04-8260 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 04-00008260
Property Address: 58235 CARMONA
APN: 764-200-006-14 -316811-
Application description: DWELLING - SINGLE FAMILY DETACHED
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 439796
Applicant:rchitect or Engineer:
Cif/7�
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 Code, and m'cense is in full force and effect.
License Class.. B nse . 67 D74
• .O ntractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State Licen a 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 _ 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 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:
Lender's Address:
LQPERMIT
Owner:
CORAL OPTION
79295 RANCHO
LA QUINTA, CA
I
LA QUINT
92253
Contractor:
SPARKS CONSTRUCTION,
P.O. BOX 1716
LA QUINTA, CA 92247
(760)771-1941
Lic. No.: 674074
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.
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 1 should become su 'act to the workers' compensation provisions of Section
700 of the Labor Code, I s wit t mply w' ovisions.
'04 Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP T 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 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 1 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 constr ' n, and hereby authorize representatives
of this co ty t enter upon the above-mentioned property for i action poses.
Tature (Applicant or A nt):
LQPERMIT
Application Number . . . . . 04-00008260
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
297.30
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
8.69
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
13.06
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
Application Number .
. . . . 04-00008260
Permit . . . . . . ELEC-NEW
RESIDENTIAL
Qty Unit Charge
Per
Extension
791.00 .0200
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ELEC GARAGE OR NON-RESIDENTIAL
15.82
- - Permit . . . PLUMBING
Additional desc . .
Permit Fee . . . .
214.50 Plan Check Fee
13.41
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
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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 14, PLAN 6CR, 5,089 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
599.49
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
29.73
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
.a -4
-- LQPERMIT
Application Number
04-00008260
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Other Fees . . . . . . . . . STRONG MOTION (SMI) - RES 43.97
DIF STREET MAINT FAC -RES 15.00
DIF TRANSPORTATION - RES 1098.00
Fee summary Charged
Permit Fee Total 2406.94
Plan Check Total 332.46
Other Fee Total 3078.19
Grand Total 5817.59
Paid Credited Due
------- ---------- ----------
.00 .00 2406.94
.00 .00 332.46
.00 .00 3078.19
.00 .00 5817.59