The URL can be used to link to this page

12-0081 (SFD)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 12-00000081 1 Property Address: 52555 HUMBOLDT BLVD APN: 767-200-091-18 -34968 - Application description: DWELLING - SINGLE FAMILY Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 460965 Tiht " BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: EAST OF MADISON LLC PO BOX 1482 DETACHED LA QUINTA, CA 92247 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 5/07/12 Contractor: Applicant: Architect or Engineer: DBCA INC O P.O. BOX 1482 0'A LA QUINTA, CA 92 G (760)393-5271 Lic. No.: 9153 6 ---- --- -----� Ct -------------------------------------------------------------------------�p- -_ --- - - --------- LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I a licensed under provisions.of Chapter 9 (commencing with Section 7000) of Division 3 of the Business rof als Code, and my License is in full force and effect. License Cl ss: B ense No.: 915336 ate:1. contract WNER-BUILDER DECLARATION . I hereby affirm under penalty of perjury that I exempt from the Contractor's State License Law for the . following reason (Sec. 7031.5, Business and fessions 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 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, 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 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: 1 Lender's Address: l� LQPERMIT j WORKER'S COMPEN-S7fvN RATION/, I AT10 /(l/ I hereby affirm under penalty of perjury one of the following decli 1 have and will maintain a certificate of consent to self-insu a for wor ers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of thework for which this permit is issued. � JALJ have and will maintain workers' compensation insurance, as required< y 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 Policy Number YJUB282D7797-12 _ 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�ome subject to the workers' compensation laws of California, and agree that, if I should be�s to the workers'compensation provisions of Section X3700 of the Labor Code, I slmJ31rt with c ply with those provisions. WARNING: FAILURE TO SECURE WORKERS11OMPENSATION 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 THEP FOST 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, 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 the abov formation is correct. I agree to comply with all city and county ordinances and state laws relating to building c ru io and hereby authorize representatives of this c ty enter upon the above-mentioned property for i ct n pur ses. te: ��ature (Applicant•or Ag nt): ••,� -sem Application Number . . 12-00000081 Permit BUILDING PERMIT Additional desc . Permit Fee . . . . 1693.00 Plan Check Fee 1100.45 Issue Date . . . Valuation . . . . 400965 Expiration Date 11/03/12 Qty Unit Charge Per Extension BASE FEE 639.50 301.00 --------------- 3.5000 ----------- THOU BLDG ----------- 100,001-500,000 --------------------------- 1053.50 ------------ Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 147.50 Plan Check Fee 36.88 Issue Date . . . . Valuation . . . . 0 Expiration Date 11/03/12 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 ----------------------------------------------------------------------------- 6.50.00 EA MECH EXHAUST HOOD 6.50 Permit ELEC-NEW-RESIDENTIAL Additional desc . Permit Fee 188.33 Plan Check Fee 47.08 Issue Date . . . . Valuation 0 Expiration Date 11/03/12 Qty Unit Charge Per Extension BASE FEE 15.00 4435.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 155.23 905.00 ---------------------------------------------------------------------------- .0200 ELEC GARAGE OR NON-RESIDENTIAL 18.10 PermitPLUMBING Additional desc ` Permit Fee _ 252.0.0 Plan Check Fee 63.00 Issue Date Valuation . . . . 0' . Expiration Date . 11/03/12 Qty Unit Charge _Per' Extension BASE FEE 15.00 28.00 6.0000 EA PLB FIXTURE 168.00 LQPERMIT LQPERMIT Application Number . . . . . 12-00000081 Permit . . . . . . PLUMBING Qty Unit Charge Per Extension 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 11/03/12 Qty Unit Charge Per Extension BASE FEE 15.00 --------------------------------------------------=------------------------- Special Notes and Comments SFD, LOT 18 PLAN 1R, 4435 S.F.PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS OR DRIVEWAY APPROACH. 2010 CODES. ---------------=------------------------------------- Other Fees . . . . . ----------------------- . . . . ART IN PUBLIC PLACES -RES 502.41 BLDG STDS ADMIN (SB1473) 17.00 DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER - RES 995.00 ENERGY REVIEW FEE 110.05 DIF FIRE PROTECTION -RES 140.00 GRADING PLAN CHECK FEE .00 DIF.LIBRARIES - RES 355.00 MULTI -SPECIES (MSHCP) FEE 1254.00 DIF PARK MAINT FAC - RES 22.00 DIF PARKS/REC - RES 892.00 STRONG MOTION•(SMI) - RES 40.10 DIF STREET MAINT FAC -RES 67.00 DIF TRANSPORTATION - RES 1930.00 Fee summary Charged Paid Credited -------------------- Due ---------------------------- Permit Fee Total ---------- 2295.83 .00 .00 2295.83 Plan Check Total 1247.41 .00 .00 1247.41 _. Other Fee Total 6398.56 .00 .00 6398.56 Grand Total 9941.80 .00 .00 9941.80 LQPERMIT