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04-8221 (SFD)e� �F�Q�rw BUILDING & SAFETY DEPARTMENT (760),777-7012 CAMPICO FAX (760) 777-7011 LIF©RNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Ap 1 ���Bc 0C 41000082-2=1 Date 2/17/05 Pr e cess;".-`. 47815—SOFT`MOONLIGHT APN: 649-030-069-15 -31311 - Application description . . . DWELLING•= SINGLE FAMILY DETACHED Property Zoning_. . . ... . . HIGH DENSITY RESIDENTIAL Application valuation . . . . 85421 Owner Contractor 1-----------------L-�-� 'e r'I:+r - i- S.�`. �n ate• iY°•fir------------------ -- SANTA ROSA DEVELOPMENT INC CONSOLIDATED CONTRACTING, INC. 46753 ADAMS ST 46753 ADAMS STREET LA QUINTA. CA 92253 LA QUINTA CA 92253 (760) 771-3345 (760),324-5488 WCC: STATE FUND WC: 1770749-2005 01/01/06 CSLB: 824183 09/30/05 CCC:. -B-C8 ------ Structure Information PLAN 3 ----- Construction Type . . . . . TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/CONG <=10 Flood Zone ... . . . . NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 # BEDROOMS 3.00 FIRE SPRINKLERS NO GARAGE SQ FTG 422.00 PATIO -.SQ, FTG 42 . 00 NUMBER `OF UNITS i. 00 1ST FLOOR SQUARE FOOTAGE 1339.00 Permit . . . . . . BUILDING PERMIT,1 -� Additional desc Permit Fee . . . - 518.00 Plan Check Fee 84.18 Issue Date c Valuation 72.708 Qty Unit Charge Per Extension BASE FEE 414.50 23.00 4.5000 THOU BLDG 50,001-100,000 103.50 ---------------------------------------------------------------------------- Permit . . . . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee . . . . 70.31 Plan Check Fee 4.40 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE.FEE - 15.00 1339.00 .0350 NEW RES - 1' OR 2 FAMILY 4 . 46.87 422.00 .0200 ±�ELEC' ELEC GARAGE OR NON-RESIDENTIAL`` '�J' ` 8.44 ----------=-------------------- i, -----------=--------------------- ------ - - - - -- I�I� � P.O. BOX 1504 • lh��/ 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: -�,�/ Date: 30D S• Applicant: Applicant's Mailing Address: Architect or Engineer: ".�vL�tAly Architect or Engineer's Address: Lic. No.: - C- &I :u 21 BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed ugr provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is jIl full force and effect. b License Class JU License No. #94103 3-:60-05 Contractof I Ur, 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 ($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.). (--) 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 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. 7� 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 _ssu . AyLworkers' compensation insurance carver an� p_olyQu1bef Carrier ' j'tq Tom' •F'VA� Policy Numbef '] —] V (� _ 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 provi S. ate �, 30 -QS A,.plicant/ WARNING: FAILURE TO SECURE WORKERS' C MPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND OLLARS ($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 construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name _A / • Lender's Address IV n 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 construction, and hereby authorize representatives of this county to ter upon the bove-mentioned property for inspection purposes. on nate 1-10 -05 Signature (Applicant or Agent): s Page 2 Application Number . . . . . 04-00008221 Date 2/17/05 ` Permit GRADING PERMIT Additional desc Permit Fee. 15.00 Plan Check Fee .00 Issue Date Valuation _-. 0 - Qty Unit Charge Per Extension J'. BASE FEE 15.00 Permit . . . MECHANICAL Additional desc Permit Fee . . . . 46.00 Plan Check Fee 2.88 Issue Date Valuation 0 - Qty Unit Charge Per Extension BASE FEE 15.00 .1.00 .9.0000 EA MECH FURNACE <=100K 9.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 1.00 6.5000 EA" MECH VENT FAN 6.50 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 Permit PLUMBING Additional desc Permit Fee . . . . 115.50 Plan Check Fee 7.22 Issue Date . . . . Valuation . . . . 0 .Qty Unit Charge Per Extension BASE FEE 15.00` 8.00 6.0000 -EA PLB FIXTURE 48.00 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. 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3..00 1:00 15.0000 EA PLB GAS METER' 15,.00 ---------------------------------------------------------------=------------ Special Notes and Comments SFD - LOT 15 PLAN 3CR, 1339 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 Y --------------------------------------------= Other Fees ---------------------- ART IN PUBLIC PLACES -RES --------- .00 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER -'RES 366.00 ENERGY REVIEW FEE 8.42 Page 3 Application Number. . . . 04-00008221 Date 2/17/05 ------------------------------------------ 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 8.54 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 .Fee summary Charged Paid Credited# Due Permit Fee -Total 764.81 .00 .00 764.81 Plan Check Total 98.68 .00 ..00 98.68 Other Fee Total 2421.96- .00 .00 2421.96 Grand Total 3285.45 .00 .00 3285.45 Certificate of Occupancy T44f °t 4Qumtw 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: 47-815 SOFT MOONLIGHT LOT #15 Use classification: SINGLE FAMILY DETACHED Building Permit No.: 04-8221 Occupancy Group: R-3 Type of Construction: V -N Owner of Building: SANTA ROSA DEVELOPMENT INC Building Official POST IN A CO S PLACE Land Use Zone: RH Address: 46-753 ADAMS ST City, ST, ZIP: LA_QUINTA, CA 92253 By: KIRK KIRKLAND Date: 05-19-2006