04-7502 (SFD)SAN 04 2005
LA QUINTA
T4hf 4 4 a"
BUILDING & SAFETY. DEPARTMENT
Box 1504 _ (760).777-7012
95 CALLE TAMPICO FAX (760) 777-7011
UINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
Application Number
Property Address
APN:
Application description
Property Zoning
Application valuation
BU;I,LDING PERMIT
UM0'007 Date 11/30/04
. . . 79665 CORTE DEL VISTA
609-380-997-24 -293233-
. . . DWELLING - SINGLE FAMILY DETACHED
. . . LOW DENSITY RESIDENTIAL
. . . 188445
L
Owner
Contractor
PONDEROSA HOMES II, LLC PONDEROSA HOMES II, INC. -
6671 OWENS DRIVE
6671 OWENS DRIVE
PLEASANTON CA 94588 PLEASANTON
CA 94588
(760)' 318-7710 •
WCC: TANNER INSUR
WC: 15671603
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 CBC
# BEDROOMS
5.00
FIRE SPRINKLERS
NO
GARAGE SQ FTG
448..:00
PATIO SQ FTG
387.00
NUMBERI OF" UNITS "'
1.00
1ST FLOOR SQUARE FOOTAGE
3051.00
----------------------------------------------------------------------------
Permit . . . . . . BUILDING.PERMIT
Additional desc
Permit Fee . . . .
951.00 Plan Check Fee
618.15
Issue Date . . .
Valuation . .
. . 188445
Qty Unit Charge
Per
Extension
BASE FEE
639.50
89.00 3.5000
THOU BLDG 100,001-500,000^F
311.50
Permit . . . . . . MECHANICAL
Additional desc
Permit Fee . . . .
90.00 Plan Check Fee
22.50
Issue Date . . . .
Valuation . .
. . 0
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
'9 •,18.00
5.00 6.5000
EA MECH VENT FAN
32.50
N
P.O. BOX 1504�� VOICE (760) 777-7012
Tilf
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 04' J50(:9 Date: / - Al 0 s
Applicant:—Architect
Applicant's Mailing Address:—Architect
c. No.:
or Engineer:
or Engin er's Address:
A/GL4-44�
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
-Coe and my Lice in full force and effect.
icense Class -►D /License No. ?SZ e bawl
,93Ce 014)-s— ontrector DD�IL . iOSS/� I/YJ�'yd
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 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
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.
l 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
ed. M workers' compensation in nce
Carrier i ,Q1kJ ,G ��./S. care/nd are:
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
fort with comply with those provisions.
ate 1 Ap p I i �ca n tL
WARN G: FAILURE 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
1 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.
1 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 ereby authorize repr sentatives of this county to enter upon the above-mentioned property for inspection purposes.
to 0� Signature (Applicant or Agent):
P
Application Number . . . . 04-00007502
Page 2
Date 11/30/04
Qty
Unit Charge.
Per
Extension
1.00
6.5000
EA MECH EXHAUST HOOD
6.50
----------------------------------------------------------------------------
Permit .
. . . . .
ELEC-NEW RESIDENTIAL
Additional
desc
Permit Fee
. . . .
130.75 Plan Check Fee
32.69
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
----------------------------------------------------------------------------
Permit ..
. . . . .
PLUMBING
Additional
desc
Permit Fee
. . . .
190.50 Plan Check Fee
47.63
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
-------------------------------------------------
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
24,3051 SF.
PLAN 2AXR-OPTION
BEDROOM 5/BATH
4(+213
SF)W/2 CAR GARAGE
(GARAGE 448
SF). PERMIT
DOES NOT INCLUDE
BLOCK WALLS,
POOL, SPA OR DRIVEWAY
APPROACH.
-------------- ----------------------------------------------------------------
Other Fees
. . . . .
. . .. . ART IN PUBLIC PLACES -RES
00
DIF COMMUNITY CENTERS -RES
97.00
N
Page 3
Application Number
. . . . .
04-00007502
Date
11/30/04
----------------------------------------------------------------------------
Other Fees . . . .
. . .
DIF CIVIC CENTER -
RES
366.00
ENERGY REVIEW FEE
61.82
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 CreditedDue
-----------------
Permit Fee Total
----------
1377.25
--------------------
.00
----------
.00
1377.25
Plan Check Total
720.97
.00
.00
720.97.
Other Fee Total
2485.66
.00
.00
2485.66
Grand Total
4583..88
.00
.00
4583.88