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04-3682 (SFD)may' 444" P.O. BOX 1504 78-495 CALLS TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 r Application Number . . . 04-0000368.2 Date 1/13/05 Property Address . . . . . . 78395 CLARKE CT APN: 643-170-999-30 -31348 - Application description DWELLING -,SINGLE FAMILY DETACHED Property Zoning . . . . . . LOW DENSITY RESIDENTIAL Application valuation . . . . 200686 Owner' --------------------------------- PH RANCH LLC 78370 HIGHWAY 111 STE 200 LA QUINTA, CA 92253 Contractor EHLINE COMPANY 55375 MEDALLIST DR LA QUINTA, CA 92253 (760) 771-8130 WCC: STATE FUND WC: 2290006783' 01/01/06 CSLB: 482086 11/30/05 CCC: B D N 20 X005 JA of �,nu� �1 d P.O. Box 1504 • VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 0 4- 340$ oZ Date: •OS Applicant: Architect or Engineer: Applicant's Mailing Address: chitect ic. No.: or Engineer's Address: 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 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 I 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 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.). 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 1(':6, for this reaspn 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: Carrier 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, l 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.). 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 Ouinta, 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:enter upon ye-mentioned property for inspection purposes. ate ��ignature (Applicant or Agent): ---------------------------------------------------------------------------- Application Number . . . . . 04-.00003682 ---------------------------------------------------------------------------- ------ Structure Information 3276 SQ. FT. SFD MODEL F-2 ----- Construction Type . . . . . TYPE V - NON RATED Occupancy Type . . . DWELLG/LODGING/CONG <=10 Flood Zone NON -AO FLOOD ZONE FEE Other struct info . . . . . CODE EDITION 2001 CBC # BEDROOMS 4.00 114.66 FIRE SPRINKLERS NO GARAGE SQ FTG 498.00 9.96 PATIO SQ FTG 266.00 EA NUMBER OF UNITS' 1.00 -----------------------------------------------------•----------------------- 1ST FLOOR SQUARE FOOTAGE 3276.00 Permit . . . . . . BUILDING PERMIT Additional desc Additional desc . . Permit Fee . . . . 993.00 Plan Check Fee 645.45 Issue Date . . . . Valuation . . . . 200686 Qty Unit Charge Per Extension 48.75 BASE FEE 639.50 101.00 3.5000 ---------------------------------------------------------------------------- THOU BLDG 100,001-500,000 353.50 Permit . . . . . . MECHANICAL Charge Additional desc Permit Fee . . . . 108.00 Plan Check Fee 27.00 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension EA BASE FEE 15.00 3.00 9.0000 EA MECH FURNACE <=100K 27.00 3.00 9.0000 EA MECH B/C <=3HP/100K BTU 27.00 5.00 6.5000 EA MECH VENT FAN 32.50 1.00 6.5000 ---------------------------------------------------------------------------- EA MECH EXHAUST HOOD 6.50 Permit . . . . . . Additional desc . . Permit Fee . . . . Issue Date . . . . ELEC-NEW RESIDENTIAL 154.62 Plan Check Fee 38.66 Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 3276.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 114.66 498.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 9.96 1.00 ---------------------------------------------------------------------------- 15.0000 EA ELEC TEMPORARY POWER POLE 15.00 Permit . . . . . . PLUMBING Additional desc . . Permit Fee . . . . 195.00 Plan Check Fee 48.75 Issue Date' . . . . Valuation . . . . 0 Qty Unit Charge Per Extension a BASE FEE 15.00 19.00 6.0000 EA PLB FIXTURE 114.00 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 --------------------------------------------------------------------------- ,r Application Number . . . . . 04-00003682 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING Qty Unit Charge Per Extension 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 4.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 12.00 6.00 .7500 EA PLB GAS PIPE >=5 4.50 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 30, PLAN F-2,3276 S.F. PERMIT DOES NOT INCLUDE POOL & SPA , BLOCK WALLS OR DRIVE WAY APPROACH. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES 20.00 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 64.55 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 20.06 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged = - ------ - - - Paid Credited Due - - - - ---- Permit Fee Total -- - - - - ------ -- - - ------ - - - - ---- 1465.62 .00 .00 -- - - - - - - 1465.62 Plan Check Total 759.86 500.00 .00 259.86 Other Fee Total 2509..61 .00 .00 2509.61 Grand Total 4735.09 500.00 .00 4235.09 i T4tjf 4 4'QUkrC4(j P.O. Box 1504 LA QUINTA, CALIFORNIA 92247-1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 January 13, 2005 To Whom It May Concern: BUILDING & SAFETY DEPARTMENT (760)777-7012 FAX (760) 777-7011 Please replace the permit you have #04-7855 with this replacement, # 04-3862. PH Ranch, LLC changed the plan type from a D1 to an F2, thereby increasing the square footage of the house by 140 square feet. Please call me if you have any questions, 760-777-7084. Sorry for the inconvenience. Sincerely, Kay Hensel, Office Assistant {� r Ile Certificate'of Occupancy ' ; U 4�IJ lei . G� OF'Tk Building & Safety. Department g Y p This Certificate is issued pursuant to the requirements of Section 109 of the California Building t h ` 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. s BUILDING ADDRESS: 78-395 CLARKE COURT 7 K rFy 1 V Use classification.: SINGLE FAMILY DWELLING Building Permit No.: 04-3682 a , ` 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 - R b b'wt Date: OCTOBER 17, 2006 Building Official Y 1: POST IN A CONSPICUOUS PLACE _ .... _ _ _ _ . _.. _ _ - - - _ - _ — _ - _ . _ . - - - - - - - - • -- -- - - - " r r