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07-1276 (SFD)P.O. BOX 1504 78-495 CALLE TAaMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: 0`7 000'072.-76 808'5'5—PASEO—DE ROSARIO APN: 766-110-016-56 -33597 - Application description: DWELLING - SINGLE FAMILY Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 228034 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT DETACHED Applicant: Architect or Engineer: LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I ant 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: B License No.: 750957 Date: Contractor: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/17/08 Owner: R.T. HUGHES 78-900 AVENUE 47, STE. 200 h� LA QUINTA, CA 92253 !p Contractor: GHA ENTERPRISE, INC. � 30875 DATE PALM DRIV UIT fPC` 8 2C, CATHEDRAL CITY,.CA 9 23 (760) 969-1400 or QUI I L i c. No.: 750957 '�—�IIICE hee� OWNER -BUILDER DECLARATION I -hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 Contractor's Stale 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).: (_ 1 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 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.). (_ 1 I am exempt under Sec. , B.&P.C. for this reason Date: f 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: Lender's Address: LQPFR\IIT WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury'orle 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 S ATE FUND Policy Number 719000223 1 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 tV 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. 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 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 buil�spennuanpaosneesr. eby authorize representatives off t/Iva county to enter up n the above-mentioned pro rt aD t : 1 I d gnature (Applicant or Agent): Application Number . . . . . 07-00001276 Permit . . . . . . BUILDING PERMIT .Additional desc Permit Fee . . . . 1091.00 Plan Check Fee 709.15 Issue Date . . . . Valuation . . . ... 228034 Expiration Date 10/14/08 Qty Unit Charge Per Extension BASE FEE 639.50 129.00 3.5000 ----------------------------------------------------------------------- THOU BLDG 100,001-500,000 .451.50 7 ------ -Permit . . . . . . . MECHANICAL Additional desc Permit Fee . . . . 117:50 Plan Check Fee 50.50 Issue Date. Valuation . . . . 0 Expiration Date 10/14/08 Qty. Unit Charge Per Extension BASE FEE 15.00 2.00 9.0000 EA MECH FURNACE <'=100K 18.00 1.00 11.0000 EA MECH FURNACE >100K 11.00 2.00 9.0000 EA MECH B/C <=3HP/100K BTU 18.00 1;00 16.5000 EA MECH B/C >3-15HP/>100K.-500KBTU 16.50 5._00 .6.5000 EA MECH'VENT FAN 32.50 1.00 6.5000 --------------------------------- EA MECH 7 EXHAUST HOOD ----------- --------- 7 --------------- 6.50 -7 Permit . . . . . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee 156.21 Plan Check Fee 39.28 Issue Date Valuation 0 'Expiration Date 10/14/08 Qty Unit Charge Per BASE FEE .-Extension .15.00 3635.00 .0350 ELEC NEW RES 1 OR 2,FAMILY 127.23 699..00 ..0200 7 --------------------------------------------------------- ELEC.GARAGE OR NON-RESIDENTIAL 13.98 ---------------------- Permit .. . . . . . PLUMBING Additional desc Permit.Fee 185.25 Plan Check Fee 44.81 Issue Date . . . . Valuation . . . . 0 Expiration Date 10/14/08 Qty Unit Charge Per Extension BASE FEE 15.00 f,Q1T_.RA11T Application Number . . . . . 07-00001276 Permit . . . . . . PLUMBING Qty Unit Charge Per Extension 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 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 9.00 .7500 EA PLB GAS PIPE >=5 6.75 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 Expiration Date 10/14/08. Qty Unit Charge Per Extension BASE FEE 15.00' ----------------------------------- Special Notes and, Comments ------------------------- - SFD - LOT 56, PLAN 3CR, 3635 SF. PERMIT DOES NOT INCLUDE 'POOL, SPA,, BLOCKWALLS, OR DRIVEWAY APPROACH. 2001. CBC, CMC, CPC, 2004 CEC, 2005 ENERGY CODES Other Fees ART IN -PUBLIC PLACES -RES 73.69. °DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER - RES 995.0.0 ENERGY REVIEW.FEE 71.14' DIF.FIRE PROTECTION -RES 140.00. " GRADING PLAN CHECK FEE .00 DIF LIBRARIES _ RES 355.00. DIF PARK MAINT FAC - RES 22.00 DIF PARKS/REC•-.RES 892.00 - STRONG MOTION (SMI) - RES 22.94' DIF STREET MAINT'FAC-RES 67.00 DIF TRANSPORTATION - RES 1930.00 Fee summary Charged Paid Credited Due Permit.Fee Total 1564.96 Plan Check Total 843.74 .Other Fee Total 4642.77 Grand Total 7051.47 i.�rrk�nr 2.28 .00 1562.68. 843.74 .00 .00 71.14 .0.0 4571.63 917.16 .00 6134.31