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10-1398 (SFD)P.O. BOX 1504 T4'!t 4 t!'dG�Gv 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Numbemr '-10-00001398 1 Owner: Property Address: 81435 COLUMBUS WY JLS PROPERTIES LLC APN: 767-690-008- - - 3409 HANOVER Application description: DWELLING - SINGLE FAMILY DETACHED DALLAS, TX 75225 Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 473895 Applicant: Architect or Engineer: ..VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Contractor: TAYLOR CONSTRUCTION INC, DAVID 306 N.W. EL NORTE PKWY, #490 ESCONDIDO, CA 92026=J �I (760) 533-8262 Lic. No.: 773623 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I licensed under provisions of Chapter 9 (commencing with Section 7 001 of Division 3 of the Busines n Professionals Code, and my License is in full force and effect. Licen Cla s: Li se No.: 773623 ate: ntractor: 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 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 (5500).: (_ 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.). (_ ) I am exempt under Sec. , B.&P.C. for this reason Date: Owner: 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: T] LQPERMIT WORKER'S 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 EXEMPT Policy Number EXEMPT 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 t become subject to the workers' compensation laws of California, and agree that, if I should c me subject to the workers' c pensation provisions of Section 700 of the Labor Code sh II forth it c y with t provisions. E plicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATIO OVERAGE 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, 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. 1 certify that I have read this application and state thobuildig ormation is correct. I agree to comply with all city and county ordinances and state laws relating touction, and here authoriz representatives of chjs cou ty t enter upon the above-mentioned prctio 0 4ate�L Si ature (Applicant or Agent): Application Number . . . . . 10-00001398 Structure Information Construction Type . . . . . TYPE V, UNPROTECTED Occupancy Type . . . . . DWELLG/LODGING/CONG <=10 Other struct info . . . . . CODE EDITION 2007/08 ENERGY # BEDROOMS 4.00 FIRE SPRINKLERS NO GARAGE SQ FTG 1032.00 PATIO SQ FTG 952.00 NUMBER OF UNITS .00 ----------------------=---------------------7------------------------------- 1ST FLOOR SQUARE FOOTAGE 5458.00 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 1948.50 Plan Check Fee 1266.53 Issue Date . . . . Valuation . . . . 473895 Expiration Date 10/25/11 Qty Unit Charge Per Extension BASE FEE 639.50 374.00 3.5000 ---------------------------------------------------------------------------- THOU BLDG 100,001-500,000 1309.00 Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 194.00 Plan Check Fee 48.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 10/25/11 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 4.00 11.0000 EA MECH FURNACE >100K 44.00 2.00 9.0000 EA MECH B/C <=3HP/100K BTU 18.00 3.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 49.50 8.00 6.5000 EA MECH VENT FAN ' 52.00 1.00 6.5000 ---------------------------------------------------------------------------- EA MECH EXHAUST HOOD 6.50 Permit . . . ELEC-NEW RESIDENTIAL Additional desc . . Permit Fee . . . . 241.67 Plan Check Fee 60.42 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 10/25/11 Qty Unit Charge Per Extension BASE FEE 15.00 LQPERMIT Application Number . . . . 10-00001398 Permit . . . . . . ELEC-NEW RESIDENTIAL Qty Unit Charge Per Extension 5458.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 191.03 1032.00 ..0200 ELEC GARAGE OR NON-RESIDENTIAL 20.64 1.00 15.0000 EA ELEC TEMPORARY POWER POLE 15.00 ---------------------------------------------------------------------------- Permit . . . PLUMBING Additional desc . Permit Fee 384.75 Issue Date . . . . Expiration Date . 10/25/11 Plan Check Fee . . 96.19 Valuation . . . . 0 Qty Unit Charge Per 15.00 -------------------------------------------------------- -------------------- Special Notes and Comments Extension 5458 SF SINGLE FAMILY DWELLING (4818SF MAIN LIVING + 640 SF CASITA] 952 SF BASE FEE 15.00 27.00 6.0000 EA PLB FIXTURE 162.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 22.00 6.0000 EA PLB ROOF DRAIN 132.00 3.00 7.5000 EA PLB WATER HEATER/VENT 22.50 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 15.0.0 .7500 EA PLB GAS PIPE >=5 11.25- 1.251.00 1.00 ---------------------------------------------------------------------------- 15.0000 EA PLB GAS METER 15.00 Permit . . Additional desc . . Permit Fee . . . . Issue Date . . . . Expiration Date . . GRADING PERMIT 15.00 Plan Check Fee . . .00 Valuation . . . . 0 10/25/11 Qty Unit Charge Per Extension BASE FEE 15.00 -------------------------------------------------------- -------------------- Special Notes and Comments 5458 SF SINGLE FAMILY DWELLING (4818SF MAIN LIVING + 640 SF CASITA] 952 SF PATIO, 1032 SF GARAGE. TYPE V -B CONSTRUCTION. R-3 OCCUPANCY. 2007 CODES 2008 ENERGY. 2008 DIF.**PERMIT DOES NOT INCLUDE BLOCK WALLS, FENCES, SWIMMING POOLS, SPA, DRIVEWAY APPROACH and BBQ'S** 2008 DIF. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES 684.74 BLDG STDS ADMIN (SB1473) 19.00 DIF COMMUNITY CENTERS -RES 74.00 LQPERMIT Application Number . . . . . 10-00001398 --------------------------------------------------------------------- Other Fees . . . . . . . . . DIF CIVIC CENTER _ RES ------- 995.00 ENERGY REVIEW FEE 126.65 DIF FIRE PROTECTION -RES 140.00 DIF LIBRARIES - RES 355.00 MULTI -SPECIES (MSHCP) FEE 1284.00 DIF PARK MAINT FAC - RES 22.00 DIF. PARKS/REC - RES 892.00 STRONG MOTION (SMI) - RES 47.39 DIF STREET MAINT FAC -RES 67.00 DIF TRANSPORTATION - RES 1930.00 Fee summary ----------------- Charged ---------- Paid Credited ---------- --- - ------ ---------- Due Permit Fee Total 2783.92 .00 .00 2783.92 Plan Check Total 1471.64 1000:00 .00 471.64 Other Fee Total 6636.78 .00 .00 6636.78 Grand Total 10892.34 1000.00 .00. 9892.34 LQPERMIT CITY OF LA QUINTA SUB -CON TR CTOR LIST JOB ADDRESS d �7'� �OrGI i�'►f%G1S PERMIT NUMBER _ OWNER �f � ' 90�07 BUILDER, L//%,/� �`��l/% �G�%-rte !h►� This form shall be Dosted on the Job with the Building IgsRection Card at all times in a consicuous place. Only persons appearing on this list or their employees are authorized to work on this job. Any changes to this list. must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance. y of building permit._ For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response. . ... ..... .. .. .: :v :: ....:;;;•:.:: :ti •;�:. :. :.: •.: `.::.: �"':: S'i':i.; :i :!��i:•.i�':+::!viii::^::�: �\00, -a � s"/70. _ a 4,'Q/� Mc GEE SUR VEYING, INC. 45-100 Golf Center Pkwy, Ste .G, Indio, CA 92201 Phone (760) 342-2249 — Fax (760) 342-5044 June 15, 2011 City of La Quinta 78-495 Calle Tampico La Quinta, CA 92253 Re: Form Certification — 3657 Pursuant to your request a field survey was conducted on the above referenced project to determine the vertical location of the building forms. The above mentioned were found as follows: LOT ADDRESS FORM (DES) FORM (FIELD) 16 - 81-435 Columbus Way 997.50' 997.46' Sincerk.Gee Wayn L.S. 5479 Z L