to cancellation.
1 certify that I have read this application and state that the above inform ' ect. I agree to comply with all city and county ordinances and state laws relating to building
construction, a he y authorize representatives of this county to er the above-mentioned property for inspection purposes.
pace Q ignature (Applicant or Agent):
Application Number . . . . . 04-00006373
Page 2
Date 9/21/04
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
6.00
6.5000
EA
MECH VENT FAN
39.00
1.00
6.5000
EA
MECH EXHAUST HOOD
6.50
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Permit .
. . . . .
ELEC-NEW RESIDENTIAL
Additional
desc . .
Permit Fee.
. .
180.16 Plan Check Fee
11.26
Issue Date
. . . .
Valuation . . . .
0
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
4336.00
.0350
ELEC NEW RES - 1 OR 2 FAMILY
151.76
670.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
13.40
------------------------
Permit .
--
. . . .
PLUMBING
Additional
desc . .
Permit Fee
. . . .
205.50 Plan Check Fee
12.85
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
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
10.00
.7500
EA
PLB GAS PIPE >=5
7.50
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 . . . .
0
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
----------------------------------------'------------------------------------
Special Notes and Comments
SFD - LOT
4. PLAN 3BR,
4336
SF. PERMIT
i✓
Fee summary Charged
Permit Fee Total 2085.16
Plan Check Total 288.19
Other Fee Total 2893.00
Grand Total 5266.35
Paid Credited
.00
Page
3
Application Number . . . . .
04-00006373 Date
9/21/04
----------------------------------------------------------------------------
Special Notes and Comments
.00
DOES NOT INCLUDE BLOCK WALLS,
POOL, SPA
OR DRIVEWAY APPROACH. 75% PLAN
CHECK FEE
REDUCTION APPLIED FOR MULTIPLE
ISSUANCE
OF SAME PLAN TYPE.
----------------------------------------------------------------------------
Other Fees . . .
ART IN PUBLIC PLACES -RES
425.19
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
25.81
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
37.00
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary Charged
Permit Fee Total 2085.16
Plan Check Total 288.19
Other Fee Total 2893.00
Grand Total 5266.35
Paid Credited
.00
.00
.00
.00
.00
.00
.00
.00
Due
2085.16
288.19
2893.00.
5266.35
A
�-a- �c Certificate of Occupancyo
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G OF'TBuildin & Safet Department
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This Certificate is issued pursuant to the requirements of Section 109 of the California Building
y
Code, certifying that, at the time of issuance, this structure was in compliance with the
provisions of the Building Code and the various ordinances of the City regulating building
construction and/or use.
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k
S ,
BUILDING ADDRESS: 81-675 BROWN DEER PARK
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t
Use classification: SINGLE FAMILY DWELLING Building Permit No.: 04-6373
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Occupancy Group: R3 Type of Construction: VN Land Use Zone: RL
7
3
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Owner of Building: CALIFORNIA COVE (a) LA QUINTA, LLC Address: 8105 IRVINE CENTER DR. STE.800
x
City, ST, ZIP: IRVINE, CA 92618
—b By: GARY HARTMAN
Date: NOVEMBER 4, 2005
t
Building Official
y
POST IN A CONSPICUOUS PLACE