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04-7855 (SFD)y' BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760)•777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number Property Address APN: Application description Property Zoning . . . . Application valuation . Date 12/16/04 . . . 78395 CLARKE CT 643-170-999-30 -31348 - . . DWELLING - SINGLE FAMILY DETACHED . . . LOW DENSITY RESIDENTIAL . . . 192449 Owner Contractor ------------------------ ------------------------ PH RANCH LLC EHLINE COMPANY 78370 HIGHWAY 111 STE 200 55375 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 3136 SQ. FT SFD MODEL D-1 ----- Construction.Type . . . . .. TYPE V - NON RATED Occupancy Type DWELLG/LODGING/CONG <=10 Flood Zone NON -AO FLOOD ZONE Other st.ru- �D inf� CODE EDITION 2001 CBC # BEDROOMS 3.00 FIRE SPRINKLERS NO GARAGE SQ FTG 504.00 PATIO SQ FTG 240.00 Y 0 gyp. NUMBER OF UNITS 1.00 1ST FLOOR SQUARE FOOTAGE 3136.00 Permit . . . . . BUILDING PERMIT Additional desc Permit Fee 965.00 Plan Check Fee*. 156..81 Issue Date . . . . Valuation . . . . 192449 Qty Unit Charge Per Extension BASE FEE 639.50 93.00 3.5000 THOU BLDG 100,001-500,000 325.50 --------------------------------------------------------- ------------------ Permit . . . . . MECHANICAL Additional desc . . Permit Fee . . . . 108.00 Plan Check Fee 6.75 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension .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 .00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU .00 P.O. BOX 1504�� VOICE (760) 777-7012 Tihf 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 55 Date: fad' x46'0 Applicant: I Architect or Erigineer: Applicant's Mailing Address: Architect or Engineer's C- Lic. No. Q7 Z/0 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 OWNER43UILDER DECLARATION I hereby affirm under penalty of perjury that 1 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 applicanCfor 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 fora permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ( j 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.). �j 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. P.C. f is a n 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 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, 1 shaft forth 'thcomply with tho visions. e 51,Applicant WARNING: FAILURE TO SECURt 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 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, indemnity 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 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 c e n bove-menfii�one(dcprr-o�peerty for inspection purposes. ZDat �ign.ture(Applicant or Agent): \\ j" Application Number . . . . . 04-00007855 Page 2 Date 12/16/04 Qty Unit Charge Per Extension 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 . . . . 149.84 Plan Check Fee 9.37 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 3136.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 109.76 504.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 10.08 1.00 15.0000 EA ELEC TEMPORARY POWER POLE 15.00 ------------------------------------------------------- Permit ... . . . . --------------------- PLUMBING Additional desc Permit Fee . . . . 177.00 Plan Check Fee 11.06 Issue Date . . . . Valuation . . . . 0 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. 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 D1,3136 sq.ft. PERMIT DOES NOT INCLUDE POOL, SPA,BLOCK WALLS OR DRIVEWAY APPROACH. 75% REDUCTION TO PLAN CHECK FEE DUE TO MULTIPLE ISSUANCE OF SAME -PLAN TYPE ,4 ol Page 3 Application Number . . . . 04-00007855 Date 12/16/04 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES .00 DIF .COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 15.68 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 19.24 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary ----------------- Permit Fee Total Plan Check Total Other Fee Total Grand Total Charged Paid 1414.84 .00 183.99 .00 2439.92 .00 4038.75 .00 Credited Due .00 1414.84 .00 183.99 .00 2439.92 .00 4038.75 Twit 4 4 a" P.O. BOX 1504 LA QUINTA, CALIFORNIA 92247-1504 BUILDING & SAFETY DEPARTMENT 78-495 CALLE TAMPICO (760) 777-7012 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 January 13, 2005 To Whom It May Concern: 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