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04-5858 (SFD)r, AMPICO 1FORNIA-92253 BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760),777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 ,pr A 1' a umber 04-00005.8.58 Date 2/01/05 P1 Pr er ddress .. . X16 -83`C$ TIC WY AP 767-200-.99'9-5.3 -31202.1- Application description . . . DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . . LOW DENSITY RESIDENTIAL Application valuation.. .1,6.5860 Owner Contractor DESERT CHEYENNE, INC. :HERINGTON DEVELOPMENT, JAMES 0 78401 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: 1542746 11/01/05 CSLB: 753190 04/30/06 CCC: B ---------- 11 -------------,--- Structure Information ------------------------- Construct on 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 4.0:0 FIRE SPRINKLERS NO GARAGE SQ'FTG 658.00, PATIO SQ.FTG .319.00 NUMBER OF UNITS 1.00 1ST FLOOR,SQUARE FOOTAGE 2600.00 Permit BUILDING PERMIT Additional desc . Permit Fee . . . . 870.50 Plan Check Fee 565.83 Issue Date . . . . Valuation 1658.60 Expiration Date 8./01/0.5 Qty Unit Charge Per Extension BASE FEE 639.50 66..00 3.5000 THOU BLDG 1,00;001-500,000 2.31.00 PermitMECHANICAL Additionaldesc . Permit Fee . . . . 90.00 Plan Check Fee 22.50 Issue Date . . . . Valuation 0 Expiration Date 8/01/05 Qty Unit Charge Per Extension BASE.FEE. 15.00 2.00 9.0000 EA MECH FURNACE <�100K 18-.00= a P.O. Box 1504 • VOICE. (760) 777-701,2 '78-495 CALLE' TAMPIC'O FAX (760) 777-7011 LA QUINTA, CALIFORNIA ,92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: — Date: .�• /D' Applicant: ( Architect or Engineer:.' • _ Applicant's Mailing Address: ct chiteor Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under. penalty of, perjury that 1 am licensed Ader provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals C , and my License is full force and effect. $cense Clas n+o. 7 If OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that 1 am exempt from the Contractors' State License Law for the following reason, (Sea 7031.5, Business and Professions Code: Any city or county that'requires a permit to construct, alter, improve, demolish, or repair any stricture, prior to its lssuanoe; 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 Division3 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 1, 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 improvementis 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 1, as owner of the property, am•exclusively contracting with licensed contractors to constrict 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 contractors) 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 self4nsure for workers' compensation, as provided for by Section3700 of the Labor Code, for the performance Yof'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 thispermit is AIRI� works co ensation insurance carrier a �(� _ I certify that, in the performance of the for ich this permit is issued, f shall not employ any person in'any manner so as to become, subject to the workers' compensation laws of;Califomia„and It if I should become subject to the workers' compensation provisions of Sedion 3700 of the Labor Code, I shall forthwith comply with those provisions. WARNING: FAILURE TO SECURE WORKERS' COMOIENSATION 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 (Sea 3097, Civ. C). Lenders Name Lenders Address APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the condhlfons 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 per fomied under orpursuant,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 Quints, its officers, agents and employees for any act or omission rela to the work being performed under or following issuance of this-permiL. 2. Any permit issued as a result of this -application becomes null Vpd void ' work is not commenced within 180 days from date.of'issuance of such permit or oessation-of work for 180 days will subject permit to cancellati I certify that I have read this application and state that the above infommatiI agree to comply with all city and county ordinances and state laws relating to building constriction, and hereby au thorize repntatives of this -county to enter u hove -mentioned property for inspection purposes. (Applicant or. Agent): :i Page 2 Application Number 04-00005858 Date 2/01/05 Qty Unit Charge Per Extension. 2.00 9.0000 EA MECH B/C <=3HP/10,OK BTU 18.00 5.00 6.5000 EA NMECH VENT FAN 32.50 1:010 6.5'000 EA MECH EXHAUST HOOD 6.50 Permit ELEC-NEW RESIDENTIAL Additional desc . Permit Fee . . . . 11.9.1.6 Plan Check Fee 29.79 Issue Date . . . . Valuation . . . . 0 Expiration Date 8/01/05 Qty Unit Charge Per Extension BASE FEE 15.00 2600.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 91.!00 6.58.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 13.16 Permit . . . . . . .PLUMBING Additional desc . . Permit Fee . . . . 166.50 Plan Check Fee 41.63 Issue Date . . . . Valuation 0 Expiration Date 8/01/05 Qty Unit Charge Per Extension BASE FEE 1.5.00 16.00 6.0000 EA PLB FIXTURE 96.00 1.0'0 15.0000 EA PLB BUILDING SEWER 15.00 1.010• 7.5000 EA PLB WATER HEATER/VENT 7.5.0 1.0;0 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 . . . 1.5.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 8/01/05 Qty Unit Charge Per Extension BASE FEE 15.00 --------------------------------------------------------------------------------- Special Notes and Comments SFD - LOT 53, PLAN 2B, 2600,SF. PERMIT DOES NOT INCLUDE. POOL, SPA, BLOCK WALLS, OR DRIVEWAY APPROACH a Page 3 Application Number . . . . . 04-00005858 Date 2/01/05 Other Fees ART IN PUBLIC PLACES -RES .00 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 56.58 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 16.58 DLF STREET MAINT FAC, -RES 15:00 DIF TRANSPORTATION - RES 1098.00 Fee summary Permit Fee Total Plan Check Total Other Fee Total Grand Total Charged Paid 1261.16 .00. 659.75 2.50.00 2478.16 .00 4:399.07 2.5,0:00 Credited Due .00 126.1.16 .00 40`9.75 .00 2478.16 .00 4149,.07 Certificate of Occupancy OF Building & Safety Department This Certificate is issued pursuant to the requirements of Section 109 of the 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: 81-683 CHARISMATIC WAY Use classification: SINGLE FAMILY DWELLING Building Permit No.: 04-58.58 r Occupancy Group: R-3 Type of Construction:. VN Land Use Zone: RL Owner of Building: DESERT CHEYENNE, INC. Address: 78-401 HIGHWAY 111, STE. G City, ST, ZIP: LA QUINTA, CA 92253 ��..L By: GARY SHOWALTER, Date: SEPTEMBER 23, 2005 � Building Official 1 POST IN A CONSPICUOUS PLACE F