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10-0927 (SFD)4 P.O. BOX 1504 ^' 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 ` BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number.C10-0_00_00927 Owner: Property Address: 52805 HUMBOLDT BLVD EAST OF MADISON LLC APN: 767-880-015- - - PO BOX 1482 Application description: DWELLING - SINGLE FAMILY DETACHED LA QUINTA, CA 92247 Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 428833 Contractor: Applicant: Architect or Engineer: DBCA INC P.O. BOX 1482 LA QUINTA, CA 92247 (760)393-5271 1j! f Lic. No.: 915336 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty oLBusiness a I nsed under provisions of Chapter 9 (commencing with Section 700 f Division 3 of nd fessio Code, and my License is in full force and effect. Licens ass: B Lice No.: 915336 9 ntrac / O ER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am mpt from the Contractor's State License Law for the following reason (Sec. 7031 .5, Business and Pro ions Code: Any city or county that requires a permit to construct, aper, improve, demolish, or repair any cture, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is I ensed 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 [heir 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.). (_ I 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—) 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 agericy for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: 1� r LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/22/10 (7 �1 g � Iy _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ r — • WORKER'S COMPENSATIO ATION 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 TRAVELERS PROP Policy Number YEUB282D779708 _ 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 A1��'.'oma subject to the workers' compensation laws of California, and agree that, if I should b' a bl to the workers' compensation provisions of Section 3700 of the Labor Code, I s for with c ly with those provisions. WARNING: FAILURE TO SECURE WORKERS' MPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEN IES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE ST 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 state that the above in mati is correct. I agree to comply with all city and county ordinances and state laws relating to building co st tion an eby authorize representatives of�this ccloount to enter up the above-mentioned property for in p 'on p rposes. pate: 1 N �6 ignature (Applicant or Application Number . . . . 10-00000927 ------ Structure Information VILLA 2 - 4287 SF LIV. 2 STORY SFD ----- Other struct info . . . . . CODE EDITION 2007 # BEDROOMS 4.00 FIRE SPRINKLERS NP GARAGE SQ FTG 922.00 PATIO SQ FTG 1365.00 NUMBER OF UNITS 1.00 '1ST FLOOR SQUARE FOOTAGE 3586.00 2ND FLOOR SQUARE FOOTAGE 1273.00 ---------------------------------------------------------------------------- Permit BUILDING PERMIT Additional desc Permit Fee . . . 1791.00 Plan Check Fee 291.03 Issue Date . . . . I Valuation . . . 428833 Expiration Date 3/21/11 Qty Unit Charge Per Extension BASE FEE 639.50 329.00 3.5000 THOU BLDG 100,001-500,000 1151.50 ---------------------------------------------------------------------------- Permit . . . . . MECHANICAL Additional desc . Permit Fee . . . . 179.50 Plan Check Fee 9.37 Issue Date Valuation . . . . 0 Expiration Date 3/21/11 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 9.0000 EA MECH FURNACE <=100K 27.00 4.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 66.00 10.00. 6.5000'EA MECH VENT FAN 65.00 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 ---------------------------------------------------------------------------- Permit . . . ELEC-NEW RESIDENTIAL Additional desc . Permit Fee . . . . 218.51 Plan Check Fee 12.37 Issue Date . . . . Valuation 0 Expiration Date 3/21/11 Qty Unit Charge Per Extension BASE FEE 15.00 4859.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 170.07 922.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 18.44 1.00 15.0000 EA ELEC TEMPORARY POWER POLE 15.00 LQPERMIT LQPERMIT Application Number 10-00000927 ---------------------------------------------------------------------------- Permit . . . PLUMBING Additional desc . Permit Fee . . . . 273.00 Plan Check Fee 14.25 Issue Date . . . . Valuation . . . . 0 Expiration Date 3/21/11 Qty Unit Charge Per Extension BASE FEE 15.00 32.00 6.0000 EA PLB FIXTURE 192.00 1.00 15.0000 EA PLB BUILDING SEWER __15.00 2.00 7.5000 EA PLB WATER HEATER/VENT 15.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.0.0 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 12.00 .7500 EA PLB GAS PIPE >=5 9.00 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 3/21/11 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments SFD, PLAN 2 WITH CASITA GATSBY-4859 SF LIVING, 1365 SF PATIOS,922 SF GARAGE . PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL, SPA, DRIVEWAY APPROACH. 2007 CODES. 75% REDUCTION TO PLAN CHECK FEES DUE TO MULTIPLE ISSUANCE OF SAME PLAN TYPE. DEVELOPER IMPACT FEES CARRIED OVER FROM OLD PERMIT #08-629. September 22, 2010 1:00:46 PM KHENSEL. ---------------------------------------------------------------------------- Other Fees . . . . . . . . ART IN PUBLIC PLACES -RES 572.08 BLDG STDS ADMIN (SB1473) 18.00 ENERGY REVIEW FEE 29.10 STRONG MOTION (SMI) - RES 37.93 Fee summary Charged Paid Credited ----------------- Due ---------------------------------------- Permit Fee Total 2477.01 .00 .00 2477.01 LQPERMIT Application Number . . . . . 10-00000927 Plan Check Total 327.02 .00 .00. 327.02 Other Fee Total 657.11 .00 .00 657.11+ Grand Total 3461.14 .00 .00 3461.14 LQPERMIT