04-4967 (SFD)°� u��cicv
BUILDING & SAFETY DEPARTMENT
Up.0d
1504. (760),777-7012
-,.F 78-495 16ALLE TAMPICO FAX (760) 777-7011
AUG 0 4 2LIPA4Q 1110 11A, CALIFORNIA 9'2253 INSPECTION REQUESTS (760) 777-7153
T
CITY OF LA QUINTA BUILDING PERMIT
INANCE DEPT.
Application Number <__0 47- -Q-.O-CQ_�4 Date 6/15/04
_9�6 T� Da.
Pr I- ' operty Address . . . . . . 78235 RED HAWK LN
APN: 658-140-999-35 -29436
Application description DWELLING - SINGLE FAMILY DETACHED
Property Zoning LOW DENSITY RESIDENTIAL
...Application valuation 154159
Owner Contractor
-------------------------- --------------
IVANHOE LA QUINTA COVE. TRANS WEST -HOUSING, INC.
..C/O k BARRY MCCOMIC 9968 HIBERT STREET, STE #102
7979 IVANHOE AVE STE 550 SAN.DIEGO - ..CA 92131
LA JOLLA CA 92037. (858) 653-3003
WCC: STATE - FUND'
WC': :1648813 '10/01/04
CSLB: 701039: 01/31/05
CCC: B
--------------=----------- -Structure Information -------------------------
Construction
-----------7------------
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
FIRESPRINKLERSNO
GARAGE SQ FTG 6.72.00
PATIO SQ FTG 339.00.
NUMBER OF UNITS 1.00
FIRST FLOOR SQ'FTG, 2386.00
------------------------ 7- -------------------------------- --------- ---------
Permit . . . . . . BUILDING PERMIT.
Additional desc
Permit Fee 832.00' Plan Check Fee135.20
Issue Date. Valuation 154159
Qty Unit Charge Per Extension
BASE FEE 639.50
55.0.0 3.5000 THOU- BLDG 100,001-500,000 192.50
-----------
------------------------------ -------------------- ---------------
Permit . . . . . . MECHANICAL
Additional 'desc
Permit Fee . . . . 90.00 Plan Check Fee 3.75
Issue Date Valuation 0
Qty . Unit Charge Per Extension
v
P.O. Box 1564 •
�� 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: 04- 4q(o l Date: — Li 'O `'I*
Applicant:cNrct grNigee
Applicant's Mailing Address:
Architect or Engineer`s Address:
Lic. No.: Qql--f17
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
e, and my License}' full force and effect.
License Class License No. O / O ,T r'%
' Date )i V-0
OWNER -BUILDER DECLARATION
hereby affir '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
/��ed. My wprke compensation incur nce carrier a�1dp�I* umber are:
/Carrier f / %f I C- M /- �licy Number Z E 7 9,P73
_ 1 certify that, in the performance of the work for which thispermit is issued, 1 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 those provisions.
—G
WARNING: FAILURE TO SECURE WORKERS' 60MPENSATION 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 (Sec. 3097, Civ. C.).
Lender's Name //��
Lender's Address A
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 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 building
construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes.
Date E ^0'y'— 6-t-7 -_ `Signa cure (Applicant or Agent):
Application Number . . . . . 04-00004967
Page 2
Date 6/15/04
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 <=3HP/100K BTU
18.00
.00
16.5000
EA
MECH B/C >3-15HP/>100K-500KBTU
00
5.00
6.5000
EA
MECH VENT FAN
32.50
1.00
---
6.5000
EA
MECH EXHAUST HOOD
6.50
-------------------------------
Permit .
. . . .
------------------------------------------
ELEC-NEW RESIDENTIAL
Additional
desc
Permit Fee
. . .
146.23 Plan Check Fee
9.14
Issue Date
Valuation
0
Qty
Unit Charge
Per
Extension
BASE FEE
1 15.00
2386.00
.0350
ELEC NEW RES - 1 OR 2 FAMILY
83.51
2386.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
47.72
----------------------------------------------------------------------------
Permit .
. . .
PLUMBING
Additional
desc
Permit Fee
. . . .
178.50
Plan Check Fee
11.16
Issue Date
Valuation . . . .
0
Qty.
Unit Charge
Per
Extension
BASE FEE
15.00
18.00
6.0000
EA
PLB-FIXTURE
108.00
1.00
15.0000
EA
PLB BUILDING SEWER
15.00
1.00
7.5000
EA
PLB WATER HEATER/VENT
7.50
1.00
3.00.00
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
. . . .
15.00 Plan Check Fee
.00
Issue Date
. . .
Valuation . . . .
0
Qty
Unit Charge
Per
Extension
-----------------------------------------------
.
BASE FEE
=----------
1.5.00
Special Notes
and Comments
------------------
SFD LOT 35
PLAN 1B PERMIT
DOES NOT
14
Page 3
Application Number
. . . . .
04-00004967 Date
6/15/04
-------------------------------------------------------7--------------------
Special Notes and Comments
INCLUDE BLOCK WALL,
POOL, SPA
OR
DRIVEWAY APPROACH.75%
PLAN CHECK FEE
REDUCTION FOR MULTIPLE
ISSUANCE OF SAME
PERMIT TYPE.
----------------------------------------------------------------------------
Other Fees . . . .
. ... . .
ART IN PUBLIC PLACES -RES
.00
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
13.52
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
15.41
DIF STREET MAINT FAC-RES4
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
-- - - - - =-
Charged
Paid Credited
Due
- - - - - - - - -
Permit Fee Total
---- - - - - --
12'61.73
---- - -- - ------ - - - - ----
.00 00
-- - - - - - -
1261.73
Plan Check Total
159.25
.00 .00
159.25
Other Fee Total
2433.93
.00 .00
2433.93
Grand Total.
3854.91
00 .00
3854.91