04-4423 (SFD)_r
4
Tihf 4 4 4"
BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760),777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number .
. . . . -4=0=0=00442 Date
12/16/04
Property Address.-
78420 CLARKE CT
APN:
643-170-999-14 -31348 -
Application description
DWELLING - SINGLE FAMILY DETACHED
Property Zoning . . .
. . . . LOW DENSITY RESIDENTIAL
Application valuation
. . . . 196109
Owner
Contractor
------------------------
PT HAPPY RANCH LLC.
------------------------
EHLINE COMPANY
78-570 HWY 111
553.75 MEDALLIST DR
LA QUINTA
CA 92253 LA QUINTA
CA 92253
(760) 771-8130
WCC: -STATE FUND
WC: 2290006783
01/01/05
CSLB: 482086
11/30/05
CCC: B
------ Structure Information
3055 SQ. FT. SFD OPTION -2 MODEL -2
-----
Construction. ype,. TYPE V.- NON RATED
Occupa Ty Q
DWELLG/LODGING/CONG <=10
Flood
e
NON -AO FLOOD ZONE
Other rucb
info
CODE EDITION 2001
CBC
# BEDROOMS
4.00
FIRE SPRINKLERS NO
CITY OF LA (QUINTA
FINANCE DEPT.
GARAGE SQ FTG
640.00
PATIO SQ FTG
663.00
NUMBER OF UNITS
1.00
1ST FLOOR SQUARE FOOTAGE
3055.00
----------------------------------------------------------------------------
Permit . . . . . .
BUILDING PERMIT
Additional desc
Permit Fee
979.00 Plan Check Fee .
636..35
Issue Date . . . .
Valuation . . . .
196109
Qty Unit .Charge
Per
Extension
BASE FEE
639.50
97.00 3.5000
THOU BLDG 100,001-500,000
339.50
---------------------------------------------------------
Permit . . . . . .
------------------
MECHANICAL
Additional desc
Permit Fee . . . .
114.50 Plan Check Fee
28.63
Issue Date . . . .
Valuation
0
Qty Unit Charge Per
BASE FEE '
3.00 9.0000 EA MEC14 FURNACE <=100K
3.00 9.0000 EA MECH B/C <=3HP/100K BTU
6.00 6.5000 EA MECH VENT FAN
Extension
15.00
27.00
27.00
39.00
P.O. BOX 1504�� VOICE (760) 777-7012
T44f
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: Date: 04
Applicant: chitect
Applicant's Mailing Address: Architect
Lic. No.:
or Engineer:
or ngin 1==;2 r ss;
ciga�o
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
1 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 License No.
Date Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that l am exempt 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 Ute 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.).
(' .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 1 am exempt under Sec. , BA P.C. for this reason
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.
_ 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 insurance carrier and policy number are:
Cartier Policy Number
I certify that, in the performance of the work for which this permit is issued, I shall 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 shah
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.).
Lender's Name
Lenders 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 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 pernil. 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 cocun to enter on,the ve-mentioned property for inspection purposes.
Date ! L. `� �h, �y
/ ' ��`' Signature (Applicant or Agent):
A
Page 2
Application Number . . . . . 04-00004423 Date 12/16/04
Qty Unit
Charge
Per
Extension
1.00
6.5000
EA MECH EXHAUST HOOD
6.50
----------------------------------------------------------------------------
Permit . . .
. . .
ELEC-NEW RESIDENTIAL
Additional desc
. .
Permit Fee .
. . .
149.73 Plan Check Fee
37.43
Issue Date .
. . .
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
3055.00
.0350
ELEC NEW RES - 1 OR 2 FAMILY
106.93
'640.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
12.80
1.00
15.0000
EA ELEC TEMPORARY POWER POLE
15:00
-----------------------------------------------------------------------------
Permit . . .
. . .
PLUMBING
Additional desc
. .
Permit Fee .
. . .
198.00 Plan Check Fee
49.50
Issue Date .
. . .
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
21.00
6.0000
EA PLB FIXTURE
126.00
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
2A PLB WATER INST/ALT/REP
3.00
1.00
9.0000
EA PLB LAWN SPRINKLER SYSTEM
9.00
10.00
.7500
EA PLB GAS PIPE >=5
7.50
1.00
15.0000
EA PLB GAS METER
15.00
-------------------------------------------------7--------------------------
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
3055 SQ. FT. SFD.
THIS
PERMIT DOES NOT
.INCLUDE POOL &
SPA ,
BLOCK WALLS OR
DRIVEWAY APPROACH.
----------------------------------------------------------------------------
Other Fees
.. .
. . . . ART IN PUBLIC PLACES -RES
.00
DIF COMMUNITY CENTERS -RES
97.00
DIF; CIVIC CENTER - RES
366.00
..o
Page 3
Applicatiori Number . . . . 04-00004423 Date 12/16/04
-------------7--------------------------------------------------------------
Other Fees . . . . . . . . . ENERGY REVIEW.FEE 63.64
DIF FIRE PROTECTION -RES 97.00
GRADING PLAN CHECK FEE .00
DIF LIBRARIES - RES 225.00
DIF PARK MAINT FAC - RES 5.00
DIF PARKS/REC - RES 502.00
STRONG MOTION (SMI) - RES 18.92
DIF STREET MAINT FAC -RES 15.00
DIF TRANSPORTATION - RES 1098.00
Fee summary Charged
Permit Fee Total 1456.23
Plan Check Total 751.91
Other Fee Total 2487.56
Grand Total 4695.70
Paid Credited Due
---------- ---------- ----------
.00 .00 1456.23
500.00 .00 251.91
.00 .00 2487.56
500.00 .00 4195.70
Certificate of Occupancy
U = _
T4'!t
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j�
OF'I9� Building & Safety Department
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This Certificate is issued pursuant to the requirements of Section 109 of the California Building
Code, certifying that, at the time of issuance, this structure was in compliance with the
provisions of the Building Code and the various ordinances of the City regulating building
construction and/or use.
F
BUILDING ADDRESS: 78-420 CLARKE COURT
;
t
a.
Use classification: SINGLE FAMILY DWELLING Building Permit No.: 04-4423
Occupancy Group: R3 Type of Construction: VN Land Use Zone: RL
Owner of Building: PH RANCH, LLC Address: 78-370 HIGHWAY 111, STE. 200
City, ST, ZIP: LA QUINTA, CA 92253
_
By: KIRK KIRKLAND
Date: SEPTEMBER 7, 2006
Building Official
POST IN A CONSPICUOUS PLACE