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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