05-5116 (SFD)TP1 BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
BUILDING PERMIT .
Application Number: 05-00005116 Owner:
'Property Address: 8160-8—RANCHO SANTANA DR L NNAR HOMES
APN: 767-200-999-4 -312022- MWYOPLAQUINT
004 COOK STREET
Application description: DWELLING - SINGLE FAMILY DETACHED M DESERT, CA 92211
Property Zoning: LOW DENSITY RESIDENTIAL60)601-3100
Application valuation: 173670 Contractor:Applicant: Architect or Engineer:L4NNAR HOMES OF CALIFORNIA INC
c1Cdlina:E DEFT '0004 COOK ST.
PALM DESERT, CA 92211
_ (951)817-3600
Lic. No.: 728102
fgD�
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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 Code, and my License is in full force and effect.
License C ss: B License No.: 728102
Date: ntractor:
/ OWNER -BUILDER DECLARATION
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 a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
(_ 1 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 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 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
Date: 11/21/05
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.
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 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 should become subject to the workers' compensation provisions of Section
/ 3700 of the Labo , I shall f rthwith comply with those provisions.
/WARNING: FAILURE TO SECURE KERS' 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 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.
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 ate laws relating to building construction, and hereby authorize representatives
oft ounty `o enter up a above-mentioned pr erty for inspection pu poses.
Date.. V Signature (Applicant or Agent): I fin
Application Number .
. . . . 05-00005116
Permit . . .
BUILDING PERMIT
Additional desc .
Permit Fee . . . .
898.50 Plan Check Fee
146.01
Issue Date . . . .
Valuation . . . .
173670
Expiration Date
5/20/06
Qty Unit Charge-
Per
Extension
BASE FEE
639.50'
.74.00 3.5000
----------------------------------------------------------------------------
THOU BLDG 100;001-500,000
259.•00
Permit . . .
MECHANICAL
Additional desc
Permit Fee . . . .
95.00 Plan Check Fee
5.94
Issue Date . .
Valuation . . . .
0
Expiration Date
5/20/06
.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 <=3HP/100K BTU
27.00
3.00 6.5000
EA MECH VENT FAN
19.50
1.00 6.5000
EA MECH EXHAUST HOOD
6.50
Permit
ELEC-NEW RESIDENTIAL
Additional desc
Permit Fee
124.53 Plan Check Fee
7.78
Issue Date . . . .
Valuation
0
. Expiration Date
5/20/06
Qty Unit Charge
Per,
Extension
BASE FEE.
15.00
2742.00 .0350
ELEC NEW RES - 1 OR 2' FAMILY
95.97
678,00 .0200
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ELEC GARAGE OR NON-RESIDENTIAL
13.56
Permit. . .
PLUMBING
Additional desc
-
` Permit Fee . . . .
161.25 Plan Check Fee
10.08
Issue Date . . .
Valuation . . . .
0
Expiration Date-.
.5/20/06
Qty,. Unit Charge
Per
Extension
BASE FEE
15.00
15.00 6.0000
EA PLB FIXTURE
90.00
„ 1.00 15.0000
EA PLB BUILDING SEWER
15.00
LQPERMTT
Application Number . . . . . 05-00005116
Permit . . . PLUMBING
Qty Unit Charge Per
Extension
1.00 7.5000 EA PLB WATER HEATER/VENT
7.50
1.0.0 3.0000 EA PLB WATER INST/ALT/REP
'3.00
1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM_
9.00
9.00 .7500 EA PLB GAS PIPE >=5
6.75
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 5/20/06
'.
Qty Unit Charge Per
Extension'
BASE FEE
15.00
- ----- - - - - -- - - - -- - - - --
.Special Notes and Comments
SFD -.2742 SF. LOT 4, PLAN 1AR/3 CAR.
GARAGE 678 SF.PERMIT DOES NOT
4
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
'58.40
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
17.36
DIF STREET MAINT FAC -RES
15.00,
DIF TRANSPORTATION - RES
1098.00
Fee summary Charged Paid Credited
Due
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Permit Fee Total 1294.28 .00 .00
Permit
1294.28
Plan Check Total 169.81 .00 .00
169.81`
Other Fee Total 2500.76 .00 .00
2500.76
Grand Total 3964.85 .00 .00
3964.85
r
LQPERMIT .
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