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04-3467 (SFD)T.df 4 4QdArw BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760) 777-7012 78-495 CALLS TAMPICO FAX .(760) 777-7011 LA. QUINTA; .CALIFORNIA 9'2253 INSPECTION -REQUESTS (760) 777-7153 BUILDING PERMIT Application Number 04-70:0-0-0 3'4 ..Date 4/14/04 Property Address 57895 STONE CREEK.TR E APN: 762-240-999-65 -30834 - Application description ..DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL Application valuation 225593 Owner Contractor ------------------------ MADISON ESTATES ------------------------ SOUTH POINT CONSTRUCTION' -INC 437^ S HIGHWAY 101 NO 220 44420'VIA DEL SOL SALANA BEACH CA 92075 LA QUINTA CA 92253 (760) 345-5521. WCC: STATE FUND WC: 0460010835 08/21/04 CSLB: 447883 08/31/04 CCC:. B ---------------------------- Structure Information ------------------------- ,Construction Type . . TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/CONG <=10 Flood Zone . . . . . . . . NON -AO FLOOD ZONE Other struc.t- info . . . . . CODE EDITION 2001 CBC FIRE SPRINKLERS NO GARAGE SQ FTG 910.00 PATIO SQ FTG 680.00 NUMBER OF UNITS 1.00. FIRST .,FLOOR SQ FTG 3;474.00 Permit BUILDING PERMIT Additional desc Permit Fee . . . . 1080.50 P1an'Check Fee 175.581 Issue Date . . . . Valuation 225593 Qty' Unit Charge Per Extension BASE FEE 639.50 126.00 3.5000 THOU BLDG 100,001-500,00.0 441.00 ----------- ---------------------------------------------------------------- Vsz-rrni MECHANICAL .Additional desc Permit Fee 137:00 Plan Ch Issue Date Valuati Qty Unit Charge Per BASE FEE 3.00 9 0000.EA MECH.FURNANCE <=100 y ecek.D Fee on JUL 12 2004 CITY OF LA QUERY�itens l FINANCE DEPT. 15 . K 27. 56 0 on 00 00 4 P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: d �- 3TC0 7 I Date: 7 -q-o4 App Ican . . Applicant's Mailing Address: C, (GL— (, -"ffchitect or Engineer's Address: Sly- too ndA14-g.,,%. A✓le LSA J Zo 1 c ��- lam, l�-�s � �- �►- 9zus-� ,Lic. No. t'J" J 0 S CT a 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 Code, and my License is II force and effect. �/ 7 license Class_ —;G—cense Nq/f!� 7 r) 3 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License taw for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county ttiat requires a permit to constrict, 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 ddlars ($500).): U 1, 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 ft improvements are not intended or offered for sale. If, howeyer, 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 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.). U I am exempt under Sec. , B.8 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 self4nsure 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 i.s • My workers' cgmpensation insurance carter and poli number are: Carrier CmVyu M ,Fo�Number Lji, - d b '. 6—A 3S _ I certify that, in the performance of the work for which th1s reit 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 961a become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. / i 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 ($700,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY I hereby affirm under alty�I perjury We is a nstructon lending agency for the performance of the work for which this permit is issued (Sec. 3097. Civ. C.). ✓Lenders Name ,-,I enders 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, indemnify and hold harmless the City of La Ouinta, 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 inform 'on is cor agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this wunty to a er u n b e mentioned property for inspection purposes. Dat Zoa a -re (Applicant or Agent): Application Number. . . 04-00003467 Page 2 Date 4/14/04 Qty Unit Charge Per Extension 3.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 49.50 6.00 6.5000 EA MECH VENT FAN 39.00 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 ---------------------------------------------------------------------------- Permit . . . . . . ELEC-NEW RESIDENTIAL Additional .desc Permit Fee . . . . „154.79 Plan Check Fee 9.68 Issue.Date Valuation 0 Qty Unit Charge Per Extension BASE FEE 15'.0G--`' 3474.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 121:,!59 910.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 18.20 ---------------------------------------------------------------------------- Permit . . . PLUMBING Additional desc Permit Fee . . . . 213.00 Plan Check Fee 13.31 Issue Date . . . . Valuation- 0 Qty Unit Charge Per, Extension BASE FEE 15.00 19,.00 6.0000 EA PLB FIXTURE 114.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 3.00 6.0000 EA. PLB ROOF DRAIN 18.00 2.00 7.5000 EA PLB WATER HEATER/VENT 15.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 12.00 .7500 EA PLB GAS PIPE >=5 9.00 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 65, PLAN C. PERMIT DOES NOT INCLUDE BLOCK WALL, POOL OR DRIVEWAY Page 3 Application Number . . . . . 04-00003467 Date 4/14/04 ----------------------- Special Notes and -------------------------------------- Comments - -------------- APPROACH. 75% PLAN CHECK FEE REDUCTION FOR MULTIPLE ISSUANCE OF SAME PLAN TYPE. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES 63.98 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00' ENERGY REVIEW FEE 70.23 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 22.55 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 10.98.00 Fee summary -=--------------- Charged Paid Credited Due Permit Fee Total ---------- 1600.29.. ------------------------------ .00 .00•'. 1600:29 Plan Check Total 207:13 00 .00 207.13 Other Fee Total 2561.76 .00 .00 2561.76 Grand Total 4369.18 .00 .00 4369..18 1:. Certificate of Occupancy- �4 3 J:J � � , • 1llllr/ll��� I.AXWOYAIM 1981 OF Building & 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: 57-895 STONE CREEK TR. k -,Use classification: SINGLE FAMILY DWELLING Building Permit No.: 04-3467 Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL Owner of Building: MADISON ESTATES Address: 437 S. HIGHWAY 101 #220 City, ST, ZIP: SALANA BEACH, CA 92075 By: GARY HARTMAN Date: 12-08-2005 Building Official POST IN A CONSPICUOUS PLACE