04-5487 (SFD)Applicati
BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760).777-7012
8-495,CALLE5�TAMPI o
DL�Q'CIINTA; CA'I IFORI�.
G "alll
CITY 0r LA QUINYA
FINANCE DEPT.
e°r
Property Address . . .
APN:
Application description
Property Zoning . . . .
Application valuation .
Owner
FAX (760) 777-7011
92253 INSPECTION REQUESTS (760) 777-7153
DING PERMIT
IVANHOE LA QUINTA COVE
C/O R BARRY MCCOMIC
7979 IVANHOE AVE STE 550
LA JOLLA CA 92037
04-00005487 Date 7/15/04
47900 WIND' SPIRIT DR
658-140-999-37 -29436 -
DWELLING - SINGLE FAMILY DETACHED
LOW DENSITY RESIDENTIAL
199884
Contractor
TRANS -WEST HOUSING, INC.
9968 HIBERT STREET, STE #102
SAN DIEGO CA 92131
(858) 653-=003
WCC: STATE FUND
WC: 1E48813
10/01/04
CSLB: 7C1039
01/31/05
CCC: B
--------------------------
Structure Information -------------------------
'Construction Type . .
. . . TYPE V - NON RATED
Occupancy Type . . .
. . . DWELLG/LODGING/CONG <=10
Flood Zone . . . . .
. .•. NON -AO FLOOD ZONE
Other struct info . .
. . . CODE EDITION
2001 CRC
# BEDROOMS
3.00
FIRE SPRINKLERS
NO
GARAGE SQ FTG
704.00
PATIO SQ FTG
315.00
NUMBER OF UNITS
1.00
----------------------------------------------------------------------------
FIRST FLOOR SQ FTG
3180.00
Permit . . . . . .
BUILDING PERMIT
Additional desc
Permit Fee . . . .
989.50 Plan Check Fee
160.80
Issue Date . . . .
Valuation_.
199884
Qty Unit Charge
Per
Extension
BASE FEE
639.50
100.00 3.5000
----------------------------------------------------------------------------
THOU BLDG 100,001-500,000
350.00
Permit . . . . . .
MECHANICAL
Additional desc . .
Permit Fee
90.00 Plan Check Fee
5.63
Issue Date . . . .
Valuation_
0
Qty Unit Charge
Per
Extension
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
Application Number:
Applicant:
Applicant's Mailing Address:
• r
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date:
--ArchitectLf
or in er:
Architect or Engineer's Addre s:
c. No.
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions f Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
and my License i ' full force and effect. /
/'license Class /� License No. 1
C/ %
Date ontrector /�
OWNER -BUILDER DE RATION
1 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 for a 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 I, 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. , B.& 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 ave and will intain workers' compensati n insurance, as required by Section 3700 ofthe Labor Code, for the performance of the work for which this permit is
/ i su Mill
e mpensatio . rance carrier and policy number r
Carrier Policy Number `
_ I certify that, in the perfo ante of the work for which this permit is issued, I shall note ploy any arson 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
rthwith comply with those provisions.
/bate Applicant
WARNIN : F PRE 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.
I. 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 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
constructiorl. and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes.
ate /signature (Applicant or Agent):
.A
� M �
Application Number . . . . . 04-00005487
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
5.00
6.5000
EA
MECH
VENT FAN
32.50
1.00
6.5000
EA
MECH
EXHAUST HOOD
6.50
----------------------------------------------------------------------------
Permit .
. . . . .
ELEC-NEW RESIDENTIAL
Additional
desc
Permit Fee
. . . .
140.38
Plan Check Fee
8.78
Issue Date
. . . .
Valuation . . . .
0
Qty
Unit Charge
Per
Extension
BASE
FEE
15.00
♦3180.00
.0350
ELEC
NEW RES - 1 OR 2 FAMILY
111.30
704.00
.0200
ELEC
GARAGE OR NON-RESIDENTIAL
14.08
----------------------------------------------------------------------------
Permit
. . . . .
PLUMBING
Additional
desc
Permit Fee
. . . .
1.78.50
Plan Check Fee
11.16
Issue Date
Valuation . . . .
0
Qty
Unit Charge
Per
Extension
BASE
FEE
15.00
18.00
6.0000
EA
PLB
FIXTURE
108.00
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
1.00
9.0000
EA
PLB
LAWN SPRINKLER SYSTEM
9.00
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
Valuation . . . .
0
Qty
Unit Charge
Per
Extension
BASE
FEE
15.00
----------------------------------------------------------------------------
Special Notes
and Comments
SFD - LOT
37 PLAN 1B
3180
SF. PERMIT
Page 3
Application Number
. . . . .
04-00005487 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 SAME PLAN TYPE.
----------------------------------------------------------------------------
Other Fees
. . . . . .
ART IN PUBLIC PLACES -RES
.00
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
16.08
DIF FIRE PROTECTICN-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
19.98
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION, - RES
1098.00
Fee summary
-----------------
Charged
Paid Credited
Due
Permit Fee Total
----------
1413.38
------------------------------
.00 .00
1413.38
Plan Check Total
186.37
.00 .00
186.37
Other Fee Total
2441.06
.00 .00
2441.06
Grand Total
4040.81
.00 .00
4040.81