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04-5474 (SFD)m O� BUILDING & SAFETY DEPARTMENT (760).777-7012 ¢T 78-495 CAL�ET�AMPICO FAX (760) 777-7011 LA .QUI.NTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 19cv,^� BUILDING PERMIT Application Number . . Property Address . . . APN: Application description Property Zoning . . . . Application valuation . Owner ------------------------ IVANHOE LA QUINTA COVE C/O R BARRY MCCOMIC 7979 IVANHOE AVE STE 550 LA JOLLA CA 92037 -04-000'05474. 47895 WIND SPIRIT DR 658-140-999-73 -29436 - DWELLING - SINGLE FAMILY LOW DENSITY RESIDENTIAL 215169 Contractor Date 7/15/04 DETACHED TRANS -WEST HOUSING, INC. 9968 HIBERT STREET, STE 4102 SAN DIEGO CA 92131 (858) 653-3003 WCC: STATE FUND WC: 1648813 10/01/04 CSLB: 701039 01/31/05 CCC: B -------------------------- Structure Information ------------------------- Construction Type TYPE V - NON RATED Occupancy Type .. . . . . . DWELLG/LODGING/LONG <=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 FTG 3362.00 -----------------------'------------------------------------------------------ Permit . . . . ... BUILDING PERMIT Additional desc Permit Fee 1045.50 Plan Check 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 ---------------------------------------------------------------------------- Permit . . . . . MECHANICAL Additional desc Permit Fee . . . . 77.00 Plan Check Fee 4.81 Issue Date . . . . Valuation 0 Qty Unit Charge Pet Extension P.O. BOX 1504 w VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Q!�- r!� 7Z/ Applicant: Applicant's Mailing Address: Date: ---Architect or Engineer: _*WN - Architect or Engineer's Address: --�- Lic. No. BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed undQr provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my Licens in full force and effect. � '70 p 02A License Class / License No. l / Date V Iwo. W1 �_L_C_ OWNER -BUILDER DECLARATION I hereby affirm 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 fora permit subjects the applicant to a 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 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 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.). C-) 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. I have and will maintain workers' compensation insurance, as required by Sectio 3700 of the Labor Code, for the performance of the work for which this permit is �� iss ed. My rk ' comp ens ' insurance carrier and policy number are: Cartier Policy Number &19//}.�� / 166rtifjithat, ih the plarformance of the work for which this permit is issued, I shat not amp oy 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. /lYte cant . WARNIN 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. 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 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 above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, an hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. iJ r �eignature (Applicant or Agent): C Page 2 Application Number . . . . . 04-00005474 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 ---------------------------------------------------------------------------- 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 OR 2 FAMILY 117.67 688.00 .0200 ELEC GARAGE OR NON-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/ALT/REP 3.00 9.0000 EA PLB'LAWN SPRINKLER SYSTEM 9.00 _1.00. .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 ---------------------------------------------------------------------------- Permit . . . . . . GRADING PERMIT Additional desc . . Permit Fee 15.00 Plan Check Fee .00 Issue Date . . . . Valuatior_ . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments SFD - LOT 73 PLAN 2CR 3362 SF. PERMIT Page 3 Application Number . . . . . 04-00005474 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. w -------------------------------------------- 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 Paid Credited Due Permit Fee Total ---------- 1480.43 ------------------------------ .00 .00 1480.43 Plan Check Total 196.14 .00 .00 196.14 Other Fee Total 2481.42 .00 .00 2481.42 Grand Total 4157.99 .00 .00 4157.99