09-0510 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
C&t!t 4 4 49h
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 09-00000510
Property Address: 81667 CHARISMATIC WY'
APN: 767-640-011- - -
Application description: DWELLING - SINGLE FAMILY DETACHED
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 165860
Applicant: Architect or Engineer:
ata
LICENSED CONTRACTOR'S DECLARATION
('hereby affirm under penalty of perju_ Ittit I am licensed under provisions of Chapter 9 (commencing with
Section,7000) of'Division 3 of- the Bu at and Professionals Code, and my License is in full force and effect.
License Class: B License No.: 753190
Date%X dj Contractor..
OWNER-SUILDER DrECLARATION
I hereby affirm under penalty of perjury tit t I am,exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business and Professions Code: Any city or county thavrequires a permit to
construct; alter, improve, demolish, or repair -any structure, prior to its issuance, also,requires theapplicant for the
permit to file a signed statement that he or she is licensed pursuant to,the provisions:of the.Contractor's State
License La"w (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 permitsubjecwthe applicant to a civil penalty of not more than five hundred dollars (9500).:
1 _ 11, 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,;8uslness 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 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. heor she did not build or
Improve forthe purpose of sale.).
1 1 I, as owner of the property, am exclusively contracting with licensed contractors to constructthe project (Sec.
7044, Business: and. Professions Code: The Contractors' State License Law does not apply loan 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.).
I—) I am exempt under Sec. , B.BP.C, for this reason
Date: Owner::
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, C(r. C.).
Lender's Name: 114
Lender's Address: OT
LQPERMIT
Owner:
DESERT CHEYENNE', INC..
78401 HIGHWAY 111, SUITE
LA QUINTA, CA 92253
(760)777-9920
Contractor:
HERINGTON DEVELOP INC,
40960 CALIFORNIA OAKS
MURRIETA, CA 925.62
(951)677-8415
Lic. No.: 753190
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 7774153
Date: 10/12/09
------------------
WORKER'S 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..
_ 1 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+issued. My workers' compensation
insurance carrier and policy number are:
Carrier S3kTH .FOND Policy Number
I certify that, in:the pe ance of the work for which this permit is issued. I.shall notempioy, any
person in,any mann as to become subject to the workers' compensation laws of California,
and agree that; if I s become subject to the workers' compensation provisions of Section
/ 00 of the Labor C l,shall'forthwith comply with those,provisions.
Nse<�� dS pplicam:,,
WARNING: FAILURE TO SECURE WO KERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AWEMPLOYER TO CRIMIN L PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (8100,00.0). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES:
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made"to the Director of Building and Safety fora permit subjectto 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 parmitissued as a result of this application,
the owner, and the. applicant; each agrees to, and. shall defend,. indemnity and hold harmless the City
of La.Oulnta: 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 appli tio
ys n becomes null and void If work is not commenced
ta
within 180 dafrom date of Issuance o su ;permit, or oessationof work for 180 days will subject
permit to cancellation:
1 certify that I'have read this application and state that above information is correct. I agree to comply with all
city and county ordinances and state laws relating to I ng construction, and hereby authorize representatives
of this counyy toenter upon the above-mentioned pro for inspection,purposes.
(Applicant orAgent):
Application Number . . . 0.9-00000510
Structure Information
Construction Type .
. . . . TYPE V - NON RATED
Extension
Occupancy Type . .
. . DWELLG/LODGING/LONG <=10
BASE FEE
Flood Zone. .
. . . . .NON -AO FLOOD ZONE
3.5000
Other_ struct info .
. . . . CODE EDITION
2007 CBC
. . MECHANICAL
## BEDROOMS
4.0.0
desc . .
FIRE SPRINKLERS
NO
Permit Fee
GARAGE SQ FTG
658.00
22.152
PATIO SQ FTG
319.00
Valuation :.
NUMBER OF UNITS
1.00
Date
IST FLOOR SQUARE FOOTAGE
2600.00
Permit. . . .
BUILDING_ PERMIT
Extension
Additional desc . .
BASE FEE
Permit Fee . . . .
870.50 Plan Check Fee
565.84
Issue Date . . . .
Valuation . .
. . 165860
Expiration Date . . 11/17/0.9
Qty Unit Charge
Per
Extension
BASE FEE
639.50,
66.00
3.5000
THOU 13LDG'100,001-500,.000
231.00
Permit.
