05-2557 (SFD)411 A-11111111, •
P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 6/23/05
Application Number: 05-0_0002557 Owner:
Property Address: 77883 DESERT DR IVANHOE LA QUINTA COVE
APN: 658-140-999-139 -29436 - C/O R BARRY MCCOMIC
Application description: DWELLING - SINGLE FAMILY DETACHE d 7979 IVANHOE AVE STE 550
Property Zoning: LOW DENSITY RESIDENTIAL Q LA JOLLA, CA 92037
Application valuation: 179876
Jut 2 0 ZOl9r Contractor:
Applicant: /architect or Engineer: 1JJ TRANS WEST HOUSING, INC.
ClryOF9968 HIBERT STREET, STE #102
FIlk,ANCEDEuTA SAN DIEGO, CA 92131
Com G ?
(858)653-3003
Q J tic. NO..:: 701039
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 70001 of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License C ss: License No.: 1039
l
Dat G ntractor:
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).:
(_) 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.).
(_ 1 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.I.
Lender's Name:
Lender's Address:
LQPERMIT
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 1648813
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
/ 3 0 of the Labor Code, I shall fo with comply with thoLejoeVisjons.
;Date: �` �f �;cant:
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 or finances and state laws relating to building construction, and hereby authorize representatives
of this co,
t enter upon the above-mentioned property for in cti�o"n purposes%�
�te;t ignature (Applicant or Agent): �i(iLC t
:r
LQPERMIT
Application Number .. . . 05-00002557
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
685.00
PATIO SQ FTG
546.00
NUMBER OF UNITS
1.00
----------------------------------------------------------------------------
.1ST FLOOR SQUARE FOOTAGE
2783.00
Permit . . . .
BUILDING PERMIT
Additional desc .
Permit Fee
919.50 Plan Check Fee
149.42
Issue Date . . . .
Valuation . . . .
179876
Expiration Date
12/20/05
Qty Unit Charge
Per
Extension
BASE FEE
639.50
80.00 3.5000
--------=---------- ---------------------------------------------------------
THOU BLDG 100,001-500,000
280.00
Permit . . .
MECHANICAL
Additional desc .
Permit Fee . . . .
64.00 Plan Check Fee
4.00
Issue Date . . . .
Valuation . . .
0
Expiration Date
12/20/05
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00 9.0000
EA MECH FURNACE <=100K
18.00
2.00 9.0000
EA MECH B/C <=3HP/100K BTU
18.00
1.00 6.5000
EA . MECH VENT FAN
6.50
1:00 6.5000
-----------------------------------------7----------------------------------
EA MECH EXHAUST HOOD
6.50
Permit
ELEC-NEW RESIDENTIAL
Additional desc .
Permit Fee . . . .
126.11 Plan Check Fee
7.88
Issue Date . . . .
Valuation . . . .
0
Expiration Date
12/20/05
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2783.00 .0350
ELEC NEW RES - 1 OR 2 FAMILY
97.41
685.00 .0200
-ELEC GARAGE OR NON-RESIDENTIAL
13.70
Application Number . . . . . 05-00002557
Permit . . .
PLUMBING
Additional desc . .
Permit Fee. . . . .
178.50 Plan Check Fee
11.16
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
12/20/05
Qty Unit Charge
Per
Extension
BASE. FEE
15.00
18.00 6.0000
EA PLB FIXTURE
108.00
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
9.00
8.00 .7500
EA PLB GAS PIPE >=5
6.00
1.00 15.0000
----------------------------------------------------------------------------
EA PLB GAS METER
15.00
Permit . . . GRADING PERMIT
Additional desc .
Permit Fee
15.00 Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 0
Expiration Date .
12/20/05
Qty Unit Charge
Per
Extension
BASE FEE
15..00
----------------------------------------------------------------------------
Special Notes and Comments
SFD - LOT 139, PLAN 2AR 2783 SF. PERMIT
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 . . . . .
. . .. . ART IN PUBLIC PLACES -RES
.00
DIF COMMUNITY CENTERS -RES
97..00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
14.94
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
17.98
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary Charged Paid Credited
Due
LQPEfN11T
Application Number . . . . . 05-00002557
---------------------------
Permit Fee Total
----------
1303.11
----------
.00
.00
----------
1303.11
Plan Check Total
172.46
.00
.00
172.46
Other Fee Total
2437.92
.00
.00
2437.92
Grand Total
3913.49
.00
.00
3913.49
LQPERAIIT