04-5537 (SFD)4
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 . . . .
Property Address . . . . .
APN:
Application description
Property Zoning . . . . ...
Applicatign valuation . . . .
Owner
-IVANHOE LA QUINTA COVE
C/O R BARRY MCCOMIC
7979 IVANHOE AVE STE 550
LA JOLLA CA 92037
04-_00005537_- Date , 7/16/04
47850 STILLWATER DR
658-140-999-58 -29436 -
DWELLING - SINGLE FAMILY DETACHED
LOW DENSITY RESIDENTIAL
154159
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
----------------
Permit
Additional
Permit Fee
Issue Date
FIRE SPRINKLERS NO
GARAGE SQ FTG 672.00
-PATIO SQ FTG 339•:-00
NUMBER OF UNITS
1.00
FIRST FLOOR SQ FTG 2386.00
---- ----=----'au-��- -
---------------------------------------
iN''''iIIUIi'f h(1.J
. . . �BUILDIN�G PERMIT t
Plan Check Fee 135.20
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
BASE FEE
Exts?nsion
15.00
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: 0z1- 5537
Date: /0 • 14-
Applicant:chitec
or
/A C
��ineer:
Applicant's Mailing Address:
Architect or Engineers Address:
No.: GO 8'1
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
Code, and my Licen§rjs in full force and effect.
/6ioginse Class r ,cense No. �Gt'�. 3"7
vsen
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from tie 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 ,he 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 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 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
o ers' compensatio " nce carrier ark po' y umber are:
lamer Policy Number L(O`7 /?I • ,
_ 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.
—ate Al – 0 y ,cant
WARNING: FAILURE TO SECURE WORKERS' CO ENSATION 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 isiued (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, 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.
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 enter upon the above-mentioned property for inspection purposes.
ate AUS -13 06%Signature (Applicant or Agent))ag_ /
'Page
2
Application
Number .
. . .
. 04-00005537 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 .
-----------
. . . . .
--------------------------------------
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
1.009.0000
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.
7 -------------------------------------------------------------------
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
581 PLAN 1AR 2386
SF. PERMIT
Page 3 .
Application Number
04-00005537 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
.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
3820.31