06-3859 (SFD)A-0
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
X06-00003859
47896 DANCING BUTTERFLY
649-030-069-119 -31311 -
DWELLING - SINGLE FAMILY
HIGH DENSITY RESIDENTIAL
84922
Tiht 4 4& Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SANTA ROSA DEVELOPMENT INC
46753 ADAMS ST
DETACHED LA QUINTA, CA 92253
(760)771-3345
Architect or Engineer:
Iz9
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 and Professionals Code, and my License is in full force and effect.
License Class: B[ C8 License No.: 824183
ate:lj 8 (J tractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason ISec. 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 (5500).:
(_) 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, as owner of the property, am exclusively contracting with licensed contractors to construct the project ISec.
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 _ 1 I am exempt under Sec. , BAP.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: Ilk
LQPERA11T
Contractor:
CONSOLIDATED CONTRACT
46753 ADAMS STREET
LA QUINTA, CA 92253
(760)771-3345
Lic. No.: 824183
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/30/06
�FNNOV 20 2006 ID.
OF LA QUINTA
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 STATE FUND - Policy Number 1770749
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
3700 of the Labor Code, I shall forthwith comply with those provisions.
Date:`,
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES 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 Ouinta, 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 information is correct. I agree to comply with all
city.and county ordinances and state laws relating to building construction, and hereby autporize representatives
of this c dAtttyyy to enter upon the above-mentioned property for inspection purposes.
pet, S' cure (Applicant or Agent):
LQPERMIT
Application Number . . . . . 06-00003859
Permit
. . .
BUILDING PERMIT
Additional
desc . .
Permit Fee
. . .
572.00
Plan Check Fee
92.95
Issue Date
. . . .
Valuation . . . .
84922
Expiration
Date
4/28/07
Qty Unit Charge.
Per
Extension
BASE
FEE
414.50
35.00
---------------------------•-------------------------------------------------
4.5000
THOU .BLDG
50,001-100,000
157.50
Permit
. . .
MECHANICAL
Additional
desc .
Permit Fee
. . . .
46.00
Plan Check Fee
2.88
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date
4/28/07
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
1.00
9.0000
EA MECH
FURNACE <=100K
9.00
1.00
9.0000
EA MECH
B/C <=3HP/100K BTU
9.00
1.00
6.5000
EA MECH
VENT FAN
6.50
1.00
----------------------------------------------------------------------------
6.5000
EA MECH
EXHAUST HOOD
6.50
Permit
. . .
ELEC-NEW RESIDENTIAL
Additional
desc . .
Permit Fee
. . . .
70.07
Plan Check Fee
4.38
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date
4/28/07
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
1331.00
.0350
ELEC
NEW RES - 1 OR 2 FAMILY
46.59
424.00
----------------------------------------------------------------------------
.0200
ELEC
GARAGE OR NON-RESIDENTIAL
8.48
Permit
. . .
PLUMBING
Additional
desc .
Permit Fee
116.25
Plan Check Fee
7.27
Issue Date
Valuation . . . .
0
Expiration
Date
4/28/07
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
8.00
6.0000
EA PLB FIXTURE
48.00
1.00
15.0000
EA PLB BUILDING SEWER
15.00
Application Number . . . . 06-00003859
Permit . . . . . . PLUMBING
Qty Unit Charge Per
Extension
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
5.00 .7500 EA PLB GAS PIPE >=5
3.75
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 4/28/07
Qty Unit Charge Per
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes and Comments
SFD - LOT 119, PLAN 2B, 1331 SF. PERMIT
DOES NOT INCLUDE POOL, SPA, BLOCK WALLS
OR DRIVEWAY APPROACH. 75% REDUCTION TO
PLAN CHECK FEES DUE TO MULTIPLE
ISSUANCE OF SAME PLAN TYPE
2001.CBC, CMC, CPC, 2004 CEC, 2005
ENERGY CODES
----------------------------------------------------------------------------
Other.Fees . . . . . . . ., DIF COMMUNITY CENTERS -RES
74.00
DIF CIVIC CENTER - RES
995..00
ENERGY REVIEW FEE
9.30
DIF FIRE PROTECTION -RES
140.00
GRADING PLAN CHECK FEE
.00
DIF LIBRARIES - RES
355.00
DIF PARK MAINT FAC - RES
22.00
DIF PARKS/REC - RES
'892.00
STRONG MOTION (SMI) - RES
8.49
DIF STREET MAINT FAC -RES
67.00
DIF TRANSPORTATION - RES
1930.00
Fee summary Charged Paid Credited
---------------------------------------------------------
Due
Permit Fee Total 819.32 .00 .00
819.32
Plan Check Total 107.48 .00 .00
107.48
Other Fee Total 4492.79 .00 .00
4492.79
Grand Total 5419.59 .00 .00
5419.59
LQPERMIT
�a��uivri`Q,•�,
f� Certificate of Occupancy
_ _-- 4 ui�crcv
t� 4�
OF 9w� Building YDepartment& Safet
This Certificate is issued pursuant to the requirements of Section 109 of the California Building
Code, certifying that, at the time of issuance, this structure was in compliance with the
provisions of the Building Code and the various ordinances of the City regulating building
construction and/or use.
BUILDING ADDRESS: 47-896 DANCING BUTTERFLY, LOT 119
Use classification: SINGLE FAMILY DWELLING Building Permit No.: 06-3859
Occupancy Group: R-3 Type of Construction: V -N Land Use Zone: RH
Owner of Building: SANTA ROSA DEVELOPMENT INC Address: 46-753 ADAMS ST
City, ST, ZIP: LA QUINTA, CA 92253
By: KIRK KIRKLAND
Date: JULY 10, 2007
Building Official
POST IN A CONSPICUOUS PLACE
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