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06-1140 (SFD)P.O. BOX 1504 78495 CALLE TAMPICO LA QUINTA; CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: T4t!t 4 XP Qm&& BUILDING &.:SAFETY DEPARTMENT BUILDING PERMIT 06-00001140 81775 EAGLE CLAW DR 764-280-999--115 -300235- DWELLING - SINGLE FAMILY DETACHED MEDIUM HIGH DENSITY RES 170639 Architect or Engineer: Q.0-15 fa C�jYlSi�-Q_� � - VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS -(760) 777-7153 Date: 3/20/06 QUI -NTA F MCQUEEN GAINEY CENTER ALE. AZ 85258 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. Lioen C s2s: License No.: :672285 at U� ntrector. �'� OWNE"UILDER DECLARATION I hereby. affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 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 orshe'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).: (_ } 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 oroffered,for sale. If, however, the building or improvement is sold within onte.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, as owner of the property, amexclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law.dces _not apply to sn owner of property who builds or improves thereon, and who contracts for the projects with a contractors) licensed pursuantto 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.). Lenders Name: Lender's Address: GUM HOMES, INC. 81260 AVENUE 62 LA QUINTA CA 92253 (760)777-6005 Lic. No.: 672285 350 ---------------- 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, 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 perrnit'is issued. My workers' compensation insurance carrier and policy number are:, Carrier AMERICAN` HOME Policy Num r 1247619 _ I certify that,, in the performance of -the work f whichthls permit is issued, I shall not employ any person in any manna o as to become su to the workers', compensation laws of California, and agree that, 'rf I s Id become subj the workers' cempensation provisions of Section of'the 4 C 11 folh b2M& with those provisions. 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 (8100;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 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 Quints, 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 Lha have ad this application and state that the<above informati is correct. I agree to comply with,all city and my obi a send to laws relating to b '(ding constructio end hery�y authorize representatives of t ' tgen n above-mentione�d/pfd ns l- ate: ti nature (Applicant or Ageif�{J Application Number . . . . . 06-0000.1140 Structure Information Construction Type . . . . . TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING%LONG <=10 Flood Zone . . . . . NON -AO FLOOD ZONE. Other- struct into . . . . . CODE EDITION 2001 CBC FIRE SPRINKLERS NO GARAGE SQ FTG 576.00 PATIO SQ FTG 177.00 NUMBER OF UNITS 1.00 1ST FLOOR SQUARE FOOTAGE 1943.00 Permit . . . BUILDING PERMIT Additional desc .. Permit Fee . . . . 888.00 Plan Check Fee 577.20 - Issue Date . . . . - Valuation . . . . 170639 Expiration Date . . 9/16/06 Qty Unit Charge Per Extension BASE FEE 639.50 71.00 3.5000 ------------------------------------------------------------------------------ THOU BLDG 100,001-500,000 248.50 Permit . . . MECHANICAL Additional desc . Permit Fee 70.50 Plan Check Fee 17.63 Issue Date . . . . Valuation . . . . 0 Expiration Date . . . 9/16/06 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 9.0000 EA MECH FURNACE .<=100K 18.00 2.00 9.0000 EA MECH B/C <=3HP/100K BTU 18.00 2.00 6.5000 EA MECH VENT FAN 13.00 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 Permit . . . Additional desc Permit Fee. Issue Date . . Expiration Date . . Qty Unit Charge 1943.00 .0350 .576.00 .0200 LQPERMff . ELEC-NEW RESIDENTIAL 94.53 Plan Check Fee . . Valuation . . . . 9/16/06 23.63 0 Per Extension BASE FEE 15.00 ELEC NEW RES - 1 OR 2 FAMILY 68.01 ELEC GARAGE OR NON-RESIDENTIAL 11..52 Application Number . . . . . 06-00001140 Permit. . . . PLUMBING Additional desc . . Permit Fee . . . . 152.25 P1an.Check Fee... 35.81 Issue Date . . Valuation . . . . 0 Expiration. Date 9/16/06 Qty Unit Charge Per Extension BASE FEE 15.00 14.00 6.0000 EA PLB FIXTURE 84.00 1.00 15.0000 EP. PLB BUILDING SEWER 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 3.0'000 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 3.15 1.00 15.0000 E PLB GAS METER 15.^0 Permit . . . GRADING PERMIT Additional desc . Permit Fee . . . . 15.00 Plan Check Fee .00 Issue. Date Valuation . . . . 0 Expiration Date . . 9/16/06 Qty Unit Charge Per Extension. BASE FEE 15.00 ------------------------------------------------------------ --------------------- -- ---------------------------------------------------------- Special Special. Notes and Comments SFD - LOT 115, PLAN 4520C, 1943 SF/ 255 SF CAS.ITA;BOX BAY @ MBR -26 SF 4' GARAGE EXT - 88 SF.PERMIT DOES NOT INCLUDE BLOCK WALLS,POOL, SPA OR DRIVEWAY APPROACH. 20.0.1 CBC, CMC, CPC, 2004 CEC, 2.005 ENERGY CODES Other Fees . . . . . -------------------------------------- . . . . ART IN'PUBLIC PLACES -RES .00 DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER - RES_ 480.00 ENERGY REVIEW FEE 57.72 DIF FIRE PROTECTION -RES 140.00 GRADING PLAN CHECK FEE .00 DIF LIBRARIES - RES 355.00 DZF PARk MAINT FAC - RES 22.00 DIF _PARKS/REC - RES 8.92.00 STRONG MOTION (SMI) - RES 17,,06 DIF STREET'MAINT FAC -RES 67.00 DIF TRANSPORTATION - RES 1666.00 Iru:DIcI�,Iva Application Number . . . . . 06-00001140 Fee summary Charged ----------- Paid ----------- ------------------ Permit Fee Total 1220.28 .00 Plan Check Total 654.27 .00 Other Fee Total 3770.78 .00 Grand Total 5645.33 .00 LQPBRMrr Credited Due .00 1220.28 .00 654.,27 .00 3770.78 .00 5645.33