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05-2594 (SFD)OX 15,04, VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Application Number: 05-00002594 ----------------------------------------------— WORKER'S COMPENSATION DECLARATION Owner: Property Address: 4-8339"'STILLWATER DR ' Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. IVANHOE LA QUINTA COVE APN: 6587140-999-119 -29436 - C/O R BARRY MCCOMIC Application description: DWELLING - SINGLE FAMILY DETACHED issued. �I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor 7979 IVANHOE AVE STE 550 Property Zoning: LOW DENSITY RESIDENTIAL OWNER -BUILDER DECLARATION LA JOLLA, CA 92037 Application valuation: 217237 Carrier STATE FUND Policy Number 1648813 Applicant: rchitect or Engineer: O /► 22 00F(37- 00F(J� 1 OJ vil ,u� 1 Contractor: 'TRANS WEST HOUSING, INC. 9968 HIBERT STREET, STE #102 S858D653O3003 92131 Llc. No.: 701039 Date: 6/27/05 ------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION - - ----------------------------------------------— WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I 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 C ss: B License No.: 701039 _ for by Section 3700 of the Labor Code, for the performance of the work for which this permit is I S ) 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 workers' compensation OWNER -BUILDER DECLARATION 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 applicant 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 and agree that, if I sh I eco me subject to workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the abor 1 hall forthwith c I with those provisions. 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).: ate? plicant: 1 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the wuik, and _ the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SE URE 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 wijl have the burden of proving that he or she did not build or improve for the purpose of sale.). 1 _ 1 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 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—) 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: LQPERAIIT 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. 1 certify that I have read this application and statAmformation is correct. I gree to comply with all city and county ordinances and state laws relatinstructionan ereby authorize representatives of this co my t enter up the above-mentionepection pur Date �/ 45Signature (Applicant or Age OX LQPERI%lrT Application Number . . . . . .05-00002594 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 4.00 FIRE SPRINKLERS NO GARAGE So FTG- 603.00 PATIO SQ FTG 487,00 NUMBER OF UNITS 1.00 ----------------------------------------------------------------------------- 1ST FLOOR SQUARE FOOTAGE 3478.00 Permit . . . . . . BUILDING PERMIT Additional desc Permit Fee . . . . 1052.50 Plan Check Fee 171.03 Issue Date. Valuation . . . . 217237 Expiration Date 12/24/05 Qty Unit Charge Per Extension - BASE FEE 639.50 118.00 3.5000 ------------- --------------------------- THOU BLDG 100,001-500,000 7 ---------------- 7 ------------------ 413.00 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 .148.79 Plan Check Fee 3.30 Issue Date Valuation . . . . 0 Expiration Date 12/24/05 Qty Unit Charge Per Extension BASE FEE 15.00 3478.00 .0350 ELEC NEW RES 1 OR,2 FAMILY 121.73 LQPERMIT • Application Number 05-00002594 Permit . . . . ELEC-NEW RESIDENTIAL QtyUnit Charge Per Extension 603.00 .0200 ------------------------------------------- ELEC GARAGE OR NON-RESIDENTIAL - 12.06 Permit .' PLUMBING Additional desc . Permit Fee 196.50 Plan Check Fee 12.28. Issue Date . . Valuation 0 Expiration Date .12/24/05 Qty Unit Charge Per Extension BASE FEE 15.00 21.00 6.0000 EA PLB FIXTURE 126.00 . 1.00 15.0000 EA PLB BUILDING SEWER 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 1.50 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 Expiration Date 12/24/05 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments SFD,- LOT 19 PLAN 3AR 3478 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 43.09 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE, 17.10 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 LQPERMIT LQPERMIT J Application Number . . . . . 05-00002594 ------------------------------------------ Other Fees . . . . . . . ----------------- - STRONG MOTION (SMI) RES -- 21.72 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES- 1098.00 Fee summary Charged Paid Credited Due Permit Fee Total 1502.79 .00 .00 1502.79 Plan Check Total 198.24 .00 .00 198.24 Other Fee Total 2486.91 .00 .00 2486.91 Grand Total 4187.94 .00 .00 4187.94 LQPERMIT J Certificate-. of Occupancy }fir IK:•. ro .t�• _ Y` OB itding & Safety Department This Certificate is issued pursuant to the requirements of Section 109 of the California Building .Code, certifying that, at the time of issuance, this structure was in compliance. with the provisions of the Building Code and the various ordinances of. the City regulating building construction and/or use. BUILDING ADDRESS: 48-339 STILLWATER DR Use classification: SFD Building Permit No.: 05-2594 Occupancy Group: R3 Type of Construction: VN Land Use Zone: RL Owner of Building: IVANHOE LA QUINTA COVE Address: 7979 IVANHOE AVE STE 550 City, ST, ZIP: LA JOLLA CA 92037 By: S WILLETT Date. 4-26-06 Building Off ial POST IN A CONSPICUOUS PLACE