04-4965 (SFD)a
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r�
BUILDING & SAFETY DEPARTMENT
II,I I:,w P.O. Box 1 I i 4. (760),777-7012
OF Tt� 78-495 CAS LEj TAMPICO FAX (760) 777-7011
U AUG CLA QUUIINTACALIFORNIA 92253 INSPECTION REQUESTS (760).777-7153
CITY OFI-AQUINTA BUILDING PERMIT
PINANC` DEPT,
Application Number . . . x04=00004965 Date 6/15/04
Property Address .. . . . . •7-8127 RED HAWK LN
APN: 658-140-999-29 =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 R*BARRY MCCOMIC9968 HIBERT STREET, STE'#102
7979 IVANHOE AVE STE-550 SAN DIEGO - ''.CA 92131
LA JOLLA CA 92037 (858) 65373003
WCC: STATE FUND
WC.: 1648813 10/01/04.
CSLB: 701039, 01/31/05
CCC: B
-------------------------- Structure Information -----
construction Type TYPE V -'NON RATED
Occupancy Type . . . DWEI,LG/LODGING/LONG <=10
Flood Zone NON -AO FLOOD ZONE
Other struct info ... CODE EDITION...'', 2001 CBC
FIRE.SPRINKLERS NO
GARAGE SQ FTG 6.72.0.0
PATIO SQ FTG 339.0,0.,
NUMBER OF UNITS 1.00
FIRST FLOOR SQ FTG 2386.00,
Permit BUILDING PERMIT.
Additional- desc
Permit Fee 832.00 Plan Check Fee 135.20
Issue Date Valuation 154159
Qty Unit Charge Per. Extension
BASE FEE 639.50
55.00 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
P.O. Box 1504 •
VOICE (760) 777-7012
78-495,,CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760)'777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: Date: y -044
Applicant:
Applicant's Mailing Address:
chJ'1er ct o�f�ng' eer:
/�lCO�/tit`y
Architect or Engineer's Address:
ic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
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
Cede, and my Licensei full force and effect.
/License Class 8 � se No.
ate a G�r Contractor 1p�
OWNER -BUILDER DECLARATION
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 constrict, 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' compensat' insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
Myy�rkers' compensation�as ra�nce caner ed pfp µu rare:
Cartier �5. !"C/Nli "Policy Number ! b K rd��
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 those provisions.
ate
WARNING: 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.
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
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 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 state laws relating to building
construction, and hereby authorize representatives of this county to enter upon the above{neintioned property for inspection purposes.
S' ignature (Applicant or Agent): �Cf't
Page
2
Application
Number .
. .
. . 04-00004965 Date
6/15/04
Qty
Unit Chargee
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
15.00
2386.00
.0350
ELEC NEW RES -'l 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
3.0000
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
15.00
------------------------
Special Notes
-------------------
and Comments
---------------------------------
SFD LOT 29'PLAN
1AR PERMIT
DOES NOT
Page. 3
Application Number
. . . . .
04-00004965 bate
6/15/04
Special Notes and Comments
INCLUDE BLOCK WALL,
POOL, SPA
OR
DRIVEWAY APPROACH.75% PLAN CHECK FEE
REDUCTION FOR MULTIPLE
ISSUANCE OF SAME
PERMIT TYPE.
-------------------------------------7--------------------------------------
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 -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
-----------------
Charged
Paid Credited
Due
Permit Fee Total
----------
1261.73
------------------------------
.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