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04-6829 (SFD).q ti BUILDING & SAFETY DEPARTMENT I. BOX 1504 h (760).777-7012 8- 95 CALLE TAMPICO FAX (760) 777-7011 A U:INTA, CALIFORNIA 92253 INSPECTION REQUESTS (7.60) 777=7153 r �N�►� BUILDING PERMIT Application. -Number ,,C-047-00006829 Date'- { 10/19/04 Property Addre's's.,'.... . . . . 56018 PALMS DR APN: 764-030-006- - - Application description . . DWELLING - SINGLE FAMILY DETACHED Property Zoning -LOW DENSITY RESIDENTIAL Application.valuation 3.25108 Owner. Contractor BIRDIE HOMES III, LLC -------------- FIRST PACIFICA DEV CORP 5. EAST CITRUS .AVE, STE. 105. 300 EAST STA—_E—ST, SUITE #100 REDLANDS. CA 92373 REDLANDS CA 92333 (909) 798-3688 WCC: STA='E FUND WC.: 00083532004 01/01/05 - CSLB; .760044 03/31/05 _ CCC: B -----=--------------------- Structure Information. ------------ -------- Construction Type TYPE V - NON RATED Occupancy Type DWELLG/LODGING/LONG <=10 Flood Zone . . . . . NON -AO FLOOD ZONE Other struct. info . . . CODE EDITION 2001 CBC FIRE SPRINKLERS NO GARAGE SQ FTG 730.0,0 PATIO SQ FTG 635.00 NUMBER OF UNITS'.: FIRST FLOOR SQ FTG 3742.00 Permit . . . . BUILDING PERMIT'' Additional desc Permit Fee . . . . 1430.50 'Plan Check Fee 929.83 Issue Date Valuation 325108 Qty Unit Charge Per Extension. BASE FEE 639.50 226.00 3.5000 THOU BLDG 100,001-500,000 791.00 Permit . . . . . . MECHANICAL Additional.desc Permit Fee... 127.50 Plan Check Fee 31.88 Issue Date Valuation . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 9.0000 EA MECH FURNACE <=i00K ..27.00 3.00 9.0000 EA MECH B/C <=3HP/100K BTL' 2,7.0.0 8.00 6.5000 .EA '`.MECH VENT"FAN 52.00 ' 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 (;f ?it�v ot 4. P.O. BOX 1504 . . 78-495 CALLE TAMPICO VOICE (760) 777-7012 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: ' �O Date: g� y' • r� Applicant: ect (r Engineer: y1 n U _,.e-&. 1 ,_11�enr".� 'Applicant's Mailing Address: Address: No.. C_ \ ) Dc+ k BUILDING PERMIT DECLARATIONS 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 . de, and my Licensers jn full force and effect. License Class "C'j 1 nse No._J�1 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I amexempt from the Contractors' 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 Contractors' 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).): U 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 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 or 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.). .0 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 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.). U I am exempt under Sec. , BA P.C. for this reason Date WORKERS' 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. A.1 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 e . ers' com . insu carrier an psurope re:����� arrier ___ icy Number _Ice if at, in the i5e'rf8r_mVndb of the work for which this permit is issued,Jshall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL 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. 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.). Lenders Name Lender's Address 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 harnless 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 upon the ab ove-mentione property for inspection purposes. / ateA— Signature (Applicant or Agent): i } Page 2 Application Number 04-00006829 Date 10/19/04 Permit . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee . . 160.57 Plan Check.Fee 40.14 Issue Date Valuation . . . . 0 Qty Unit 'Charge Per Extension BASE FEE, 15.00 3742.00 0350 ELEC NEW RES - 1 OR 2 FAMILY 130.97 730.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 14.60 Permit . . . . PLUMBING Additional desc'. Permit Fee 221.25 Plan Check Fee 55.31 Issue.Date Valuation . . . . 0 Qty Unit.Charge Per Extension. BASE FEE 15.00 24.00 6.0000 EA PLB FIXTURE 144.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 2.00 7.5000'EA PLB WATER HEATER/VENT .15.00 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 15..00 Plan Check Fee .00 Issue Date . . . Valuation 0 Qty Unit Charge Per Extension BASE. FEE. 15.00 Special Notes and Comments SFD - LOT 26, PLAN 3AR-C1, 3742 SF. PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS, OR.DRIVEWAY APPROACH Other Fees . . . . . ART IN PUBLIC PLACES -RES 312.77 "DIF,COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY,REVIEW FEE 92.98 DIF FIRE PROTECTION -RES 97.00 GRADING -PLAN CHECK FEE .00 DIF LIBRARIES.- RES 225.00 Page 3 Application Number . . 04-0000682-9 Date 10/19/.04 Other Fees . . . . . DIF PARK MAINT FAC- RES - 5.00 DIF PARKS/REC - RES 502.00 STRONG,MOTION (SMI) - RES .32.51 DIF STREET-MAINT FAC-RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Paid Credited Due Permit Fee•Total 1954.,82 .00 .00 1954.82 Plan Check Total 1057.16 .00 .00 1057.16 Other Fee Total 2843.26 .00 .00 2843.26 Grand Total 5855.24 .00` .00 5855.24