04-8215 (SFD)U
BUILDING .& SAFETY DEPARTMENT
P.O. Box 1504 (760).777-7012
95 LE TAMPICO FAX (760) 777-7011
D
Q�TN CA;LIFOR.NIIA 92253 INSPECTION REQUESTS (760) 777-7153
MAR 1: Zoos BUILDING PERMIT
Cffy QF; LA. QUlB
A plier0 0 Q82 5 Date 2/17/05
P er y Address,.,;.. . . 79325 ROSE DAWN
APN: 649-030-069-36 -31311 -
Application description . . . DWELLING - SINGLE FA14ILY DETACHED
Property Zoning . . . . HIGH DENSITY RESIDENTIAL
Application valuation 78808
r
Owner Contractor
SANTA ROSA DEVELOPMENT INC CONSOLIDATED CONTRACTING, INC.
46753 ADAMS ST 46753 ADAMS STREET
LA QUINTA CA 92253 LA QUINTA CA 92253.
(760) 771-3345 (76.0) 324-5483
WCC: STATE FUND
WC: 177074.9-2005 01/01/06
CSLB: 8241:33 09/30/05
CCC: B -C8
------ Structure Information PLAN 1 ----
Construction Type . . . . . TYPE V - NON RATED
Occupancy Type . . . . . . DWELLG/LODGING/LONG <=10
Flood Zone . . . . . . . . NON -AO FLOOD ZONE
Other struct info . . . CODE EDITION 2001
# BEDROOMS 2.00
FIRE SPRINKLERS NO'
GARAGE SQ FTG 423.00
PATIO SQ FTG. y, 25.00
`. NUMBER.'0F UNITS 1.00
1ST FLOOR SQUARE FOOTAGE 1227.00
-----7----------------------------------------------------------------------
Permit. . . . . . BUILDING PERMIT
Additional desc
Permit Fee 491.00 Plan Check Fee 79.79
Issue Date Valuation . . . 66626
Qty Unit Charge Per Extension
BASE FEE 414.50
17.00 4.5000 THOU BLDG 50,001-100,000 76.50
-------------------------------------------=--------------------------------
Permit . . . . . . ELEC-NEW RESIDENTIAL
Additional desc
Permit Fee 66.41 Plan Check Fee 4.15
Issue Date . . Valuation 0.
Qty Unit Charge Per Extension
BASE FEE .15.00
1227.00 .0350 ELEC NEW RES - 1 OR2 FAMILY 42.95
423.00 .0200 ELECGARAGE OR NON-RESIDENTIAL- 8.46
r
P.O. Box 1504 Tit9k
FAX (760) 777-7011 I
LA -495 CALLS TAMPICO VOICE (760) 777-7012
QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: O ,� r.- Date: 3-30,05
Applicant:
Applicant's Mailing Address:
CTO
Architect or Engineer:
Architect or Engineer's Address:
Lic. No.: G -0111M
t3UILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under rovisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
de, and my License is in full force and effect. iceo�
icense Class Lnse No. d' L65
Date cJ 4 0 "4 6 Contractdf Gtr
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).):
U 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 or 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.).
U 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.).
U I am exempt under Sec. , BA P.C. for this reason
Date Owner
WORKERS' 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
Xof 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
is ued. Myy �workers' compensation insurance carJi r and policy numbgr are:
/Carrier 5U'tiE �i V I.AQ Policy Numbefr
_ I certify that, in the performance of the work for which this permit is issued, I shall notE't 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 workers' compensation provisions of Section 3700 of the Labor Code, 1 shall
`/. forthwith comply with tho_seeppr 'sions.
tate 3-'bP-a� A,.plicant✓ .100
WARNING: FAILURE TO SECURE WORKE 'COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOU AND 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.
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 /
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 information is correct. I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this coun ' nter upon the above-mentioned property for inspection purposes.
Date �3y—� Signature (Applicant or Agent):
Page
2
Application Number .
. .
04-00008215 Date
2/17/05
Permit . . . . . . GRADING PERMIT
Additional desc
Permit Fee . . . .
15.00 Plan Check Fee
.00
Issue Date
Valuation . . . .
0
Qty Unit Charge
Per
Extension
----------------------------------------------------------------------------
BASE FEE
15.00
Permit . . . . . . MECHANICAL
Additional desc
Permit Fee
46.00 Plan Check Fee
2.88
Issue Date . . . .
Valuation
0
_ Qty Unit.Charge
Per
Extension
BASE FEE
15.00
1.00 9.0000
EA
MECH FURNACE <=100K
9.00
1.00 9.0000
EA
MECH B/C <=3HP/100K BTU
9.00
1.00 6.5000
EA
MECH VENT FAN
6.50
1.00 6.5000
----------------------------------------------------------------------------
EA
MECH EXHAUST HOOD
6.50
Permit . . . . ... PLUMBING
Additional desc
Permit Fee . . . .
115.50 Plan Check Fee.
7.22
Issue Date . . . .
Valuation
0
Qty Unit Charge
Per
Extension
BASE FEE
15.00
8.00 6.0000
EA
PLB FIXTURE
48.00
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
1.00 3.0000
EA
PLB GAS PIPE 1-4 OUTLETS
3.00
1.00 15.0000
--------------------------
EA
PLB'GAS METER
15.00
-----------------------=---------------------------
Special Notes and Comments
SFD - LOT 36, Plan 1A,
1227
SF. 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
.00
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE'
7.98
i
Page
3
Application Number
. . . . .
04-00008215. Date_
2/17/05
Other Fees . . .
---------------------------------------------
. . ...
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
7.88
DIF -STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES,
1098.00
Fee summary
Charged
Paid Credited
Due
Permit Fee Total
733.91
.00 .00
733.91
Plan Check Total
94.04
.00 .00
94.04
Other Fee Total
2420.86
00 .00
2420.86
Grand Total
3248.81
.00 .00
3248.81
..........
'..
Certificate f Occupanc
•.'.o'
WA
W=
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BuildingeetyD19partm nt
OF &'Saf
f;'V
This Certificate is'issued, pursuant to the requiremen6; of Section 109 of the California Building
Code, -'certifying that, at the time of issuance, - this � ;structure was in compliance with the
A
provisions of the Budding Code and the various ordinances of the City ' regulating building
construction and/or use..
BUILDING ADDRESS: 79-325 ROSE -DAWN LOT 36
Use classification: SINGLE FAMILY DETACHED' a Building Permit No.: 04-8215
Occupancy Group: R-3 Type'of tonstructiolnsV-N Land Use Zone: Rk
Owner of Building: SANTA ROSA DEVELOPMENT INC Address: 46-753 ADAMS ST
City, ST, ZIP: LA QIJINTA; CA 922,5a
By: KIRK KIRKLAND
Date:- AUGUST -4, 2006
Building Official
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