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04-8195 (SFD)T4hf 4 4 Q" G TAMPICO ALIFORNIA 92253 Property Address,• APN: Application description Property Zoning . . . . Application.valuation . Owner BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 . . . 04-000081.95-, Date 2/17/05 79320 COOL REFLECTION 649-030-069-4 -31311 - . . . DWELLING - SINGLE FAMILY DETACHED . . . HIGH DENSITY RESIDENTIAL . . . 84922 SANTA ROSA DEVELOPMENT INC 46753 ADAMS ST LA QUINTA CA 92253 (760) 771-3345 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 2 ----- Construction Type . . . . . TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/LONG <=10 Flood Zone . ... . . . . . NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 # BEDROOMS 3.00 FIRE SPRINKLERS NO GARAGE SQ FTG 424.00 PATIO SQ FTG 36.00 `NUMBER OF UNITS 1.00 1ST FLOOR SQUARE FOOTAGE 1331.00 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 518.00 Plan Check Fee 84.18 Issue Date . . . . Valuation . . . . 72273 Qty Unit Charge Per Extension BASE FEE 414.50 23.00 4.5000 THOU BLDG 50,001-100,000 103.50 ------------------------------------------- Permit . . . . . . -------------------------------- ELEC-NEW RESIDENTIAL Additional desc . . Permit Fee . . . . 70.07 Plan Check Fee 4.38 Issue Date . . . . Valuation . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1331.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 46.59 424.00 .0200 ----------=----------------------------------------------------------------- ELEC GARAGE OR NON-RESIDENTIAL 8.48 P.O. Box 1504 • VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: (� — �f 9s Date: Applicant: Applicant's Mailing Address: &l TeACTog Architect or En *neer: j�A . V;0 LL � Architect or Engineer's Address: Lic. No.: G -b ►� 1 a� 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. +� $ a4� 83,License Class A2 License No. Xate —��"�� Contracto CoUSeLfrnhrMD Cp1.l.T (1�GQ'La.LG NC, 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 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.). U 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. , BA P.C. for this reason Date Owner 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 caro and otic number aiie-- ' ^ / Carrier 5gh VVLL�_Policy Number 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, 1 shall forthwith comply with those pr 'ons. Vtl)ate "�D-bb Applicant/01 WARNING: FAILURE TO SECURE WORKECOMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUS ND 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 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 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 count nter upon the above-mentioned property for inspection purposes. ate ���y—G,–L Signature (Applicant or Agentj/ Page 2 Application Number . . . . . 04-00008195 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 9.00OO-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 ---------------------------------------------------------------------------- Special Notes and Comments SFD - LOT 4 PLAN 2BR, 1331 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 8.42 Page 3 Application Number 04-00008195 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 8.49 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary ----------------- Charged. Paid Credited Due Permit Fee Total ---------- 764.57 -------------------- .00 ---------- .00 764.57 Plan Check Total 98.66 .00 .00 98.66 Other Fee Total 2421.91 .00 .00 2421.91 Grand Total 3285.14 .00 .00 3285.14