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04-7097 (SFD)I T-Vf 4 4 4" P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760),777-7012 `FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 Application Number . . . . . L04_0_0-0.0_7--097- Date 11/16/04 Property Address . . . . . . 80764 VIA PUERTA AZUL APN: 762-240-003-21 -300962- Application description . . . DWELLING - SINGLE FAMILY DETACHED Property Zoning .. . . MEDIUM DENSITY RES Application valuation . . . . 112634 Owner ------------------------ PUERTA AZUL PARTNERS 17700 SW UPPER BOONES FERRY RD SUITE 100 PORTLAND OR 97224 Contractor DAVIS/REED CONSTRUCTION INC 169 SAXONY ROAD, STE #105 ENCINITAS CA 92024 (760) 634-2350 WCC: STATE FUND WC: WC298892003 06/12/05 CSLB: 81.3480 10/31/06 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 # BEDROOMS 1.00 FIRE SPRINKLERS NO GARAGE SQ FTG 250.00 PATIO SQ FTG 617.00 NUMBER OF UNITS 1.00 ---------------------------------------------------------------------------- FIRST FLOOR SQ FTG 1740.00 Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee 685.00 Plan Check Fee 111.31 Issue Date . . . . Valuation . . . . 112634 Qty Unit Charge Per Extension BASE FEE 639.50 13.00 3.5000 THOU BLDG 100,.001-500,000 45.50 ---------------------------------------------------------------------------- Permit MECHANICAL Additional desc Permit Fee . . . . 78.50 Plan Check Fee 4.91 Issue'Date . . . . Valuation . . . . 0 . 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 P.O. Box 1504 441�G�� VOICE (760) 777-7012 78-495 CALLE TAMPICO TiffFAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: ?og,7 Date: (%• y Applicant:—Architect or Engineer. Applicant's Mailing Address:—Architect or Engineer's Address: c. No. BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (co encing wit Section 700 ) of Division 3 of the Business and Professionals CPde and myLicense,�s i II force and effect. icense Class icense No. OWNER -BUILDER DEXLARATION l I hereb affi nder p4alty 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 peril 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 1, 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.). U 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 I am exempt under Sec. , B.& P.C. for this reason Date WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of p jury one of the following declarations: I have a d'will maint n a on of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance X�/ of th work for ich th' aril is is d. I have nd will m ntain rke tion insurance, as required by Section 3700 f Labor Code, for Ktherf ince of the work for ich this peril is ss rkers' c nsurance carrier and policy numberare:Carrier Policy Number /I c if t �t, ' performance the workfor is peril is issue all not em ny permsanin r`so as to a subject to the workers' corn ensati laws of California, and a that, if I I ce ub'ect t orkers' m nsation provisions of Section 3 0 of the Labor Code, I shall pp ��nn 1 Pe P forthwith obmoly with those Drovisio s_ LURE TO SECURE WORKEROMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND ' TO ONE HUNDRED THOU AND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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.). Lenders Name Lender's Address rt 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 nut of if work is na menced within 180 days from date of issuance of such permit, or cessati of work for 180 days will subject permit to c lation. 1 certify that I ha read is application and state that the abo information ' tract. 1 ag o c y wi city and county ordinances and state laws relating to building construccttion, d her y au orize representatives of this my to enter onon the abov a property for spection purposes. / ` ! /.�� Date � Si�e (Applicant or Agent . .1 Application Number . . . . .. 04-00007097 Page 2 Date 11/16/04 Qty Unit Charge Per Extension 6.00 6.5000 EA MECH VENT FAN 39.00 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 ---------------------------------------------------------------------------- Permit . . . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee . . . . 80.90 Plan Check.Fee 5.06 Issue Date Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1740.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 60.90 250.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL = 5.00 --------------------------------------------------------------------------- Permit . . . . . . PLUMBING Additional desc Permit Fee . . . . 146.25 Plan Check Fee 9.14 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 13.00 6.0000 EA PLB FIXTURE 78.00 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 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 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 21. PLAN 4B, 1740 SF. PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL, SPA OR DRIVEWAY APPROACH. 75% PLAN CHECK FEE REDUCTION APPLIED FOR MULTIPLE ISSUANCE OF SAME PLAN TYPE. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES .00 Page 3 Application Number . . . . . 04-00007097 Date 11/16/04 ----------------------------------------------------------------------------- Other Fees . . . . . ... . . DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 11.13 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 11.26 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary ----------------- Charged Paid Credited Due Permit Fee Total ---------- 1005.65 ------------------------------ .00 .00 1005.65 Plan Check Total 130.42 .00 .00 130.42 Other Fee Total 24.27.39 .00 .00 2427.39 Grand Total 3563.46 .00 .00 3563.46