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05-3009 (SFD)P.O. BOX 1504. 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Archit( BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 License is in full force and effect. License Clgss: P LicAnse No.: 701039 ate: 1p ontractdr. ' OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 Contractor's 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).: (_ 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 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 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.). (_ 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.). (_ 1 I am exempt under Sec. , B.&P.C. for this reason Dater 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 ISec. 3097, Civ. C.). :Lender's Name: ' Lender's Address: LQPERMrT Owner: 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 4102 SAN DIEGO, CA 92131 (858)653-3003 Lic. No.: 701039 1 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/19/05 WORKER'S 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 issued. My workers' compensation insurance carrier and policy number are: Carrier STATE FUND Policy Number 1648813 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 37�00 of the Labor Code, I shall fort ith comply ith those provisions. 0 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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. 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 co I Jnty tp enter upon t bove-mentioned property for inspection purposes. nature (Applicant or Agent): Application Number: 05100003009 Property Address: 48611 STILLWATER DR APN: 658-140-99 -129 -29436 - Application .description: DWELLING = SINGLE FAMILY Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 197485 Archit( BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 License is in full force and effect. License Clgss: P LicAnse No.: 701039 ate: 1p ontractdr. ' OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 Contractor's 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).: (_ 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 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 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.). (_ 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.). (_ 1 I am exempt under Sec. , B.&P.C. for this reason Dater 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 ISec. 3097, Civ. C.). :Lender's Name: ' Lender's Address: LQPERMrT Owner: 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 4102 SAN DIEGO, CA 92131 (858)653-3003 Lic. No.: 701039 1 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/19/05 WORKER'S 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 issued. My workers' compensation insurance carrier and policy number are: Carrier STATE FUND Policy Number 1648813 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 37�00 of the Labor Code, I shall fort ith comply ith those provisions. 0 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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. 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 co I Jnty tp enter upon t bove-mentioned property for inspection purposes. nature (Applicant or Agent): Application Number . . . . . 05--00003009 Structure Information "Construction Type . . . . . TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/LONG <=10 Flood Zone . . . . . NON -AO FLOOD ZONE '-Other s,truct info CODE EDITION 2001 CBC FIRE SPRINKLERS NO GARAGE SQ FTG 672.00 PATIO SQ FTG 814.00 NUMBER OF UNITS 1.00 ----------------------------------------------------------------------------. 1ST FLOOR SQUARE FOOTAGE. 3033.00 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 982.50 Plan Check Fee 638.63 Issue Date Valuation . . . . 197485 Expiration Date 1/15/06 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 16.00 Issue Date . . . . Valuation 0 Expiration Date 1/15/06 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 I MECH EXHAUST HOOD -------------------------------------------------- 6.50 Permit . . . ELEC-NEW RESIDENTIAL Additional desc . Permit Fee_ 255.56 Plan Check Fee 63.89 Issue Date . . . . Valuation . . . . 0 Expiration Date', 1/15/06 Qty Unit Charge, Per Extension BASE FEE 15.00 3033.00 .0350 ELEC NEW RES.- 1 OR 2 FAMILY 106.16 6720.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 134.40 LQPERAIIT , - LQPERMTT Application Number . . . . . 05-00003009 --------------------------------- Permit . . . ------------------------------------------- PLUMBING Additional desc . Permit Fee . . . 190.50 Plan .Check Fee 47.63. Issue Date Valuation . . . .0 Expiration Date 1/15/06 Qty Unit Charge Per Extension BASE FEE 15.00 20.00 6.0000 EA PLB FIXTURE 120.00 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 Fee . . . . .15.00 Plan Check Fee .00. Issue Date Valuation . . . . 0 Expiration,Date 1/15/06 Qty _Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments SFD - LOT 129, PLAN 3C, 3033 SF. PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL, SPA OR DRIVEWAY APPROACH ---------------------------------- Other Fees . . . . . ------------------------------------------ . . . . ART IN PUBLIC PLACES-RES .00 DIF COMMUNITY CENTERS-RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 63.86 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 LQPERMTT LQPEnlrr Application Number . . . . . 05-00003009 Permit Fee Total 1507.56 .00 .00 1507.56 Plan Check Total 766.15 .00 .00 766.15 Other Fee Total 2488.60 .00 .00 2488.60 Grand Total 4762.31 .00 .00 4762.31