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04-5406 (SFD)P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 9.2253 BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760).777-.7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153' Application Number . . . . 04.-00,00540'6.,'-_ Date' 7/13/04 Property Address. . . . . 81140 SHINNECOCK HILLS _ APN: 762-340-006- 62-340-006-Application description . . . DWELLING - SINGLE FAMILY Application-description DETACHED Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL Application valuation 316193, Owner Contractor SOUTHERN HILLS DEVELOPMENT SOUTHERN HILLS DEVELOPMENT INC 55161 SOUTHERN HILLS 81070 CHANTICLEER DR LA QUINTA CA 92253 LA QUINTA CA 92253 (760) 771-3497 WCC: EXEMPT WC: EXEMPT 05/31/05 CSLB: 838041 05/31/06 CCC: B' -------------------------- Structure Information ------------------------- Construction Type . . . . . TYPE V - NON RATED Occupancy Type . . . . . .. DWELLG/LODGING/LONG <=10 Flood Zone. . . . . . . . .. NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 CBC FIRE SPRINKLERS NO GARAGE SQ FTG 970.00 PATIO SQ FTG 996.00 NUMBER OF UNITS 1.00 .FIRST FLOOR SQ FTG 3512.00 --------=------------------------------------------------------------------- Permit . . . . . . .BUILDING PERMIT Additional desc Permit Fee . . . . 1399.00 Plan CYieck Fee 227.34 Issue Date Valuation . . . . 316193 Qty Unit Charge Per Extension BASE'FEE 639.50 217.00 3.5000 THOU BLDG 100,001-500,000 759.50 -------------------_--------------------------------------------------------- Permit . . . . . . MECHANICAL Additional desc Permit Fee . . . . 132.50 D an �K Chec ee. 8.28 Issue Date Valuatio 0 Qty ' Unit Charge Per JUL 15 2004 BASE FEE CITYOFLA Extension 15.00 P.O. Box 1504 • VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 4INSPECTIONS (760) 777-7153 ,/ BUILDING & SAFETY DEPARTMENT Application Number: o7- 5y0Date: —15 -0�% Applicant: Applicant's Mailing Address: chitect or Engineer: Architect or Engineer's Address: ic. No.: BUILDING PERMIT DECLARATIO 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 Cade, and my Licensgis in full force and effect. icense Class /License No.FL Date 2—/5 —Q Tactor OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of pedu 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 ($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 ^ " 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 issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number 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. /3 WARNING: FAILURE TO SECUREX'ORKERS' 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 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, indemnity 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 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. 1 certify that I have read this application and state that the above information is correct. 1 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 the above-mentioned roperty for inspection purposes. ate2- A Signature (Applicant or Agent) 1 0 Page 2 Application Number 04-00005406 Date 7/13/04 Qty, Unit Charge Per Extension 4.00 9.0000 EA MECH FURNACE <=100K 36.00 4.00 9.0000 EA MECH B/C <=3HP/100K BTU 36•.00 6.00 6.5000 EA MECH VENT FAN 39.00 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 ------------------- Permit . . ------- . . . ----------- ELEC-NEW RESIDENTIAL ---------------:-------------- ----------- Additional desc Permit Fee . . . . 157.84 Plan Check Fee 9.87 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 3512.00 .0350 ELEC NEW.RES - 1 OR 2 FAMILY 122.92 996.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 19.92 ------------------------------- Permit . . . . . . PLUMBING ---------------------------- ----------------- Additional desc Permit Fee 191.25 Plan Check Fee 11.77 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 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 9.00 .7500 EA PLB GAS PIPE >=5 6.75 1.00 15.0000 EA PLB GAS METER 15.00 ---------------------------------------------------------------------------- Permit . . . . . GRADING PERMIT Additional desc Permit Fe.e 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 14,.PLAN 6 3512 SF. PERMIT Page 3 Application Number . . . . . 04-00005406 Date' 7/13/04 ---------------------------------------- Special Notes and Comments ------------------------------------ DOES NOT INCLUDE BLOCK WALLS, POOL, SPA OR DRIVEWAY APPROACH. 75% REDUCTION TO PLAN CHECK FEE DUE TO MULTIPLE ISSUANCE OF SAME PLAN TYPE ---------------------------------------------------------------------------- Other Fees . . . . . . . . ART IN PUBLIC PLACES -RES, 290.48 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 22.73 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 31.61 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary ----------------- Charged' Paid Credited Due Permit Fee Total ---------- 1895.59 ------------------------------ .00 .00 1895.59 Plan Check Total 257.26 .00 .00 257.26 Other Fee To 2749.82 .00 .00 2749.82 Grand Total 4902.67 .00 .00 4902.67 Nov 29 04 03:07p RF STRUCTURRLkSANTRMRRIR 760 836 0856 p.1 R F STRUCTURAL CONSULTANTS, INC. 75-153 MERLE DRIVE, STE_ B, PALM DESERT, CA 92211 PHONE (760) 836-1000 FAX (760) 836 -OM E- MAIL RAYMOND@RFSTRUCTURAL.COM NOVEMBER 29, 2004 SOUTHERN HILLS DEVELOPMENT 81-070 CHANTICLEER DRIVE LA QUINTA, CA_ 92253 Attn.: MR. JIM1 EVANDELL Re.: THE SUMMIT AT PGA WEST. LOT # 147 PLAN # 6 8 LL4O SHINIVECOCK--H[L;LS- - LA QUTNTA, CA. 92253 FOLLOW-UP TO WALK THROUGH JOB NO.: 4149 DEAR JIM u THIS LETTER ADVISES THAT WE HAVE OBSERVED THE STRUCTURAL REQUIREMENTS THAT ARE VISIBLE DURING CONSTRUCTION AT THE TIME OF OUR SITE VISIT. WE BELIEVE THAT THE AS -BUILT CONSTRUCTION AT THE TIME OF OUR VISIT IS IN GENERAL CONFORMANCE WITH OUR STRUCTURAL PLANS AND RELEVANT CORRESPONDENCE ISSUED BY'OUR OFFICE. WE OBSERVED THE BUILDING IN ITS FRAMED CONDITION PRIOR TO INSTALLATION OF DRYWALL AND STUCCO. WE OBSERVED THE VISUAL AND ACCESSIBLE STRUCTURAL, REQUIREMENTS, ( EXCLUSIONS ARE ITEMS SUCH AS: FOOTING SIZE AND REINFORCEMENT, TOP PLATE SPLICES, ROOF SHEATHING, AND ANY STRAPS ABOVE THE ROOF SHEATHING.). - RESPECTFULLY /pFESsrO��:� . ��o�P� M. FgPry�n2 No. 57959 EXP. 06-30-0 6 sT c IV1����Q' qTF OF CALF%� ZEYAD FAQIH, PE CITY OF LA QUINTA SUB -CONTRACTOR LIAT C JOB ADDRESS PERMIT NUMBER OWNER,Ai4?_k-:L C �-ru v , BUILDER JUV—� 1� r✓lt� �� �� I P This form shall be costed on the iob with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work nn this iob. Anv chances to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance