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05-1258 (SFD)T_ VY 4 4 Qat & BOX 1504 95 CALLE TAMPICO )UINTA,'CALIFORNIA 92253 BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153' kation Number . . . . X0-5'='0=0-0=0-12:5.8 �` --Date 4/06/05 Property Address' 79075 SHADOW TR APN: 649-030-069-16 -31310 - Application description DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . . . . HIGH DENSITY RESIDENTIAL Application valuation . . . . 171930 Owner Contractor ------------------------ SANTA ROSA DEVELOPMENT ------------------ -------- INC MAFFEI, DAVID LETTERIELLO 46753 ADAMS ST 1451 QUAIL STREET, #212 LLA 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 1 W/CASITA (MARKET"RATE HOUSING) ----- Construction Type . . TYPE V - NON RATED Occupancy Type . . ... . . DWELLG/LODGING/CONG <=10 Other"struct info . . . . . CODE EDITION 2001 #.BEDROOMS 5.00 ~ FIRE SPRINKLERS ANO ` GARAGE SQ FTG 676.00 PATIO SQ FTG 293.00 NUMBER OF UNITS + 1.00 1ST FLOOR SQUARE FOOTAGE 2706.00 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc ` Permit Fee . . . . 891.50 Plan Check Fee 144.87 Issue Date . . . . Valuation 171930 Qty Unit Charge Per Extension BASE FEE 639.50 72.00 3.5000 THOU BLDG 100,001-500,000 252.00 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL��.� Additional d.esc Permit Fee . . . . 114.50 Plan Check Fee 7.16 Issue Date Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 9.0000 EA MECH FURNACE <=100K 27.00 3.00 9.0000 EA MECH B/C.<=3HP/100K BTU , 27.00 6.00 6.5000 EA MECH VENT FAN 39:00 1.00 6.5000 EA MECH OTHER VENT SYSTEM 6.50 T4 at 4 P.O. BOX 1504 , 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: 0 5 - u58 Applicant: Arc Applicant's Mailing Address: ch ic. VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: � • (Y • c�J Arch t=rner: itect or Engineer's ddress: t3UIL.UINU PERMIT DECLARATIONS t2l 2.1 2 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 Cod , and my License is i full force and effect. 3 S c� cense Class nse No._ ate ontractor x4i`� 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 (5500).): 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. . B.& P.C. for this reason Date Owner WORKERS' COMPENSATION: DECLARA T ivN 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. F% 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 ,/ su d. My w r ' c pensation incnce carrier an Fps n mb r/ar /� arrier%'/ -Policy Number//) �(� '?j� 0i�j certify that, in the performance of the work for which this itis iss ed, I s all not emp 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 ft ly/ 0 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES 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. 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 1� 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 applicat:on 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 cons tructio and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. ate Signature (Applicant or Agent): I Page 2 Application Number . . . . . 05-00001258 Date 4/06/05 ----------------------------------------=------------ Permit ----------------------- ELEC-NEW RESIDENTIAL Additional desc Permit Fee . . . . 123.23 Plan Check Fee 7.70 Issue Date . . . . Valuation . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 2706.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 94.71 676.00 .0.200 ELEC GARAGE OR NON-RESIDENTIAL 13,52 ---------------------------------------------- Permit . . . . ---------------------------- PLUMBING Additional desc Permit Fee 207.00 Plan Check,Fee 12.94 Issue Date . . . . Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 20.00 6:0000 EA PLB FIXTURE 120.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 ' 2.00 6.0000 -EA PLB ROOF DRAIN 12.00 2.00 7.5000 EA PLB WATER HEATER/VENT 15.00 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 ---------------------------------7------------------------------------------ Special Notes and Comments SFD -LOT 16, PLAN lA/CASITA, 2706 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 14.49 Page 3 Application Number 05-00001258 Date 4/06/0.5 ---------------------------------------------------------------------------- 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 17.19 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary ----------------- Charged ---------- Paid Credited Due Permit Fee Total 1351.23 ---------- ---------- ----- .00 .00 - ---- 1351.23 .Plan Check Total 172.67 .00 .00 172.67 Other Fee Total 2436.68 .00 •.00 2436.68 Grand Total J 3960.58 .00 .00 3960.58