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05-4841 (SFD)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: T4',!t °f 4 Q" 05-00004841 80085 NORTH RESIDENCE CLUB DR •775-380-999-9 -31627 - DWELLING - SINGLE FAMILY DETACH] MEDIUM DENSITY RES ED 287914 itect or Enginee U � I BUILDING & SAFETY DEPARTMENT . -BUILDING PERMIT . VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/31/.05 Owner: NADADOR, LLC 78120 CALLE ESTADO, SUITE 203 LA QUINTA, CA 92253 OEIl C 1 Contractor: 1 ZDOS JACOBS HOMES INC, PETER P.O. BOX 692 LA QUINTA, CA 92247 FIN OF L4 (760) 777-9921 A� a�C �eePT Lic . NO.: 799449 ----=---------------------------------------------- LIC SED CONTR TOR'S DECLARATION ' I hereby affirm under penalty of,perjury that licensed d r provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business d P fessi Code, and my License is in full force and effect. License Class: B cense No.: 799449 �te: 'i/2 y ontractor: OWNE -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am axe pt 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.). (_) 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.). - 1 1 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: �1h LQPERMIT -------------------- - ----- - -------------------- 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 HRH INSUR Policy Number . 176983305 _ I certify that, in the performa of the work f which this permit is issued, I shall not employ any person in any manner s to b ome s le t to the workers' compensation laws of California, and agree that, if I sho bec u ' the workers' compensation provisions of Section �% 37700 of the Labor C I I f th omply with those provisions. �t12-1 cant:. 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. 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 becom s null and void if work isnot commenced within 180 days from date of issuance of such per , 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 rmatio i correct. I agree to comply with all city and county ordinances and state laws relating to buildin hereby authorize representatives of this county to enter upon the above-mentioned property i io p oses. 19,ature,(Applicant or Agent): ,2 ' LQPERMIT , Application Number .05-00004841 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 531.00 PATIO SQ FTG 422.00' NUMBER OF UNITS 1.00 ---------------------------------------------------------------------------- 1ST 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 100,0017500,000 658.00 Permit . . MECHANICAL Additional desc . Permit Fee 171.50 P1an.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 117.78 LQPERMIT , LQPERMIT Application_Number •05-00004841 •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 9, PLAN A. PERMIT DOES NOT INCLUDE POOL, SPA,•BLOCK WALLS, OR DRIVEWAY .APPROACH. 75% REDUCTION TO PLAN CHECK FEE DUE TO MULTIPLE ISSUANCE YPE"-OF SAME PLAN TYPE- ----- - --------------------------------- Other 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 LQPERMIT Application Number . . . . . 05-00004841 -----------------_ -------------------------- 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 242:2.5 .00 .00 242.25 Other Fee Total 2677.'73 .00 :00 .2677.73 Grand Total 4734.83 .00 00 4734:83 LQPERMIT