05-1366 (SFD)P.O. BOX 1.504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 9.2253
40,a"
BUILDING & SAFETY DEPARTMENT
(760).777-7012.
FAX (760) 777-7011
INSPECTION REQUESTS (7'60) 777-71.53
g 2005
BUILDING PERMIT
APR
QVIP1Tp►
_ .
C1 `' tuber
X0.5-00001366
Date 4/12./05
-T�roperty Address . .
. . . . 81603 CHARISMATIC WY'
APN:
767-200-999-48 -312021-
Application description DWELLING - SINGLE FAMILY
DETACHED
Property Zoning . . .
. LOW DENSITY RESIDENTIAL
Application valuation
. . . . 137715
Owner
Contractor
DESERT CHEYENNE, INC.
HERINGTON DEVELOPMENT, JAMES 0
7840.1 HIGHWAY 111, SUITE
G 40960 CALIFORNIA
OAKS RD; #283
LA QUINTA
CA 92253 MURRIETA
CA 92562
(760) 777-9920
(951) 677-8415
WCC: STATE FUND
WC: 15442746
11/01/05
CSLB: 7531.90
04/30/06
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
3.00
FIRE SPRINKLERS
NO
GARAGE SQ FTG
650.00
PATIO SQ FTG
2.36.00
NUMBER'OF UNITS
1.00
1ST FLOOR SQUARE FOOTAGE
2130.00
Permit
BUILDING PERMIT
Additional desc .
Permit Fee . . . .
772..50 P1an,Check Fee
502.13
Issue Date . . . .
Valuation
137715
Qty Unit Charge
Per
Extension
. BASE FEE
639.50
38.00 3.5000
THOU BLDG 100,001-500,000
133.00
Permit . . . . . .
MECHANICAL
Additional desc .
Permit Fee . . . .
83.50 Plan Check Fee
20.88
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
18.00
4.00 6.50.00
EA MECH VENT'FAN
26.00
Y
P.O. BOX 1504 • VOICE (760) 777-.7.012
78-49.5 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING &" SAFETY DEPARTMENT
Application Number: 0:5 " 1310 to Date: y • 1 � 'O
Applicant:
Applicants Mailing Address:
Architect or Engineer:
chitect or Engineer's Address:
No. J 't ? n�
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that I'am licensed under provisions of Chapter 9 (commencing with Section 7 ) of Division 3 of the Business and Professionals
Code, and my License isVult force and effect. ✓ /'
/license Class icense No. 7
/Date " ontractor
OWNER43UILDER DECLARATION
I herebyaffirn under penalty of.perjury that I am exempt from the Contractors' State License Law for the following rea n (S . 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 fore permit subjects
the applicant to a civil penalty of, not more than five.hundred dollars ($500).):
U 1, as owner of the property, or my employees with wages as their sole compensation, will do the. work, and In&structure is not intended'oroffered for sale (Sec. 7044,
Business and Professions Code: The2 Contractors' State License Law does not applyto.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 yearof"completion, the owner -builder will have the burden of proving that he orshe did not build or improve for the purpose of sale.).
U 1, 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.).
Lj I am exempt under --Sec. , BA P.C. for this reason
Data 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' compensatio surance. as required by Section 3700 of the Labor Code. for the performance of the work for which this.pernft is
M§W y work9lS' compensation in ce,carierand
_ I certify that, in the performance of the rk for which this permit is issued. I shall not employ any person in any manner so as to become subject to the workers'
compensation Iawsof California, and re at, if I should become subject to the workers' compensation provisions of Section 3700 ofthe,Labor Code, I shall
forthwith comply with those provision
WARNING: FAILURE TO'SECURE WORKERS' OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES.AND
CIVIL FINES UP TO ONE HUNDRED THOUSA 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 /�
LendePs Address ' WA
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby madeto the Director of Building and Safety for 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 Ouinta, 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 "n " and void if work is notcommenced within 180 days from date of issuance of such permit, or
cessation of work for 180 days will subject permit to cancel tion.
i"certify that l have read this application and state that the above into tiomis 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 en u n the above-mentioned property for inspection purposes.
ate
1�"__&Ilr ignature (Applicant or Agent):
./
Page
2
Application Number .
. . . . 05-0001013-66 Date
4/12./05
Qty Unit Charge
Per
Extension.
1.0'0 6.5000
EA MECH EXHAUST HOOD
6.50
Permit . . ELEC-NEW RESIDENTIAL
Additional desc . .
Permit. Fee . . . .
102.55 Plan Check Fee .
2.5.64
Issue -Date
Valuat-ion
0
Qty Unit Charge
Per
Extension
BASE FEE
15.00
21;30.00 .0350
ELECT NEW RES - 1 OR 2FAMILY
7.4.55
6,50.00 .0200
ELEC GARAGE OR NON-RESIDENTIAL
13.00
Permit . . PLUMBING
Additional desc .
Permit Fee . . . .
1.54.50 Plan 'Check Fee
38.63
Issue Date . . . .
Valuation . . . .
0
Qty Unit Charge
Per
Extension
BASE FEE
15.00
14.00 6.0000
EA PLB FIXTURE
84.00
1_00 15.0.00+0
EA PLB BUILDING SEWER
15.0-0
1.00 7.5000
EA PLB WATER HEATER/VENT
7.50
1.0 0 3.. 0 0 0,0
.EA PLB WATER INST/ALT/REP
3_0,0
1.00 9.00°00
EA PLB LAWN SPRINKLER SYSTEM
9.0:0
8.00 .7500
.EA PLB GAS PIPE >=5
6.00
1.00 15.0000
EA 'PLB GAS METER
1.5.00
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
SVD - LOT 48, PLAN 1B,
2130 SF'. PERMIT
DOES NOT INCLUDE POOL,
SPA, BLOCK WALLS
OR DRIVEWAY'APPROACH.
Other Fees .
. . . . ART IN PUBLIC PLACES' -RES'
.0:0
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
50.21
,J
Page 3
Application Number 05-00001366 Date 4/12/05
Other Fees .. . . . . . . DIF FIRE PROTECTI'.ON-RES 97.00
GRADING PLAN CHECK FEE .'00
DI'F LIBRARIES - RES 225.00
DI.F PARK MAINT FAC - RES 5.00
DIF PARKS/REC.- RES 5:02.00
STRONG MOTION (SMI) - RES 13.77
DIF STREET MAINT FAC -RES 15.00
DIF TRANSPORTATION - RES 1098.00
Fee summary Charged
Permit Fee Total 11.28.05
Plan Check Total, 587.28
Other Fee Total 2468.98
Grand Total 4184.31
Paid Credited Due
.00 .00 1.12.8.,0,5
.00 .00 587.28'
.00 .00 2468.9.8
.00 .00 4184.31