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04-3782 (SFD)�yf P.O. Box 1504 - 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING PERMIT BUILDING & SAFETY'DEPARTMENT (7 60)-7 77-7 01-2- `` FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 Application Number . . . . X04'-000.03782~ Date 4/29/04 Property Address . . . . . 77620 CALLE POTRERO APN: 774-282-025-14 -000000- Application description . . . DWELLING - SINGLE FAMILY DETACHED Property Zoning . COVE RESIDENTIAL Application valuation 201799 Owner Contractor` ----------------------- --�--,,'--------------- -- TAYLOR DAVID Q/ ESTHER L TAYLOR, 'DAVID Q. 68100 RAMON RD P.O. BOX 2263 CATHEDRAL CITY CA 92234 PALM SPRINGS- CA 92263 (760) 324-4507 WCC: NONE WC: EXEMPT 11/30/04 CSLB: 787595 11/30/04 CCC: B -------------------------- Structure Information -------------------------- Construction.Type . . . . . TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/CONG <=10 Flood Zone . . . . . . . . NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 CBC # BEDROOMS 3.00 FIRE SPRINKLERS NO GARAGE SQ FTG 1955.00 PATIO SQ FTG 996.00 NUMBER OF UNITS 1.00 FIRST FLOOR SQ FTG 2960.00 -------------------------------------------'------'=---�=--------------------- Permit . . . ... . BUILDING PERMITS Additional desc Permit Fee . . . . 996.50 Plan Check Fee 647.73 Issue Date 7/28/03 Valuation 201799 Qty Unit Charge Per, Extension BASE FEE 639.50 102.00 3.5000 THOU BLDG 100,00`'r-500;0,00�°` ` 357.00 ---------------------------------------------- - --------- Permit . . . . . . MECHANICAL °„ ° g , i .- Additional desc Permit Fee 77.00 Plan Check Fee 19.25 Issue Date Valuation . . . . 0 Qty Unit Charge Per Extension P.O. Box 1504• �� VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 4INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: to'y— 398,Z Date: Applicant: I Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS . 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 full force and effect. License lass S C` / i ' nse No. Date J 0 ! Contractor 124 _A� OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).): U 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 or 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.). U I, 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.). 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 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: Cartier Policy Number _ 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 Labor Code, I shall forthwith comply with thZprisiongs. Date _ -501 O Applicant WARNING: FAILURE TO SECURE WORKERS' COMPENSATI 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 erjury thattthere is{aa construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). F'ce 1 Lender's Name ,4e/51 /%nOIOi /-- Lender's Add Zed, 9 �l 1 C ZZ 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. 1 certify that.l 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 building construction, and hereby authorize representatives of this county tVut e ab ention property for inspection purposes. Date �� Signature (Applicant or Agent): cPW Page 2 Application Number 04-00003782 Date 4/29/04 Qty Unit Charge Per Extension BASE FEE 15.00 2.00' 9.0000 EA MECH FURNACE <=100K 18.00 2.00. 9.0000 EA - MECH B/C <=3.HP/100K BTU 18.00 3.00. 6.50.00 EA MECH VENT FAN 19.50 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 ---------------------------------------------------------------------------- Permit . . . . .J. ELEC-NEW RESIDENTIAL Additional desc Permit Fee 172.70 Plan Check Fee 43.18 Issue Date . . . . Valuation 0 .Qty Unit Charge Per Extension BASE FEE 15.00 2960.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 103.60 1955.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 39.10' 1.00 15.0000 EA ELEC TEMPORARY POWER POLE 15.00 ----------------------------------- Permit . . . PLUMBING ----------------------------------------- Additional desc Permit Fee . . . . 300.75 Plan Check.Fee 75.19 Issue Date . . Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 26.00 6.0000 EA PLB FIXTURE 156.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 11.00 6.00.00 EA PLB ROOF DRAIN 66.00 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 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 Qty Unit Charge Per Extension BASE FEE 15.00 I N� Page 3 Application Number 04-00003782 00003782 Date 4/29/04 -------------------------------------------------------------------- Special.'Notes and Comments --------- 2960 SF: SFD PERMIT DOES NOT INCLUDE BLOCK WALL, POOL/SPA OR DRIVEWAY APPROACH ---------------------------------------------------- Other Fees . . . . . . . . . ------------------------ DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC -CENTER - RES• 366.00 ENERGY REVIEW FEE 40.18 ENERGY REVIEW FEE 64.77 DIF FIRE PROTECTION -RES 97.00 GRADING PLAN CHECK FEE .00 GRADING PLAN CHECK FEE .00 GRADING PLAN CHECK FEE .00. GRADING PLAN CHECK FEE .00 GRADING PLAN CHECK FEE 00 GRADING PLAN CHECK FEE .00 GRADING PLAN CHECK FEE .00 DI.F LIBRARIES - RES 225.00 DIF PARK MAINT FAC - RES 5.00 DIF PARKS/REC RES 502.00 COVE PRECISE PLAN FEE 100.00 STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged - - - - - - - - - - - - - - - --- - - --- Paid. Credited Due - - Permit Fee Total 1561.95 - - - - - - - - - - - - - - - - - 00 7 - - - - .00 - - - - - - - - 1561.95 Plan Check Total 765.35 250.00 .00 535.35 Other Fee Total 2609.95 00 .00 2609.95 Grand Total 4957.25 250.00 .00 4707.25