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07-2750 (SFD)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 07-00002750 Property Address: 57340 PENINSULA LN APN: 762-150-005- - - Application description: DWELLING - SINGLE FAMILY Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 417484 Tit�v 4 XP Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: ROY SCHUBERT 55-480 PEBBLE BEACH DETACHED LA QUINTA, CA 922.53 Contractor: Applicant: Architect or Engineer: A & M CONSTRUCTION P.O. BOX 366 LA QUINTA, CA 92247 (760)564-4832 Lic. No.: OOR SQUARE FOOT Lic. No.: 746198 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am lic nsed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Pr fessionals Code, and my License is in full force and effect. License Class:, 13 C10 License No.: 746198 Date: 7- Ucontractor: 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 _ 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 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.). ( ) 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: LQPERAIIT NEvE;k '5u,L.T 7 ? VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/07/08 D SEP 241008 �I OF L Q�INTq Akt^ - -- 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. 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 this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier STATE FUND Policy Number 044-0028137-07 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 ecoma subject to the workers' compensation provisions of Section 3700 of, the Labor Code shall forthwith comply with those provisions. L/ � f Date: Z l"��A,plicant: WARNING: FAILURE TO SECURE ORKERS' 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 Pnsntrormation iis correct. I agree to comply with all city and county ordinances and state laws relating to buildituction,and hereby authorize representatives of this county tc enter u on the above-mentioned propertyspection purposes. Dateg�y r Signature (Applicant or Agent): IN Application Number . . . . . .07-00002750 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 1752.50 Plan Check Fee 1139.13 Issue Date . . . . Valuation . . . . 417489 Expiration Date . . 2/03/09 Qty Unit Charge Per Extension BASE FEE 639.50 318.00 ----------------------------- 3.5000 THOU BLDG ------------------------------------------- 100,001-500,000 1113.00 Permit . . . ELEC-NEW RESIDENTIAL Additional desc . . Permit Fee . . . . 215.57 Plan Check Fee 53.89 Issue Date Valuation . . . . 0 Expiration Date 2/03/09 Qty Unit Charge Per Extension ' BASE FEE 15.00 4846.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 169.61 798.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 15.96 1.00 ---------------------------------------------------------------------------- 15.0000 EA ELEC TEMPORARY POWER POLE 15.00 Permit . . . GRADING PERMIT Additional desc . Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . 0 Expiration Date . . 2/03/09 Qty Unit Charge Per Extension ---------------------------------------------------------------------------- BASE FEE 15.00 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 145.50 Plan Check Fee 36.38 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 2/03/09 Qty Unit Charge Per Extension BASE FEE 15.00 4.00 9.0000 EA MECH FURNACE <=100K 36.00 4.00 9.0000 EA MECH B/C <=3HP/100K BTU 36.00 8.00 6.5000 EA MECH VENT FAN 52.00 1.00 -----------------------=---------------------------------------------------- 6.5000 EA MECH EXHAUST HOOD 6.50 LQPE%IIIT Application Number Permit Additional desc . Permit Fee . . . . Issue Date . . . . Expiration Date . . . . . . . 07-00002750 PLUMBING 267.00 Plan .Check Fee Valuation . 2/03/09 66.75 0 Qty Unit Charge Per Extension BASE FEE 15.00 27.00 6.0000 EA PLB FIXTURE 162.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 4.00 6.0000 EA PLB ROOF DRAIN 24.00 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 12.00 .7500 EA PLB GAS PIPE >=5 9.00 1.00 15.0000 EA PLB GAS METER 15.00 ---------------------------------------------------•------------------------- Special Notes and Comments 4846 SQ. FT. SFD THIS PERMIT DOES NOT INCLUDE POOL & SPA, BLOCK WALLS.OR DRIVEWAY APPROACH. --------------------=--------------------------------------------=---------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES 543.71 DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER - RES 995.00 ENERGY REVIEW FEE 113.91 DIF FIRE PROTECTION -RES 140.00 GRADING PLAN CHECK FEE 15.00 DIF LIBRARIES - RES 355.00 DIF PARK MAINT FAC - RES 22.00 DIF PARKS/REC - RES 892.00 STRONG MOTION (SMI) - RES 41.74 DIF STREET MAINT FAC -RES 67.00 DIF TRANSPORTATION - RES 1930.00 Fee summary Charged Paid Credited ---------------=----------------------------------------- Due . Permit Fee Total 2395.57 .00 .00 2395.57 Plan Check Total 1296.15 750.00 .00 546.15 Other Fee Total 5189.36 .00 .00 5189.36 Grand Total 8881.08 750.00 .00 8131.08 LQPE&AIIT