04-7501 (SFD)M
JAN 04,2005-\,
BUILDING &-SAFETY -DEPARTMENT
P.O.'_BOx 15.04...
5.04
i p. I yam, (760) 777-70,12
V.495 CALL:E TAMPICO_.. FAX (760) 777-70.11
kcQl UINTA, CALIFORNIA- 92253 -INSPECTION REQUESTS, (760) 777-7153
BUILDING PERMIT
Qty Unit.Charge Per
2.00 9.0O00 EA
2.00 9.0000 EA
Extension
:,BASE -FEE:. ... 15. 00
-MECH FURNACE <=100K 'i 18.00
MECH 8/Q <=3HP/100K^BTU 18.00
F LAQk1I1,:TA
(;IT,Y Z a t:,
FINppjLq(tpt1�ojn
Number.
- - , . - Date
0 � �71�, 1
11/30/04
7=0p'erty Address —:432:45 PARKWAY ESPLANADE W
APN:
609-380 169;97-25, -2<93233-
Application description,-
DWELLIN0f `6t I-,NGLE FAM I LY DETACHED
Property Zoning-
LOW DENSITY. �R ESIDENTIAL
Applicationvalifation2013
-60,.
tz
Owner
Contractor
------------------
PONDEROSA HOMES II' LLC.
RONDEROSA. HOMES II, INC.
400 S.-. FAR•RELL DRIVE,
6 6 7 1,: OWENS:` DRIVE
PALM- SPRINGS.,. CA 92.264
Pf9A$A0 ' TOW.,
94588
LA QULNTA
.-CA
CA 912.5 -3 -;7'
(7 6 0).� 18 710.
WCC TANNER.' IN SUR
WC': f!56'71.603
10/01/05
.7;52884
08/31/06
q,;CCC:
--------------------
Structure, Infprma;tion ----------
-----------
Construction ,Type
TYPE V NON ,RATED_
occupancy Type.
DWELLLG,/1ODG.ING/C ONG -<=10
Flood Z6ne .. . . .
... . NON -A FLOOD, ZONE'
Other struct info
CODE ,EDI*T`-I`b'N,"'-- 2001
CRC
BEDROOM&
5_00
FIRE' SPRINKLERS No
GARAGE- SQ,FTG'
5 02. j0*0
PATI OSQ";FTG ,
500.00
P'NUMBER ''OF :UNITS-
1.00
1ST FLOOR'SQUARE FOOTAGE.
3232-00
-----------------------
Permit.
-------
BUILDING, PERMIT
------
Additional de . sc
Per'mit.Fee
an`,Ch6.ck--- Fee
647.73
Issue Date
Valuation . . . .
2'01360
Qty Unit Charge
Per
Extension
BASE. -FEE a,
.639.50
102-.00 5000,
THOU BLDG,10;0,,001-5-00, 0:00
'357.00
---------------------------------
Permit
Permit
-------------------------------------
-,----------------------..-.------------------
MECHANI-CAL.
.Additional desc
Permit.Fee
83.50,,. Plan Check Fee
20.88
Issue Date
Valuation'
0'
Qty Unit.Charge Per
2.00 9.0O00 EA
2.00 9.0000 EA
Extension
:,BASE -FEE:. ... 15. 00
-MECH FURNACE <=100K 'i 18.00
MECH 8/Q <=3HP/100K^BTU 18.00
P.O: Box 1504 •4 4 �� 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: — X50 Date: • SI •�
Applicant:
Applicant's Mailing Address:
chitect or Engineer:
Archit t or ngineer's Address:
c. No. 55�0�
t3UILDING 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
gode, and my Licen full force and effect. �
License Class �Cicense No.
/ -te Corlfractor C�% 6�
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 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 dollars ($500).):
U 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 or 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.).
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.& 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 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.
11Fhave 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
1«ued. My workers' compensation iysa nce carrier and policy number are:
Carrier 0'.IXJLJb14 T, s old icy Number
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 3700 of the Labor Code, I shall
forthwith comply with those provisions.
ate / b Applicant
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.
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
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 information is correct. I agree to comply with all city and county ordinances and state laws relating to building
constructi n, a hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes.
-,-b<ate �� Signature (Applicant or Agent):
Page
2
Application Number
04-00007501 Date
11/30/04
Qty Unit
Charge
. „Per
Extension
4.00
6. 5,0,0.0
EA MECH VENT' FAN
26.00
1.00
6.5000.:
EA .MECH EXHAUST HOOD.
6.50
-----------------------------------------------------------------------------
Permit
. .
ELEC-NEW RESIDENTIAL
Additional desc
Permit Fee
138.16 Plan Check Fee
33.87
Date. Issue Dat
Va'l'Ation
0
Qty Unit
Charge
'Per
Extension
BASE , FEE
15.00
3232.00
..0350
ELEC NEW 'RES* .' 1''OR 2 'FAMILY
113.12
502.00
`.0200
ELEC,.GARAGE OR NON-RESIDENTIAL
10.04
Permit ... .
. . .
PLUMBING
Additional desc
Permit Fee
19:6.50 P1an,,Check.'Fee
44.63
Issue Date .
. .
:. .'` Valuation
0
Qty Unit
Charge
Per
Extension.
BASE FEE
15.00
21.00
.6.0000
EA : TLB-� ° FIfXTURE
126.00
.1.00
15.0000
EA ; PLB-:BUILD,ING -SEWER
15.00
1. 0 0
7. 5 0-0 0
EA_PLB,., .WATER ' HEATER'/ VENT
7.50
1.00
3.0000
EA PLB-,WATER INST%ALT/REP
3.00
1.0'0
9.0000
EA P,..LBL'AWN SPRINKLER SYSTEM
9.00
8.00
.75,0.0.',
EA PLB GAS PIPE...5=5
6.00
1.00
15.0000
EA,. PLB'GAS;ME-TER
15.00
Permit . . .
. . .
GRADING 'PERMIT
Additional desc,,.:
Permit Fee
15.00 Plan^Check. Fee.
.00
Issue Date .
. .
Valuation
0
Qty ..Unit
Charge.
Per ..
Extension
BA'SE,.'FEE
15.00
Special Notes
and.f-Comments
SFD - LOT_.25.
PLAN,3CXL+OPTION°.BEDROOM
5/BATH 4 (17 9 SF)
W/2 .CAR
GARAGE. :(GARAGE
502 SF) PERMIT
DOES NOT
INCLUDE BLOCK
WALLS, POOL, SPA,.
-OR
DRIVEWAY.APPROACH.
Other Fees .
. . . .
. . ,. ART'IN PUBLIC PLACES -RES
20.00
DIF COMMUNITY CENTERS -RES
97.00
Page
3
Application Number
04-000:07501 Date
11/30/04
Other Fees
DI--FYCIVIC CENTER - RES
366.00
.,-ENERGY . REVIEW ,.FEE
64.77
DIF FIRE .,PROTECTION. --RES
97.00
�GRADING� PLAN ."CHECK `FEE
.00
DIF—LIBRARIES - RES'.
225.00
DLF. PARK -D IN:T� � FAC:: ', RES
5.00
DIF', PARKS/RECy'-' RE Sf
502.00
=STRONG .,MOTIW- ( SMI) - RES
11
19.46
DIF. -STREET,: MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
Charged-
;Paid Credited ,•
Due
Permit Fee Total-
1'429:'66
:0.0:•, ..00
1429..66
Plan .Check Total
747.11
= 0'0,- .00
747:11
Other Fee Total
2509..23.,
•:0.0 00
2509.23
Grand Total''
:4686-: 0.0
i''
.001. -;'0 0
4686.00