14-0187 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application- Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
A cant: ^
" C� A.
14-00000187
58769 JEREZ
764-200-999-13 -316813-
DWELLING - SINGLE FAMILY
LOW DENSITY RESIDENTIAL
394031
T4ht 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
TD DESERT DEVELOPMENT LLC
81570 CARBONERAS
DETACHED LA QUINTA, CA 92253
Architect or Engineer:
Nfq
--------------------------------------------------
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 rofessionals Code, and se is in full force and effect.
License Class: B License -Nd.— 762 9)87
xDatO Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State Licen a 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 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 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 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 contractors) licensed
pursuant to the Contractors' State License Law.).
1 _ 1 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: 2/25/14
Contractor: 1kC5rry01F
TD DESERT DEVELOPMENT LP
P.O. BOX 1716
LA QUINTA, CA 92247 2 6 2014
(760)771-1941
LiC. No.: 762987 LAQUINTA
-----------------------------------------------
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 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 issued. My workers' compensation
insurance carrier and policy number are:
Carrier CA REST MUTUAL Policy Number CRO1134517
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 Labor Cod II forthwith comply with those provisions.
4Datt� L� Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION CO ERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FIN S 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. '
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 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 th a above info ation is correct. I agree to comply with all
city and county ordinances and state laws relatin o building const ruc ion, and hereby aut representatives
of this cou ty to nter upon the above -menti o d property for i6specI n purposes
CDateP2 Signature (Applicant Agent):
Application Number . . . . . 14-00000187
------ Structure Information 4,331SF DWELLINGVB/RES-3/CLASS A-FR/13D -----
Other struct info . . . . . CODE EDITION 2010
# BEDROOMS 4.00
FIRE SPRINKLERS 5239
GARAGE SQ FTG 908.00
PATIO SQ FTG 1307.00
NUMBER OF UNITS 1.00
1ST FLOOR SQUARE FOOTAGE 4331.00
----------------------------------------------------------------------------
Permit
BUILDING 2013
Additional
desc .
Permit Fee
. . . .'
682.63
Plan Check Fee
00
Issue Date
. . . .
Valuation . . .
. 394031
Expiration
Date
8/24/14
Qty Unit Charge
Per
Extension
BASE
FEE
573.43
195.00
----------------------------------------------------------------------------
.5600
THOU BLDG
$200,001-$1M
109.20
Permit
ELECTRICAL
2013
Additional
desc .
Permit Fee
. . . .
227.63
Plan Check Fee
.00
Issue Date
Valuation . . .
. 0
Expiration
Date
8/24/14
Qty Unit Charge
Per
Extension
.00
23.8300
LS ELEC
FIXTURES, FIRST 20
.00
.00
23.8300
EA ELEC
SERVICES
.00
1.00
23.8300
EA ELEC
TEMP POWER POLES
23.83
1.00
143.0000
LS ELEC
NEW RES, FIRST 1 KSF
143.00
5.00
----------------------------------------------------------------------------
12.1600
EA ELEC
NEW RES, ADD'L 1 KSF
60.80
Permit
. . . MECHANICAL 2013
Additional
desc .
Permit Fee
. . . .
405.20
Plan Check Fee
.00
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date
8/24/14
Qty Unit Charge
Per
Extension
- 4.00
35.7500
EA MECH
FURNACE
143.00
4.00
35.7500
EA MECH
CONDENSER/COMP-
143.00
9.00
11.9200
EA MECH
VENT FAN
107.28
1.00
------------------------------------------------------------------=---------
11.9200
EA MECH
EXHAUST HOOD
.11.92
-
0
LQPERMIT
Application Number . . . . . 14-00000187
Permit . . . PLUMBING 2013
Additional desc .
Permit Fee . . . . 357.59 Plan Check Fee
.00
Issue Date . . . Valuation
0
Expiration Date . . 8/24/14
Qty Unit Charge Per.
Extension
22.00 11.9200 EA PLBG FIXTURE/TRAP
262.24
1.00 11.9200 EA PLBG BUILDING SEWER
11.92
2.00 11.9200 EA PLBG WATER HEATER/VENT
23.84
1.00 11.9200 EA PLBG WATER INST/ALT/REP
11.92
1.00 11.9200 EA PLBG BACKFLOW DEVICE
11.92
.00 11.9200 LS PLBG GAS SYS, 1-4 OUTLETS
.00
1.00 35.7500 LS PLBG GAS SYS, 5+ OUTLETS
35.75
----------------------------------------------------------------------------
Special Notes and Comments
4,331SF DWELLING - PLAN 25RA, LOT 13
[VB/RES-3/CLASS A-FR/13D/ENGINEERED]
THIS PERMIT DOES NOT INCLUDE BLOCK
WALLS, POOL, SPA OR WATER FEATURES
**REDUCED PLAN CHECK FEE FOR MULTIPLE
ISSUANCE OF PLAN TYPE** 2010 CALIFORNIA
BUILDING CODES.
February 13, 2014 9:19:47 AM jjohnson.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES
485.08
-BLDG STDS ADMIN (SB1473)
16.00
DIF COMMUNITY CENTERS -RES
129.00
DIF CIVIC CENTER - RES
942.00
DIF FIRE PROTECTION -RES
433.00
DIF LIBRARIES - RES
344.00
MULTI -SPECIES (MSHCP) FEE
1278.00
DIF PARK MAINT FAC - RES
40.00
DIF PARKS/REC - RES
2048.00
PLAN CHECK, MULTIPLE STR
47.67
STRONG MOTION (SMI) - RES
39.40
TUMF: RESIDENTIAL
1837.44
DIF STREET MAINT FAC -RES
116.00
DIF TRANSPORTATION - RES
2842.00
Fee summary Charged Paid Credited
Due
---------------------------------------------------------
Permit Fee Total 1673.05 .00 .00
1673.05
Plan Check Total.. .00 .00 .00
.00.
Other Fee Total 10597.59 .00 .00
10597.59
Grand Total 12270.64 .00 .00
12270.64
LQPERMIT
Application Number . . . . . 14-00000187