04-6444 (SFD)4
Tdf 4 4 QU&I
BUILDING & SAFETY DEPARTMENT
P:0. Box 1504 (760),777-7012
78-495 CALLE TAMPICO. FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
A,
OCT 2 2
2334 It
Application Number
Property
APN :onoHsa,:9<<
Applicatidescription . . .
Property Zoning . . . . . . .
Application valuation . . .
G PERMIT
4-000V06-44471 Date 9./27/04
`78330 -VIA DIJON'
604-032-999-20 -305212-
DWELLING - SINGLE FAMILY DETACHED
LOW DENSITY RESIDENTIAL
186652
Owner Contractor
LENNAR HOMES OF CALIFORNIA LENNAR HOMES OF CALIFORNIA INC
78401 HIGHWAY 111, STE C 78401 HIGHWAY 111, SUITE, C
LA QUINTA, CA LA QUINTA CA 92253
LA QUINTA CA 92253
Qty Unit'Charge Per
Extension
WCC: OLD REPUBLIC
IN
WC: MWC10877600
11/01/04
CSLB: 728102
09/30/04.
CCC: B
--------------------------
St'ructure Information -------------------------
Construction Type . ...
. . TYPEV - NON RATED
Occupancy Type . . .
. . . DWELLG/LODGING/LONG <=10
Flood Zone . . . .
NON -AO FLOOD ZONE
Other struct info . .
. . . CODE EDITION 2001
CBC
FIRE SPRINKLERS NO
GARAGE SQ FTG
637.00
PATIO SQ FTG.
236.00.
NUMBER OF UNITS
1.00
FIRST FLOOR SQ FTG 2990:00
----------------------------------
Permit ... . . . .
-------------------------------
BUILDING -PERMIT
-----------
Additional desc
Permit Fee . . . .
944.00 Plan Check.Fee
613.60
Issue Date . . . .
Valuation
186652
Qty Unit Charge
Per
Extension
BASE FEE
639.50
87.00 3.5000
THOU BLDG 100,001-500,000
3,04.50
----------------------------------------------------------------------------
Permit
MECHANICAL
.Additional desc
Permit Fee
70.50 Plan Check Fee
17.63,
Issue Date . . . .
Valuation . . . .
0
Qty Unit'Charge Per
Extension
P.O. Box 1504
78-495 CALLS TAMPICO � VOICE (7 60) 777-7(11:
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: Date: /d•22.0�{
Applicant: hi ct or Engineer:
&94M M 12h" l Q
Applicant's mailing Address: Architect or Engineer's Add ss:
/foo ;? /&Ac
S,4 04 qa -iro /
Lip. NO.: 3 a 3 q �
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
C de, and my License jS in full force and effect. -1�- ( D
cense Class A ;cense No.
Date �6 • ontractor_
OWNER43UILDER 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 fora 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 structureis 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.).
U 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.).
U I am exempt under Sec. , BA P.C. for this reason
Date Crooner
WORKERS' 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 37.00 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
,t� }est M yvoyke�s sompensafion ' rance carrier'ar�d policy number g
�rrier�/�G/ liLlO[�G /policy Number /�((�f�G ,q /LP6,0
sr _ 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' compensafion provisions of Section 3700 of the Labor code, 1 shall
forthwith comply with those provisions.
ate Q� a `o plicant 1,.�op�L 9—
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.
CONSTRUCTION LENDING AGENCY
1 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.).
Lenders Name
Lenders Address
CA
IMPORTANT Application is hereby made to the Director of Buildingand Safety ACKNOWLEDGEMENT
T
ty 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 o1 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 rept' sentatives of this county to enter upon the above-mentioned property for inspection purposes.
ate ! �%` a'0 Signature (Applicant or Agent): /`��
a ,oa ,
i
Page
2.
Application
Number
.04-00006444 Date
9/27/04
Qty
Unit Charge.
Per
9
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
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
. . .
132.39
Plan Check .'Fee
33.10
Issue Date
Valuation . . .
0
Qty,
Unit Charge
Per
Extension
BASE
FEE
15.00
2990.00
.0350
ELEC
NEW RES - 1 OR 2 FAMILY
104.65
'. 637..00
.0200
ELEC
GARAGE.OR NON-RESIDENTIAL
12.74
Permit
PLUMBING
Additional
desc
Permit Fee
189.75
Plan Check Fee
47.44
Issue Date
. . . .
Valuation . . . .
0
Qty
Unit Charge.
Per
Extension
BASE
FEE
15.00
20.00
6.0000
EA
PLB
FIXTURE
12000
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
•7.00
.7500
EA
PLB
GAS PIPE >=5
5.25
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
..Qty,
Unit Charge
Per
Extension
BASE
FEE
15.00
------------------------------------------------------------------------------
Special Notes and Comments
SFD = LOT
20 PLAN 3XZ,
2990
SF.
PERMIT-
Page
3
Application Number .
. . . .
04-00006444 Date
9/27/04
-----------------------------------------------------------------------------
Special Notes and Comments
DOES NOT INCLUDE POOL,
SPA, BLOCK
WALLS,
OR DRIVEWAY APPROACH
Other Fees . . . . .
. . .
ART IN PUBLIC PLACES -RES
.00
DIF COMMUNITY CENTERS -RES
.97.0.0_
DIF CIVIC CENTER - RES
366.00
ENERGY'REVIEW FEE
61.36
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
18.66
DIF STREET MAINT FAC' -RES
15.00'
DIF TRANSPORTATION - RES
1098.00
Fee summary Charged
Paid Credite3
Due
Permit- Fee Total
1351.64
.00 .00
1351.64
Plan Check Total,
711.77
.00 .00
711.77
Other Fee Total
2485.-02
.00 .00
2485:02
Grand Total
4548.43
.00 .00;
4548:43
C-(DPY
' Certificate ®f insulation, ,
Your home has been insulated with John Mansville Fiberglas: insulation products, which are designed .
' for today's safety standards and tomorrow's energy requirements.
e Rberglass is inorganic and thereforepermanently noncombustible, so it does not a to be treated "
with fire -retardant chemicals that will likely lose their effectiveness over time. It has not been treated
with chemicals that can corrode wiring or metal. Fiberglass will not absorb moisture nor will it
settle over time as may other insulation materials.
This also certifies that insu_ iation have been professionally installed in this home to provide the
following thermal performance.
Lennar Hornes
Job Name: La Quinta Del Oro Tract: 30521 Plank 3Z Phase: Z
Lot No: 20 Job Address: SFR- 76-330 Via Oijon, La Quinta, CA
c
Ceiling Area: R-30 batt insulation Garage Ceiling: Non -Access:
N With Living Above & Sloping Areas
LO
c _
L ` Exterior.Walls R-13 batt insulation- Overhangs: Access Attic:
a- With Living Abov® .
N
Between Floors: Interior Walls:
Subcontractor...0 J Insulation, Inc.
r
0 72-227 Adelaid St, Thousand Palms, CA 92276
Signed: 1ul' C� .t P Q
N Mike. Dickerson, General Manager - Palm Springs Division -
R -means resistance to heat flow. The higher the R -value, the greater the_ insulating power.
-va'ues. Keep this certificate with your other
Ask your builder for the fact sheet on R
0 valued papers. If you.ever sell this home, this certificate should be passed onto the buyer.