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06-0235 (SFD)P:O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: /06 0000235-1' Property Address: C_ 52805 PALAZO APN: 767-200-011-29 -318742- Application description: DWELLING - SINGLE FAMILY Property Zoninq: LOW DENSITY RESIDENTIAL Application valuation: 191320 Applicant: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT DETACHED rchjtect or Engineer: Owner: TAYLOR WOODROW, 15 CUSHING IRVINE, CA 9261 (341)000-1200,® VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 �4* ContractorLOR : 15YCUSHINGDROW H ®® IRVINE, CA 92618 _ p (760)275-0598 %? �$� �• - `}r . ;a^ i` Lica No.. 352047 --------------------------------,y/r�) A ------------------------ ------------- 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 3 of the Business 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: Lic No 7 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is /' � issued. Date: _ D Contractor: Y 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor T Code, for the performance of the work for which this permit is issued. My workers' compensation OWNS - UILDER LARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exemp from the Contractor's State License Law for the Carrier LIBERTY MUTUAL Policy Number WA76SD283614055 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 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 Labor Code, I shall forthwith�.'o ly ith th a visions. 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).: - te: pplicant: (_ 1 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and 1-10 the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The - WARNING: FAILURE TO SECURE WORKERS' C ENSAT COVERAGE IS U WFUL, AND SHALL Contractors' State License Law does not apply to an 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 ($100,0001. 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.). APPLICANT ACKNOWLEDGEMENT (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for pursuant to the Contractors' State License Law.). - whose benefit work is performed under or pursuant to any permit issued as a result of this application, (_ 1 I am exempt under Sec. * , B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall -defend, indemnify and hold harmless the City Dater 1/13/06 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: LQPERMIT 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 t wilding construction, an hereby IC7presentatives of this co my t enter upo he above-mentioned p for inspection purpose D ignature (Applicant or Agent): Application Number . . . . 06-00000235 Permit BUILDING PERMIT Additional desc . Permit Fee . . . . 961.50- Plan Check Fee 156.25 Issue Date . . . . Valuation . . . . 191320 Expiration Date 7/12/06 Qty Unit Charge Per Extension BASE FEE 639.50 92.00 3.5000 ---------------------------------------------------------------------------- THOU BLDG 100,001-500,000 322.00 Permit . . . MECHANICAL Additional desc . Permit Fee 108.00 Plan Check Fee 6.75 Issue Date . . . . Valuation . . . . 0 Expiration Date 7/12/06 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 9.0000 EA MECH FURNACE <=10OK 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 Permit ELEC-NEW RESIDENTIAL Additional desc . Permit Fee 134.85 Plan Check Fee 8.43 Issue Date . . . . Valuation . . . . 0 Expiration Date.. 7/12/06 Qty Unit Charge 'Per Extension BASE FEE 15.00 3047.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 106.65 660.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 13.20 Permit•. . . • PLUMBING Additional desc . Permit Fee . . 174.75 Plan Check Fee 10.92 Issue Date Valuation 0 Expiration Date 7/12/06 Qty Unit, Charge Per Extension BASE FEE 15.00 17.00 6.0000 EA. PLB FIXTURE 102.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 LQPERMIT Application Number . . . . . 06-00000235 Permit . . . . . . PLUMBING Qty_ Unit,Charge Per Extension 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 11.00 .7500 EA PLB GAS PIPE >=5 8.25 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 7/12/06 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments SFD - LOT 29, PLAN 4B, 3047 SF. 2001 CODES. PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL, SPA OR DRIVEWAY APPROACH. 75% REDUCTION TO PLAN CHECK FEES 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 15.63 DIF FIRE PROTECTION -RES 97.00 DIF LIBRARIES - RES 225.00 DIF PARK MAINT FAC - RES 5.00 DIF PARKS/REC - RES 502.00 STRONG MOTION (SMI) - RES 19.13 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION _ RES 1098.00 Fee summary Charged Paid Credited Due ---------- ---------- Permit Fee Total 1394,.10 .00 .00 _ 1394.10 Plan Check Total 182.35 .00 .00 182.35 Other Fee Total 2439.76 .00 .00 2439.76 Grand Total 4016.21 .00 .00 4016.21 LQPERMIT