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05-0506 (SFD)Y4. BUILDING & SAFETY DEPARTMENT P.,O. BOX 1504 (760).777-7012 OF 95 CALLE TAMPICO FAX (760) 777-7611 1 INTA, CALIFORNIA 92253 INSPECTION REQUESTS (76-0) 777-7153 BUILDING PERMIT 'Los p 19a, t er . . . . . 010Lr 0'0" 00506 Date2/09./05 ope M,ess .79140 7140S�&DoWTR.' P, 649-030-069-31 -31310 - ppl.0 tion.description . . . DWELLING—' SINGLE FAMILY DETACHED P perty Zoning HIGH DENSITY RESIDENTIAL Application valuation 190828 Owner -Contracto . r --------------------- ------------------------ SANTA ROSA DEVELOPMENT INC MAFFEI, DAVID LETTERIELLO 46753 ADAMS ST 1451 QUAIL STREET, #212 LA QUINTA CA 92253 NEWPORT BEACH CA -192660 (760) 771-33.45 A945) 8,63-9642 WCC: STATE FUND WC: 1620469-2005 01/01/06 CSLB: 375176 11/30/06 CCC: B Structure Information PLAN 2 W/CASITA MARKET RATE HOUSING - ----- Construction Type . . . . . TYPE V - NON RATED Occupancy Type DWELLG/LODGING/CONG <=10 Other struct info . . . . . CODE EDITION .2001 # BEDROOM'S 5.00 FIRE SPRINKLERS NO GARAGE SQ FTG 679.00 PATIO SQ FTG 286."00 NUMBER OF UNITS 1.00 1ST,PLOOR SQUAREFOOTAGE3037.00 ------------------------------------- Permit ---------------------------------------- BUILD1NG-PERMIT Additional-desc Permit Fee 958.00 Plan lan Check Fee 155.68 Issue Date Valuation, 190828 Qty Unit Charge Per Extension BASE FEE 639.5*0 91.00 3.5000 THOU BLDG 100,001-500,000 318.50 --------------- --------------------------------- Permit . . . . . ------------------------------ . . MECHANICAL Additional desc Permit Fee 114.50 Plan Check Fee-. 7-.16' Issue Date,. Valuation. . . . .0 Qty Uni-t 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/1-OOK BTU 27.,00 6.00 6.5000 EA MECH,VENT FAN 39.00 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 A P.O. Box 1504 • VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 4INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Date: 3 ' IS*05- Applicant: I Architgct Or Engineer: t` , Applicant's Mailing Address: itect or Engineer's Address: Lic. No.: _ - C J ( p�.�� �5 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 .Ode, and License n full force and effect. / ense Classss � ,cen a No. ate nth Tactor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am xempt 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 Section7031.5 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 Owne 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. ave and will maintain workers' compensati n insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is suSd.�My �rkers`sKnpensation ' rance Carrie and�ligyare: ^ � arrier — } V� w� olicv Number ( 8 _0 — I certify that, in the performance of the work for which hi�rmit 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, I shall forthwith comply with those provisions. J ,-Inrate licant WARNING: FAILURE TO SECURE WOR S' 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 A 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 employeesfor 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 county to enter upon t a ve-mentioned property for inspection purposes. ate t�% _ Sign/ ature (Applicant or Agent): Page 2 Application.Number.,. . . . 05-00000506 Date 2/09/05 ---------------------------------------------------------------------------- Permit ELEC-NEW RESIDENTIAL Additional desc Permit Fee . . . . 134.88 Plan Check Fee 8.43 Issue Date . . . . Valuation 0 Qty Unit Charge Per " Extension BASE FEE 15.00 3037.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 106.30 679.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL. 13.58 ---------------------------------------------------------------------------- Permit PLUMBING Additional desc Permit Fee . . . . 199.50 Plan Check Fee 12.47 Issue Date Valuation . . . . 0 Qty Unit Charge Per Extension BASE" FEE 15.0 0 20.00 6.0000 EA PLB FIXTURE 120.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 2.0.0 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 15.10000 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 31 PLAN 2B/CASITA, 3037 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 9.7.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 15.57 a Page 3 Application Number . . . . . 05-00000506 Date 2/09/05 ---------------------------------------------------------------------------- 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 19.08 DIF STREET MAINT FAC -RES 15.0.0 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Permit Fee Total 1421.88 Plan Check Total 183.74 Other Fee Total 2439.65 Grand Total 4045.27 Paid Credited .00 .00 .00 .00 .00 .00 .00 .00 104 Due 1421.88 183. 74 2439.65 4045.27 Certificate of Occupan'cy- Tjhf G� OF'I'1Building &. 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: 79-140 SHADOW TRAIL, LOT 30 Use classification: SINGLE FAMILY DWELLING Building Permit No.: 05-507 Occupancy Group: R-3 Type of Construction: V-N - Land Use Zone: RH Owner of Building: SANTA ROSA DEVELOPMENT INC Address: 46-753 ADAMS ST City, ST, ZIP: LA QUINTA, CA 92253 By: KIRK KIRKLAND Date: MARCH 30, 2007 Building Official POST IN A CONSPICUOUS PLACE