13-1488 (SFD)1
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
13-00001488
Property Address:
80220 VIA PESSARO
APN:
772-550-015- - -
Application description:
DWELLING - SINGLE FAMILY
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
416480
Tiht 4 e(P Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
DAVID DORWARD
#300,10328-81 AVE.
DETACHED EDMONTON, ALBERTA,T6E1X2
Contractor:
Applicant: Architect or Engineer: JONES DEVELOPMENT CORP,
78060 CALLE ESTADO STE
CONiRa a() ti (760)285-871212 LA QUINTA, 92253
Lic. No.: OOR SQUARE FOOT Lic. No.: 987962
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 Prof e ' Is Code, and my License is in full force and effect.
License Class: B License No.: 987962
Date: � Contractor:
ER -BUILDER DECLARATION
I hereby affirm under penalty of per' that I exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, peer'
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 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).:
1 _ 1 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 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.).
(_ 1 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.).
( ) I am exempt under Sec. , BAP.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.).
Lender's Name: _
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/22/13
JDr-
Y
0!`C o z:)2 013
CITY 4F LA QUINTA
FINANCE DEPT.
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ 1 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 Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier STATE FUND Policy Number 9076465-13
I certify that, in the performance of the work for which this permit is issued, 1 shall not employ any
person in any manner so as to become su ' e workers' compensation laws of California,
and agree that, if I should become lett to thew kers' compensation provisions of Section
3700 of the Labor Code o with comply ith those provisions.
Date: Applicant:
WARNING: FAILURE TO SECURE WORK ' C P ATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMIN EN AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADD T TO TH OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABO CODE, INTEREST, AND ATTORNEY'S FEES.
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 ab qction,
orrect. I agree to comply with all
city and county ordinances and state laws relating to ing co ereby authorize representatives
of this county to nter upon the above-mentioned petty f nsps.
Date: Signature (Applicant or Agent .
Application Number . . . . . 13-00001488
Permit
BUILDING 2013
Additional
desc . .
Permit Fee
. . . .
694.95
Plan Check Fee
00
Issue Date
. . . .
Valuation . . .
. 416480
Expiration
Date . .
5/21/14
Qty Unit Charge
Per
Extension
BASE
FEE
573.43
217.00
----------------------------------------------------------------------------
.5600
THOU BLDG
$200,001-$1M
121.52
Permit
ELECTRICAL 2013
Additional
desc .
Permit Fee
-
226.65
Plan Check Fee
.00
Issue Date
. . . .
Valuation . . .
. 0
Expiration
Date . .
5/21/14
Qty Unit Charge
Per
Extension
1.00
23.8300
LS ELEC
FIXTURES, FIRST 2-0
23.83
1.00
23.8300
EA ELEC
SERVICES
23.83
1.00
23.8300
EA ELEC
TEMP POWER POLES
23.83
1.00
143.0000
LS ELEC
NEW RES, FIRST 1 KSF
143.00
1.00
----------------------------------------------------------------------------
12.1600
EA ELEC
NEW RES, ADD'L 1 KSF
12.16
Permit
GRADING PERMIT
Additional
desc .
Permit Fee
. . . .
153.00
Plan Check Fee
.00
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date . .
5/21/14
Qty Unit Charge
Per
Extension
BASE
FEE
117.00
4.00
---------------------------------------------------------------------7------
9.0000
THOU GRADING 1001-10,000
36.00
Permit
MECHANICAL 2013
Additional
desc . .
Permit Fee
. . . .
440.96
Plan Check Fee
.00
Issue Date
. . . .
Valuation
0
Expiration
Date . .
5/21/14
Qty Unit Charge
Per
Extension
4.00
35.7500
EA MECH
FURNACE
143.00
4.00
35.7500
EA MECH
CONDENSER/COMP
143.00
12.00
11.9200
EA MECH
VENT FAN
143.04
1.00
11.9200
EA MECH
EXHAUST HOOD
11.92
LQPERAI IT
Application Number . . . . . 13-00001488
Permit . . . PLUMBING 2013
Additional desc . .
Permit Fee . . . . 464.87 Plan Check Fee .00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 5/21/14
Qty Unit Charge Per
Extension
28.00
11.9200 EA
PLBG FIXTURE/TRAP
333.76
1.00
11.9200 EA
PLBG BUILDING SEWER
11.92
4.UU
11.9200 EA
PLBG ROOF DRAIN
47.68
2.00
11.9200 EA
PLBG WATER HEATER/VENT
23.84
1.00
11.9200 LS
PLBG GAS SYS, 1-4 OUTLETS
11.92
1.00
35.7500 LS
PLBG GAS SYS, 5+ OUTLETS
35.75
----------------------------------------------------------------------------
Other Fees
. . . . . . .
. . ART IN PUBLIC PLACES -RES
541.20
BLDG STDS ADMIN (SB1473)
17.00
DIF COMMUNITY CENTERS -RES
129.00
DIF CIVIC CENTER - RES
942.00
DIF FIRE PROTECTION -RES
433.00
GRADING PLAN CHECK FEE
22.50
HOURLY PLAN CHECK
834.50
DI•F LIBRARIES - RES
344.00
PLAN CHECK, ELECTRICAL-
104.63
DIF PARK MAINT FAC - RES
40.00
PLAN CHECK, MECHANICAL
204.95
PLAN CHECK, SFD GRADING
143.00
PLAN CHECK, PLUMBING
455.32
DIF PARKS/REC - RES
2048.00
BLDG PC 200K -1M
1745.09
STRONG MOTION (SMI) - RES
41.65
TUMF: RESIDENTIAL
1837.44
DIF STREET MAINT FAC -RES
116.00
DIF TRANSPORTATION - RES
2842.00
Fee summary
-----------------
Charged
----------
Paid Credited
------------------------------
Due
Permit Fee
Total 1980.43
.00 .00
1980.43
Plan Check
Total
.00 .00 .00
.00
Other Fee Total
12841.28
.00 .00
12841.28
Grand Total
14821.71
.00 .00
14821.71
LQPERMIT
Bin #
Oty Of La Quinta l 2
Building &r Safety Division
I
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
ermit #
14�/I
Pro'ect Addre4i �e 55 h(ZD '
Owner's Name: Vl p
A. P. Number: -7 — -2 1 0 _ o, s _ j '
Address: —4 300 — 151 Av
Legal Description:
City, ST, Zip: fol M
Contractor: T.AJ 16v\0
Telephone:
Address: 79-0&0 CA1 0 & 1-,4J-x2
Project Description: W"
City, ST, Zip: / ; Z z5;-3
v
Telephone: %0
>'»< '`z>><><'=?`•
,
State Lie. # :
City Lie. #.
Arch., Engr., Designer:
Address:
kiC. f O
l
City., ST, Zip:
Telephone:
.;;><
<. ? < ...<> - ^ »>
...
Construction Type: ca
YP Oc panty:
State Lic. #.:>;
,
Project type (circle one): New Add n Alter Repair Demo
Name of Contact Person:' o 4� es
Sq. Ft.:
#Stories:
#Units:
Telephone # of Contact Person. (v0 . ?�S �j 12—
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check 110ance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
god Review, ready for correct io s/issue
Electrical
Subcontactor List
Called Contact Person
ZZ
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3a Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit rtes