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05-2597 (SFD)A� f: P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: => BUILDING & SAFETY DEPARTMENT BUILDING PERMIT rU 5-00002597 4-8315—STILLWATER DR 658-140-999-118 _29436' - DWELLING - SINGLE FAMILY_ DETACHED .LOW DENSITY RESIDENTIAL 199884 Architect or Engineer: D VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/27/05 , ------------------------------------------------------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION Owner: WORKER'S COMPENSATION DECLARATION IVANHOE LA QUINTA COVE C/O R BARRY MCCOMIC " Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. 7979 IVANHOE AVE STE 550 _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided LA JOLLA, CA 92037 for by Section 3700 of the Labor Code; for the performance of the work for which this permit is /�/7 y! ` ate:v �f d ntractor: Contractor: issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor TRANS WEST HOUSING, INC. 9968 HIBERT STREET, STE #102 JUL1 1 PJ SAN DIEGO, CA 92131 insurance carrier and policy number are: (858)653-3003 iwns: LiQUINTA Lic. No.: 701039 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/27/05 , ------------------------------------------------------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: " Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided - License CI s: B License No.: 701039 for by Section 3700 of the Labor Code; for the performance of the work for which this permit is /�/7 y! ` ate:v �f d ntractor: 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 issued. My workerscompensation OWNER -BUILDER DECLARATION r- insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 1648813 following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicarit for the person in any manner so as to become subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State arld agree that, if 1 should become subject to the workers' compe ation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 00 of the Labor C e, I shall fort ' h comply with those pr, 'ions. ' that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by —� i _ any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: scant: (_ 1 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL , Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for 'sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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.). (_) 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.). (_ 1 I am exempt under Sec. , B.&P.C. for this reason Date: Owner: 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: LQPER IIT 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 author epresentatives of th'issccou/y to ter upon the above-mentioned prop ty fo i p purpoises. ate/ nature (Applicant or Agent): Application Number . . . . . 05-00002597 LQPE611T Structure Information- -Construction Type TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/CONG <=10. Flood Zone . . NON -AO FLOOD ZONE Other struct info . . . . CODE EDITION 2001 CRC # BEDROOMS 3.00 FIRE SPRINKLERS NO GARAGE SQ FTG 704.00 PATIO SQ FTG '315.00 NUMBER OF UNITS 1.00 1ST FLOOR SQUARE FOOTAGE 3180.00" Permit BUILDING PERMIT Additional desc Permit Fee . . . . 989.50 Plan Check Fee 160.80 ` Issue Date Valuation 199884 Expiration Date 12/24/05 Qty Unit Charge Per Extension BASE FEE 639.50 100.00 3.5000 ------------------------------------------------------------------------- THOU BLDG 100,001-500,000. 350.00 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 90..00 Plan Check Fee 5.63 Issue Date Valuation . . . . 0 Expiration Date 12/24/05 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 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 140.38 Plan Check Fee 8.78 Issue Date . . . . Valuation . . . . 0 Expiration Date 12/24/05 Qty Unit Charge Per Extension" BASE FEE 15.00 3180.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 111.30 LQPE611T Application Number . . . . 05-00002597 Permit . . . . . ELEC-NEW RESIDENTIAL Qty Unit Charge Per Extension: 704.00 .0200 ----------------------------------------------------------------------------- ELEC GARAGE OR NON-RESIDENTIAL 14.08 Permit . . . PLUMBING Additional desc . Permit Fee 178.50 Plan Check Fee 11.16 Issue Date Valuation 0 Expiration Date 12/24/05 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 Fee15.00 Plan Check Fee.. .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 12/24/05 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments SFD - LOT 118 PLAN 1C,3180 SF. PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL, SPA OR DRIVEWAY APPROACH. 75% PLAN CHECK FEE REDUCTION APPLIED FOR 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 16..08 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 LQPERA1IT . LQPERMIT Application Number. . . . . . 05-00002597 -------=-------=------------------------------------------------------------ Other Fees . . . . . . . STRONG MOTION (SMI) - RES 19.98 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Paid Credited Due Permit Fee Total -- 1413.38 -- -------- - --- ---------- .00 .00 1413.38 Plan Check Total 186.37 .00 .00 186.37 Other Fee Total 2441.06 .00 .00 2441.06 Grand Total 4040.81 .00 .00 4040.81 LQPERMIT