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04-7488 (SFD)1000 >�� q BUILDING & SAFETY DEPARTMENT P O: -Box 1504: Y; r . (760).777-7012 D LCnLE TnMPIco8495p ' FAX (760) 777-7011 A QUINTA, CALIFORNIA 92253 INSPECTIO.N .REQUESTS (760) 777-7153 JAN. 0 4.2005 ry BU.ILDINGTPERMIT . CITY OF LAAUINTA FINANCE DEPT. p .kation Number - . , . 04"00.007488. Date 11/29/04 Property Address,;,•• 432.7,7�PARKWAY ESPLANADE W APN: `60,9-380'-997=26F -29:3233 <... t Application descripion DWELLING ,',SINGLE FAMILY DETACHED Property Zoning . . . . :LOW.,DENSITY RESIDENTIAL Application valuation :'180632` Owner Contractor --------------------- --------- PONDEROSA s�-,t 3';. -----.----=--------------. PONDEROSA HOMES II,. INC. PONDEROSA HOMES II, INC. 6671 OWENS DRIVE. *6671 O.WENS,.DRIV-E PLEASANTON,-•CA-PhEA_SANTON CA 94588 PLEASANTON CA 94588 _.(7,60),:•318-7710 * WC C: TANNER INSUR WC.__.15671603 10/01/05 CSLB: 752884 08/31/06 CCC.:. B -----.---------------.-- --Structure Information•,.-.-:------=---------------- Constrtiction Type : TYPE V - NON RATED Occupancy Type . . . . D,WELLG/LODG_.ING/LONG <=10 Flood Zone NON -AO FLOOD ZONE Other st'ruct info CODE EDITION 2001 CRC # BEDROOMS 4.00 FIRE SPRINKLERS NO 1 GARAGE- SQ'; FTG,,,., 671,0-0 PATIO:`SQ` TG; '3'&7.00 NUMBER OF -UNITS 1.00 1ST''FLOOR.SQUARE FOOTAGE 2838.00 --------------------- Permit BUILDING PERMIT Additional desc. Permit Fee .9-23-.00 Plan Check.Fee 599.95 Issue Date : Valuation 180632 Qty Unit'Charge Per Extension BASE FEE 639.-50 81.00 3, 5'00.0 THOU BLDG 100,0 PA. -500, 000. �'; 283.50 Permit. MECHANI•CAL': Additional desc Permit Fee 90..00 :;. Plan. Check Fe`.e 22.50 Issue Date Valuation" 0 Qty Unit Charge Per Extension ° BASE_'.FEE 15.00 2.00 9.0000 EA: .,,rM,ECH FURNACE <=TOOK 18.00 2.00 9.0000 EA MECH B/C <=3HP/100K BTU 18.00 P.O. BOX 1504 • '�� VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 0 44 ' Date: Applicant:—Architect or Engineer: Applicant's Mailing Address: Archit ct o Engin Address: ic. No.: S,:Go6. 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 Licens full force and effect. nse Class /License No. i$—z S 4 '/o/�1E'/➢�y��j ,----Dat e 7 D /Contractor 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 fora 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.). ( j 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. , BA P.C. for this reason Date 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. Y__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 ��ed. My worked' compensaf ' surance carrier and policy number are: amer I A24khF/l —as Policy Number iS'�7/ 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 fo hwith comply with those provisions. ate �.� Ap` plicant 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 construction, an hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. ate ! t Signature (Applicant or Agent): fir.: .. .... .. .4 .. y „,... `'•. Page 2 Application Number 04-000'0748:8 Date 11/29/04 Qty. Unit Charge. Per Extension 5.00 6`°:`5000 EA •. MECH. VENT, FAN.' 32.50 1.0.0 6.5000 EA MECH. EXHAUS.T`, HOOD v .. 6.50 Permit ELEC-NEW RESIDENTIAL Additional desc Permit Fee 127:75 Plan.Check Fee 31.94 Issue Date . . . . Valuation 0 Qty Unit Charge Per Extension BASE. '.FEE 15.00 2838.00 0350- ELEC` NEW..RES- - _ 1 OR .2 FAMILY 99.33 671.00 .0200 ELEC:GARAGE-OR.'NON-RESIDENT IAL 13.42 Permit PLUMBING Additional desc Permit.. Fee 172.50 PIaft.,Check Fee 43.13 Issue Date Valuation . . . . 0 Qty Unit•.Charge Per Extension BASE ' FEE 15.00 . 17.00 6.0000.. EA PLB', FIXTURE102.00 1.00. 15.0:000 EA "PLB BUILDING SEWER 15.00 1.00 7'.5000 EA PLB`;WATER, HEATER/VENT 7.50 1.00 3'.000.0 EA 'PLB WATER INST/ALT/REP 3:00 1.00 9:0.000 EA: PLB` LAWN, SPRINKLER `SYSTEM 9.00 8 . 0-0 .-1,500 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 P.lan.-Check Fe.e .00 Issue Date • Valuation . . . . 0 Qty Unfit. Charge Per` Extension BASE FEE; 15.00 Special Notes and tomment•s . SFD - LOT.26. PLAN-2BXR., 2,838 SF% PERMIT DOES NOT INCLUDE BLOCK.WALLS,.PQOL, SPA, OR DRIVEWAY APPROACH. Other Fees . . . . ART IN PUBLIC.PLACES-RES .00 . DIF, ..COMMUNITY CENTERS -RES 97.00 DIF; CIVIC CENTER - RES 366'.00 Page 3 Application Number•, 04- 00'0.07488.''' Date 11/29/04 -- - - --- - - - - -------- - - - -- - -- - - _ =S- ----- ---------- - - - - Other Fees °.. . . . :ENERGY REVIEW FEE; 60.00 `DhF FIRE PROTECTION' -RES 97.00 GRADING •,,PLAN' CHECK ,,.FEE . 00 DIF LIBRAR.I,ES - RES 225.00 DIF PARK-.''MAINT 'FAC '- RES 5.00 DI>F ,'PARKS/REC '- RES 502.00 STRONG MOTION• (SMI)> - RES 18.06 DIF STREET MAINT.FAC-RES 15.00 DIF TRANSPORTATION - RES 1098..00_ Fee summary Charged Paid Credited Due Permit Fee Total 1328'.•25 .00 .00 1328.25 Plan Check Total. 697:5.2' .00 00 697.52 Other Fee Total- 2483;:06' .00 :00 2483.06 Grand Total45083`' 00 00 4508.83 }