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04-6460 (SFD)BUILDING & SAFETY DEPARTMENT (760).7-77-7 * 012 4PIC0. FAX (760j777-7011 oRNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT APN: Application description . . . Property Zoning . . . . . . . Application valuation Owner LENNP_R HOMES OF CALIFORNIA 78401 HIGHWAY 111,.STE C LA.QUINTA, CA 04-00006460 Date 9/27/04 X78340 -VI)V-PAVION 6047032 -999=46 -305212 - DWELLING - SINGLE FAMILY DETACHED LOW DENSITY RESIDENTIAL 177026 Contractor ------------------------ LENNAR HOMES OF CALIFORNIA INC 78401 HIGHWAY 111, SUITE C LA QUINTA CA 92253 LA QUINTA 1CA 92253 WCC: OLD REPUBLIC IN WC: ..MWC10877600 11/01/04 CSLB: 728102 09/30/04 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 FIRE SPRINKLERS NO GARAGE SQ FTG 426.00 PATIO SQ FTG 236.00 NUMBER.OF UNITS 1.00 FIRST FLOOR SQ FTG 2894.00 --------------------:-------------------------------------------.------------- Permit . . . . . . BUILDING PERMIT Additional.desc Permit Fee . . . . 912.50 Plan Check Fee 148.28. Issue Date Valuation 177026 Qty Unit Charge Per Extension BASE FEE 639.50 78.00 3.5000 THOU BLDG 100,001-500,.000 - 273.00 -------------------------- Permit . . . . . . ------------------------------•------- MECHANICAL ------------ Additional.desc Permit Fee 52.50 Plan Check Fee 13.13 Issue Date Valuation. . . 0 Qty Unit Charge Per Extension P.O. Box 1504 1�G��/ 78-495 CALLS TAMPICO VOICE (760) 777-7.01: LA QUINTA, CALIFORNIA 92253 4VFAX (760) 777-7011 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: �� - (QI��Q Date: Applicant: —Archilect or Engineer: VCM%^ 1AnnA(A," Applicant's Mailing Address: Architect orngineer's Address: I�K 0' i to 4,+ . Std C -A Lic. No.: 3-9 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 Code, and my License is in full force and effect. cense Class T7 ---License No.— Date 0 ' ' 0 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 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.). (, 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 1 am exempt under Sec. . B.& P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of pedury 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 is ed. My workers' compensation in nce carrier and policy number are: Carrier QUA l 21 k %j �L Number M IA I J1. i QV' --1-1 1, 000 _ I certify th t, in the performance of the work for which this permit is issued, I shall not employ 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 �I fforthwithl comply with those provisions. Date � -� OI ' 0 `j/ Applicant WARNING: 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. I herebyaffirm under CONSTRUCTION LENDING AGENCY 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 Buildingand Safety Apermit 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 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 construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. DateO "t nature (Applicant or Agent): Page 2 .. Application Number . . .. 04-00006460 Date 9/27/04• Qty' Unit Charge Per Extension BASE FEE 15.00 • r 1.00 9.0000 EA MECH FURNACE <=100K .9.00, 1.00 9.0000 EA -MECH B/C <=3HP/100K BTU '9.00 2.00 6.5000 EA. MECH VENT.FAN 13.00 1.00 6..5000 EA MECH.EXHAUST HOOD 6.50 Permit. ELEC-NEW RESIDENTIAL Additional desc Permit -Fee 124.81 Plan Check Fee 7.80• Issue Date Valuation . . 0 Qty Unit Charge Per Extension: BASE .FEE 15.00 2894.00 .0350 ELEC NEW RES'- 1 OR 2 FAMILY 101..29 426.00 0200 ELEC GARAGE OR NON-RESIDENTIAL 8.52 Permit .. . . . PLUMBING 77 . Additional desc.: Permit Fee .171.75 .Plan Check Fee,10.74 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 .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.,0*0 7.00 .7500 EA PLB.GAS PIPE >=5 5.25 1_00 ..15.0000 EA PLB GAS, METER 15.0.0 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.46. PLAN_3YR, 2894 SF. PERMIT Page 3 .Application Number . . . .. 04-0000646.0 Date. 9/27/04 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. . .". . . . . . I ART IN PUBLIC.PLACES-RES 00 DIF COMMUNITY CENTERS -RES. 97.00 " -DIF CIVIC CENTER "- RES 366.00 ENERGY REVIEW FEE 14.83 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 17.70 DIF STREET MAINT FAC -RES 15.00' DIF TRANSPORTATION - RES 1098.00 . Fee summary Charged Paid Credited Due Permit Fee Total 1276.56 .00, .00 1276.56 'Plan Check Total 179,95 .00 .00 179.95, Other Fee Total 2437.53 .00 .00 2437.53 Grand.Total 3894.04 .0.0 .00 3894.04