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05-3244 (SFD)P OX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date:. 7/27/'05 Application Number: 05-0000_3244 Owner: Property Address: 46112 ROUDEL LN DLA QUINTA NORTH PARTNERS APN: 649-040-007-15 -31816 - d 2 CROOKED STICK DRIVE' Application description: DWELLING - SINGLE FAMILY DETAC NEWPORT BEACH Property Zoning: MEDIUM DENSITY RESAI'/� NEWPORT BEACH, CA 92660 Application valuation: 196855 rIU`j 04 100 COF`4 Contractor: Applicant: 4ichitect or Engineer: /�II�L.� Qi//meq URBAN HABITAT (� -1 C 2 �CROOKED STICK DRIVECeL NEWPORT BEACH, CA 92660' (949)759-1018 Lic. No..::808808912 CX ------------------------------------------------------------------------------------------------- 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 iness 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 Class: B License No.: 808912 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. /a Contrac �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 issued. My workers' compensation OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 1741937-2005 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 suNect 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 370 s a rtwith comply with those 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 ($500).: e: Appli ( _-) 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 WARNING: FAILURE TOS WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to ari owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED 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, DAMAGES 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). (_ 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 ISec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT 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 an" struction, and hereby authorize representatives of this county to enter upon the above-mentioned p party for inspection purposes._ .9-4 —JrZ;atur pplicant or Age 1: - Z LQPERM[T Application Number 05-00003244 Structure Information Construction Type . . . . . TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/CONG <=10 Flood -Zone . . . . . NON -AO FLOOD ZONE Other struct info . . CODE•EDITION 2001 # BEDROOMS 4.00 FIRE SPRINKLERS NO GARAGE SQ FTG 768.00 PATIO SQ FTG 509.00 NUMBER OF UNITS 1.00 1ST FLOOR SQUARE FOOTAGE 3060.00 Permit BUILDING PERMIT Additional desc . Permit Fee . . 979.00 Plan Check Fee 159.09 Issue.Date . . . . Valuation 196855 Expiration Date 1/23/06 Qty Unit Charge Per Extension BASE FEE 639.50 97.00 3.5000 --------------------------------------------------------------------- THOU BLDG 100,001-500,000 339.50 PermitMECHANICAL Additional desc . Permit 'Fee . . . . 114.50 Plan Check Fee 7.16 Issue Date Valuation . . . . 0 Expiration Date 1/23/06 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 9.0000 EA MECH FURNACE <=100K 27.00 3.00 9.0000 EA MECH B/C <=3HP/100K BTU 27.00 6.00 6.5000 -EA MECH VENT FAN 39.00 1.00 6.5000 -------------=-----------------------------------------7-------------------- EA MECH EXHAUST HOOD 6.50 Permit ELEC-NEW RESIDENTIAL Additional desc . Permit Fee . . . . 146.44 Plan Check Fee 9.15 Issue Date . . . . Valuation 0 Expiration Date 1/23/06 Qty Unit Charge Per Extension BASE FEE 15.00 3060.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 107.10 LQPER IIT Application Number . . . . 05-00003244 Permit . . . . . . ELEC-NEW RESIDENTIAL Qty Unit Charge Per Extension 1217.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL ---------------------------------------------------------------- 24.34 ------------ Permit. . . PLUMBING Additional desc . Permit Fee. 161.25 Plan Check'Fee 10.08 Issue Date . . . . Valuation . . 0 Expiration Date 1/23/06 Qty Unit Charge Per Extension BASE FEE 15.00 15.00 6.0000 EA PLB FIXTURE 90.00 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 9.00 .7500 EA PLB GAS PIPE >=5 6.75 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 1/23/06 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments SFD - LOT 15, PLAN TYPE 1B; 3,060 SQ.FT. PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS OR DRIVEWAYAPPROACH. 75% REDUCTION TO PLAN CHECK FEE DUE TO MULTIPLE ISSUANCE OF SAME PLAN TYPE Other Fees . . . . . . . . .. DIF COMMUNITY CENTERS-RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 15.91 DIF FIRE PROTECTION-RES 97.00 LIF L18kAxiE6 - RES 225.00 DIF PARK MAINT FAC - RES 5.00 DIF PARKS/REC - RES 502.00 STRONG MOTION (SMI) - RES 19.68 DIF STREET MAINT FAC-RES 15.00 LQPER IIT LQPERDiIT Application Number . . . . . 05-00003244 ---------------------------------------------------------------------------- Other Fees . . . . . . DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Paid Credited Due --------------- Permit Fee Total --------- 1416.19 ---------- .00 ------- .00 1416.19 Plan Check Total 185.48 .00 .00 185.48 Other Fee Total 2440.59 .00 .00 2440.59 Grand Total 4042.26 .00 .00 4042.26 LQPERDiIT