09-0744 (SFD)P.O. BOX 1504'
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 09-00000744 .�.�
Property Address: 52315 SILVER STAR TR
APN: 767-630-016- - -
Application description: DWELLING SINGLE FAMILY DETACHED
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 165860
Applicant- Architect or Engineer:
PJA
---------- - - - - --
---------------------------- - - - - --
ICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury t t I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busines and Professionals Code, and my License is in full force and effect.
Lic nse CI ss: License No.: 753190
Date! Z' Q'" ontractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury tha I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business a 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 ($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.).
(_ 1 1, 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 I am exempt under Sec. BAP.C. for this reason
Dater
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:
LQPERMIT
Owner:
DESERT CHEYENNE, INC.
78401 HIGHWAY 111, SUITE Gr
LA QUINTA, CA 92253
(760)777-9920
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Contractor:
HERINGTON DEVELOPMENT, JAMES O
40960 CALIFORNIA OAKS RD, 4283
MURRIETA, CA 92562
(951)677-8415
Lic. No.: 753190
0
--------------- - - -
WORKER'S COMPENSATION DECLARATION
Date: 7/10/09
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 wrkers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performa a of the work for which this permit is issued. My workers' compensation
insurance carrier and pol �y r tuber are:
Carrier STATE FUND i Policy Number 1542746-2008
_ I certify that, in the performa 'c f the work for which this permit is issued, I shall not employ any
person in any manner so a t become subject to the workers' compensation laws of California,
and agree that; if I should :ome subject to the workers' compensation provisions of Section
�X'P_li
0 of th Labor Code, I s II forthwith comply with those provisions.
to �6f yant:
WARNING: FAILURE lV SECURE WORKF 2S' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL -
SUBJECT AN EMPLOYER TO CRIMINAL ENALTIES 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
IMPORTANTApplication 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 his permit.
2. Any permit issued as a result of this appli ti n becomes null and void if work is not commenced
within 180 days from date of issuance o h permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that a bove information is correct. I agree to comply with all
city nd county ordinances and state laws relating to b d g construction, and hereby authorize representatives
o his co ty t enter upon the above-mentioned prope y for inspection purposes.
Dat t. Q /f ignature (Applicant or Agent(: 7
Application Number .
. . . .09-00000744
Structure Informat"ion
Construction Type
-TYPE V - NON RATED
Occupancy Type •. . .
. . . DWELLG/LODGING/CONG <=10
Flood ZoneNON-AO
FLOOD ZONE
Other struct info . .
.". CODE EDITION
2007 CBC
# BEDROOMS
4.00
FIRE SPRINKLERS
NO
GARAGE SQ FTG
658.00
"
PATIO"SQ FTG
319.00
NUMBER OF UNITS
1.00
1ST FLOOR -SQUARE FOOTAGE
2600.-00
Permit
BUILDING PERMIT
r
Additional desc .
Permit Fee . .
870.50 Plan Check Fee
141."46
Issue Date
Valuation
165860
Expiration Date
1/06/10
Qty Unit Charge
Per
Extension
BASE FEE
639.50
66.00 3.5000
THOU BLDG 100,001-500,000
231.00
Permit
MECHANICAL
Additional desc .
Permit Fee
90.00 Plan,Check Fee
5.'613 -
Issue Date . . . .
Valuation
0
Expiration Date
1/06/10
Qty Unit.Charge
Per
Extension
BASE FEE
15.00
2.00 9.0000
EA MECH FURNACE <=100K
18.00
2.00 9.•0000
EA MECH B/C <=3HP/100K BTU
.18.00.
5.00 6.5000
EA MECH VENT FAN
32..50
1.00 6.5000
-----------------------------------------------------------------------------
EA MECH EXHAUST HOOD
6.50
Permit ... .
ELEC-NEW RESIDENTIAL
Additional desc ..
Permit Fee . . .
119.16 Plan Check 'Fee
7.45.
" Issue Date
Valuation . . .
. 0
Expiration Date
1/06/10
Qty"Unit Charge
Per
Extension
BASE FEE
15.00
2600.00. .0350
ELEC NEW RES.- 1.OR 2 FAMILY
91.00
LQPERDIIT
• Application Number ...09-00000744
• ' Permit . . . . ELEC-NEW RESIDENTIAL
Qty Unit Charge: Per
Extension
6'58.00 .0200 ELEC GARAGE,OR NON-RESIDENTIAL
13.16
Permit . . . PLUMBING
Additional desc .
Permit Fee 166.50 Plan Check Fee
10.41
Issue Date Valuation
0
Expiration Date 1/06/10
.Qty Unit Charge, Per
Extension
._ .__.. ..... BASE FEE
15.00
16.00 6.0000 EA PLB FIXTURE
96.00
1.00 15.0000 EA PLB BUILDING SEWER
15.00-
'1.00. 75000 EA. PLB WATER HEATER/VENT
7:50'
1.00 3.0,000 EA PLB•WATER INST/ALT/REP
3.00. •�
1.00 9.0000 EA' PLB LAWN SPRINKLER SYSTEM
9.00
8.00 .7500 EA PLB GAS PIPE >=5
6.00
`•• 1.00 15.0000'EA PLB GAS METER'.
----------------------------------------------------------------------------
15.00
Perm -t • • . . . . GRADING PER.MTT
Additional desc .
Permit Fee 15.00 Plan Check Fee
00
Issue Date . .'. . Valuation . . . .
0
r Expiration Date . 1/06/10
Qty Unit Charge Per
Extension
BASE FEE
15.00
Special Notes and Comments
SFD - LOT 16, PLAN 28, 2600 SF.'PERMIT '
DOES NOT INCLUDE. POOL, SPA, BLOCK WALLS,
OR DRIVEWAY APPROACH. 2007 CODES. 75°s
REDUCTION TO PLAN CHECK FEES DUE TO
MULTIPLE ISSUANCE OF SAME PLAN TYPE
Other Fees . . . . . .. ART IN PUBLIC PLACES -RES
'.00
BLDG STDS ADMIN (SB1473)
7.00 +
t DIF COMMUNITY CENTERS -RES
-74.00,.' -
DIF CIVIC CENTER - RES
995.00
ENERGY REVIEW FEE
14.15
DIF FIRE PROTECTION -RES
140.00
GRADING PLAN CHECK FEE
.00
` DIF LIBRARIES - RES
355.,00
DIF PARK MAINT FAC - RES
22.00
• LQPERMIT - ..
Application Number
09-00000744
-----------------------
Other Fees
----------------
-----------.--------------------------
DIF PARKS/REC - RES.
892.00
STRONG MOTION (SMI) - RES.
16.58 'f
DIF STREET MAINT FAC -RES
67.00
DIF TRANSPORTATION - RES
1930.00"
Fee summary.
Charged
Paid Credited
Due .
" Permit Fee Total
1261.16
.00 .00
1261.16
Plan Check Total
164.95
.00 00
164.95
Other Fee Total
4512.73
.00 .00
4512.73
Grand Total
5938.84,
.00 .00
5938.84
1
LQPERIMIT