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04-6355 (SFD)1504 j78-495 CALLE TAMPICO LA QUINTA CALIFORNIA 92253 BUILDING PERMIT ;App.-l-caton Number 04-0.0006355 Date 9/21/04 Property Address . . . 81775 BROWN DEER PARK APN: 767-540-014- - - Application description . . . DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . . . . GOLF COURSE Application valuation . . . . 322957 BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 Owner Contractor -- - - - - - - - - - - - - - - - - - - - - -- �. -----7-.----------------- 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 4.00 FIRE SPRINKLERS NO GARAGE SQ FTG 852.00 PATIO-'SQ,FTG 488.00 NUMBER OF UNITS 1.00 FIRST FLOOR SQ FTG 3710.00 -------------7-------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc Permit Fee . . . . 1420.00 Plan Check Fee 923.00 Issue Date . . . . Valuation . . . . 322957 Qty Unit Charge Per Extension BASE FEE 639.50 223.00 3.5000 THOU BLDG 100,001-500,000 780.50 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL Additional desc Permit Fee . . . . 129.00 Plan Check Fee 32.25 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension 60 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: 10 4/- (y,3 � J� Date: a- (v ' Oe/ Applicant: chitect or Engineer: N • 44 Ae Applicant's Mailing Address: itect or Engineer's Address: r'+Y— 446 IA$ I z Lic. No.: G' /i-, I / ---. BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I Z provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals �ode, and my Liceng is in full force and effe�, icense Class se No.info ,�a1 r�rnrC t�l /,0 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury 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 strucI, 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).): ( j 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. , B.8 P.C. for this reason 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 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 ,,��,.��VVed. work rs' compensation i ance carter 9� I1'�Y�umbaj are: Cagier ti��i► 4N� p /lsolicy Number 9 y l67 I certify that, in the performance of the work foohich 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 agrOothat, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. WARNING: FAILURE TO SECURE W RS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDREWIMOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR COM, 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 oe Lender's Address 418 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 /theabove-mentioned rk 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 iI agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter up property for inspection purposes. ate �/ U Sign/ ature (Applicant or Agent): Application Number . 04-00006355 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 11.00 6.5000 EA MECH VENT FAN 71.50 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 ---------------------------------------------------------------------------- Permit . . . . . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee. 161.89 Plan Check Fee 40.47 Issue Date Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 3710.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 129.85 852.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 17.04 ---------------------------------------------------------------------------- Permit . . . . . PLUMBING , Additional desc Permit Fee 189.75 Plan Check Fee 47.44 Issue Date . . . . Valuation 0 Qty Unit Charge Per Extension - BASE FEE 15.00 17.00 6.0000 EA PLB FIXTURE 102.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 3.00 7.5000 EA PLB WATER HEATER/VENT 22.50 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 11.00 .7500 EA PLB GAS PIPE >=5 8.25 1.00 15.0000 EA PLB GAS METER 15.00 ---------------------------------------------------------------------------- Permit . . . . . . GRADING PERMIT Additional desc Permit Fee . . . . 15.00 Plan Check Free .00 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 -------------------------------------------7-------------------------------- Special Notes and Comments SFD - LOT 14, PLAN 1AR, 3710 SF. PERMIT il Fee summary Permit Fee Total Plan Check Total Other Fee Total Grand.Total Charged Paid 1915.64 Page 3 Application Number . . . . . 04-00006355 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 307.39 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 92.30 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/RE C - RES 502.00 STRONG MOTION (SMI) - RES 32.29 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 1915.64 .00 1043.16 .00 2836 ..98 .00 5795.78 .00 Credited Due .00 1915.64 .00 1043.16 .00 2836.98 .00 5795.78 c