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12-1403 (SFD)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 f�!'�GkiGv BUILDING & SAFETY DEPARTMENT BUILDING PERMIT . Application Number: 1-2- 2 00001403 _7 Property Address: 81878 SEABISCUIT WY APN: 767-200-999-32 -312023- Application description: DWELLING - SINGLE FAMILY DETACHED Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 171399 Applicant: Architect or Engineer: ------------------- 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 my License is in full force and effect. License Class: B License No.: 916227 Date: Contractor:. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor'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 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.). () I, as owner of the property, am exclusio y contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Cadle, T e Contractors' State License law does not apply to an owner of property who builds or improves thernd who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State Li@Law.). I am exempt under Sec. , B.&�f r this reason ate: / / CONS/ITRUCTION LENDING AGENCY 1 hereby affirm under penalty of perjury that there is� construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Ci C.). Lender's Name: Lender's Address: IY'� LQPERMIT Owner: DESERT CHEYENNE, 78401 HIGHWAY 1 LA.QUINTA, CA 9 (760)777-9920 Contractor: GJH DEVELOPMENT 27636"YNEZ ROAD TEMECULA, CA 92 (760)578-3545 Lic. No.: 916227 INC. VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/03/12 . 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 have and will maintain workers' compensation insurance, as requiied 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 pol'cy number are: . Carrier EU MPT Policy Number EXEMPT certify that, in the perform cof the work for which this permit is issued, I shall not employ any person in any manner so a become subject to the workers' compensation laws of California, and agree that, if I should ome subject to the workers' compensation provisions of Section 3700 of the Labor Code, 1 all forthwith comply with those provisions. /t� �( � Applicant. j WARNING: FAILURE TO SECURE WORKS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL ENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO HE 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 "wliosebebalf this application is made, each person at whose request and for whose benefit work is performe8-under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agiees•"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 v,.ork being performed under or following issuance of this permit. ' 2. Any permit issued as a result of this application %,a r�i es null and void if work is not commenced within 180 days from date of issuance of such die it, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the ab ,le n formation is correct. I agree to comply with all city and county ordinances and state laws relating to building onstruction, and hereby authorize representatives o�this county to ter up the above-mentioned property fo nspection purposes. /Date /1 / �,n.t, re (Applicant or Agent): r " Application Number . . .12-00001403 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 2010 CBC # BEDROOMS 4.00 FIRE SPRINKLERS yes GARAGE SQ FTG 658.00 PATIO SQ FTG 319.100 NUMBER OF UNITS 1.00 ----------------------------------------------------------------------------- .1ST FLOOR SQUARE FOOTAGE 2600.00 Permit BUILDING PERMIT. Additional desc . Permit Fee 891.50 Plan Check Fee 579.48 Issue Date Valuation 171399 Expiration Date 6/01/13 Qty Unit Charge Per Extension BASE FEE 639.50 72.00 3.5000 THOU BLDG 100,001-500,000 252.00 Permit MECHANICAL - • Additional desc . Permit Fee . . . . 90.'00 Plan Check Fee 22.50 Issue Date . . . Valuation 0 Expiration Date 6/01/13. Qty Unit Charge Per Extension BASE FEE 15.00 2.00 9.0000 EA MECH FURNACE <=100K 18.00 2.00 9.0000 EA MECH B/C <=3HP/100K BTU .18.00 5.00 6.5000 'EA MECH VENT FAN 32.50 1.00 6.5000 ---------------•------------------------------- EA MECH EXHAUST HOOD ------------------------------ 6.50 Permit . . . ELEC-NEW RESIDENTIAL Additional desc . Permit Fee . . . . 119.16 Plan Check Fee 29.79 Issue Date . . . . Valuation 0 Expiration Date 6/01/13 Qty Unit Charge Per Extension _ BASE FEE 15.00 2600.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 91.00 LQPERMIT ' Application Number . . . . . 12-00001403 Permit . . . . . . ELEC-NEW RESIDENTIAL Qty Unit Charge Per Extension 658.00 .0200 ---------------------------------------------------------------------------- ELEC GARAGE OR NON-RESIDENTIAL 13.16 Permit . . . PLUMBING Additional desc . Permit Fee . . . . 166.50 Plan Check Fee 41.63 Issue Date . . . . Valuation . . . . 0 Expiration Date 6/01/13 Qty Unit Charge Per Extension BASE FEE 15.00 16.00. 6.0000 EA PLB FIXTURE 96.00 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 8.00 .7500 EA PLB GAS PIPE >=5 6.00' 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 6/01/13 Qty Unit Charge Per Extension BASE FEE 15.00 7 -------------------------------------------------------------------- Special Notes and Comments SFD - LOT 32, PLAN 2A, 2600 SF. PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS, OR DRIVEWAY APPROACH. 2010 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 7.00 DIF COMMUNITY CENTERS -RES 104.00 DIF CIVIC CENTER - RES 1089.00 ENERGY REVIEW FEE 57.95 DIF FIRE PROTECTION -RES 612.00 DIF LIBRARIES - RES 334.00 MULTI -SPECIES (MSHCP) FEE 1254.00. DIF PARK MAINT FAC - RES 51.00 DIF PARKS/REC - RES 1773.00 STRONG MOTION (SMI) - RES 17.14 DIF STREET MAINT FAC -RES 158.00 LQPERMIT Application Number . . . 12-00001403 Other Fees . . . DIF TRANSPORTATION - RES 3592.00 Fee summary Charged Paid Credited Due ----------------- ---------= ----"---- ----- ----- -- ------ Permit Fee Total 1282.16 00 00 - 1282:,16 Plan Check Total 673.40 .00 .00 673.40 Other'Fee Total 9049.09 .00 .00 9049.09 Grand Total- 11004.65 _00 .00 11004.65 LQPERMIT - .