04-8242 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Td4t 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777 -7012 -
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/03/05
Application Number: 04-00008242
Owner:
Property Address: 58103 CARMONA
CORAL OPTION I
APN: 764-200-006-8 -316811-
79285 RANCHO LA QUINTA DR
Application description: DWELLING - SINGLE FAMILY DETACHED
LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
A
rt
Application valuation: 349058
11
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Contractor:
JUN O 8 2005
Applicant: rchitect or Engineer:
SPARKS CONSTRUCTION,
44I� &S%44J-0,
P.O. BOX 1716
C1TVOf LAOWNTA
LA QUINTA, CA 92247 roApff
FdimAu"
(760) 771-1941
LiC. No.: 674074
------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
-------------------------------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.-
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License fAss: ense No • 74
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
D e: 0 10F ontractor:
issued..
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
NER-BUILDER DECLARATI N
insurance carrier and policy number are:
I hereby affirm under penalty of perjury, that I am exempt from the Contractor's License Law for the
Carrier STATE FUND Policy Number 00003482004
_ following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to_
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to become subject to the workers' .compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if I should become subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
of the Labor Code, I shall forthwith c pV it t se provisions.
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 ($5001.:
'0 Qt A cant:
3P0
(_ 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
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLA FUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE NDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMA ES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.).
APPLICANT ACKNOWLEDGEMENT
(_ I I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractors) licensed
1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.).
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_ 1 I am exempt under Sec. , B.&P.C. for this reason
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
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:
V.
LQPERMIT
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 isnot 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,APAJugeby authorize representatives
of this c9enty t enter upon the above-mentioned property for inspecti urposes.
0 Q lure (Applicant or Agent):
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Application Number . . . . 04-00008242
Permit . . . . . . ELEC-NEW RESIDENTIAL
Qty Unit Charge
Per
Extension
1096.00 .0200
----------------------------------------------------------------------------
ELEC GARAGE OR NON-RESIDENTIAL
21.92
Permit . . . PLUMBING
Additional desc .
Permit Fee . . . .
196.50 Plan Check Fee
12.28
Issue Date . . . .
Valuation . . . .
0
Expiration Date . .
6/03/05
Qty Unit Charge
Per
Extension
BASE FEE
15.00
21.00 6.0000
EA PLB FIXTURE
126.00
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
Expiration Date
6/03/05
Qty Unit Charge
Per
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes and Comments
SFD - LOT 8,. PLAN 4B,
3933 SF. PERMIT
DOES NOT INCLUDE POOL,
SPA, BLOCK WALLS
OR DRIVEWAY APPROACH.
75% REDUCTION TO
PLAN CHECK FEES DUE TO MULTIPLE ISSUANCE
OF SAME PLAN TYPE
-
----------------------------------------------------------------------------
Other Fees . . . . .
. . . ART IN PUBLIC PLACES -RES
372.64
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
22.79
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
. . . . .
04-00008242
---------------=-------------------------------------------------------------
Other Fees . . .
. . .
STRONG MOTION (SMI) - RES
34.90
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
Charged
Paid Credited
Due
-----------------
Permit Fee Total
----------
1921.08
------------------------------
.00 .00
1921.08
Plan Check Total
259.38
.00 .00
259.38
Other Fee Total
2835.33
.00 .00
2835.33
Grand Total
5015.79
.00 .00
5015.79
LQPERMrr