04-5536 (SFD)Tar -444"
BUILDING & SAFETY DEPARTMENT
P.O. Box 1504
(760).777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number . . . .. 04-00005536 _ Date 7/16/04
Property Address . . . ... 47785 STILLWATER DR
APN: 658-140-999-55 -29436 -
Application description . . . DWELLING - SINGLE FAMILY DETACHED
Property Zoning . . . . LOW DENSITY RESIDENTIAL
Application valuation 154159
Owner
IVANHOE LA QUINTA COVE
C/0 R BARRY MCCOMIC
7979 IVANHOE AVE STE 550
LA JOLLA CA 92037
Contractor
TRANS -WEST HOUSING, INC.
9968 HIBERT STREET, STE #102
SAN DIEGO CA 92131
(858) 653-3003
WCC: STATE FUND
WC: 1648813
10/01/04
CSLB: 701039
01/31/05
CCC: B
----------- - --------------
Structure Information -------------------------
Construction Type . .
. . TYPE V - NON RATED
Flood Zone . ... . .
. . . NON -AO FLOOD ZONE
Other struct info
CODE EDITION
2001 CBC
FI.RE SPRINKLERS
NO
dARAGE SQ FTG
672.00
PA,TI O SQ FTG
3 3 9.:. 0 0
NUMBER OF UNITS
1.00
RAST FLOOR SQ FTG
2386.00
-----Permit-- - - --
--_;_/.=---_'-_
V-
fru'-`BUILDING PE1RMIT-----------------------------------
Additional de ac�c``
Permit Fee
832.00 Plan Check Fee
135.20
Issue Date . .
Valuation
154159
Qty Unit Charge
.Per
Extension
BASE FEE
639.50
55.00 3.5000
THOU BLDG 100,001.-500,000
192.50
------------------------- --------------------------------------------------
Permit . . . . . . MECHANICAL
Additional desc
Permit Fee . . . .
90.00 Plan Check Fee
5.63
Issue Date . . . .
Valuation . .
. . 0
Qty Unit Charge
Per
Extension
BASE FEE
,15.00
P.O. BOX 1504 «
VOICE (760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: Date: /0 • / 4 U
Applicant: -Architect r En ineer:
iis',r�
Applicant's Mailing Address: Architect or Engineer's Address:
ic. No.: Q o 8.7" j
t3uILUINU 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
Com, and Licensl in full force and effect. — r 3
Xcense Classss F 1) icense No.—
,—Date
o._/Date JP— a " a%ntractor ak/
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 dcllars ($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 wdl have the burden of proving that he or she did not build or improve for the purpose of sale.).
U 1, 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 1 am exempt under Sec. , BA 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.
i _ 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
X.�d Myaytork�' compensation mance carrier J1d Ii mberare:
amer E (Z/licv Number t S
_ 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.
WARNING: FAILURE TO SECURE WORKERS' C6 PENSA—ION 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 construct on lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name
Lender's Address
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 nade, 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 omiss°on 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 1 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 the above-mentioned property for inspection purposes.
- i�gnature (Applicant or Agent`R D
Q
Page
.2
Application Number .
. .
04-00005536 Date,
7/16/04
Qty Unit
Charge•
Per
Extension
2.00
9.0000
EA
MECH FURNACE <=100K
18.00
2.00
9.0000
EA
MECH B/C <=3HP/100K BTU
18.00
5.00
6.5000
EA
MECH VENT FAN
32.50
1.00
6.5000
EA
MECH EXHAUST HOOD
6.50
-------------------------------------------------=----------
Permit . . .
------------
. . . ELEC-NEW RESIDENTIAL
----
Additional desc
Permit Fee _
111.95 Plan Check Fee
7.00
Issue Date .
. . .
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
2386.00
.0350
ELEC NEW RES - 1 OR 2 FAMILY
83.51
672.00
---=------------- =---------
.0200,
ELEC GARAGE OR NON-RESIDENTIAL
13.44
Permit . . .
7 ------------------------------------------------
. . . PLUMBING
Additional desc
.
Permit Fee
178:50 Plan Check Fee
11.16
` Issue Date
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
18.00
6.0000
EA
PLB FIXTURE
108.00
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
8.00
.7500
EA
PLB GAS PIPE >=5
6.00
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 55,
PLAN 1B
2386
SF. PERMIT
Page I3
Application Number
04-00005536 Date
7/16/04
----------------------------------------------------------------------------
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
.00
DIF COMMUNITY CENTERS -RES
97-.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
13.52
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
15.41
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
-----------------
Charged
----------
Paid, Credited
Due
Permit Fee Total
1227.45
---------- -------- 7- ----------
.00 .00
1227.45
Plan Check Total
158.99
.00 .00
158.99
Other Fee Total
2433.93
.00 .00
2433.93.
Grand Total
3820.37
.00 .00
3820.37