05-3512 (SFD)P.O. 'BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 05,00010'3;532
Property Address: 79735 PARKWAY ESPLANADE S
APN: 609 -590 -003 -
Application description: DWELLING - SINGLE FAMILY
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 194630
Applicant:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
PONDEROSA HOMES II, INC.
6671 OWENS DRIVE
DETACHED PLEASANTON, CA
1dZ7_A4 PLEASANTON, CA 94588
,-,-Crchitect or Engineer:
06��3
SEP.2 n ontractor:
JONDEROSA HOMES II, INC.
CJj�.CF #5 671 OWENS DRIVE
Fj � u PLEASANTON, CA 94588
(76.0)338-7710
Lic. No.: 752884
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/09/05
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LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I-am,licensed.under provisions of'Chapter 9 (commencingwith
I. hereby affirm under penalty of.perjury one of the:i-011 wing declarations:
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
:1 have and will maintain'a certificate:of consent to self -insure for workers' compensation, as provided
License C ass: B License o.: 752884_
QoZB o.�
_
for by Section 3700.of the Labor Code,.fovthe performance of the work for which this permit is
issued.
/Date: ontractor:°=-�rcY�Y�MliO�/n
/�I have and will maintain workers' compensation insurance,,as required by Section 3700'of the Labor.
-
Code, for the performanceof the work for whichthis permit is issued.My'workers' compensation
_ OWNER -BUILDER DECLARATION
insurance carrier -and policy number; are: •- -
hereby. affirm undeapenalty. of perjury_ that 1 am exempt from the Contractor's State License Law for the
Carrier TANNER INSUR , Policy'Number 15671603 a '
following reason (Sec. 7031:5, Business and Professions;Code:: Any city or county that requires a permit to
I certify that, in the performance of'the work for which this permit is issued, I shalrnot employ any
construct, alter,' improve; demolish, or repair any structure, prior to its issuance, also.requires the applicant for the
- person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement.that he or she is licensed pursuant to the provisions of the Contractor's State -
and agree that, if I should become subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
heor she is exempt therefrom and. the basis for the alleged exemption. Any violation of Section 7031.5 by
700 of the Labor Code, I shall forthwith co �those
o�visiio�nss..„/that
�-05
any applicant for apermit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
te:' pplicant: ' Ie�'�/ Ute/
(_ 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. 704'4, Business and Professions Code: The
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner -of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES, AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his of her own employees, provided that the
DOLLARS ($100,000). IN ADDITIOMTO THECOST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
” improvements arenot intended oroffered for sale. If, however, thebuilding or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. -'
. 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.).
APPLICANT ACKNOWLEDGEMENT
(_) I, as. owner of the property, am exclusively. contracting with licensed contractors to construct the project (Sec.
IMPORTANT. Application is hereby made to the Director of•Building and'Safety;for a permit subject to the
7044, Business and Professions Code: - The Contractors' State License Law' does not apply to an owner of
conditions and restrictions set forth on this application.
.property who builds or improves thereon, and who contracts for the projects with a contractor(s)"licensed
1 . Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State*Ucense Law.).
whose benefit work is performed under or pursuant to:any permit issued as a result of this application,
1 _ 1 I am exempt under Sec. B.&P.C. for this reason
the owner, and the applicant, each agrees to, and shall defend, indemnify. and hold harmless the City
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: tp�r
Lender's Address: ( `
LQPERMIT
of La Qumta, 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 !ythorize representatives
of this cou y enter upon the above-mentioned propyMy for inspe n pufpecac.�
Datey� �(]� ' nature (Applicant or Agent.: /�/
Application Number . . . 05-00003512
LQPERMTT
Structure Information .
Construction Type . .
. TYPE V - NON RATED
Occupancy Type . . .
. . . DWELLG/LODGING/CONG <=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 .
Permi't.Fee
972.00 Plan Check Fee
157.95
Issue Date . . .
Valuation . . .
. 194630
Expiration Date
2/05/06
Qty Unit Charge
Per
Extension
BASE FEE
639.50
95.00 3.5000
THOU BLDG 100,001-5.00,000
332.50
Permit . . .
MECHANICAL
Additional desc .
Permit Fee . . . . .
83.50 Plan Check Fee
5..22
Issue Date
Valuation
0
'Expiration Date
2/05/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00 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
11.00 6.5000
EA MECH EXHAUST HOOD
---------------------------------
6.50
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Permit . . .
ELEC-NEW RESIDENTIAL
Additional desc . .
Permit Fee . . ...
135.48 Plan Check Fee
8.47
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
LQPERMTT
Application Number . . . . . 05-00003512
Permit . . . . . . ELEC-NEW RESIDENTIAL
Qty Unit Charge Per Extension
681.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 13.62
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Permit . . . PLUMBING
Additional desc . .
Permit Fee . . . . 178.50
Issue Date . . . .
Expiration Date . . 2/05/06
Plan Check Fee . . 11.16
Valuation . . . . 0
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 3.0000
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
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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
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Special Notes and Comments
SFD - LOT 21. PLAN 3BXR,
3053 SF.
PERMIT DOES NOT INCLUDE BLOCK WALLS,
POOL, SPA OR DRIVEWAY
APPROACH. 75%
REDUCTION.TO PLAN CHECK
FEE DUE TO
MULTIPLE ISSUANCE OF
SAME PLAN TYPE
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Other Fees . . . . .
. . . . ART IN PUBLIC PLACES -RES
.00
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
15.80
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
LQPERMIT
Application Number . . . . . 05-00003512
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Other Fees . . . . . . . . . STRONG MOTION (SMI) - RES 19.46
DIF STREET MAINT FAC -RES 15.00
DIF TRANSPORTATION - RES 1098.00
Fee summary Charged
Permit Fee Total 1384.48
Plan Check Total 182.80
Other Fee Total 2440.26
Grand Total 4007.54
LQPERMIT
Paid Credited Due
.00 .00 1384.48
.00 .00 182.80
.00 .00 2440.26
.00 .00 4007.54