05-3509 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
9
c&ht °F XPQ,"-
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
05-00`003509
79703 PARKWAY. ESPLANADE S
609-590=005- - -
DWELLING - SINGLE FAMILY DETACHED
LOW DENSITY RESIDENTIAL
194630 4
.,,�rchitect or Engineer:
t9`-6 b s�Q�
— — — — — — — — — — — — — — — — — — — — — — —'— — — — — — — — — — — — — — — — — — — — — — — — — — — .
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under pepalty 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 Class: B L' ens No.: 752884
ate: 9 O ontractor: C�k�O
•/ 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 statementthathe 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 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 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.).
(_) I am exempt under Sec. , B.&P.C. for this reason
Date:
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 (Sec. 3097, Civ. C.).
Lender's Name: �{
Lender's Address: !
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/09/05
---------------------------------------------—-
WORKER'S
__________________________—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 endwillmaintain 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 TANNER INSUR Policy Number 15671603
_ 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
%(00 of the L bor Co e, I shall forthwith comply ' h those pro
ate: Y_' licant: '
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINALPENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,0001. 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 shalldefend, 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
oft cou tnter upon t above-mentioned pro pe fofrQins�pe/yam/pon pu oses /
crate: 0�8 f7�gnature (Applicant or Agent): u�►"� ��V
Owner:
PONDEROSA HOMES II, INC.
6671 OWENS DRIVE
PLEASANTON, CA
4-
PLEASANTON, CA 94588
ontractor:
ONDEROSA HOMES II, INC.
6671 OWENS DRIVE
PLEASANTON,
CA 94588
(760) 318-7710
Lic. No.: 752884
— — — — — — — — — — — — — — — — — — — — — — —'— — — — — — — — — — — — — — — — — — — — — — — — — — — .
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under pepalty 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 Class: B L' ens No.: 752884
ate: 9 O ontractor: C�k�O
•/ 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 statementthathe 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 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 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.).
(_) I am exempt under Sec. , B.&P.C. for this reason
Date:
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 (Sec. 3097, Civ. C.).
Lender's Name: �{
Lender's Address: !
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/09/05
---------------------------------------------—-
WORKER'S
__________________________—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 endwillmaintain 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 TANNER INSUR Policy Number 15671603
_ 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
%(00 of the L bor Co e, I shall forthwith comply ' h those pro
ate: Y_' licant: '
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINALPENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,0001. 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 shalldefend, 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
oft cou tnter upon t above-mentioned pro pe fofrQins�pe/yam/pon pu oses /
crate: 0�8 f7�gnature (Applicant or Agent): u�►"� ��V
Application Number . . . . . 05-00003509-
Structure
5-00003509
LQPERMrr
Structure Information
Construction Type . .
. . . TYPE V - NON RATED
Occupancy Type . .
. . DWELLG/LODGING/LONG <=10
Flood Zone . .
. . . NON -AO FLOOD ZONE -
Other struct info . .
. . . CODE EDITION
2001 CRC
# BEDROOMS
4.00
FIRE SPRINKLERS
NO
GARAGE SQ FTG,
-681. 00
"PATIO SQ FTG
500.00
NUMBER OF UNITS
1.00
-------------------------------------=--------------------------------------
1ST FLOOR"SQUARE FOOTAGE
3053.00
Permit . . .
BUILDING PERMIT
Additional desc .
Permit Fee . . . .
97.2.00 Plan Check Fee
631.80
Issue Date
Valuation . . .
. 194630
Expiration Date
2/05/06
Qty Unit Charge
Per
Extension
BASE FEE
639.50
95.00 3.5000
THOU BLDG 1.00,001-500,000.
332.50.
Permit
MECHANICAL
Additional desc .
Permit Fee . . . .
83.50 Plan Check Fee
20.88
Issue. Date
Valuation . . .
. 0
Expiration Date
2/05/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00 i. 9.0000
EA MECH FURNACE <=100K
18.00
2.00 9:0000
EA MECH B/C <=3HP/100K.BTU
18.00.
4.00 6.5000
EA MECH VENT FAN
26.00
1.00 6.5000
----------------------------------------------------------------------------
EA MECH EXHAUST HOOD.
6.50
Permit . . .
ELEC-NEW RESIDENTIAL
Additional desc .
Permit Fee . . . .
135.48 Plan Check Fee
33.87
Issue Date
Valuation
0
Expiration Date
2/05/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
3053.00 .0350
ELEC NEW RES - 1 OR 2 FAMILY
106.86
LQPERMrr
Application Number .
. . . . 05-00003509
Permit . . . .
ELEC-NEW RESIDENTIAL
Qty Unit Charge
Per-
Extension
681.00 .0200
-------------------------------------------------------------------7---------
ELEC GARAGE OR NON-RESIDENTIAL
13.62
Permit . . .
PLUMBING
Additional desc :
Permit Fee
178.50 Plan Check Fee
44..63
Issue Date . .'.
Valuation
0
Expiration Date
2/05/06
Qty Unit Charge
Per,
Extension
BASE FEE
15..00 .
18.00 6.0000
EA PLB.FIXTURE
108.00
1.00 15.0000
EA PLB BUILDING SEWER
15.00
1.-00 7:.5000
EA PLB =WATER HEATER/VENT
7.50
1:00 3.00AO'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
2/05/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes and•Comments
SFD_ - LOT 23. PLAN 3CXL,
3053 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
.63.18
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
19.46
LQPERMIT
Application Number . . . . . 05-00003509
----------------------------------------------------------------------------
Other Fees . . . . . . . . . DIF STREET MAINT FAC -RES 15.00
DIF TRANSPORTATION - RES 1098.00
Fee summary Charged
Permit Fee Total 1384.48
Plan Check Total 731.18
Other Fee Total 2487.64
Grand Total 4603.30
LQPERMTT
Paid Credited Due
.00 .00 1384.48
.00 .00 731.18
.00 .00 2487.64
.00 .00 4603.30