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05-2605 (SFD)i "P.O: BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 4 Xfv Qu4m BUILDING & SAFETY DEPARTMENT . BUILDING PERMIT Application Number: 05-00002605 1 Owner: Property Address: 483-87`STILLWATER DR. IVANHOE LA QUINTA COVE APN: 658-140-999-121 -29436 - C/O R BARRY MCCOMIC Application description: DWELLING - SINGLE FAMILY DETACHED 7979 IVANHOE AVE STE 550 Property Zoning: LOW DENSITY RESIDENTIAL LA JOLLA, CA 92037 Application valuation: 215169 so n--� VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/27/05 Applicant: rchitect or Engineer: U JUL 1 9 Z005T WEST HOUSING, INC. 99 IBERT STREET, STE #102 S D EGO, CA 92131 lJJ CITY OF LA QUINTA 8) 653-3003 FINANCEDEPT. Lic. Cl.: 701039 --------------------------------------------------------------------------------------------------- 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 CI ss: Lice n No.: 701039 for by Section 3700 of the Labor Code, for the performance of the work for which this permit. is issued. ate: ontractor: I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor ML 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_ 1 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 should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or/ 700 of the Labor Code, I sl)" forthwit comply wit rhos provisions. _ that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031 .5 by n // �5 • any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)•: Dote: l (((! ypli�ant: o / C C (_ 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 doesthework 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 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. , BAP.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: a LQPERMU . 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 representatives of this�cJo m�,ignature above-mentioned property for inspectio purpose 0 : Q lApplicant or Agent): �Y -h•� tel. Application Number 05-00002605, LQPERMIT 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 # BEDROOMS 4.00 FIRE SPRINKLERS NO GARAGE SQ FTG 688.00, . PATIO SQ FTG 705.00 NUMBER OF UNITS 1:00 -----------------------------------------------------:----------------------- 1ST. -FLOOR SQUARE FOOTAGE 3362.00 Permit . . BUILDING PERMIT . Additional desc . Permit Fee 1045.50 Plan Check Fee 679.58 Issue Date' Valuation 215169 Expiration Date 12/24/05 Qty 'Unit Charge Per Extension BASE FEE 639.50 116.00 3.5000 ---------------------------------------------------------------------------- THOU BLDG 100;001-500,000 406.00 Permit MECHANICAL Additional 'desc . Permit Fee . . . 77.00 Plan Check Fee . .19.25 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 3.00 6.5000 EA MECH VENT FAN. 19.50 1.00 6.5000 ------------------------------------------------------------------------------ EA MECH EXHAUST HOOD 6.50 ,-Permit ELEC-NEW RESIDENTIAL Additional desc . Permit Fee 146.43 Plan Check Fee 36.61 Issue Date Valuation 0. Expiration Date 12/24/05 Qty Unit Charge Per Extension BASE FEE • 15.00 3362.00 .0350 ELEC NEW RES - 1 OR 2'FAMILY 117.67 LQPERMIT LQPERIIT Application Number 05-00002605 Permit . . . . .. . d ELEC-NEW RESIDENTIAL Qty Unit• Charge Per Extension 688.00 .0200 ---------------------------------------------------------------------------- ELEC.GARAGE OR NON-RESIDENTIAL 13.76 Permit PLUMBING Additional desc Permit Fee, . . . ." 196.5.0 Plan Check Fee 49.13 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 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 .00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS .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 121 PLAN 2BR,3362 SF. PERMIT. DOES NOT INCLUDE BLOCK WALLS, POOL, SPA OR DRIVEWAY APPROACH. Other Fees . . ------------------- ------- ------------- . . . . ART IN PUBLIC PLACES -RES 37.92 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 67.96 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 21.51 LQPER IIT Application Number . . . . . 05-00002605 Other Fees . . . . DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Paid Credited Due Permit Fee Total 1480.43 .00 00' 1480.43 Plan Check Total 784.57 .00 .00 784.57 Other Fee Total 2532.39 .00 .00 2532.39 Grand Total 4797.39 .00 .00 4797.39