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04-7399 (SFD)BUILDING & SAFETY DEPARTMENT P:O. Box 1504 (760).777-7012 78-495 CALLE TAMPICO , FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 Application Number . . Property Address . . . APN: Application description Property Zoning . . . . Application valuation . Owner ------------------------ PUERTA AZUL PARTNERS BUILDING PERMIT '-04---000073-99--:-'� Date 11/2.3/04 . . . 80805 VIA PUERTA AZUL 762-240-003-74 -300962- . . . DWELLING - SINGLE FAMILY DETACHED . . . MEDIUM DENSITY RES . . . 98984 17700 SW UPPER BOONES FERRY RD SUITE 100 PORTLAND-� a '>� 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: 813480 10/31/06 - - CCC. B ----------------- .----------- '-Struc-ture 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 2.00 FIRE SPRINKLERS NO GARAGE SQ FTG 251.00 PATIO SQ FTG 316.00 NUMBER OF UNITS 1.00 1ST FLOOR SQUARE FOOTAGE 1571.00 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc Permit Fee . . . . 635.00 Plan Check Fee 412.75 Issue Date . . . . Valuation . . . . 98984 Qty Unit Charge Per Extension BASE FEE 414.50 49.00. 4.5000.THOU BLDG 50,001-100,000 220.50 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL Additional desc Permit Fee . . . . 78.50 Plan Check Fee 19.63 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 �� 78-495 CALLE TAMPICC' VOICE (760)• 777-7012 LA QUINTA, CALIFORNIA 92253 4V FAX (760) 777-7011 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: d�^ 7,3�q Date: wI - 0 Applicant:—Architect or Engineer: 4kx Applicant's Mailing Address: Architect or Engineer' Address: . 6c. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (common 'ng with Section 7000) of Division 3 f the Business and Professionals �C de, and my L' se is in I f rce and effect. ense Class icense No. Date —14 o�ntractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of pedury that I am exempt from the Contractors' State License Law for the followi son (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.). 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 hereon, 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 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 3700 of the Labor Code, for the performance _Xof the work for 'ch this permit is issued. 4 have a I maintain workers' compensation insurance, as required by Section 3700 of Labor Code, for the performance of the work for which this permit is d. on insurance carrier and policy number are: arrier iss y workers' compensation olicy Number (� �' I cern , in the performance of the work for w is permit is issued, I she of employ anyny pars annex so aas to b me s je the workers' mpe sation laws of California, and age at, if I should become subject to t e workers' compensation provisions of Section 3700 of ttfe Labor Code, I shall orth�fh cgtnply with1hose orcvisinacw VVAKNINLjf FOILURE TO SECURE WO MPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL TI CIVIL FI S PTO ONE HUNDRED SA D DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATIES AND ON, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. CONSTRUCTION I hereby affirm under penalty of perjury that there is a construction lending agency orJthe peAGENCY performance of he 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 Building and Sa Safety for G mit o he 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 officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit 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 Ouinta, its 2. Any permit issued as a result of this application becomes null-and-vord i ww%rk is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to c�e� ation. I certify that I have read his application and state that thea a i� nformation is ct. I agre ply wi all city and county ordinances and state laws relating to building construction, and ere autho a representatives of I county to enter up above- ed prope for inspection purposes. Date nature (Applicant or Agent): 1 Page 2 Application Number . . . . . 04-00007399 Date 11/23/04 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 75.01 Plan Check Fee 18.75 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1571.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 54.99 251.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 5.02 ------------------------------------------------=--------------------------- Permit . . . . . . PLUMBING Additional desc . . Permit Fee . . . . 145.50 Plan Check Fee 36.38 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 EAPLB WATER .INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00 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 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments SFD - LOT 74. PLAN 3RA, 1571 SF. PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL, SPA OR DRIVEWAY APPROACH. ----------------------------------- Other Fees . . . . . ----------------------------------------- . . . . ART IN PUBLIC PLACES -RES .00 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 Page 3 Application Number . . . . . 04-00007399 Date 11/23/04 -----------------------7---------------------------------------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE 41.28 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 9.89 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary ----------------- Charged Paid Credited Due Permit Fee*Total ---------- 949.01 ------------------------------ . .00 00 949.01 Plan Check Total 487.51 .00 x.00 487.51 Other Fee Total 2456.17 .00 .00 2456.17 Grand Total 3892.69 .00 .00 3892.69