12-1460 (SFD)P P"
Tiht 4
P.O. BOX 1504 ^� VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (7 60) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 12/21/12.
Application Number: 2-'000-014_6`02 Owner:
Property Address: 57684 SALIDA DEL SOL ALTA VERDE CORAL MOUNTAIN
APN: 762-240-014-56 -34243 - 315-S. BEVERLY DRIVE
Application description: DWELLING - SINGLE FAMILY DETACHED BEVERLY HILLS, CA 90212 D
Property Zoning: RL AG/EQ OVERLAY 14
203
Application valuation: 183035 tA� rt
Contractor: C1V 0P LAQ�INTA
Applicant: Architect or Engineer: ALTA- VERDE BUILDERS, INC.. FINANCED
71905 HIGHWAY 111, SUITE
RANCHO MIRAGE, CA 92270
(760)776-1111
Lic. No.: 969219
• LICENSED CONTRACTOR'S DECLARATION WORKER'S. COM PENSATION'DECLARATION -
_ I hereby affirm under penalty of peri t at I am licensed under pr i ions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
i Section 7000 ,of Division 3 of the Bu ne s and Professionals Code, 'd my Cicense is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License lass . - License No. 969219 - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is -
1'yI ,.. issued.
ate: 1 ` ontractor: )�,I have and will maintain workers' compensation insurance, asrequired by Section 3700 of the Labor
T Code, for the performance of the work for which this permit is issued. My workers' compensation
OWNER -BUILD ECLARATION insurance'c_ arrier and policy number are:-
' I hereby affirm under penalty of perjury that I -- exempt from t e Contractors Stat License Law, for the Carrier STATE: FUND Policy Number 9006140,
following reason (Sec..7031.5, Business -a d rofessions Code:' ny cit , or count hat requires a permit to _ I certify that, int peaormance'of the work for which this, permit is.issued, l shall not employ any
construct„alter, improve, demolish, or'repair any structure, prior to' issuan so requires the applicant for the person in any m rso 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, ' I ould 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 3700 of the La r C e, I shall forthwith coin ith those provisions.
that he or sheds exempt, therefrom and the basis for the alleged exemption.. Any violation,of Section 70.31.5 by. -
any applicant for a permit subjects the applicant to a civilpenalty of-not.more thanfive hundred dollars ($500).:
(_) 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,oroffered for sale (Sec: 7044, Business and Professions,Code: The
Contractors' State License Law does not apply to an owner of propertywho 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 orshe did not build or
improve for the purpose of sale.). -
(_) 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 toan'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:
LQPER.MIT
Date:1-,w �� pplicant:
WARM Gi FAILURE TO SECURE WORKE ' COMPENSATIO COVER E IS UNLAWFUL, AND:SHALL
SUBJECT AN EMPLOYER.TO CRIMINAL PE ALTIES AND IL FINES -UP. 0 ONE HUNDRED THOUSAND
DOLLARS (S 100,000). IN ADDITION TO E COST OF'. OMPENSATION DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF. THE LABOR CODE, I EREST, AND A ORNEY'S F S.
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 a\toi
becomes null and void if work is not commenced
within 180 days from date of issuanpermit, or cessation of work for 180 days will subject
permit to cancellation. -
I certify that I have read this application and state bove information is correct. I g e to comply with all
cit y and cou y ordinances and state laws relating g construction, and hereby au horizrepresentatives
of this un►t} to enter on the above-mentioned or inspection purposes.
data: \ � `[ Signature (Applicant or Agent
L
Application Number . . . . . 12-00001460
Permit
. . .
BUILDING PERMIT
Additional
desc . .
Permit Fee
. . . .
933.50
Plan Check Fee
606.78
Issue Date
Valuation
183035
Expiration
Date
6/19/13
Qty Unit Charge
Per
-Extension
BASE
FEE
639.50
84.00
3.5000
THOU BLDG
100,001-500,000
294.00
Permit
. .
