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04-4317 (SFD)BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012 77 Bj tALLE TAMPICO FAX (760) 777-7011 LA Q1111 ffA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 ATprication Number . . Property Address . . . APN: Application description Property Zoning . . . . Application valuation . Owner BUILDING PERMIT X04-00004317_ Date 6/09/04 . . . 43155 CORTE DEL ORO .609-380-997-11 293233- . . . DWELLING - SINGLE FAMILY DETACHED LOW DENSITY RESIDENTIAL 1285.08 LENNAR HOMES OF CALIFORNIA 78401 HIGHWAY 111, STE C LA QUINTA, CA LA QUINTA CA 92253 Contractor ------------------------ LENNAR HOMES OF CALIFORNIA INC 78401 HIGHWAY 111, SUITE C LA QUINTA CA 92253 Qty Unit Charge. Per Extension WCC: OLD REPUBLIC IN WC: MWC10877600 11/01/04 CSLB: 728102 09/30/04 CCC: B -------------------------- Structure Information ------------------------- Construction Type . . . . . TYPE V - NON RATED '.Occupancy Type . . . . . . DWELLG/LODGING/LONG <=10 Flood Zone . . .NON -AO, FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 CRC 4 BEDROOMS 4.00 FIRE SPRINKLERS NO GARAGE SQ FTG 447.00 PATIO SQ FTG 45.00 NUMBER OF UNITS 1.00 FIRST FLOOR SQ FTG 2083.00 ---------------------------------------------------- Permit . . . . . ------------------------ BUILDING PERMIT Additional.desc Permit Fee . . 74,1.00 Plan Check Fee-. 481.65 Issue Date Valuation 128508 Qty Unit Charge Per Extension BASE FEE 639.50 29.00 3.5000 THOU BLDG 100,001-500,000' 101.50 ---------------------------------------------------------------------------- Permit . . . . MECHANICAL Additional.desc Permit Fee . . . . 33.00 Plan Check Fee 8.25 Issue.Date . . . . Valuation . . . . 0 Qty Unit Charge. Per Extension T 1 v C 4 • " P.O. BOX )504 VOICE (760) »'r-' 01: 78-495 CALLS TAMPICO FAX (760) 777-701 i LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-715: BUILDING & SAFETY DEPARTMENT Application Number: Date: Applicant: Applicant's Mailing Address: or or Lic. No. 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 Ci�ee--and my License i n full force and effect. kens, Class t License No.It�9 fid' Date Q ontractor OWNER43UILDER 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, 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 Contractors' State License taw (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 ($SW).): U I, as owner o1 the property. or my employees with wages as their sole compensation. will do the work. and the structure is not intended or offered for We (Sec. 7044, Business and Professions Code: The Contractors' Stale 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 sate. 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 o1 sale.). (--) 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. , BA P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION 1 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. 1 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 i ed.y yvorkers' compensatio nce czmer d�plot n rgf�r_re e Policy Number /' /�/u' _ I certthat, in the performance of the work for whizh 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 provisions. a Date ',,cant . WARNING: FAILURE TO SECURE WORKERS' COMP NSATION 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. 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 Lenders Address f ` 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, indemnity and hold harmless the City of La Ouima, 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 pe"rK or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this applicabori 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 above-mentioned property for inspection purposes. 1L4_--S-,-g,tature (Applicant or Agent): f .. .. .._ ter: .... Page 2 Application Number . . . . . 04-00004317 Date 6/09/04 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU. 9.00 ---------------------------------------------------------------------------- Permit . . . . . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee . . . .. 96.85 Plan Check Fee 24.21 Issue Date . . . . Valuation . . . . 0' Qty Unit Charge Per Extension BASE FEE 15.00 2083.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 72.91 447.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 8.94 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING Additional desc Permit Fee . . . . 146.25 Plan Check Fee 36.56 Issue Date . . . . Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 13.00 6.0000 EA PLB FIXTURE 78.00 1.00 15.0000 EA PLB BUILDING SEWER* 15.00 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 5.00 .7500 EA PLB GAS PIPE >=5 3.75 1.00 15.0000 EA PLB GAS METER 15.00 -----------------------------------------------------7----------------------- 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 - LOT 11 -PLAN 2. PERMIT DOES NOT INCLUDE BLOCK WALL, POOL, SPA OR .. .. .._ ter: .... Fee summary Charged Permit Fee Total 1032.10 Plan Check Total 550.67 Other Fee Total 2466.02 Grand Total 4048.79 Paid Credited Due' ---------- ---------- ---------- .00 .00 - 1032.10 .00 .00 550.67 .00 .00 2466.02 .00 .00 4048.79 Page 3 Application Number . . . . . 04-0.0004317 Date 6/09/04 ------------------------------------------=--------------------------------- Special Notes and Comments DRIVEWAY APPROACH. ---------------------------------------------------------------------------- Other Fees . . . . . . . . .. ART IN PUBLIC PLACES -RES .00 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 48.17 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/REC - RES. 502.00 STRONG MOTION (SMI) - RES 12.85 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Permit Fee Total 1032.10 Plan Check Total 550.67 Other Fee Total 2466.02 Grand Total 4048.79 Paid Credited Due' ---------- ---------- ---------- .00 .00 - 1032.10 .00 .00 550.67 .00 .00 2466.02 .00 .00 4048.79