. . MECHANICAL
Additional
desc . .
Permit Fee
. .
96.60 Plan Check Fee
22.152
Issue. Date
. . .
Valuation :.
0
Expiration
Date
11/17/09
Qty Unit Charge
Per
Extension
BASE FEE
15.00
.2..00
9.0000
EA MECH FURNACE <=100K
18.60
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
. . . .
119.16 Plan Check Fee
29.80
Issue Date
. . .
Valuation . .
0
Expiration
Date . .
11/17/09
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2600.00
.0350
ELEC NEW RES _ 1 OR 2 FAMILY
91.00
LQp"Mff
Application Number . . . . . 09-00000510
Permit . . . . . . ELEC-NEW RESIDENTIAL
Qty Unit Charge
Per
Extension
Extension
658.00
.020,0
15.00
ELEC.GARAGE OR NON-RESIDENTIAL
13.16
Permit.
. . . PLUMBING
2600
SF. PERMIT
Additional
desc .
BLOCK WALLS,
OR DRIVEWAY APPROACH.
2007
Permit Fee
. . . .
'166..50
. .
Plan Check Fee
41.6.4
Issue Date
BLDG STDS ADMIN (SB1473)
7.00
Valuation_
0
Expiration
Date
11/17/09
DIF CIVIC CENTER - RES
995.00
Qty Unit Charge
Per
ENERGY REVIEW FEE
56.58
Extension
DIF FIRE PROTECTION -RES
140.00
BASE FEE
15.00
16.00
6.0000
EA
PLB
FIXTURE
96.00
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
EP,
PLB
GAS METER
15.00
Permit. . . . GRADING PERMIT
Additional desc
Permit Fee 15.00
Issue Date . . .
Expiration Date . . 11/17/0,9
Plan Check Fee . . .00
Valuation . . . . 0
Qty Unit Charge
Per
Extension
BASE FEE
15.00
Special Notes and Comments
SFD - LOT 52, PLAN 2B;,
2600
SF. PERMIT
DOES NOT INCLUDE: ;POOL,
SPA,
BLOCK WALLS,
OR DRIVEWAY APPROACH.
2007
CODES.
---------------------------------------------------
Other Fees . . .
.
. .
--------------------------
. ART IN PUBLIC PLACES -RES
.
.0.0
BLDG STDS ADMIN (SB1473)
7.00
DIF COMMUNITY CENTERS -RES
74.00
DIF CIVIC CENTER - RES
995.00
ENERGY REVIEW FEE
56.58
DIF FIRE PROTECTION -RES
140.00
GRADING PLAN CHECK FEE
.00
DIF LIBRARIES - RES
355.00
DIF PARK MAINT FAC - RES
22.00
DIF PARKS/RRC - RES
892.00
STRONG MOTION (SMI) - RES
16.58
LQP"XiT.
Application Number . . . . 09-00000510
----------------------------------------------------------------
Other Fees . . . . . . DIF STREET MAINT FAC -RES 67.00
DIF TRANSPORTATION - RES 1930.00
Fee summary Charged
Permit, Fee. Total 1261.16
Plan Check Total. 659.80
Other. Fee Total 4555.16
Grand Total 6476..12
LQPBRMIT
Paid Credited Due
.00 .00 1261..16
.00 .,00 659.80
.00. .00 4555.16
.00 .00 6476.12
VCertificate of Occupancy,
44, Q"-
G
OF Building & Safety Department
This Certificate is issued pursuant to the requirements of Appendix Chapter 1 Section 110 of the
2007 California Building Code, .certifying that, at the time of issuance, this structure was in
compliance with the provisions of the Building Code and the various ordinances of the City
regulating building construction and (or use.
BUILDING ADDRESS: 81-667 CHARISMATIC WAY
Use classification: SINGLE FAMILY DWELLING Building Permit No.: 09-510
Occupancy Group: R-3 Type of Construction: V -N Land Use Zone: RL
Sprinklers Installed: NO Sprinklers Required: NO
Owner of Building: DESERT CHEYENNE
Address: 78-401 HIGHWAY 111. STE. G
`—� City, ST, ZIP: LA QUINTA, CA 92253
By: STEVE TRAXEL
Building Official Date: MARCH 18.2010
POST IN A CONSPICUOUS PLACE