MECHANICAL
- Additional
desc .
Permit Fee
122.00
Plan Check Fee
30.50
Issue Date
Valuation
0
Expiration
Date
6/19/13
Qty Unit Charge
Per
Extension
'BASE
FEE'
15.00
3:00
9.0000
EA MECH;..FURNACE
<=100K•
,27.00
2.00
9'.0000
EA MECH
B/C <=3HP/100K BTU..
18.0,0
1.00
16.5000
-EA. MECH
B/C >3-15HP/>100K-500KBTU
16.50
6.00
6.5000
EA MECH
VENT FAN
39`:00,
1.00
6.5000
EA MECH
EXHAUST.HOOD
6.50 `
Permit
ELEC-NEW RESIDENTIAL.
Additional
desc.._.
Permit Fee
125.16,
Plan Check Fee
.31.29
Issue Date
Valuation
•0
Expiration
Date
6`/19/13
Qty Unite Charge.
Per
Extension
BASE
FEE
15.00
284.9.00
0350
ELEC
NEW RES - 1 OR•2•FAMILY
9,9-.72
1522.00
.0200
:. ELEC`•GARAGE
OR NON-RESIDENTIAL
10.44
Permit
. .
PLUMB ING•
Additional-desc
.
Permit 'Fee
165:75
Plan Check Fee -
41.44
Issue Date
Valuation'.
0
Expiration
Date
6/19/13
Qty Unit Charge
Per
Extension
BASE
FEE
15:00
16.00
6.0000
EA PLB
FIXTURE
96.00
LQPERMIT
Application Number .
. . . . 12-00001460
Per . . . . . .
TUNlBING
Qty Unit Charge
Per
Extension
1.00 15.0000
EA PLB BUILDING SEWER
15.00
1.00 7.50 00
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
7.00 .7500
EA PLB GAS PIPE >=5
5.25
1.00 15.0000
-------------------------------------------------------------------------------
EA PLB GAS METER
15.00
Permit
GRADING PERMIT
- .. -Additional" desc .
Permit Fee
35.00 Plan Check, Fee
.00
Issue ,Date
Valuation .-
0
Expiration Date..
6/19/13.
Qty..,. Unit Charge
Per
Extension
BASE FEE...
15:.00
------------------------ ---------
Special .Notes and Comments. s,
-
SFD : -> :LOT 56 PLAN C3-,
2849 SF{ PERMIT.
a
' `DOES;,NOT INCLUDE POOL/SPA;
BLOCK WALLS OR
DRIVEWAY APPROACH. 2010=CODES.
-
-
_• --. ----------------------
Other.'F.ees
------------- - - -.- ---------------
BLDG`SIDS_ADMIN :(SB14.73)
---------------
_DIF COMMUNITY"CENTERS-RES
'104:00
DIF,'CIVICM CENTER' = . RES
1089:00
ENERGY REVIEW -,FEE ._::
60 •168`
DIF.. FIRE<PROTECTION-RES
612'.D0
-•GRADING• PLAN CHECK FEE•
.0.0
,
DIF' LIBRARIES '= RES--.
334.00
MULTI -SPECIES (MSHCP)::�:FEE
1254.00 y
DIF PARK MAINT "FAC •- RES
51--.0.0,
a
DIF '""PARKS/REC -- RES", '
1773 ..00
STRONG_ MOTION.. (SMI, - 'RES
18.30
t
DIF-:STREET""MAINT FAC -RES
158.00.
DIF TRANSPORTATION.: -.RES'
3592:00
Fee
Fee summary Charged
------------
;Paid Credited
Due
Permit Fee Total
1361.41 .00 .00
1361.41
Plan Check Total
710.01 .00.
7.10.01
Other Fee Total
..0.0.
9053.98 .00 .00:
9053:98
Grand -Total
11125:°40 .00 .00
11125:40
LQPERMIT