05-2786 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
BUILDING & SAFETY DEPARTMENT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
r
BUILDING PERMIT
_ Date: 10/19/06
.`05-00002786 Owner:
57385 CAMINO-PACIFICA LA QUINTA 57 ESTATES INCD
764-010-008-66 -31910 - 78401 HWY 111 STE G
DWELLING - SINGLE FAMILY DETACHED LA QUINTA, CA 92253
LOW DENSITY RESIDENTIAL NOV I
191165 4 Z006 1, f
rchjtect or Engineer:
-------------------
LltdISED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury tha m licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business d Professionals Code, and my License is in full force and effect.
License Ca License No.: 753190
ntractor: 1
/ 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).:
1 _ I 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.).
(_) I, as owner of the property, am exclusively c tracting with licensed contractors to construct the project ISec.
7044, Business and Professions Code: Th Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, a who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License L 1.
(_ 1 I am exempt under Sec. , B.&P.C. for i reason
( Owner:
CONSTR CTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a c nstruction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.I.
Lender's Name:
Lender's Address:
LQPERMIT
Contractor: I
HERINGTON DEVELOPMENT, JAkRS—E
40960 CALIFORNIA OAKS RD, 4283
MURRIETA. CA 92562
(951)677-8415
Lic. No.: 753190
------------------
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 and p li y number are:
Carrier STATE FUND Policy Number 1.542746-2005
_ I certify that, in the perfor ce of the work for which this permit is issued, I shall not employ any
person in any manner s• to become subject to the workers' compensation laws of California,
and agree that, if I shou ecome subject to the workers' compensation provisions of Section
3700 of the L Code I shall forthwith comply with those provisions.
at2` z // S �' pplicant:
WARNING: FAILURE TO SECURE WOR ERS' 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 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 he above information is correct. I agree to comply with all
city and cou W ordinanA�andaws relating to ilding construction, and hereby authorize representatives
of this c t o e er u -mentioned pro y for inspection purposes.
te: ?�Y c 'nature (Applicant or Agent):
E
LQPERAI IT
Application Number . . . . . 05-00002786
Permit
. . .
BUILDING PERMIT
Additional
desc .
Permit Fee
. . . .
961.50
Plan Check Fee
624.98
Issue Date
Valuation . . . .
191185
Expiration
Date
4/17/07
Qty Unit Charge
Per
Extension
BASE
FEE
639.50
92.00
----------------------------------------------------------------------------
3.5000
THOU BLDG
100,001-500,000
322.00
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'
134.66
Plan Check Fee ..
33.67
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date
4/17/07
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
3037.00
.0350
ELEC
NEW RES _ 1 OR 2 FAMILY
106.30
668.00
----------------------------------------------------------------------------
.0200
ELEC
GARAGE OR NON-RESIDENTIAL
13.36
Permit
. . .
PLUMBING
Additional
desc .
Permit Fee
. . . .
172.50
Plan Check Fee
43.13
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date . .
4/17/07
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
Application Number . . . . . 05-00002786
Permit . . . . . . PLUMBING
Qty
Unit Charge
Per
Extention
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 . .
140.00
GRADING PLAN CHECK FEE
Permit Fee
. . . .
15.00
Plan Check Fee
.00
Issue Date
. . . .
355.00
Valuation . . .
. 0
Expiration Date . 4/17/07
Qty Unit Charge
Per
Extention
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes and Comments
SFD - LOT 66, PLAN 4A,
3037 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
62.50
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
19.11
DIF STREET MAINT FAC -RES
67.00
DIF TRANSPORTATION - RES
1930.00
Fee summary Charged
Paid Credited
----------
Due
---------------------------
Permit Fee Total-
1367.16
--------------------
.00 .00
1367.16
Plan Check Total
722.66
.250.00 .00
472.66
Other Fee Total
4611.61
.00 .00
4611.61
Grand Total
6701.43
250.00 .00
6451.43
LQPERAIIT
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..
Cal/—.Certificate of Occupancy
G OFTBuildin & Safet 'Department
9► Y p
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: 57-385 CAMINO PACIFICA
Use classification: SINGLE FAMILY DWELLING Building Permit No.: 05-2786
Occupancy Group: R-3 Type of Construction: V -N 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: DECEMBER 10, 2008
Building Official
POST IN A CONSPICUOUS PLACE
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