06-3849 (SFD)Y
R
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
06-00003849 1
47845 ENDLESS SKY
649-030-069-124 -31311 -
DWELLING - SINGLE FAMILY
HIGH DENSITY RESIDENTIAL
84922
4a Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SANTA ROSA DEVELOPMENT INC
46753 ADAMS ST
DETACHED LA QUINTA, CA 92253
(760) 771-3345
/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 Cl •s/n: B C8 License No.: 824183
ate: // �" ontractor:
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 ISec. 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).:
(_) ,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.).
(_) 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.).
( ) I am exempt under Sec. , B.&P.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: 01 A
LQPERMIT
Contractor:
CONSOLIDATED CONTRACT
46753 ADAMS STREET
LA QUINTA, CA 92253
(760)771-3345
Lic. No.: 824183
VOICE (760) 777-7012
FAX (760) 777-7011.
INSPECTIONS (760) 777-7153
Date
INV 2 0 2006
CITY OF LA QUINTA
10/30/06
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 STATE FUND Policy Number 1770749
I certify that, 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 s lJorthwith comply witlrthose provisions.
a'D te: icant: ..
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.
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 construction, and hereby authorize representatives
of this /coup y to enter upon the above-mentioned prop f p tion purpo es.
Plate: ( nature (Applicant, or Agent .
Application Number . . . . . 06-00003849
Permit
BUILDING PERMIT
Additional
desc
Permit Fee
. . . .
572.00
Plan Check Fee
371.8.0
Issue Date
. . . .
Valuation . . . .
84922
Expiration
Date
4/28/07
Qty Unit Charge
Per
Extension
BASE
FEE
414.50
35.00
----------------------------------------------------------------------------
4.5000
THOU BLDG
50,001-100,000
157.50
Permit
. . .
MECHANICAL
Additional
desc .
Permit Fee
. . . .
46.00
Plan Check Fee
11.52 '
Issue Date
. . . .
Valuation . . . .
- 0 `
Expiration
Date
4/28/07
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
1.00
9.0000
EA MECH
FURNACE <=100K
9.00
1.00
9.0000
EA MECH
B/C <=3HP/100K BTU
9:00
1.00
6.5000
EA MECH
VENT FAN
6.50
' 1.00
----------------------------------------------------------------------------
6:.5000
EA MECH
EXHAUST HOOD
6.50
Permit
. . .
ELEC-NEW RESIDENTIAL
Additional
desc .
Permit Fee
,. .
70.07
Plan Check Fee
17.52
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date
4/28/07
Qty Unit Charge
Per
Extension
-
BASE
FEE
15.00
1331.00
.0350
ELEC
NEW RES - 1 OR 2 FAMILY
46.59
424.00
------------------------------------------=-------
.0200
ELEC
GARAGE OR NON-RESIDENTIAL
--------------------------
8.48
Permit
. . .
PLUMBING
Additional
desc .
Permit Fee
116.25
Plan Check Fee
29.08
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date
4/28/07
Qty Unit Charge
Per
Extension .
BASE
FEE
15.00
8.00
6.0000
EA PLB FIXTURE
48.00
1.00
15.0000
EA PLB BUILDING SEWER
15.00
LQPERMIT
Application
Number .
. . . .
06-00003849
FEE
Permit . .
. . . .
PLUMBING
SFD - LOT 124, PLAN 2C, 1331
Qty Unit Charge
Per
DOES NOT INCLUDE POOL, SPA, BLOCK
Extension
1.00
7.5.000
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
5.00
.7500
EA PLB
GAS PIPE >=5
3.75
1.00
----------------------------------------------------------------------------
15.0000
EA PLB
GAS METER
15.00
Permit
. . .
GRADING PERMIT
Additional desc .
22.00
DIF PARKS/REC - RES
Permit Fee
. . . .
15.00
Plan Check Fee
.00
Issue Date
. . . .
Valuation . . . .
0
Expiration Date 4/28/07
Qty Unit Charge Per
Extension
BASE
FEE
15.00
----------------------------------------------------------------------------
Special Notes and Comments
SFD - LOT 124, PLAN 2C, 1331
SF. PERMIT
DOES NOT INCLUDE POOL, SPA, BLOCK
WALLS
OR DRIVEWAY APPROACH.
2001 CBC, CMC, CPC, 2004 CEC,
2005
ENERGY CODES
=-----------------------------------------
----------------------------------
Other Fees . . . . . . . . .
DIF COMMUNITY CENTERS -RES
74.00
DIF CIVIC CENTER - RES
995.00
ENERGY REVIEW FEE
37.18
DIF FIRE PROTECTION -RES
140.00
GRADING PLAN CHECK FEE
.00
DIF LIBRARIES - RES
355.00
DIF PARK MAINT FAC - RES
22.00
DIF PARKS/REC - RES
892.00
STRONG MOTION (SMI) --RES
8.49
DIF STREET MAINT FAC -RES
67.00
DIF TRANSPORTATION - RES
1930.00
Fee summary Charged
---------------------------
Paid Credited
------------------------------
Due
Permit Fee Total 819.32
.00 .00
819.32
Plan Check Total 429.92
.00 .00
429.92
Other Fee Total 4520.67
.00 .00
4520.67
Grand Total 5769.91
.00 .00
5769.91
LQPERMIT