13-1603 (SFD)I;i
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Tiht 4 4.0"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 0 0_01-6 0'3 -
Property Address:
EL IN
APN: 600 -040 -017 -
Application description: DWELLING - SINGLE :FAMILY DETACHED
Property Zoning: MEDIUM DENSITY RES
Application valuation: 182376
Applicant: Architect or Engineer:
0 6 t-�S
------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
,Section 7066) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: -B LicenseNo.: 750957
a'e:�
ION
I here, '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 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 w ithin
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—) 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 ISec. 3097, Civ. C.).,
Lender's Name:
Lender's Address
LQPERMIT
Owner:
ROUDEL VENTURES, LLC
77-682 COUNTRY CLUB I
PALM DESERT, CA 9221'.
(949)533-9408
Contractor:
GHA ENTERPRISE,
30875 DATE PALM
CATHEDRAL CITY,
(760)969-1400
Lic. No.: 750957
INC.
DRIVI
CA 9:
VOICE (760) 777.-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/26/14
------------------------------ ------ ----------
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 h�ve 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 9076853-2014
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,
a nd agree that, if I should become subject to the workers' compensation provisions of Section
3700 of_the.Labo� Code, I shall forthwith comply with those provisions.
C S;j�J�pplk:a
WARNING: FAILURE TO SE PENSATION COVERAGE IS UNLAWFUL, AND SHALL
. URE W(4Kj
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.
APPLICAN T 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 rximijant to any permit issued as 3 result of thi6 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 county to enter uporf the above-mentioned qroperty for inspection purposes. .
ZI
LQPERAIIT
Application Number .
. . . . 13-0000160.3
- ------ Structure Information
2,820SF DWELLING/VB/RES-3/CLASS-A/13D
Other struct info
CODE EDITION
2010
# BEDROOMS�
4'.00
FIRE SPRINKLERS
3420
GARAGE SQ FTG
600.00
PATIO SQ FTG
263.00
NUMBER OF UNITS
1.00
- - - - - - - - - - - - - - - - -
1ST FLOOR -SQUARE FOOTAGE
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2820.00
- - - - - - - - - -
Permit . . . . . .
BUILDING PERMIT
Additional desc
ADTUSTED TO 2013 FEE SCHEDULE
Permit Fee . . . .
559.84 'Plan Check Fee
1171.03
Issue Date
Valuation . .
. . 182376
Expiration Date
9/22/14
Qty Unit Charge
Per
-Extension
-----------------------------------
BASE FEE
----------------------------------------
559.84-
Permit . . . . . . .
ELECTRICAL 2013
Additional desc
Permit Fee . . . .
203.31 Plan Check Fee
.00
Issue Date . . . .
Valuation . .
. . 0
Expiration Date
9/22/14'�
Qty Unit Charge
Per
Extension
.00 23.8300
LS ELEC FIXTURES, FIRST 20
.00
.00
EA ELEC SERVICES
.00
1.00 23.8300
EA ELEC TEMP.POWER POLES
23.83
1.00 143.0000
LS ELEC NEW RES, FIRST 1 KSF
143.00
3.00 12.1600
----------------------------------------------------------------------------
KA ELEC NEW RES, ADDIL-1 KSF
36.48
Permit . . . . . .
MECHANICAL.2013
Additional desc
Permit Fee . . . .
238.36' Plan Check Fee
.00
Issue Date . . . .
Valuation
0
Expiration Date
9/22/14
Qty Unit Charge
Per
Extension
2.00- 35.7500
EA MECH FURNACE
71.50
27QQ 35.7,500
EA - MECH CONDENSER/COMP
71 90
7.00. .11.9200
EA MECH VENT FAN
83.44
1.00 -11.92bo
--------------------------------
EA �MECH EXHAUST HOOD
---------------------------------------------
11.92
Permit . . . . . .
PLUMBING 2013
LQPERMIT
Application Number 13-00001603
.Permit . . . . . . . PLUMBING 2013
-Additional desc
Permit Fee 309.91 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 9/22/14
Qty Unit Charge. Per
Extension
19.00" 11.9200 EA PLBG FIXTURE/TRAP
226-.48
1.00' 11.9200 EA PLBG BUILDING SEWER
11.92
1.00 11.9200 EA PLBG WATER HEATER/VENT
11.92
1.00 11-.9200 EA PLBG WATER INST/ALT/REP
11.92
1.00 11 ' 9200 EA PLBG BACKFLOW DEVICE
11.9,2
1.00 35.7500 LS PLBG GAS SYS, 5+ OUTLETS
35.75
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Special Notes.and.Comments
2,820SF-DWELLI-NG - PLAN 2A, LOT 20
(VB/RES-3/CLASS A-FR/13D] THIS PERMIT
DOES NOT INCLUDE POOL, SPA, BLOCK WALLS
OR DRIVEWAY APPROACH. 2010 CALIFORNIA'
BUILDING CODES.
January 21, 2014 1:18:19 PM JJOHNSON.
BUILDING PERMIT MANUALLY ADJUSTED TO
2013 FEE SCHEDULE DUE TO DEPOSIT FEE
BEING TAKEN INCORRECTLY AT SUBMITTAL.
***DO NOT DUPLICATE/COPY FOR CREATION OF
TRACT SINGLE FAMILY DWELLING PERMITS***
February 10, 2014 10:40:49�AM AORTEGA
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7
Other Fees . . ... . . . . . BLDG STDS ADMIN (SB1473)
--------------
8.00
DIF COMMUNITY CENTERS -RES
129.00
DIF CIVIC CENTER - RES
942.00
DIF FIRE PROTECTION -RES
433.00
DIF LIBRARIES - RES
344.00
MULTI-SPECI9S (MSHCP),FEE
1278.00
PLAN CHECK, ELECTRICAL.
78.90
DIF PARK MAINT FAC - RES
40.00
PLAN CHECK, MECHANICAL
133.48
PLAN CHECK, SFD GRADING
143.00
PLAN CHECK, PLUMBING
286.07,
DIF PARKS/REC - RES
2048.00
STRONG MOTION (SMI) - RES
18.24
TUMF: RESIDENTIAL
1837.44
DIF STREET MAINT FAC -RES'
116.00
DIF TRANSPORTATION - RES
2842.00
Fee summary �Charged Paid Credited
- -----------------
Due
---------- ---------- ---------- ----------
Permit Fee.Total 1311.42 .00 .00
1311.42
Application,Num.ber . . . . . 13-00001603.
Plan Check Total 1171.03 500.00 .00 671.03
Other Fee.Total 10677-13 - .00 .00.. 10677.13
Grand Total 13159.58 500.00 .00 12659.58
LQPERMIT