04-4145 (SFD)i
g.A
BUILDING & SAFETY DEPARTMENT
P.O. BOX 1504 (760),777-7012
78-495 CALLE TAMPICO(M, ) 777-7011
LA QUINTA, CALIFORNIA 92253 INS fj TIONEQURSTS (1r 1 777-7153
BUILDING PERMITMAY 2 4 2004 U
Application Number r04-00004145 1 CITY OF LA QUI ite 5/13/04
Property.Address . . . . 79720 CORTE `INANCEDI=
�
APN: 609-580-010- - -
Application description DWELLING - SINGLE FAMILY DETACHED
Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL
Application valuation . . . . 188445
Owner Contractor
PONDEROSA HOMES II, LLC PONDEROSA HOMES II, INC.
400 S. FARRELL DRIVE, B103 6671 OWENS DRIVE
PALM SPRINGS, CA 92264 PLEASANTON, CA 94588
LA QUINTA CA 92253 (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 5.00
FIRE SPRINKLERS NO
GARAGE SQ FTG 448.00
PATIO SQ FTG 387.00
NUMBER OF UNITS 1.00
FIRST FLOOR SQ FTG 3051.00
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Permit . . . . . . BUILDING PERMIT
Additional desc . . `
Permit Fee . . . . 951.00 Plan Check Fee 154.54
Issue Date . . . . Valuation . . . . 188445
Qty Unit Charge Per Extension
BASE FEE 639.50
89.00 3.5000 THOU BLDG 100,001-500,000 311.50
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Permit . . . . MECHANICAL
Additional desc
Permit Fee . . . . 90.00 Plan Check Fee 5.63
Issue Date Valuation . . . . 0
Qty Unit Charge Per Extension
P.O. Box 1504 •4a" VOICE (760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 64-414,57 1 Date: %.
Applicant:
Applicant's Mailing Address:
Arch' or Engineer:
Architect or Engineer's Address:
No.: ci A) &U, I3f�tP,
10
BUILDING PERMIT DECLARATIONS L(a(pa
LICENSED CONTRACTOR'S DECLARATION
I hereb - affirm under penalty of perjury that I am licensed under isions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
Co and my License is in full force and effect. ^ Q
ense s_ tT'L cense No. . !�_ j} '
ate ontractor ?tY ■ V �W \ �U�
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 Section 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
INis a PL�ier,' pensation i ance carrier and polic numberare:
arrier Y-'�i�..d olicv Number �
I certify that, in the performance of the work for which this permit it iss e { ha 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.
WARNING: FAILURE TO SECURE WORKERSNC fi' PENSATIOTtGOVLRAGE 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
Lender's Address
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
construction, and hereby authorize rep sentatives of this county to enter upon the above-mentioned property for inspection purposes.
atm e �� t ignature (Applicant or Agent):
=y -
Application Number . . . 04-00004145
Page 2
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
5.00
6.5000
EA
MECH VENT FAN
32.50
1.00
6.5000
EA
MECH EXHAUST HOOD
6.50
---=-----------------------------
Permit
-----------------=-------------------------
ELEC-NEW RESIDENTIAL
Additional desc
Permit Fee .
. . .
130.75 Plan Check Fee
8.17
Issue Date .
. . .
Valuation
0
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
3051.00
.0350
ELEC NEW RES - 1 OR 2 FAMILY
106.79
448.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
8.96
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Permit . ...
. . .
PLUMBING
Additional desc
Permit Fee .
. . .
190.50 Plan Check Fee
11.91
Issue Date
Valuation
0
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
20.00
6.0000
EA
PLB FIXTURE
120.00
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
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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
-----------------7----------------------------------------------------------
Special Notes
and Comments
SFD - LOT 88.
PLAN 2CXL(1).
PERMIT DOES
Page 3
Application Number . . . .
04-00004145 Date
5/13/04
----------------------7-----------------------------------------------------
Special Notes and
Comments
NOT INCLUDE BLOCK
WALLS, POOL,
SPA OR
DRIVEWAY APPROACH.
75% PERMIT
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
15.45
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
18.84
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
-----------------
Charged.
----------
Paid Credited.
Due
Permit Fee Total
1377.25
------------------------------
.00 .00
1377.25
Plan Check Total
180.25
.00 .00
180.25
Other Fee Total
2439.29
.00 .00
2439.29
Grand Total.
3996.79
.00 .00
3996.79