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05-2784 (SFD)2 t. - P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 05-00002784 ' Property Address: 57335 CAMINO PACIFICA APN: 764-010-008-68 -31910 - Application description: DWELLING - SINGLE FAMILY Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 165971 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT DETACHED Applicant: /ect or Engineer: p -------------------------------------------------- CENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury tI am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Busine and Professionals Code, and my License is in full force and effect. License Cla License No.: 753190 ontractor: Y OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031 .5, Business 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 applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's 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).: (_) 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 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.). 1 _ 1 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.). (_ 1 I am exempt under Sec. , B.&P.C. for this reason Date: Owner: 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 ISec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPER114LT Owner: LA QUINTA 78401 HWY LA QUINTA, Contractor: HERINGTON 40960 CALI MURRIETA, (951)677-8 Lic. No.: 753190 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/20/06 57 111 CA ESTATES INC ------------------ WORKER'S 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 issued. My workers' compensation insurance carrier anj poky number are: Carrier STATE FUND Policy Number 1542746-2005 I certify that, in the pe r nce of the work for which this permit is issued, I shall not employ any person in any mann s s to become subject to the workers' compensation laws of California, andagree that, if I s become subject to the workers' compensation provisions of Section 3700 of the L C , 1 shall forthwith comply with those provisions. ate/tet 0,d/C plicant WARNING: FAILURE TO SECURE W ` KERS' 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. 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 s ch permit, or cessation of work for 180 days will subject permit to cancellation. - I certify tha ave read this application and state that th bove information is correct. I agree to comply with all city and unty ordinances a state laws relating to buil g construction, and hereby authorize representatives of t ' county todnter u the above-mentioned propert or inspection purposes. (Applicant or Agent): Application Number . . . . . 05-00002784 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 870.50 Plan Check Fee 565.83 Issue Date Valuation . . . . 165971 Expiration Date 4/18/07 Qty Unit Charge Per Extension BASE FEE 639.50 66.00 ---------------------------------------------------------------------------- 3.5000 THOU BLDG 100,001-500,000 231.00 Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 77.00 Plan Check Fee 19.25 Issue Date . . Valuation . . . . 0 Expiration Date 4/18/07 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 3.00 6.5000 EA MECH VENT FAN 19.50 1.00 ---------------------------------------------------------------------------- 6.5000 EA MECH EXHAUST HOOD 6.50 Permit ELEC-NEW RESIDENTIAL Additional desc . . Permit Fee . . . . 117.22 Plan Check Fee 29.31 Issue Date . . . . Valuation . . . . 0 Expiration Date 4/18/07 Qty Unit Charge Per Extension BASE FEE 15.00 2660.00 .0350 ELEC NEW RES'- 1 OR 2 FAMILY 93.10 456.00 ---------------------------------------------------------------------------- .0200 ELEC GARAGE OR NON-RESIDENTIAL 9.12 Permit . . . PLUMBING Additional desc . . Permit Fee . . . . 160.50 Issue Date . . . . Expiration Date . . 4/18/07 Plan Check Fee . Valuation Qty Unit Charge Per BASE FEE 15.00 6.0000 EA PLB FIXTURE 1.00 15.0000 EA PLB BUILDING SEWER LQPERMIT 40.13 0 Extension 15.00 90.00 15.00 I LQPERMIT Application Number . . . . . Permit . . . . . . PLUMBING 05-00002784 Qty Unit Charge Per BASE FEE L Extension 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 8.00 .7500 EA PLB GAS PIPE >=5 6.00 1.00 ---------------------------------------------------------------------------- 15.0000 EA PLB GAS METER 15.00 Permit . . Additional desc . Permit Fee . . . Issue Date . . . Expiration Date . GRADING PERMIT 15.00 4/18/07 Plan Check Fee . Valuation . . . 00 0 Qty Unit Charge Per Extension BASE FEE L 15.00 ------------------------------------------------------------- Special Notes and Comments -------------- SFD - LOT 68, PLAN 2AR, 2660 SF. PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS OR DRIVEWAY APPROACH. 2001 CBC, CMC, CPC, 2004 CEC, 2005 ENERGY CODES ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES 20.00 DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER - RES 995.00 ENERGY REVIEW FEE 56.58 DIF FIRE PROTECTION -RES 140.00 GRADING PLAN CHECK FEE .00 HOURLY PLAN CHECK 35.00 DIF LIBRARIES - RES 355.00 DIF PARK MAINT FAC - RES 22.00 DIF PARKS/REC - RES 892.00 STRONG MOTION (SMI) - RES 16.59 DIF STREET MAINT FAC -RES 67.00 DIF TRANSPORTATION - RES 1930.00 Fee summary Charged Permit Fee Total 1240.22 Plan Check Total 654.52 Other Fee Total 4603.17 Grand Total 6497.91 Paid Credited Due .00 .00 1240.22 250.00 .00 404.52 .00 ..00 4603•.17 250.00 .00 6247.91 1 ,- Certificate of Occupancy0 o Twit imx C OF'T1Building & SafetDepartment Y 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: 57-335 CAMINO PACIFICA Use classification: SINGLE FAMILY DWELLING Building Permit No.: 05-2784 r Occupancy Group: R3 Type of Construction: VN Land Use Zone: RL Owner of Building: LA QUINTA 57 ESTATES, INC, Address: 78-401 HIGHWAY 111, STE. G City, ST, ZIP: LA QUINTA, CA 92253 By: STEVE TRAXEL Date: OCTOBER 19, 2010 Building Official POST IN A CONSPICUOUS PLACE