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04-7099 (SFD)d� T-11'af 4 4V a" 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 . . . . . /,04--00`0"0-7-0-99---, Date 11/23/04 Property Address . . . . . . 80811 VIA-PUERTA AZUL APN: 762-240-003-73 -300962- Application description . . . DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . . . . MEDIUM DENSITY RES Application valuation 112634 Owner ``^`LL�,� Contractor ------------------------ ------------------------ PUERTA AZUL PARTNERS .(,'DAVIS/REED CONSTRUCTION INC 17700 SW UPPER B � FERRY Rq, '� 169 SAXONY ROAD, STE #105 SUITE 100 ��`�ENCINITAS CA 92024 PORTLAND 'a,OR `97224�(760) 634-2350 WCC: STATE FUND ^" WC: WC298892003 06/12/05 CSLB: 813480 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 1ST FLOOR SQUARE FOOTAGE 1740.00 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc Permit Fee . . . . 685.00 Plan Check Fee 445.24 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 19.64 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 TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: 04, �y 4 g Applicant: Architect Applicant's Mailing Address: Architect Lic. No.: or Engineer: or Engineer's VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12.1-0 MUILUINU 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 Code, and my License is in full force and effect. cense Class icense No. Date, 2 i Contractor OWNER -BUILDER DECLARATION I he y ff. 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 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 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 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 of thewo for which this permit is issued. I hav and 111 m ' workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is ued . e ' o ensatio ' ranceca7ri nd-policynumberare�,� OOlome arrier Policy Number c rti that, in tile perfo nce of the work -for which this •i sued, I shall not em y any person in any manner so as subject to the workers' compensation laws of Califomia�nd agree that, i ou a bject to the worke 'compensation provisions of Section 3700 of the Labor Code, I shall f h 'th comply with those prpwsions. / ate Applicant WARNI G: AILURE TO SECURE WOR R ' MP COVERAGE IS UNLAWFUL, AND UBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL F N S UP TO ONE HUNDRED THOU D DOLLARS ($100,000), IN ADDITION TO THE COST OF COMP ATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 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.). Lender's Name Lender's Address 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 Ouinta, its officers, agents and employees for any act or omiss' a a ed to the work `etrtg p onned under or following issuance of this permit. 2. Any permit issued as a result of this application comes null and void if work ' of enced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permi to cancellation. I certify that I have read this application and state that the ab o information is a agree to c with all city and county ordinances and state laws relating to building -construction, and ereby authorize representatives of this co nter n t bo -m n roperty for inspection purposes. Date 2 l O gnature (Applicant or Agent): Page 2 Application Number . . . . . 04-00007099 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 . . . . 80.90 Plan Check Fee 20.24 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 36.56 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 73. PLAN 4AR. 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 . . . . . 04-00007099 Date 11/23/04 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE 44.52, 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 521.68 .00 .00 521.68 Other Fee Total 2460.78 .00 .00 2460.78 Grand Total 3988.11 .00 .00 3988.11