04-6357 (SFD),O"BOX 11504
3-495 CALLE TAMPICO
LA QUINTA; CALIFORNIA 92253
BUILDING PERMIT
BUILDING & SAFETY DEPARTMENT
(760).777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
Application Number .
. . . 04-Ob006357
Date 9/21/04
Property Address
. . . 81765 BROWN DEER PARK
APN:
767-540-013- - -
Application description . . . DWELLING - SINGLE FAMILY
DETACHED
Property Zoning . . .
. . . . LOW DENSITY RESIDENTIAL
Application valuation
. . . . 370077
Owner
E Contractor
------------------------
CALIFORNIA COVE AT LA
-----------------------
QUINTA 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/CONG <=10
Flood Zone . . . ...
. . . NON -AO FLOOD ZONE
Other struct.info . .
. . . CODE EDITION
2001 CBC
# 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
----------------------------------------------------------------7-----------
Permit . . .'. . .
BUILDING PERMIT
Additional desc . .
Permit Fee . . . .
1588.00 Plan Check Fee
1032.20
Issue Date . . . .
Valuation . .
. . 370077
Qty Unit Charge
Per
Extension
BASE FEE
639.50
271.00 3.5000
THOU BLDG 100,001-500,000
948.50
-------------------------------7--------------------------------------------
Permit . . . . . . MECHANICAL
Additional desc
Permit Fee . . . .
96.50 Plan Check Fee
24.13
Issue Date . . . .
Valuation
0
Qty Unit Charge Per Extension
v'
•
P.O. BOX 15044�� 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: - 6351 Date: /o? • (p•D
Applicant:hitect or Eng'neer:
r=-6v1AN •
Applicant's Mailing Address: Architect or Engineer's Address:
:000lr� tic. No.:e, -12 , t773"
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 am license der provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
Code, and my Licen in full force and effect.
License Classla/em ,cense No. /o %
/ - /6 001 400 - /tom. do' it �/ UNIw
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of ped en.
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 permitct,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 licensedto 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 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 sate. 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. , B.& P.C. for this reason
Date Owner.
WORKERS' COMPENSATION DECLARATION
1 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
Kof 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
ss d. m workers' compensation urance carie: r]� p�ynum r are:
�er 3/ LeAF a olicy Nu b �63 76 i
—I certify that, in the performance of the work 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 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 provisio
ate r ��Ncant
WARNING: FAILURE TO SECUR 012KERS' 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 Quints, its
officers, agents and employees for any act or omission related to the ork being performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and v d 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 1 have read this application and state that the above inforrna " 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 count upon the above-mentioned property for inspection purposes.
Z"bate `Z/ d Signature (Applicant or Agent):
Application Number
. . 04-00006357
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
------------------------
Permit ... .
--
. . .
--------------------------------------------------
ELEC-NEW RESIDENTIAL
Additional desc
Permit Fee .
. . .
180.16 Plan Check Fee
45.04
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
51.38
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
----------------------------------------------------------------------------
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 131
PLAN 3BR,
4336 SF. PERMIT
Fee summary
-----------------
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
Charged Paid
2085.16
Page
3
Application Number . . . .
. 04-00006357 Date
9/21/04
----------------------------------=-----------------------------------------
Special Notes and Comments
.00
DOES NOT INCLUDE POOL, SPA,
BLOCK WALLS
OR DRIVEWAY APPROACH
----------------------------------------------------------------------------
Other Fees . . . . . . . .
. ART IN PUBLIC PLACES -RES
425.19
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
103.22
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
-----------------
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
Charged Paid
2085.16
.00
1152.75
.00
2970.41
.00
6208.32
.00
Credited Due
.00
2085.16
.00
1152.75
.00
2970.41
.00
6208.32
0
Certificate of Occupancy
4w
G� 0F9�� Building & Safety Department
This Certificate is issued pursuant to the requirements of Section 109 of the California Building
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.
BUILDING ADDRESS: 81-765 BROWN DEER PARK
Use classification: SINGLE FAMILY DWELLING Building Permit No.: 04-6357
Occupancy Group: R3 Type of Construction: V -N Land Use Zone: RL
Owner of Building: CALIFORNIA COVE Cad LA QUINTA, LLC Address: 8105 IRVINE CENTER DR. STE. 800
City, ST, ZIP: IRVINE, CA 92618
By: GARY HARTMAN
Date: NOVEMBER 10, 2005
Building Official
POST IN A CONSPICUOUS PLACE
0