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11-0640 (SFD)P.O. BOX 1504 4 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: `-%--11-00000640_ Owner: Property Address: 52705 HUMBOLDT BLVD EAST OF MADISON LLC APN: 767-200-091-15 -34968 - PO BOX 1482 Application description: DWELLING - SINGLE FAMILY DETACHED LA QUINTA, CA 92247 Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 430774,. Contractor: ^^^"^�^• Architect or Engineer. DBCA INC P.O. BOX 1482 LA QUINTA, CA 92247 - --- - - - - _ _ - (760) 393-5271 Lic. No.. 915336 UCENV,D CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I ice er provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business a , roCode,and my License is in full force and effect. Lice�r se C)bss: 1B 915336 i NER-BUILDER DECLARATION I herebyaffirm under penalty of perjury that I a xem t from the Contractor's Stat License Law for h P Y P 1 Y P e Se 0 to following reason (Sec. 7031.5, Business and Pr ssions Code: Any city or county that requires a permit to construct, alter, 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 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 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: 6/15/11 DI � ; J,� � 2� 11 � • CITYojp9AG1AA 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 TRAVELERS PROP Policy Number YEUB282D779711 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 fcome b,ectto the workers' compensation laws of California, and agree that, if I should be�su lect the workers' compensation provisions of Section /3700 of the )abor Code, I s$$rth ,th co ly with those provisions. WARNIAG: FAILURE TO SECURE WORKERIT, MPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO TST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTAND 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, indemnity 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 Aaboi rmati correct. I agreeto comply with all city and county ordinances and state laws relating to bn ctio ,and eby authorize representatives of thi my enter upon the above-mentioned props urposes at �Xatwe (Applicant or i Application Number . . . . . 11-00000640 Permit BUILDING PERMIT Additional desc . Permit Fee . . 1798.00 Plan Check Fee 1168.70 Issue Date Valuation 430774 Expiration Date 12/12/11 Qty Unit Charge Per Extension BASE FEE 639.50 331.00 --------------------------------------------------------------- 3.5000 THOU BLDG 100,001-500,000 =------------ 1158.50 Permit MECHANICAL ' Additional desc . Permit Fee . . . . 163.00 Plan Check Fee 40.75 Issue Date . . . . Valuation . . . 0 Expiration Date 12/12/11 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 9.0000 EA MECH FURNACE <=100K 27.00' 3.00 .16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 49.50 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 205.49 Plan Check Fee 51.37 Issue Date . . . . Valuation . . . . 0 Expiration Date 12/12/11 Qty Unit Charge Per Extension BASE FEE 15.00 4859.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 170.07 1021.00 ---------------------------------- .0200 ELEC ------------------------------------------ GARAGE OR NON-RESIDENTIAL 20.42 Permit . . . PLUMBING Additional desc . Permit Fee . . . . 273.00 Plan Check Fee 68.25 Issue Date . . . . Valuation . . . . 0. Expiration Date 12/12/11 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 LQPERMIT Application Number ii -00000640 Permit . . . . . PLUMBING Qty Unit Charge Per Extension 2.00 7.5000 EA PLB WATER HEATER/VENT 15.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 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 12/12/11 ` Qty Unit Charge Per Extension BASE FEE 15.00 ----------------'------------------------------------------------------------ Special Notes and Comments SFD - LOT 15 PLAN 2 WITH CASITA - 4859 SF LIVING, 1365 SF PATIOS,. 1021 SF - GARAGE -(INCLUDES 99 SF TRASH ' SHED).PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS OR DRIVEWAY APPROACH. 2007 CODES. DEVELOPER IMPACT FEES CARRIED OVER FROM OLD PERMIT #08-631. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES 576.94 BLDG STDS ADMIN (SB1473) 14.00 ENERGY REVIEW FEE 116.87 - MULTI -SPECIES (MSHCP) FEE 1284.00 STRONG MOTION (SMI) - RES 43.08 Fee summary Charged Paid Credited --------------------------------------------------------- Due Permit Fee Total 2454.49 .00 .00 2454.49 Plan Check Total 1329.07 .00 .00 1329.07 .Other Fee Total 2034.89 .00 .00 2034.89 Grand Total 5818.45 .00 .00 5818.45 LQPERMIT