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04-6169 (SFD)P.O. BOX 1504 4 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 04-00006169 Owner: Property Address: 58019 CARMONA CORAL OPTION I APN: 764-200-006-2 316811- 79295 RANCHO LA QUINTA DR Application description: DWELLING - SINGLE FAMILY DETACHED LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL D Application valuation: 439796 Contractor: Applicant: architect or Engineec: SPARKS CONSTRUCTIO I C P.O. BOX 1716 LA QUINTA, CA 92247 (760) 771-1941 (( Lic. No.: 674074 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 Co and m icense is in full force and effect. License Class: Bi Liadnse No.: 6 4074 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State Li ense Law for the fallowing 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 Lew (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 1, 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 1, 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.). (_) 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: y� Lender's Address: IX LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/03/05 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. _AL 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 STATE FUND Policy Number 00003482004 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 s"Z'b pensation provisions of Section 3 00oof the Labor Code, orthwith co pl("with those ovisions. f3ate0`�i �• plicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFU , AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUND ED 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 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 informat' s correc I agree to comply with all city and county ordinances and state laws relating t � g constr on, and here authorize representatives of this court to ter upon the above-mentione roperty r ' ection purpose . 9pte0 Si re (Applicant or Age Application Number . . . ... 04-00006169 LQPERMIT 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 4.00 FIRE SPRINKLERS NO GARAGE SQ FTG 791.00 PATIO SQ FTG 985.00 NUMBER OF UNITS 1.00 ---------------------------------------------------------------------------- 1ST FLOOR SQUARE FOOTAGE 5089.00 Permit . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 1829.50 Plan Check Fee 1189.18 Issue Date . . . . Valuation . . . . 439796 Expiration Date . . 6/03/05 Qty Unit Charge Per Extension BASE FEE 639.50 340.00 3.5000 ---------------------------------------------------------------------------- THOU BLDG 100,001-500,000 1190.00 Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 139.00 Plan Check Fee 34.75 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 6/03/05 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 7.00 6.5000 EA MECH VENT FAN 45.50 1.00 6.5000 ---------------------------------------------------------------------------- EA MECH EXHAUST HOOD 6.50 Permit . . . ELEC-NEW RESIDENTIAL Additional desc . . Permit Fee . . . . 208.94 Plan Check Fee 52.24 Issue Date . . . . Valuation . . . . 0 Expiration Date 6/03./05 Qty Unit Charge Per Extension BASE FEE 15.00 5089.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 178.12 LQPERMIT Application Number . . . . . 04-00006169 Permit . . . . ELEC-NEW RESIDENTIAL Qty Unit Charge Per Extension 791.00 .0200 -----------------------------------7---------------------------------------- ELEC GARAGE OR NON-RESIDENTIAL 15.82 Permit . . . PLUMBING Additional desc . . Permit Fee . . . . 214.50 Plan Check Fee 53.63 Issue Date . . . . Valuation . . . . 0 Expiration Date 6/03/05 Qty Unit Charge Per Extension BASE FEE 15.00 22.00 6.0000 EA PLB FIXTURE 132.00 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 14.00 .7500•EA PLB GAS PIPE >=5 10.50 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 . . 6/03/05 Qty Unit Charge Per Extension BASE FEE 15.60 ---------------------------------------------------------------------------- Special Notes and Comments SFD - LOT 2, PLAN 6AR. PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS, OR DRIVEWAY APPROACH ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES 599.49 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 118.92 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 43.97 DIF STREET MAINT FAC -RES 15.00 LQPERMIT Application Number . . . . . 04-00006169 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Permit Fee Total 2406.94 Plan .Check Total 1329.80 Other Fee Total 3167.38 Grand Total 6904.12 LQPERAUT Paid Credited Due .00 .00 2406.94 800.00 .00 529.80 .00 .00 3167.38 800.00 .00 6104.12