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04-8204 (SFD)Application Number. . . Property Address,,,-. APN : . Application description Property Zoning . Application valuation Owner 2253 ING PERMIT BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 04-_00008204] Date 2/17/05 . . . 79280 COOL REFLECTION 649-030-069-113 -31311 - . . . DWELLING - SING.LE FAMILY DETACHED . . . HIGH DENSITY RESIDENTIAL . . . 84922 ----------------} — — — — -— t'{ SANTA ROSA DEVELOPMENT INC 46753 ADAMS ST LA QUINTA CA 92253 (760) 771-3345 Contractor 0-------,----------------, 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 1 ----- 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 s `SIS i 1.00 1ST FLOOR SQUARE FOOTAGE 1331.00 ---------------------------------------------------------------------------- Permit . . ... . BUILDING PERMIT Additional des' 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 Tdf ��V 78-495 CALLE TAMPICO 444 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Application Number: (244— 6F.2o T Date: �O O$ - Applicant: Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: TD Lic. No.: C, -612,11S BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provision of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals gode, and my License is in full force and effect. ✓License Class •t2 License Not_epl`&.1 R7 /Date Ob -'U-ID b Contractor/ G01,ls6LbCL'ri �Dl i �ZA�4'lllpC LUCK 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 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. 1 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 carr and icy number are: Carrier t:f9LIn _Policy NumN Vr -" q01 &q—1�sr�0/r _ I cerlify that, in the rerformance of the work for which this permit is issued, I shall ll 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 ' 'ons. Date 3�3u—D� A,,plican WARNING: FAILURE TO SECURE WORK 'COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOU 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 commerced 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 en er upon the above-mentioned property for inspection purposes. D to 30-0 Signature (Applicant or Agent). Page 2 Application Number . . . ... 04-00008204 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 ---------------------------------------------------------------------------- Special Notes and Comments SFD - LOT 113 PLAN 2A, 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 . . . . . 04-00008204 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 18.49 DIF STREET MAINT FAC -RES 15.00. DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Permit Fee Total 764.57 .Plan Check Total 98.66 Other Fee Total 2421.91 Grand Total 3285.14 Paid Credited Due ---------- ---------- ---------- .00 .00 764.57 .00 .00 98.66 .00 .00 2421.91 .00 .00 3285.14 LWT �•� Certificate of OccupanCY ', Y/ Irrc MWanTsn G OFT9� Building & Safety Department This Certificate is issued pursuant to the requirements of Section 109 of the California Building P.j `3 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.t 2 S. BUILDING ADDRESS: 79-280 COOL REFLECTION LOW 113 i a1z cx `r Use classification: SINGLE FAMILY DETACHED Building Permit No.: 04-8204 Occupancy Group: R-3 Type of Construction: V -N Land Use Zone: RH y Owner of Building: SANTA ROSA DEVELOPMENT INC Address: 46-753 ADAMS ST= City, ST, ZIP: LA QUINTA, CA 92253 By: STEVE TRAXEL ` Date: MARCH 11, 2008 Building Official POST IN A CONSPICUOUS PLACE