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07-2054 (SFD)P.O. BOX 1504 4 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 7r0100_020.59I Property Address: 80680 VIA PORTOFINO APN: 777-150-009- - - Application description: DWELLING - SINGLE FAMILY DETACHED Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 515719 Applicant: Architect or Engineer: 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 Code, and my License is in full force and effect. License Class: B License No.: 842333 Date: Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 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 I, as o.rrnar of tha pWaport,; ,,,,, —1 --illy u9101 IIL.enaeu wnudt:Luis Lu t:unsuuct u1e pfOjeCT ISeC. 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.). Q (_) I am exempt under Sec. , B.&P.C; ( fir thj* reason Date: wner: CONS UCTION 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: 0 i N Lender's Address: fIr LQPERn11T Owner: JIM KRIENS 3504 196TH AVE. CT SUMNER, WA 98390 Contractor: SANCHEZ CONSTRUCTI 68075 VIA DOMINGO DESERT HOT SPRINGS (760)660-3512 Lic. No.: 842333 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 r Date: 7/07/08 WORKER'S 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 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 X MPT Policy Number EXEMPT I certify that, in the performance of the work for which this per is issued, I shall not employ any person in any manner so as to beco subject to the work ' compensation laws of California, and agree that, if I should becom ubject to the workers' mpensation provisions of Section 3700 of the Lob& Co , she] orthwith co I i e provisions. licant: WARNING: FAILURE TO SECURE W�RlNSATION COVE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001- IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPUH IAN I Applicafwn 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 inf ation is corre I agree to comply with all city aWenupon to laws relating to buildi uctio, and her authorize representatives of thisove-mentioned pro y for ' pection pur ;Ate: plicant or Agent): Application Number . . . . . 07-00002054 Permit BUILDING PERMIT Additional desc . . Permit Fee . . . . 2087.50 Plan Check Fee 1356.88 Issue Date . . . . Valuation . . . . 515719 Expiration Date . . 7/08/08 Qty Unit Charge Per Extension BASE FEE 2039.50 16.00 ---------------------------------------------------------------------------- 3.0000 THOU BLDG 500,001-1,000,000 48.00 Permit. . . ELEC-NEW RESIDENTIAL Additional desc . . Permit Fee . . . . 262.68 Plan Check Fee 61.92 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 7/08/08 Qty Unit Charge Per Extension BASE FEE 15.00 6100.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 213.50 959.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 19.18 1.00 ---------------------------------------------------------------------------- 15.0000 EA ELEC TEMPORARY POWER POLE 15.00 Permit. . . GRADING PERMIT Additional desc . . Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 7/08/08 Qty Unit Charge. Per Extension ---------------------------------------------------------------------------- BASE FEE 15.00 Permit. . . MECHANICAL Additional desc . . Permit Fee . . . . 188.50 Plan Check Fee 47.13 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 7/08/08 Qty Unit Charge Per Extension BASE FEE 15.00 5.00 9.0000 EA MECH FURNACE <=100K 45.00 1.00 4.5000 EA MECH VENT INST/ DUCT ALT 4.50 4.00 9.0000 EA MECH B/C <=3HP/100K BTU 36.00 1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 16.50 10.00 6.5000 EA MECH VENT FAN 65.00 LQPERA1IT �i o.:.. - - ' 1. Application Number . . . . . 07-00002054 Permit . . . . . . MECHANICAL Qty Unit Charge Per Extension 1.00. 6.5000 ---------------------------------------------------------------------------- EA MECH EXHAUST HOOD 6.50 Permit . . . PLUMBING Additional desc . . Permit Fee . . . . 263.25 Plan Check Fee 65.81 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 7/08/08 Qty Unit Charge Per Extension BASE FEE 15.00 29.00 6.0000 EA PLB FIXTURE 174.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 3.00 7.5000 EA PLB WATER HEATER/VENT 22.50 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.,00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 13.00 .7500 EA PLB GAS PIPE >=5 9.75 1.00 15.0000 EA PLB GAS METER 15.00 ---------------------------------------------------------------------------- Special Notes and Comments 6,100SF DWELLING/V-NR/RES-3/CLASS A -FR THIS PERMIT DOES NOT INCLUDE BLOCKWALLS, POOL AND SPA, OR DRIVEWAY APPROACH. 2001 CBC, CPC, CMC, 2004 CEC, 2005 ENERGY. January 10, 2008 12:34:27 PM AORTEGA ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES 789.29 DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER - RES 995.00 ENERGY REVIEW FEE 135.69 DIF FIRE PROTECTION -RES 140.00 DIF LIBRARIES - RES 355.00 DIF PARK MAINT FAC - RES 22.00 DIF PARKS/REC - RES 892.00 STRONG MOTION (SMI) - RES 51.57 DIF STREET MAINT FAC -RES 67.00 DIF TRANSPORTATION - RES 1930.00 Fee summary Charged --------------------------- Paid Credited ------------------------------ Due Permit Fee Total 2816.93 .00 .00 2816.93 Plan Check Total 1531.74 750.00 .00 781.74 Other Fee Total 5451.55 .00 .00 5451.55 Grand Total 9800.22 750.00 .00 9050.22 LQYERA11T