04-5530 (SFD)a n
t
P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number . .
Property Address . . .
APN:
Application description
Property Zoning . . . .
Application valuation .
Owner
BUILDING PERMIT
BUILDING & SAFETY DEPARTMENT
(760) .777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
04-=0-0-00-553.0 Date 7/16/04
. . . 47865 STILLWATER DR
658-140-999-57 -29436 -
DWELLING - SINGLE FAMILY DETACHED
. . . LOW DENSITY RESIDENTIAL
197485
IVANHOE LA QUINTA COVE
C/O 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
Occupancy Type . . . . . DWELLG/LODGING/LONG <=10
Flood Zone . . . . . NON -AO FLOOD ZONE
Other struct info . . . . CODE EDITION 2001 CBC
- FIR -_E SPRINKLERS NO
� GARAGE SQ FTG 672-00
SQ FTG 814.00
-
NUMBER OF UNITS 1.00
- - - - - - - - - FLOOR SQ FTG. 3033.00
----- - - - - -- - - -- --------------------------------------
Permit I�4BU,I,LDING�KPERMIT
YYL LV
Additional desc
Permit Fee 982.50 Plan Check Fee 159.66
Issue Date Valuation . . . . 197485
Qty Unit Charge Per Extension
BASE FEE 639.50
98.00 3.5000 THOU BLDG 100,001-500,000 343.00
-------------------------------------------=---------------------------------
Permit . . . . . . MECHANICAL
Additional desc
Permit Fee . . . . 64.00 Plan Check Fee 4.00
Issue Date . . . . Valuation . . . . 0
Qty. Unit Charge Per Extension
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: 04/ 536
Applicant:
Applicant's Mailing Address:
/11
Date: /0 V 4/. oy
or
Architect or Engineer's Address:
No.: 00837
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
C,pde, and my License i full force and effect.
icenseClass_ License No. ;70/0,S
/Bate /G _ 1 7 U1 fn Cont�ractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjurythat 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 opply 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.
At 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
�3� jsye�.d• e/ rk,:) compensation ins ce carrieJ%- 72ol�cyAuLn _7
er J (/�fL olicy Number /lam [ tT-d'
_ 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.
/77 —Pie-► "17
WARNING: FAILURE TO SECURE WORKERS' COWPENSATION 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
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 10 f3 r0"7- Signature (Applicant or Agent):
t
, p
Page
- 2
Application Number
04-00005530 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
-------------------------------------------
Permit
-----------------------
. . . ELEC-NEW RESIDENTIAL.
----------
Additional des.c
Permit. -Fee .
. . .
255.56 Plan Check Fee
15.97
Issue Date .
. .
Valuation . . . .
- 0
Qty Unit
.Charge
Per
Extension
BASE FEE
1.5.00
3033.00
.0350.
ELEC NEW -RES - 1 OR 2 FAMILY
106.16-
6720.00
.020'0'
ELEC GARAGE OR NON-RESIDENTIAL
134.40
------------------------------------------.--------
Permit.
. . .
--------------------------
PLUMBING
Additional desc
Permit Fee .
. . .
190.50 Plan Check Fee
Issue Date
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
20.00
6.0000
EA
PLB FIXTURE
120.00
1.00.
15.00.00
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 57,
PLAN 3B
3033
SF. PERMIT
6
Page 3
Application Number .
. . . .
04-00005530 Date. 7/16/04
----------------------------------------------------------------------------
Special Notes and Comments
DOES NOT INCLUDE BLOCK
WALLS,.POOL,
SPA
OR DRIVEWAY APPROACH.
75% REDUCTION TO
PLAN CHECK FEES DUE TO
MULTLIPLE •
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
15.97'
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
19.74
DIF"STREET MAINT FAC -RES
15.00
DIF. TRANSPORTATION - RES
1098.00
Fee summary Charged
Paid Credited
Due
' Permit Fee Total
1507.56
.00 .00
1507.56
Plan Check Total
191.54
.00 .00
191.54
Other Fee Total
2440.71
.00 .001.
2440.71
Grand Total
4139.81
.00 .00
4139.81