04-8206 (SFD)4
TAMPICO
ALIFORNIA 92253
BUILDING PERMIT
Property Address „
APN : 1. `
Application description
Property Zoning . . . . .
Application valuation . .
Owner
---------------------
_SANTA ROSA DEVELOPMENT INC
46753 ADAMS ST
LA QUINTA CA 92253
(760) 771-3345
BUILDING & SAFETY DEPARTMENT
(760).777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
04-000082Q0 Date 2/17/05
79350 COOL REFLECTION
649-030-069-9 -31311 -
DWELLING - SINGLE FAMILY DETACHED
HIGH DENSITY RESIDENTIAL
78808
x
Contractor
-------------------------- -
CONSOLIDATED CONTRACTING, INC.
46753 ADAMS STREET
LA QUINTA CA 92253
(760)
324-5488
WCC:
STATE FUND
WC:
1770749-2005 01/01/06'
CSLB:
824183 09/30/05
CCC:
B -C8
------ Structure Information PLAN 1
-----
.Construction Type . .
. . . TYPE V - NON RATED
Occupancy Type . . .
. . . DWELLG/LODGING/CONG <=10
Flood Zone
NON -AO FLOOD ZONE
Other struct info . .
. . . CODE EDITION 2001
# BEDROOMS
2.00
FIRE SPRINKLERS NO
GARAGE SQ FTG
423.00
PATIO SQ FTG
25.00
_ NUMBER,OF UNITS ' ' '
1.00
1ST FLOOR SQUARE FOOTAGE 1227.00
----------------------------------------------------------------------------
Permit . . . . . .
BUILDING PERMIT -
'Additional desc
Permit Fee . . . .
491.00 Plan Check Fee
79.79
Issue Date . . . .
Valuation . . . .
66626
Qty Unit Charge
� Per
Extension
BASE FEE
414.50
17.00 4.5000
THOU BLDG 50,001-100,000
76.50
----------------------------------------------------------------------------
Permit . . . . . .
ELEC-NEW RESIDENTIAL
Additional desc . .
Permit Fee . . . .
66.41 Plan Check Fee
4.15
Issue Date . . . .
Valuation . . . .
0
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1227.00 .0350
ELEC NEW RES - 1 OR 2 FAMILY
42.95
423.00 .0200
----------'------------------------------------------------------------------
ELEC GARAGE OR NON-RESIDENTIAL
8.46
P.O. Box 1504�� VOICE (760) 777-7012
Titf
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING cit SAFETY DEPARTMENT
Application Number: U if d20(A � Date:
Applicant:
Applicant's Mailing Address:
�o [VTKAciDk
Architect or Engineer:
M . VOLLGIi
Architect or Engineer's Address:
Lic. No.: G'-• D 1,2 10-4
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.
/11 License Class iii_ -License No. it 2 4 192
Date 3"3D—Gb Contractor" CV&t66LI r] A"[aQ CDLITI?ACTI/►.L4Tl�•C,
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 1, 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.).
U I, as owner of the property, am exclusively contracting with licensed contractors to construct the protect (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' Slate License Law.).
U I am exempt under Sec. , BA P.C. for this reason
Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
1 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.
�r 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. M workers' compensation insurance carrier
,..,.
_ 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, I shall
forthwith comply with those pro isions.
I
Vate �J—�JO� B 6 Applicant
WARNING: FAILURE TO SECURE WORKS S COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUS D DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTE EST, 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 A
Lender's 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 county to er upon thea ove-mentioned property for inspection purposes.
i
ate $ 4b -o5 Signature (Applicant or Agent .
Page
2
Application Number
. . . . 04-00008206 Date
2/17/05
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
-------------------------------------°---------------------------------------
Permit . . . . . . MECHANICAL
Additional desc
Permit Fee
46.00 Plan Check Fee
2.88
Issue Date . . . .
Valuation . . . .
0
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 9.0000
EA MECH FURNACE <=100K
9.00
1.00 9.0000
EA MECH B/C <=3HP/100K BTU
9.00
1.00 6.5000
EA MECH VENT FAN
6.50
1.00 6.5000
EA MECH EXHAUST HOOD
6.50
----------------------------------------------------------------
Permit . . . . . . PLUMBING
------------
Additional desc
Permit Fee . . . .
115.50 Plan Check Fee
7.22
Issue Date . . . .
Valuation . .
0
Qty Unit Charge
Per
Extension
.BASE FEE
15.00
8.00 6.0000
EA PLB FIXTURE
48.00
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
1.00 3.0000
EA PLB GAS PIPE 1-4 OUTLETS
3.00
1.00 15.0000
EA PLB GAS METER
15.00
-----------------7----------------------------------------------------------
Special Notes and Comments
SFD - LOT 9, Plan 1C,
1227 SF. 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
----------------------------------------------------------------------------
Other Fees . . . . .
ART IN PUBLIC PLACES -RES
.00
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
7.98
2 M.
Page 3
Application Number
. . . . .
04-00008206
Date
2/17/05
----------------------------------------------------------------------------
Other Fees . . .
. . . . . .
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
7.88
DIF STREET MAINT FAC
-RES
15.00
DIF TRANSPORTATION
- RES
1098.00
Fee summary
-----------------
Charged
----------
Paid Credited
----------
----------
Due
Permit Fee Total
733.91
----------
.00
.00
733.91
Plan Check Total
94.04
.00
.00
94.04
Other Fee Total
2420.86
.00
.00
2420.86
Grand Total
3248.81
.00
.00
3248.81
Certificate of Occupancy
rev
OF1'�Buildin & Safet Department
g Y p
This Certificate is issued pursuant to the requirements of Section 10v of the California Building
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.
BUILDING ADDRESS: 79-350 COOL REFLECTION LOT 9
f
Use classification: SINGLE FAMILY DETACHED Building Permit No.: 04-8206
Occupancy Group: R-3 Type of Construction: V-N Land Use Zone: RH
Owner of Building: SANTA ROSA DEVELOPMENT INC Address: 46-753 ADAMS ST
City, ST, ZIP: LA QUINTA, CA 92253
By: KIRK KIRKLAND
e
,[.
Date: AUGUST 11, 2006
E
Building Official
r
i
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