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05-2785 (SFD)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 c&t!t °F 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 05-00002785 Owner: Property Address: 57355 CAMINO PACIFICA LA QUINTA 57 ESTATES INC APN: 764-010-008-67 -31910 - 78401 HWY 111 ST Application description: DWELLING - SINGLE FAMILY DETACHED LA QUINTA, CA 92 Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 183114 Applicant: rchaect or Engineer: ------------------------------------------------- ICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury th I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Busines d Professionals Code, and my License is in full force and effect. License Class- B License No.: 753190 Yi C rector: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury th t 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).: (_ 1 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 _ 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 (Sec. 3097, Civ. C.). Lender's Name: I I Lender's Address: LQPERMIT Contractor: HERINGTON DEVELO 40960 CALIFORNIA MURRIETA, CA 9?5 (951)677-8415 Lic. No.: 753190 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/19/06 ------------------ 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. DC I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the perfo once of the work for which this permit is issued. My workers' compensation insurance carrier an oli y number are: Carrier STATE FUND Policy Number 1542746-2005 MEMPLOYERTO t, in the perf nce of the work for which this permit is issued, I shall not employ any n any manner s to become subject to the workers' compensation laws of California, e that, if I sho I become subject to the workers' compensation provisions of Section the L or Co I shall forthwith comply with those provisions. e� scant:WARNINGO SECURE WO ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT R 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 oI ermit. 2. Any permit issued as a result of this appbecomes null and void if work is not commenced within 180 days from date of issuance permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state tha information is correct. I agree to comply with all city and county ordinances and state laws relating to onstruction, and hereby authorize representatives of this count toe ter upon th above-mentined prr inspection purposes. Date:I� /`' J' nature (Applicant or Agent): 4z Application Number . . . . . 05-00002785 Permit . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 933.50 Plan Check Fee 606.78 Issue Date . . . . Valuation . . . . 183114 Expiration Date 4/17/07 Qty Unit Charge Per Extension BASE FEE 639.50 -84.00 ---------------------------------------------------------------------------- 3.5000 THOU BLDG 100,001-500,000 294.00 Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 83.50 Plan Check Fee 20.88 Issue Date Valuation . . . . 0 Expiration Date 4/17/07 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 4.00 6.5000 EA MECH VENT FAN 26.00 1.00 ---------------------------------------------------------------------------- 6.5000 EA MECH EXHAUST HOOD 6.50 Permit . . . ELEC-NEW RESIDENTIAL Additional desc . Permit Fee . . . . 128.48 Plan Check Fee 32.12 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 4/17/07 Qty Unit Charge Per Extension BASE FEE 15.00 2949.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 103.22 513.00 ---------------------------------------------------------------------------- .0200 ELEC GARAGE OR NON-RESIDENTIAL 10.26 Permit . . . PLUMBING Additional desc . Permit Fee. . . 166.50 Plan Check Fee 41.63 Issue Date . . . . Valuation . . . . 0 Expiration Date 4/17/07 Qty Unit Charge Per Extension BASE FEE 15.00 16.00 6.0000 EA PLB FIXTURE 96.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 LQPERMIT . - v Application Number . . . . . 05-00002785 Permit . . . . . . PLUMBING Qty Unit Charge Per BASE FEE 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 . . . GRADING PERMIT Additional desc . . Permit Fee . . . . 15.00 Issue Date . . . . Expiration Date . . 4/17/07 Plan Check Fee . . .00 Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 --------------------------------------------------------------+-------------- Special Notes and Comments SFD - LOT 67, PLAN 3BR, 2949 SF. PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS OR DRIVEWAY APPROACH. 2001 CBC, CMC, CPC, 2004 CEC, 2005 ENERGY L 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 60.68 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 18.31 DIF STREET MAINT FAC -RES 67.00 DIF TRANSPORTATION - RES 1930.00 Fee summary Charged Permit Fee Total 1326.98 Plan Check Total, 701.41 Other Fee Total 4608.99 Grand Total 6637.38 LQPERMIT Paid Credited Due . .00. .00 1326.98 250.00 .00 451.41 .00 .00 4608.99 250.00 .00 6387.38 Certificate of Occupancy0 o V � • - - 412" �i OFBuilding Y p & 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: 57-355 CAMINO PACIFICA Use classification: SINGLE FAMILY DWELLING Building Permit No.: 05-2785 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 mob' Date: OCTOBER 19, 2010 Building Official POST IN A CONSPICUOUS PLACE