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05-4847 (SFD)P.O. BOX 1504 ^� 78495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number:�05-00004847 Owner: Property Address: .5 220_RESIDENCE CLUB COVE NADADOR, LLC APN: 775-380-999-15' -31627- O 78120 CALLE ESTADO, SUITE 203 Application description: DWELLING - SINGLE FAMILY DETACHE 4 LA QUINTA; CA 92253 Property Zoning: MEDIUM DENSITY RES Application valuation: 287914 10, • C/�,. (•�10 Contractor: Applicant:.: /Architect or Engineer: ��,y-O� �s JACOBS HOMES INC, PETER wl{►C�4Q P.O. BOX 692 L �Y�/(� FO��j� LA QUINTA, CA 92247 / / / (760)77. 799 �J 7[' /2 921 LiC. No.: : 799449 -------------------------------------------------- LICE ED CONT TOR'S DECLARATION ' I hereby affirm under penalty of perjury that I licensed r provisions of Chapter 9 (commencing with Section 7000) of Division -3 of the Business d o ass' a Code, and my License is in full force and effect. License/Class: B icense No.: 799449 VW OWNE -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—) 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 contractors) licensed pursuant to the Contractors' State License Law.). (_ 1 I am exempt under Sec. , BAP.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: 1� LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/31/05 7---------------------------------------7------ 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 JJ issued. i 1 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 HRH INSUR Policy Number 176983305 _ .1 certify that, in the performanfol of the work for which this permit is issued, I shall not employ any person in any manner so a o become bject to the workers' compensation laws of California, and agree that, if I shout e s ct to the workers' compensation provisions of Section � X31000 of the Labor Cod I f ith comply with those provisions. fDatef 2 Y `•PPlicant: WARNING: FAILURE TO SECURE WORKERS'MPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$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 per it, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the abo in rmation is rrect. I agree to comply with all city and county ordinances and state laws relating to buildin n ructio , ereby authorize representatives of this county to enter up o the above-mentioned property in ecti u ses. �e: Signature (Applicant or Agen* > Application Number 05-00004847. Structure Information Construction Type 'TYPE V -'NON RATED Occupancy. Type . . . . .- . DWELLG/LODGING/LONG <=10 Flood Zone . . . . . NON -AO FLOOD ZONE Other struct info . . : . . CODE EDITION 2001 CBC # BEDROOMS. 3.00 FIRE SPRINKLERS NO GARAGE'SQ FTG 531.00 PATIO SQ FTG .422.00 l NUMBER OF UNITS 1.00 IST FLOOR SQUARE FOOTAGE 3365.00 Permit BUILDING PERMIT - Additional desc . Permit Fee 1297.50 Plan Check Fee 210.85 Issue Date Valuation . . . . 287914 Expiration Date 4/29/06 Qty Unit Charge Per Extension BASE FEE 639.50 188.00 3.5000 ---------------------------------------------------------------------------- THOU BLDG 100,001-500,000 658.00 Permit . . . MECHANICAL Additional desc . Permit Fee 171.50 Plan Check Fee . 10.72 Issue Date Valuation 0 . Expiration Date .. 4/29/06 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 12.00 6.5000 EA MECH VENT FAN 78.00 1.00 6.5000 --------------------------- EA - MECH'EXHAUST HOOD ----------------------=-------------------------- 6.50 Permit . . . ELEC-NEW RESIDENTIAL Additional desc . Permit Fee . . 145.60 Plan Check Fee 9.10 Issue Date Valuation 0 Expiration Date 4/29/06 Qty. Unit Charge Per Extension BASE FEE 15.00 _ 3365.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 111.78 LQPERMIT - LQPERMIT • Application.Number . . . . . 05-00004847 Permit- ELEC-NEW RESIDENTIAL Qty Unit Charge •Per Extension 641.00- .0200 ELEC GARAGE -OR NON-RESIDENTIAL 12.82 Permit PLUMBING Additional desc . Permit Fee . . . . 185.25 Plan Check Fee 11.58 Issue Date Valuation 0 Expiration Date 4/29/06 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 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 •7.00 .7500 EA PLB GAS PIPE >=5 5.25 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 4/29/06 Qty Unit Charge' Per Extension BASE FEE 15.00 Special Notes and Comments '. SFD - LOT 15, PLAN AR. PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS, OR DRIVEWAY APPROACH -75% REDUCTION TO PLAN CHECK FEE DUE TO MULTIPLE ISSUANCE OF SAME PLAN TYPE -------------------------------.--------------------------------------------- Other Fees . . . .- . ART IN PUBLIC PLACES -RES 222.74 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 21.09 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 LQPERMIT • Application Number . . . . 05-00004847 -- ----- Other Fees . . . . ----------- . . . . -------------------------- - STRONG MOTION (SMI) RES -------------- 28.90 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098-.00 Fee summary. Charged Paid Credited Due - Permit Fee Total ---- -- - - -- 1814.85 ---- - - - - ------ - - - - ---- .00 .00 -- - - - - - - 1814:85 Plan Check Total 242.25 .00 .00 242.25 Other Fee Total 2677'.73 .00 .00 2677.73' Grand Total 4734.83 .00 :00 4734.83 G _ LQPERMTT -