04-4042 (SFD)'r
T44f 4 4 Qah&
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING PERMIT
App`licat-iori Number . . .
Property Address - `.-
APN:
Application description
Property Zoning . . . . .
Application valuation . .
Owner
PONDEROSA HOMES II, LLC
400 S. FARRELL DRIVE, B103
PALM SPRINGS, CA 92264
LA QUINTA CA 92253
p"'tA
BUILDING & SAFETY DEPARTMENT
(760).777-7012
FAX (760) 777-7011
INSPECTION,-RF-Q.„LSE-S-P�s-(T60 ff j7-7153
04-00004042
7 9 710 CORTE NU VOl
609-580-009- -
DWELLING - SINGLE FAMILY DETACHED
LOW DENSITY RESIDENTIAL
194630
Contractor
3/04
PONDEROSA HOMES II, INC.
6671 OWENS DRIVE
PLEASANTON CA 94588
(760) 318-7710
WCC: REPUBLIC
WC: 15671602
10/01/04
CSLB: 752884
08/31/04
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
# BEDROOMS
4.00
FIRE SPRINKLERS
NO
GARAGE SQ FTG
681.;00
PATIO.SQ FTG
500:00
NUMBER OF UNITS
1.00
FIRST FLOOR SQ FTG
3053.00
----------------------------------------7-----------------------------------
Permit . . . . . .
BUILDING PERMIT
Additional desc . .
Permit Fee . . . .
972.00 Plan Check Fee
157.95
Issue Date . . . .
Valuation . .
. . 194630
Qty Unit Charge
Per
Extension
BASE FEE
639.50
.95.00 3.5000
THOU BLDG 100,001-500,000
=
332.50
-----------------------------------------------------
Permit . . . . . .
----------------------
MECHANICAL
Additional desc
Permit Fee . . . .
83.50 Plan Check Fee
5.22
Issue DateValuation
. .
. . 0
Qty Unit Charge
Per
Extension
P.O. BOX 1504�� VOICE (760) 777-7012
Tvf
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 04 — 40 *Z I Date: S -,21-O4
Applicant:
Applicant's Mailing Address:
G
t4 (215
0 AV
BUILDING PERMIT DECLARATIONS' 06&
Arch' or Engineer:
Architect or Engineer's Address:
z . .Z -
!SZ L o - O�
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
Co, and my Lic ens is in full force and effect. ^ d
cense Class �VQ�e�nsepNi5p,on. !�J �A�
ate6;+ ontractor "V
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, 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 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 Secfion 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 I am exempt under Sec. , BA P.C. for this reason
Date Owner.
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.
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
Mr
d work r 'compensation in ance carrier and policy number are:
artier icy Number �
_ I certify that, in the perform- nce of t e work for which this peaffit is su , iMaTrnot 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.
WARNING: FAILURE TO SECURE WORKERS' COMNQhSATION COVERA'00S OALAWFUL, 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 44=
Lender's Address I
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
constructio and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes.
ate Sie (Applicant or Agent):
Page
` 2
Application Number .
. . . . 04-00004042 Date
5/13/04
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
135.48 Plan Check Fee
8.47
Issue Date .
. . .
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
3053.00
.0350
ELEC NEW RES - 1 OR 2 FAMILY
106.86
681.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
13.62
----------------------------------------------------------=-----------------
Permit . . .
. . .
PLUMBING
Additional desc
Permit Fee .
. . .
178.50 Plan Check Fee
11.16
Issue Date .
. . .
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
18.00
6.0000
EA PLB FIXTURE
108.00
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
8.00
.7500
EA PLB GAS PIPE >=5
6.00
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 87.
PLAN 3BXR.
PERMIT DOES NOT
Page 3
Application Number
04-00004042 Date
5/13./04
----------------------------------------------------------------------------
Special Notes and
Comments
INCLUDE BLOCK WALLS, POOL, SPA,
OR
DRIVEWAY APPROACH.
75% PLAN CHECK FEE
REDUCTION APPLIED
FOR MULTIPLE
ISSUANCE
OF SAME PLAN TYPE.
----------------------------------------------------------------------------
Other Fees . . .
. . . . . .
ART IN PUBLIC PLACES -RES
.00
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
15.80
DIF FIRE PROTECTION -RES
97.00
GRADING PLAN CHECK FEE
*00e
DIF LIBRARIES - RES
225.00
DIF PARK MAINT FAC - RES
5.00
DIF PARKS/REC - RES
502.00
STRONG MOTION (SMI) - RES
19.46
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
-----------------
Charged
----------
Paid Credited
Due
Permit Fee Total
1384.48
------------------------------
.00 .00
1384.48
Plan Check Total
182.80.
.00 .00
182.80
Other Fee Total
2440.26
.00 .00
2440.26
Grand Total
4007.54
.00 .00
4007:54