05-0511 (SFD)ot�Q�rw
AMPICO
_IFORNIA 92253
BUILDING PERMIT
Application description
Property Zoning
Application valuation .
BUILDING & SAFETY DEPARTMENT
(760).777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
05-000-0.051..1_ Date 2/09/05
_79160 SHADOW TR
649-030-069-33 -31310 -
DWELLING - SINGLE FAMILY DETACHED'
HIGH DENSITY RESIDENTIAL
171930
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 Informa-tion
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
NO
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 desc
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
4 27.00
6.00 6.5000
EA MECH VENT FAN
39.00.
1.00 6.5000
EA MECH OTHER VENT SYSTEM
6.50
.01
P.O. BOX 1504 • VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 05 ' 1 i Date: 3 • / S • e S'
Applicant: ArchiteFt or Engineer:
Wl,t�.l.�e 1 (. �k �� P.r
Applicant's Mailing Address:
42
or Engineer's Address:
No.: �� `i r5- a 1
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed wider provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
Cgde, and License i full force and effect. I'� I 7
Crcense Class
'cense o. lin
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt frctm 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 provisicns 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 basss 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 hundrec 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 prcperty 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 ree son
Date
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.
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
is�'e,d,.ft. worke ompensation i ance carrier 4plicy rfn are:
mer � V`'�f �olicv Nunber La.1 �� lr,
_ I certify that, in the performance of the work for which this permit 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.
,--D'ate_� / /5 JOS /nf b --- ( 1Y l\
WARNING: FAILURE TO SECURE WORKEW 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 Ilk
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 perml 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 enter upon t ve-mentioned property for inspection purposes.
ate J /ure (Applicant or Agent)
4
Page
2
Application Number .
Page
2
Application Number .
. . . . 05-00000511 Date
2/09/05
---------=------------------------------------------------------------------
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 .0200
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
---------------------------------------------------------------
Special Notes and Comments
------------
SFD -LOT 33, PLAN 1BR/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
1 -
Page
3
Application Number
. . . . .
05-00000511 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
17.19
DIF STREET MAINT.FAC-RESP
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
3960.-58
.00 :00
3960.58
fl
colCertificate of OccupanCY
o
=
C O 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: 79-160 SHADOW TRAIL, LOT 33
Use classification: SINGLE FAMILY DWELLING Building Permit No.: 05-0511
ss
Occupancy Group: R-3 Type of Construction: V -N Land Use Zone: RH
k
Owner of Building: SANTA ROSA DEVELOPMENT INC Address: 46-753 ADAMS ST
City, ST, ZIP: LA QUINTA, CA 92253
By: KIRK KIRKLAND
_
Date: FEBRUARY 12, 2007
Building Official
POST IN A CONSPICUOUS PLACE