The URL can be used to link to this page

05-5154 (SFD),W , 'ii P. -O' BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: 05=00005__ 154 81627 RANCHO 767-200-999-6 DWELLING - SI: LOW DENSITY R'. 185758 I Td!t 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: HOMES COOK STREET ESERT, CA 92211 77-9920 x: HOMES -OF COOK ST. ESERT, CA 17-3600 o.: 728102 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 CALIFORNIA INC 92211 Date: 11/23/05 -------------------------------------------------------------_------------------------------------ LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ .I have and will maintain a certificate of consent to self -insure for workers' compensation,as provided License lass: B _ License No.: 728102 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. �te: ` ontractor: -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 OWNER -BUILDER DECLARATION insurance carrier and olic number are: I hereby affirm under penalty of perjury that 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 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 Contractor's 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 apermit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (_ 1 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 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.). (_) 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.). (_ 1 I am exempt under Sec. , B.&P.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, Civ. C.). Lender's Name: Lender's Address: LQPERMIT I Y Carrier AON RISK SRVC Policy Number MWC11148500 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 ho Id become subject to the workers' compensation provisions of Section 3700 of the or rl'sftall forthw' h comply with those provisions. qAti Applicant: _ : 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. 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 Ouinta, its officers, agents and employees for any act or omission related to ihe-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 bu' d' construction, and hereby authorize representatives 7of t1hi ounty t enter upon ove-mentioned prop fo inspection purposes. Dat Signature (Applicant or Agent): LQPERMTT Application Number . . . . . 05-00005154 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 940.50 Plan Check Fee 152.83 Issue Date . . . . Valuation . . . . 185758 Expiration Date 5/22/06 Qty Unit Charge Per Extension BASE FEE 639.50 86.00 3.5000 ---------------------------------------------------------------------------- THOU BLDG 100,001-500,000 301.00 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 101.50 Plan Check Fee 6.35 Issue Date Valuation . . . . 0 Expiration Date 5/22/06 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 9.0000 EA MECH FURNACE.<=100K - 27.00. 3.00 9.0000 EA MECH B/C 2=3HP/100K BTU 27.00. 4.00 6.5000 EA MECH VENT FAN 26.0.0 1.00 6.5000 ----------------------------------------------------------------------------- EA MECH EXHAUST HOOD 6.50 Permit . . ELEC-NEW.RESIDENTIAL Additional desc . , Permit Fee . . . . 130.60 Plan Check Fee 8.16 Issue Date . . . . Valuation 0 Expiration Date 5/22/06 Qty Unit Charge Per Extension BASE FEE 15.00 2961.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 103.64 598.00 .0200 ---------------------------------------------------------------------------- ELEC GARAGE OR.NON-RESIDENTIAL 11.96 Permit . . . PLUMBING Additional desc . Permit Fee . . . . 199.50 Plan Check Fee 12.47 Issue` Date . . . . Valuation 0 Expiration Date 5/22/06 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 LQPERMTT LQPERMrr Application Number . . . . . 05-00005154 Permit . . . . . . PLUMBING Qty Unit Charge Per Extension 2.00 7.5000 EA PLB.WATER HEATER/VENT 15.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 10.00 .7500 EA PLB GAS PIPE >=5 7.50 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 Expiration Date 5/22/06 Qty Unit Charge Per Extension BASE FEE 15.00 --------=------------------------------------------------------------------- Special Notes and Comments SFD - LOT 60, 2961 SF PLAN 2C/3 CAR GARAGE 598 S.F. PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS OR DRIVEWAY APPROACH. 75% REDUCTION.TO PLAN CHECK FEES DUE TO MULTIPLE ISSUANCE OF SAME PLAN TYPE ---------------------------------------------------------------------------- Other Fees . . . ... . . . . ART IN PUBLIC PLACES -RES 20.00 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 15.28 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 18.57 DIF STREET MAINt FAC -RES 15.00 DIF TRANSPORTATION - RES. 1098.00 Fee summary Charged Paid Credited -- - - - - - - - - - - - - - ------ - - - - --- - - - ------ - - - - ---- Due -- ---- Permit Fee Total 1387.10 .00 .00 ------ 1387.10 Plan Check Total 179.81 .00 .00 179.81 Other Fee Total 2458.85 .00 .00 2458.85 Grand Total. 4025.76 .00 .00 4025.76 LQPERMrr