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04-3378 (SFD)T-Vf 4 4 4" P.O: Box 1504 rOF O 78-495' CALLE TAMPICO T,t� LA QUINTA, CALIFORNIA 92253 � BUILDING PERMIT Application Number . . Property Address . . . APN: Application description Property Zoning . . . . Application valuation . Owner BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011. INSPECTION REQUESTS (760) 777-7153 04-00003378 Date 8/26/04 . . . 79360 BROOKVILLE 772-040-019- - - . . . DWELLING - SINGLE FAMILY DETACHED . . . LOW DENSITY RESIDENTIAL . . . 287961 LA QUINTA ORCHARDS PARTNERS C/O LA QUINTA ORCHARD PARTNERS P 0 BOX 1716 LA QUINTA CA 92253 Contractor SPARKS CONSTRUCTION, INC P.O. BOX 1716 LA QUINTA CA 92247 (760) 771-1941 WCC: STATE FUND WC: 4610000348 01/01/05 CSLB: 674074 07/31/05 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 40.00 FIRE SPRINKLERS NO GARAGE SQ FTG 1045.00 PATIO SQ FTG 7320.00 NUMBER OF UNITS 1.00 FIRST FLOOR SQ FTG 4506.00 ------------ --------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 1297.50 Plan Check Fee 84-3.38 Issue Date . . . . Valuation . . . . 287961 Qty Unit Charge Per Extension BASE FEE 639.50 188.00 3.5000 THOU BLDG 100,001-500,000 658.00 ---------------------------------------------------------------------------- Permit . . . . . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee . . . . 193.61 Plan Check Fee 48.40 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension P.O. Box 1504ICE VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT q Application Number: (� 33 -7 Date: 1 i —U4 Applicant:- -Architect or EQgineer: (-J4-GlcA-(V rC��>7n Applicant's Mailing Address: Architect or Engineer's Address: il A0 ?f 6S/99-- ( 5 Ort Yc Lic. No.:'Z�' 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 Code, and my Lice se is in full force'and effect. License Class iLicense No. % 7540 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, Busi ess 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 appli nt 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).): 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 1 am exempt under Sec. . , BA P.C. for this reason Date 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. T 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 issued. My workers' compensation rice carrier and policy number are: artier �? 2 �� N olicv Number "FCv 1 0 �� 3 4 _ 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 provisioyk. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, ANO 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 T 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 county to enter upon the abov ntione roperty for inspection purposes. Date 9 c ignature (Applicant or Agent): y Page 2 Application Number 04-00003378 Date 8/26/04 Qty Unit Charge Per Extension BASE FEE 15.00 4506.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 157.71 1045.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 20.90 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL Additional desc Permit Fee . . . . 163.50 Plan Check Fee 40.88 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 5.00 9.0000 EA MECH FURNACE <=100K 45.00 5.00 9.0000 EA MECH B/C <=3HP/100K BTU 45.00 8.00 6.5000 EA MECH VENT FAN 52.00 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING Additional desc Permit Fee . . . . 414.75 Plan Check Fee 103.69 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 47.00 6.0000 EA PLB FIXTURE 282.00 1.00 15.000.0 EA PLB BUILDING SEWER 15.00 9.00 6.0000 EA PLB ROOF DRAIN 54.00 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 9.00 .7500 EA PLB GAS PIPE >=5 6.75 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- 4,506 SQ.FT. LIVING, 1045 SQ.FT. Page 3 Application Number . . . . 04-00003378 Date 8/26/04 ---------------------------------------------------------------------------- Special Notes and Comments GARAGE, 732 SQ.FT. PATIO. R-3 OCC. TYPE V -N CONSTR. 2001 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES 219.90 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 84.34 DIF FIRE PROTECTION -RES 97.00 DIF LIBRARIES - RES 225.00 DIF PARK MAINT FAC - RES 5.00 DIF PARKS/REC - RES 502.00 STRONG MOTION (SMI) - RES 28.79 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee'summary ----------------- Charged ---------- ---------- Paid Credited -------------------- Due Permit Fee Total 2084.36 .00 .00 2084.36 Plan Check.Total 1036.35 250.00 .00 786.35 Other Fee Total 2738.03 .00 .00 2738.03 Grand Total 5858.74 250.00 .00 5608.74 79 P.O. BOX 1504 APPLICATION ONLY L idding c �00 �a(C� L 78-495 CALLE TAMPICO I 1 �LA OUINTA, CALIFORNIA 92253 ner/ Q L Mailing BUILDING: TYPE'CONST. OCC. GRP. Address e` v 40x 1716 A.P. Numb -7-72- O City Zip Tel. / /' CQ &k t77�`- 9aa s3 %%� �-Iggl Legal Description �hQ o?(�S:?5� '- ofIL Contract" `I A Project Descrdption eg6*;I I. I.P/�40-/-/W- Address '4 Address ' ' P d B6 /7//- City/ tGC �4(`n Zip�aas3 Tel. State Lic. City & Classif. Lic. # a Arch., Engr., 24a Designer a�/fin1[e / m AddressTe '6 b (�� ,� O_ Q,?s a City Zip State V� q�ai a Lic. # C �� LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is In full force and effect. SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,8usiness and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to'Rs issuance also requires the applicant for such permit, to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that -he 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). l:' 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, Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such 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 did not build or Improve for the purpose of sale.) I 11, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds of improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) 17 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION Ihereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company n Copy is filed with the city. O Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) I certify that in theperformance of thg 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. Date Owner NOTICE TO APPLICANT., 11, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. 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 city to enter the above• mentioned property for inspection purposes. Signature of applicant —Date— Mailing ateMailing Address City, State, Zip WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Sq. Ft. n Size I 0 No. No. Dw. Stories Units New Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT G Plan Chk. Dep. ) O �- Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. - Infrastructure J "1 6% v +.L TOTAL REMARKS ------1 ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION