04-5520 (SFD)1j
I I T.Vf 4 4 a"
BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760).777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number 04=000"05;520% Date 7/15/04
Property Address . . . . "�47"685 WIND%SPIRCT DR
APN: 658-140-999-66 -29436 -
Application description . . . DWELLING - SINGLE FAMILY DETACHED
Property Zoning . . . . . . . LOW DENSITY RESQDENTIAL
Application valuation . . . . 215169
Owner Contractor
------------------------ -------------------------
IVANHOE LA QUINTA COVE TRANS -WEST HOUSING, INC.
C/O R BARRY MCCOM.IC 9968 HIBERT STREET, STE #102
7979 IVANHOE AVE'' STE;5;50 7 ,� SAN DIEGO CA 92131
q,a lfi•�u u,1"y
LA JOLLA p� CA �9 =2-037 (858) 653-3003
NOV 16 2004 WCC: STATE FUND °
WC: 1648813 10/01/04
cl�roz��ara"ooCSLB: 701039 01/31/05
FWA� XE U20 �
CCC: B
-------------------------- Structure Information --7 ----------------------
Construction Type . . . . . TYPE V - NON RATED
Occupancy Type . . . . . DWELLG/LODGING/CONG <=10
Flood Zone NON -AO FLOOD ZONE
Other struct info . . . . . CODE EDITION 2001 CBC
# BEDROOMS 4.00
FIRE SPRINKLERS NO
GARAGE SQ FTG 688..00
PATIO SQ FTG 705.00
NUMBER OF UNITS 1.00
FIRST FLOOR SQ FTS 3362.00
----------------------------------------------------------------------------
Permit . . . . . . BUILDING PERMIT
Additional desc
Permit Fee . . 1045.50 Plan Czeck Fee 169.90
Issue Date . . . . Valuation 215169
Qty Unit Charge Per Extension
BASE FEE 639.50
116.00 3.5000 THOU BLDG 100,001-500,000 406.00
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Permit . . . . . MECHANICAL
Additional desc
Permit Fee . . . . 77.00 Plan Check Fee 4.81
Issue Date . . . . Valuation 0
Qty . Unit Charge Per Extension
(E I
P.O. BOX 1504
f1Y
78-495 CALLE TAMPICO VOICE (760) 777-7012FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 04 • SSoZD Date:
I' t•
App ICan
Applicant's Mailing Address:
--Architect
Architect
-4c. No.
or Engineer:
or Engineer's Address:
t3UILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
1 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
Ce, and my License jlin full force and effect. � (�
/license Class r ;i license No. V
--bate ontractor � v" w
OWNER -BUILDER DECLARATION
I hereby a rm under penalty of perjury that I am exempt from the Contractors' 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 or she is licensed pursuant to the provisions of the Contractors' 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 p civil penalty of not more than five hundred dollars ($500).):
U 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 sate (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 or 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.).
U 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.).
U I am exempt under Sec. , BA P.C. for this reason
Date Owner
WORKERS' 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.
1 h ve 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
i s e My woVrs'comobnsation irys�2nce carrier and policy number are:
�rrier. ' policy Number I �]Q 1
I certify that, in the erforma ce of the work for which this permit is issued, 1 shall no e p yla�ny on in any manner so as to become subject to the workers'
compensation laws of Calilomia. and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Libor Code, I shall
forthwith comply with those provisions.
ate • '-�Applicant Dy
7-7
WARNIN : FA URE 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.
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
Lenders Address _
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
constructio , an hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes.
Date (5 �ure (Applicant or Agent): 911 1�4
Application Number . . . . . 04-00005520
Page 2
Date 7/15/04
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
3.00
6.5000
EA
MECH
VENT FAN
19.50
1.00
6.5000
EA
MECH
EXHAUST HOOD
6.50
--------------------------------------------------------7-------------------
Permit . .
. . .
ELEC-NEW RESIDENTIAL
Additional desc
Permit Fee
146.43
Plan Check Fee
9.15
Issue Date
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
BASE
FEE
15.00
3362.00
.0350
ELEC
NEW RES - 1 CR 2 FAMILY
117.67
688.00
.0200
ELEC
GARAGE OR NOIR-RESIDENTIAL
13.76
-----------------------------------------
Permit . . .
. . .
PLUMBING
------------------------------------
Additional desc
. .
Permit Fee .
. . .
196.50
Plan Check Fee
12.28
Issue Date .
. . .
Valuation
0
Qty Unit
Charge
Per
Extension
BASE
FEE
15.00
21.00
6.0000
EA
PLB
FIXTURE
126.00
1.00
15.0000
EA
PLB
BUILDING SEWER
15.00
1.00
7.5000
EA
PLB
WATER HEATER/VENT
7.50
1.00
3.0000
EA
PLB
WATER INST/AL--/REP
3.00
1.00
9.0000
EA
PLB
LAWN SPRINKLER SYSTEM
9.00
.00
3.0000
EA
PLB
GAS PIPE 1-4 OUTLETS
.00
8.00
.7500
EA
PLB
GAS PIPE >=5
6.00
1.00
15.0000
EA
PLB
GAS METER
15.00
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Permit . . .
. . .
GRADING PERMIT
Additional desc
Permit Fee .
. . .
15.00
Plan Check Fee
.00
Issue Date .
. . .
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
----------------------------------------------------------------------------
BASE
FEE
15.00.
Special Notes
and Comments
SFD - LOT 66 PLAN
2B
3362
SF. PERMIT
Fee summary Charged
Permit Fee Total 1480.43
Plan Check Total 196.14
Other Fee Total 2481.42
Grand Total 4157.99
Paid Credited Due
---------- ---------- ----------
.00 .00 1480.43
.00 .00 196.14
.00 .00 2481.42
.00 .00 4157.99
Page
3
Application Number . . . . .
04-00005520 Date
7/15/04
----------------------------------------------------------------------------
Special Notes and Comments
DOES NOT INCLUDE BLOCK WALLS,
POOL, SPA
OR DRIVEWAY APPROACH. 75% PLAN
CHECK FEE
REDUCTION APPLIED FOR MULTIPLE
ISSUANCE
OF PERMIT TYPE.
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Other Fees . . . . . . . . .
ART IN PUBLIC PLACES -RES
37.92
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
16.99
DIF FIRE PROTECTION -RES
97.00
GRADING PLAN CHECK FEE
.00
DIF LIBRARIES - RES
225.00
DIF PARK MAINT FAC - RES
5.00
DIF PARKS/REC - RES
502.00
STRONG MOTION ;SMI) - RES
21.51
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary Charged
Permit Fee Total 1480.43
Plan Check Total 196.14
Other Fee Total 2481.42
Grand Total 4157.99
Paid Credited Due
---------- ---------- ----------
.00 .00 1480.43
.00 .00 196.14
.00 .00 2481.42
.00 .00 4157.99