04-5840 (SFD)P.O. Box 1504
78-4`9'6 CALLE TAMPICO
F LA�'QQINTA, CALIFORNIA 92.253
BUILDING PERMIT
�F�a�rw
BUILDING & SAFETY DEPARTMENT
(760) .777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
' Application. Number .
. . . ..04-=00 840 Date
8/04/04
,__P-roperty Address
8-0-32-5—V A PONTITO
APN:
772-450-037-73 -298942-
Application description
. . . DWELLING - SINGLE FAMILY DETACHED
Property Zoning . . .
. . . . LOW DENSITY RESIDENTIAL
Application -valuation
. . . . 260430
Owner
Contractor
SEDONA HOMES, INC..
SUNROSE CORPORATION
49-950 JEFFERSON ST.
#130-134 49950 JEFFERSON, #130-134
INDIO, CA
INDIO
CA 92201
INDIO
CA 92201 (760) 772-2224
(760) 777-7522
WCC: STATE FUND
WC: 16404622003
09/22/04
CSLB: 533670
06/30/06
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
CBC
FIRE SPRINKLERS NO
GARAGE SQ FTG
651.00
PATIO SQ FTG
293.00
NUMBER OF UNITS
1.00
FIRST FLOOR SQ FTG
3017.00
-----------------------------------------------------------------------------
Permit . . . . . .
BUILDING PERMIT
Additional desc
Permit Fee
723.38 Plan Cheek Fee
781.95
Issue Date . . . .
Valuation . . . .
260430
Qty Unit Charge
Per
Extension
BASE FEE
159.88
161.00 3.5000
THOU BLDG 100,001-500,000
563.50
------------------------------------------------------
Permit . . . . . .
-------------------
MECHANICAL'
Additional desc
Permit Fee . . . .
95.00 Plan Cheek Fee
5.94
Issue Date . . . .
Valuation . . . .
0
Qty Unit Charge
Per
Extension
P.O. Box 1504 • �/
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: 040I Date: '5-
5-O
Applicant: —Architect or Enaineer: e
Applicant's Mailing Address:
Architect or En�IneerI Address:
-Lic. No.:.
BUILDING PERMIT DECLARATIONS
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
�, and my License is in full force and effect. 7D
icense Class_ �se No.67733 b
/ Date ontractor��
i
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 for a permit subjects
the applicant to a civil penalty of not more than rive 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. , BA P.C. for this reason
Date
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' compens nsurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
/ yps_ued. j1Qy worker ' compensatio ' Sur
carrier and olicy number are:
` Carne�/l— Poli t ;Z.
I certify that, in the performance of the work for which this' rmit is issued, I shall not Wploy 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.
Datepp�A licanI
WARNING: FAILURE TO SECURE WOR RS' 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, indemnify 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
construglion, and hereby aut�igzna
E
entatives of this county to enter upon the above-mentioned property for inspection purposes.
Oate � pplicant or A ent : -
,J
Page
2
Application Number .
. .
. . 04-00005840 Date
8/04/04
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
3.00
9.0000
EA
MECH FURNACE <=100K
27.00
3.00
9.0000
EA
MECH B/C <=3HP/100K BTU
27.00
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 .
.
133.62 Plan Cheek Fee
8.35
Issue Date .
. . .
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
3017.00
.0350
ELEC NEW RES - 1 OR 2 FAMILY
105.60
651.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
13.02
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Permit . .
. . .
PLUMBING
Additional desc
. .
Permit Fee .
. . .
181.50
Plan Check Fee
11.35
Issue Date .
. . .
Valuation . . . .
, 0
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
17.00
6.0000
EA
PLB FIXTURE
102.00
1.00
15.0000
EA
PLB BUILDING SEWER
15.00
2.00
7.5000
EA
PLB WATER HEATER/VENT
15.00
1.00
3.0000
EA
PLB WATER INST/ALT/R:EP
3.00
1.00
9.0000
EA
PLB LAWN SPRINKLER SYSTEM
9.00
10.00
.7500
EA
PLB GAS PIPE >=5
7.50
1.00
15.0000
EA
PLB GAS METER
15.00
----------------------------------------------------------------------------
Permit
GRADING PERMIT
Additional desc
Permit Fee .
. . .
15.00 Plan Cheek Fee
.00
Issue Date .
.
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
----------------------------------------------------------------------------
BASE FEE
15.00
Special Notes
and Comments
SFD - LOT 73 PLAN
3RA
3017
SF. PERMIT
Page 3
Application Number
. . . . .
04-00005840 Date
8/04/04
7 ----------------------------------------------------------------------
Special Notes and
Comments
DOES NOT INCLUDE BLOCK
WALLS,
POOL, SPA
OR DRIVEWAY APPROACH.
75% REDUCTION
TO
PLAN CHECK FEE DUE
TO MULTIPLE
ISSUANCE
OF SAME PLAN TYPE
----------------------------------------------------------------------------
Other Fees . . .
. . . . . .
ENERGY REVIEW FEE
78.20
DIF FIRE PROTECTION -RES
97.00
GRADING PLAN CHECK FEE
.00
DIF LIBRARIES - RES
225.00
DIF PARK MAINT FA- - RES
5.00
DIF PARKS/REC - RES
502.00
STRONG MOTION (SMI) - RES
26.04
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATIO-N - RES
1098.00
Fee summary
-----------------
Charged
----------
Paid Credited
Due
Permit Fee Total
1148.50
------------------------------
.00 .00
1148.50
Plan Check Total
807.59
.00 .00
807.59
Other Fee Total
.2046.24
.00 .00
2046.24
Grand Total
4002.33
.00 .00
4002.33