04-5543 (SFD)T44f 4 4 Q"
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 -04-000055`4:3=- Date 7/16/04
Property.Address . . . . -47820 STILLWATER DR
APN: 658-140-999-59 -29436 -
Application description . . . DWELLING - SINGLE FAMILY DETACHED
Property Zoning . . . .. . . . LOW'DENSITY RESIDENTIAL
Application valuation . . . 179876
Owner
IVANHOE LA QUINTA COVE
C/O R BARRY MCCOMIC
7979 IVANHOE AVE STE 550
LA JOLLA CA 92037
Construction Type .
Occupancy Type
Flood Zone
Other struct info
r
Dr,
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 --------------------------
. . . TYPE V - NON RATED
. . . DWELLG/LODGING/LONG <=10
NON -AO FLOOD ZONE
.---.,..--.--CODE EDITION 2001
CBC
FIRE SPRINKLERS NO
._- _
-GARAGE SQ FTG
685.00
PAT�I0 SQ FTG 546.00
n gd
NUMBER OF UNITS 1.00
_ �FIdRST FLOOR SQ FTG 2783.00
------------- - - - - -- 1 --------------------------------------
Permit BUILHNG`PERMIT
Additional desc
Permit Fee 919.50 Plan Check Fee 149.42
Issue Date Valuation . . . . 179876
Qty Unit Charge Per I Extension
BASE FEE 639.50
80.00 3.5000 THOU BLDG 100,001-500,000 280.00
----------------------------------------------------------------------------
Permit MECHANICAL
Additional desc
Permit Fee . . . . 64.00 Plan Check Fee 4.00
Issue Date . . . . Valuation . . . . 0
Qty Unit Charge Per
Extension
' r
i
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: 0 y- Sj� Date:
Applicant: —Architert or ineer:
Applicant's Mailing Address: Architect or Engineer's Address:
ic. No.: DG Y-37
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
caCe, and my License In full force and effect. /
nse Class '3 --rGeense No. �U d
/gate
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 sate. 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 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.).
(� I 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 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
—My rkers' compensat urance ca,Ter�rld,P9lp�urnkgr are:
l CarrierCJj�i� Policy Number _ C(oo ii [[ ss
_ 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' COM44ATION 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
1 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
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 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 r�epresentatives of this county to enter upon the above-mentioned property for inspection purposes.
ate /O -fir o� igniS ature (Applicant or Agent)
Page
2
Application Number
. .
. . 04-00005543,
Date
7/16/04
Qty Unit
-;Charge
Per
Extension
BASE
FEE
15.00
2.00
9.0000
EA
MECH
FURNACE <=100K
18.00 .
2.00
9.0000
EA
MECH
B/C <=3HP/100K BTU
18.00
1.00
6.5000
EA
MECH
VENT FAN
6.50
1.00
6.5000
EA
MECH
EXHAUST HOOD
6.50
7 ---------------------------------------------------------------------
Permit
ELEC-NEW RESIDENTIAL
Additional desc
Permit Fee
126.11
Plan Check Fee-.
7.88
Issue Date
Valuation,
0
Qty Unit
Charge
Per
Extension
BASE
FEE
15.00
2783.00
.0350
ELEC
NEW RES - 1 OR 2 FAMILY
97.41.
685.00
.0200
ELEC
GARAGE OR NON-RESIDENTIAL
13.70
----------------------------------------------------------------------------
Permit . . .
. . .
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
91.00
8.00
.7500
EA
PLB
GAS PIPE >=5
6'. &0
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 59,
PLAN 23-2783
SF. PERMIT
• f
r
Page 3
Application Number
04-00005543 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
14.94
DIF FIRE PROTECTION -RES
97.00
GRADING PLAN CHECK FEE
.00
DI.F LIBRARIES - RES
225.00
DIF PARK MAINT FAC - RES
5.00
DIF PARKS/REC - RES
502.00
STRONG . MOT.ION (SMI) - RES
17.98
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
Charged
Paid Credited
Due
Permit Fee Total
1303.11
.00 .00
1303.11
Plan Check Total
172.46
.00 .00
172.46
Other Fee Total
2437.92
.00 .00
2437.92
Grand Total
3913.49
.0.0 .00
3913.49