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04-7846 (SFD)Tihf* 4 4 Q" 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) 77.7-7153 BUILDING PERMIT Application Number . . . . . 44--0.0.00_7846 Date 12/16/04 Property Address . . . . . . 78320 CLARKE CT APN: 643-170-999-24 -31348 - Application description . . . DWELLING - SINGLE FAMILY DETACHED Property Zoning. . . . . . . . LOW DENSITY RESIDENTIAL Application valuation . . . 173868 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 2800 SQ.FT. SFD ----- 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 4 BEDROOMS 3.00 FIRE SPRINKLERS NO D LrJ a GARAGE. SQ FTG. 504.00 PATIO SQ FTG 288.00 2 n'� -NUMBER OF UNITS 1.00 1ST FLOOR SQUARE FOOTAGE 2800.00 ---------------- ------------ ----------- ------------------------------------ Permit CITY OF LA Q"A�T�` B:U.ILDING PERMIT Additional des•cFIN"ANCEO` Permit Fee'- 898.50 Plan Check Fee'. 584..03 Issue Date . . . . Valuation . . . . 173868 Qty Unit Charge Per Extension BASE FEE 639.50 74.00 3.5000 THOU BLDG 100,001-500,000 259.00 --------------------------------------------------------=------------------- Permit . . . . . . MECHANICAL Additional desc Permit Fee . . . . 101.50 Plan Check Fee 25.38 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 4.00 6.5000 EA MECH VENT FAN 26.00 f ce . ot 4 a P.O. BOX 1504 • as VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number:Qq- -7844(., Date: 101 •.0 v Applicant:—Architect Applicant's Mailing Address: chftec ic. No.. or Engineer: V 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 orcounly 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 ($5D0).): 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 (ksold 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.). 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 contractors) licensed pursuant to the Contractors' State License Law.). U I am exempt uunnde1r 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: Carrier. 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, I shall forthwith comply with those provisions. tk 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 .l Lender's Address w bor 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 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 it 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 appfication an tate that the above information is cored. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize rep entatives of this cou egM�bove-mentioned property for inspection purposes. ategt)%, Signature (Applicant or A ent :� Page 2 Application Number 04-00007846 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 138.08 Plan Check Fee 34.52 Issue Date Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 2800.00 .0350 ELEC NEW RES - 1 OR 2.FAMILY 98.00 504.00 .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 . . . . 174.75 Plan Check Fee 45.75 Issue Date Valuation . . . . 0 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 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN,SPRINKLER SYSTEM 9.00 .00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS .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 Qty Unit Charge Per Extension BASE FEE. 15.00 ---------------------------------------------------------------------------- Special Notes and Comments SFD - LOT 12, 2800 SF., PLAN B3R: PERMIT DOES NOT INCLUDE POOL,SPA BLOCK WALLS OR DRIVE WAY APPROACH. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES .00 DIF COMMUNITY CENTERS -RES 97.00 i Page 3 Application Number . . . . . 04-00007846 Date 12/16/04 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . DIF CIVIC CENTER- RES 366.00 ENERGY REVIEW FEE 58.40 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 17.38 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Permit Fee Total 1327.83 Plan Check Total 689.68 Other Fee Total 2480.78 Grand Total 4498.29 Paid Credited Due ---------- ---------- ---------- .00 .00 1327.83 .00 .00 689.68 .00 .00 2480.78 .00 .00 4498.29 Certificate of Occupancyo Y TAt!t Ot c G OFTi9� Building & Safety Department c. { ' 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 s provisions of the Building Code and the various ordinances of the City regulating building a construction and/or use. r BUILDING ADDRESS: 78-320 CLARKE COURT F fi r r Use classification: SINGLE FAMILY DWELLING Building Permit No.: 04-7846 k "r, Occupancy Group: R3 Type of Construction: VN Land Use Zone: RL Owner of Building: PH RANCH, LLC Address: 78-370 HIGHWAY 111, STE. 200 h City, ST, ZIP: LA QUINTA, CA 92253 C By: KIRK KIRKLAND Date: MARCH 8, 2007 Building Official POST IN A CONSPICUOUS PLACE