04-8362 (SFD)T4hf 4,4 aub4
BUILDING & SAFE_ TY DEPARTMENT
P.O. Box 1504 , . 3
78-495 CALLS TAMPICO (760).777-7012 ^ �'� ~ ,4
FAX (760) 777-7011
LA QUINTA; CALIFORNiA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
%l�pplication Number . . ...04-0
00 08362 Date 4/06/05
Property Address
79055 SHADOW TR
APN:
649-030-069-18 -31310 -
Application description .
. . DWELLING"•-, SINGLE FAMILY
DETACHED
Property Zoning . . . . .
. HIGH DENSITY RESIDENTIAL
Application valuation . .
. . 168635
Owner
Contractor .
SANTA ROSA DEVELOPMENT INC
MAFFEI, DAVID LETTERIELLO
46753 ADAMS ST
1451 QUAIL -STREET,
#212
LA QUINTA CA,92253
NEWPORT BEACH
CA 92660
(760) 771-3345
(949) 863-9642
WCC: STATE FUND -
WC: 1620469-2005
01/01/06
'CSLB: 375176
11/30/06
CCC: B
------ Structure Information
PLAN 2 MARKET RATEHOUSING'
-----
Construction Type . . . .
. TYPE V - NON RATED
Occupancy Type . . . . .
. DWELLG/LODGING/LONG <=10
Other struct info
CODE EDITION
2001
# BEDROOMS
4.00
FIRE SPRINKLERS
NO
GARAGE SQ FTG
679.00
PATIO SQ FTG
286.00
NUMBER.OF UNITS ..
1.00•
----------------------------------------------------------------------------
1ST FLOOR SQUARE FOOTAGE
'2649.00
Permit . . . . . . BUILDING
PERMIT
Additional desc
Permit Fee . . . . 881.00
'Plan Check Fee
572.65
Issue Date . . . .
Valuation
168635
Qty Unit Charge Per
Extension
BASE FEE
639.50
69.00 3.5000 THOU
BLDG 100,001-500,000
241.50
-------------------------------------,�--M�------------------
PermitMECHANICAL
Additional desc
Permit Fee !
90.00 Plan Check Fee
22.50
Issue Date c
Valuation . . .
. .0
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
P.O. BOC 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
Application Number: O14 - (ooZ
Applicant:
Applicant's Mailing Address:
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: -7 / O�
Archit, t r E
— 11n�r: fyaw
—Architect or Engineer's Address:
. No.: _ �i12r1
BUILUING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penally 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 License is,i II force and effect. ns
cense�Class
f la ss s icense No. ( �/
,,---Date( ntractor
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, demotish, 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 huncred 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-bui'der 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. . B.& P.C. for this reason
Date Owner.
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the follow�ng 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
t have and will m intain workers' compensati n insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
u d. M orkers' ompensatio ranee carrier ali u
Carrier Policy Number ot .�
certify that, in the pert rmance of the work for which thi perms is iss e , I hall 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 provisions.
ate Y I P5 A plicant AW
WARNIN : FA URE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FI S U 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.
CONSTRUCTION LENDING AGENCY
hereby affirm under penalty of perjury that there is a co•istruction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name Q
Lender's Address r C
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
const ion, and hereby authorize representatives of this county to/enter
upon the above-mentioned property for inspection purposes.
ate I �ignature (Applicant or Agent):
i
f
,
Page
2'
Application Number .
. . . . 04-00008362 Date
,4/06/05
-------------------------------------------------------
Permit . . . I . . .
---------------------
ELEC-NEW RESIDENTIAL
Additional desc
Permit Fee
121.30 Plan•Check Fee
30.33
.,Issue Date.
Valuation . . . .
0
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2649.00 .0350
ELEC NEW RES - 1 OR -2 FAMILY
92.72
679.00 .0200
ELEC GARAGE OR NON-RESIDENTIAL.
13.58
----------------------------------------------------------------------------
Permit . . . .'
PLUMBING
Additional desc..
Permit'Fee
181.50 Plan Check Fee
45.38
Issue Date
Valuation . . . .
0
-Qty Unit Charge
Per
Extension•
BASE FEE
15.00
17.00 6.0000
EA PLB FIXTURE
102.00
1.00 15.0000
EA PLB BUILDING SEWER
15:00
2:00 6.0000
EA PLB ROOF DRAIN
12.00
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
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
Special,Notes and Comments
SFD - LOT 18, Plan 2AXR, 2649 SF. PERMIT
DOES NOT INCLUDE POOL,
SPA, BLOCK WALLS
OR DRIVEWAY APPROACH.
2001 CBC.
----------------------------------------------------------------------------
Other Fees . . .
. . . . ART IN PUBLIC PLACES -RES
.00
`DIF COMMUNITY CENTERS -RES
'97.00
D'IF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
57:27
DIF FIRE PROTECTION -RES
97.00
GRADING PLAN CHECK FEE
.00
P
Page
3
Application Number
. . . . .
04-00008362
Date
4/06/05
----------------------------------------------------------------------------
Other Fees . .
. . . . .
DIF LIBRARIES - RES
225.00
DIF PARK MAINT FAC
- RES
5.00
DIF PARKS/REC - RES
502.00
STRONG MOTION (SMI)
- RES
16.86
DIF STREET MAINT FAC
-RES
15.00
DIF TRANSPORTATION
-'RES
1098.00
Fee summary
Charged
Paid Credited.
Due
---------=-------
Permit Fee Total
----------
1288.80
--------------------
.00
----------
.00
1288.80
Plan Check Total
670.86
.00
.00
670.86
Other.Fee Total
2479.13
.00
.00
2479.13
Grand Total
4438.79
.00
.00
4438.79
P
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to .of Occupanco y
'Certificate
7iX
o
OF. Building & Safety Department
}
_ This Certificate is issued pursuant to the requirements of Section 109 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- 055 SHADOW TRAIL
ti
Use classification: SFD Building Permit No.: 04-8362
Occupancy Group: R-3 Type of•Construction: VN Land Use Zone:' RL
• , ♦
3
Owner -of Building: 48T" & ADAMS, LLC. Address: 79-055 SHADOW TRAIL
- City, ST, ZIP: LA QUINTA CA 92253
By: KIRK KIRKLAND
September 25, 2008
A:tDate:
{
r Building Official
Al
POST IN A CONSPICUOUS PLACE
3