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04-7504 (SFD)s C jw P.O. BOX 1504 �9 -495 CALLE TAMPICO QUINTA, CALIFORNIA 92253 JAN 04 2005 O(J� 4 �wa�rw BUILDING PERMIT on pumper . . . . Ad dr e s s,. APN: Application description Property Zoning . . . . . . Application valuation . . . BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 04-0-0-007-504 Date 11/30/04 79645 CORTE DEL VISTA 609-380-997-22 -293233- DWELLING - SINGLE FAMILY DETACHED LOW DENSITY RESIDENTIAL 201360 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) 31877710 WCC: TANNER INSUR WC: 15671.603 10/01/05 CSLB: 752884 08/31/06 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 5.02.00 PATIO SQ F'I'G 500.00 NUMBER OF.UNITS 1.00 1ST FLOOR SQUARE FOOTAGE 3232.00 -------------------------------------------------- Permit. . . . . . . -------------------------- BUILDING PERMIT Additional desc Permit'Fee . . . . 996.50 Plan Check Fee.. 161.93 Issue Date . . . . Valuation . . . . 201360 Qty Unit Charge Per Extension BASE FEE 639.50 102.00 3.5000 THOU BLDG 100,001-500,000 357.00 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL - Additional desc Permit Fee 83.50 Plan Check Fee 5.22 Issue Date Valuation 0 Qty. Unit Charge Per Extension BASE FEE15.00 4 2.00 9.0000 EA MECH FURNACE <=100K '18.00 2.00 9.0000 EA MECH B/C <=3HP/100K BTU. 18.00 P.O. Box 1504 • VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: � 4' -7504 Date: i Applicant: +_;Xrchitect or Engineer: Applicant's Mailing Address: . —1 rchitept orXngineer's Address: _ • S1�,4-cn' 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 C de, and my Licensee �i ' full force and effect. cense Class _!b ense No. "%SZ Date J14 Lo. Con /!!! 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 r 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' compensa ion insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is d. �My workers' compensation1urance carrier and policy number are: artier .44 _W �iGCs. P� olicy Number / I certify that, in the performance of the work for which 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 to with comply with those provisions. �te J OSS A nt WARNING: 4AILURE TO SECURE WORKERS' 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. 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 representatives of this county to enter upon the above-mentioned property for inspection purposes. ate 1 4 10-S7 ignature (Applicant or Agent): J Page 2 Application Number . . 04-00007504 Date 11/30/04 Qty Unit Charge Per Extension 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 . . . . 138.16 Plan Check Fee 8.47 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 3232.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 113.12 502.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 10.04 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING Additional desc Permit Fee . . . . 196.50 Plan Check Fee 11.16 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 21.00 6.0000 EA PLB FIXTURE 126.00 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 ------------- -------------------------------------------------------------- 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 22. PLAN 3BXL+OPTION BEDROOM 5/BATH 4 (17 9 .S F ) W/2 CAR GARAGE ( GARAGE 502 SF) PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL, SPA, OR DRIVEWAY APPROACH. 75% REDUCTION TO PLAN CHECK FEE DUE TO MULTIPLE ISSUANCE OF SAME PLAN TYPE ---------------------------- Other Fees ... . . . ----------------------------------------------- . . ART IN PUBLIC PLACES -RES 20.00 Y/ Page 3 Application Number 04-00007504 Date 11/30/04 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 16.19 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 19.46 DIF -STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged ---------- Paid Credited Due ----------------- Permit Fee Total 1429.66 ---------- -------------------- .00 .00 1429.66 Plan Check Total 186.78 .00 .00 186.78 Other Fee Total 2460.65 .00 .00 2460.65 Grand Total 4077.09 .00 .00 4077.09