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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