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10-0926 (SFD)r r 4 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T4ht 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: C10-0�0926-7� Property Address: 52825 HUMBOLDT BLVD APN: 767-880-014- - - Application description: DWELLING - SINGLE FAMILY DETACHED Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 376454 Applicant: Architect or Engineer: PIP LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that II' nse under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business a d ofess n Code, and my License is,in full force and effect. Licens la ssAB Lice a No.: 915336 Date: Coy ctor. NER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I a xempt from the Contractor's State License Law for the following reason (Sec. 7031 .5, Business and P ssions Code: Any city or county that requires a permit to construct, after, improve, demolish, or repair an tructure, 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 70001 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 1, 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.). (_ ) 1 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 Owner: EAST OF MADISON LLC PO BOX 1482 LA QUINTA, CA -92247 Contractor: DBCA INC P.O. BOX 1482 6 LA QUINTA, CA 922471 (760)393-5271 Lic. No.: 915336 F VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 ®Lti7 U Ulu Date: 9/22/10 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. V, 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 TRAVELERS PROP Policy Number YEUB282D779708 _. 1 certify that, in the performance of work for which this permit is issued, I shall not employ any person in any manner so as t b betthe o the workers' compensation laws of California, and agree that, if I should be m workers' compensation provisions of Section (937%00 of the Lab r Code, I sh I ty with those provisions. a4 te: 1L-( r'V ica WARNING: FAILURE TO SECURE WORKERS' PENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENA�S AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE T OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTER 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 stateLtheov in ation is correct. I agree to comply with all city and county ordinances and state laws relating c s tion, ereby authorize representatives of this county to enter upon the above-mentionedr i sn pDate: ' G 'V � nature (Applicant or Agen Application Number 10-00000926 LQPERMIT ------ Structure Information VILLA UNIT 1 - 4244 SF LIV. ----- Construction Type . . . . . TYPE V, UNPROTECTED Occupancy Type DWELLG/LODGING/CONG <=10 Other struct info . . . . . CODE EDITION 2007 ## BEDROOMS 4.00 FIRE SPRINKLERS NO GARAGE SQ FTG 905.00 PATIO SQ FTG .118.8.00 NUMBER OF UNITS 1.00 1ST FLOOR SQUARE FOOTAGE 3353.00 - ---------------------------------------------------------------------------- 2ND FLOOR SQUARE FOOTAGE .891.00 .Permit BUILDING PERMIT Additional desc .' . Permit. Fee . . . . 1609.00 Plan Check Fee 261.46 Issue Date . . . . Valuation . . . . 376454 Expiration Date 3/21/11 Qty Unit Charge Per Extension BASE FEE - 639.50 277.00 3.5000 THOU BLDG 100,001-500,000 969.50 Permit MECHANICAL Additional desc . Permit Fee 147.50 Plan Check Fee 9.22 Issue Date Valuation . . . . 0 Expiration Date 3/21/11 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 2.00 11.0000 EA MECH FURNACE >100K 22.00 3.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 49.50 7.00 6.5000 EA MECH VENT FAN 45.50 1.00 6.5000 ---------------------------------------------------------------------------- EA MECH EXHAUST HOOD 6.50 Permit ELEC-NEW RESIDENTIAL Additional desc . . Permit Fee . . . . 196.64 Plan Check Fee 12.29 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 3/21/11 Qty Unit Charge Per Extension BASE FEE 15.00 LQPERMIT .1 , Application Number . . . . . 10-00000926 Permit . . . . . . ELEC-NEW RESIDENTIAL Qty. Unit Charge Per Extension 4244.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 148.54 905.00' .0200 ELEC GARAGE OR NON-RESIDENTIAL 18.10 1.00 15.0000 ---------------------------------------------------------------------------- EA ELEC TEMPORARY POWER POLE 15.00 - Permit . . . PLUMBING Additional desc . Permit Fee . . . . 252.00 Plan Check Fee 15.75 Issue Date . . . . Valuation . . . . 0 Expiration Date 3/21/11 Qty Unit Charge Per Extension' . BASE FEE 15.00 28.00 6.0000 EA PLB FIXTURE 168.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 2.00 6.0000 EA PLB ROOF DRAIN 12.00 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 10.00 .7500 EA PLB GAS PIPE >=5 7.50 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 3/21/11 Qty Unit Charge Per Extension BASE FEE .15.00 ---------------------------------------------------------------------------- Special Notes and Comments VILLA UNIT 1 CARAWAY, LOT 10 -4244 SF LIVING,. 1188 SF PATIOS,905 SF GARAGE 2 -STORY SFD.PERMIT DOES NOT INCLUDE BLOCK WALLS, POOLS, SPA, DRIVEWAY APPROACH. 2007 CODES. 75% REDUCTION TO PLAN CHECK FEES DUE TO MULITPLE ISSUANCE OF SAME PLAN TYPE. DEVELOPER IMPACT FEES CARRIED OVER FROM OLD PERMIT #08-625 September 22, 2010 12:58:35 PM KHENSEL. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES 441.14 LQPERMIT Application Number . . . . . 10-00000926 ---------------------------------------------------------------------------- Other Fees . . . . ... BLDG STDS ADMIN (SB1473) 15.00 ENERGY REVIEW FEE 26.15 STRONG MOTION (SMI). - RES 37.65 Fee summary Charged Paid Credited Due ----------------- ---------- ------------------------------- ---------=Permit Permit Fee Total 2220.14 .00 .00, 2220.14 Plan Check Total 298.72 .00 .00 298.72 Other Fee Total 519.94 .00 .00 519.94 Grand Total 3038.80 .00 .00 3038.80 LQPERMIT