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04-7082 (SFD)C 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 BUILDING PERMIT Application Number `0-4=0-0-0-070-82--} Date 11/16/04 Property Address . . . . . . 80818 VIA PUERTA AZUL APN: 762-240-003-12 -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: WC298892004 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 -=-------------------------------------------------------------------------- FIRST FLOOR SQ FTG 1740.00 Permit BUILDING PERMIT - Additional desc Permit Fee 685.00 Plan Check Fee 445.25 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 19.63 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 1504I4 CE VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number. 64. 708'a Date: 11' ((o • pL/ Applicant: chitect or Engineer: &, i / Applicant's Mailing Address: chitect or Engineer's Address: ic. No. G Z12 — BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under pe alt f perjury that I am licensed under provisions of Chapter 9 ( ncing,with Section 7000) of Division 3 of the Business and Professionals Code, and License is i rce and effect. License CI ss �I ^nse No. I OWNER -BUILDER DECLARATION I her bVuflr firm 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 orty 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 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. , 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 'll mai air�tertificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance �[ of the rk for hich't '3 permit is issued. ! I ha_v,�e/a will int ' orkers' compensaf nsuraTice, as?egoiredJZy Section 3700 of the Labor Codef the performan of a work for which this permit is r� o er p n i surance carrier and policy numbs e: /� �/j! �rrier Policy Number " `-� _ IF7,thpwith/mp!X,with at, a performs ce of the work for which this permit is issued, I s all not employ any person in any manner so as to become subject to the workers' /satiQn laws of Califo nd agree th ould me sub' to the workers' compensation provisions of Section 3700 of the Labor Code, I shall those provisions. Zl� Date FALURE TO SECURE WORKERS" COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND P TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN 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 tj 1A 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 o�b'e�come ssion related to ing rid under or following issuance of this permit. 2. Any permit issued as a result of this application and void if work is not comms d within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permlation. I certify thatI haveread th' application and state that the aation i ct. I ee to co ply v�ith all city and county ordinances and state laws relating to building construction, ar�ereb�thodze representatives of this coeqioWproqerty for inspection purposes. Signature (Applicant or Agent): Application Number . . . . . 04-00007082 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 20.23 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1740.00 .035.0 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 12. PLAN 4B, 1740 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 . . . . . 04-00007082 Date 11/16/04 ---------------------------------------------------------------------------- .Other Fees . . . . . . . . . ENERGY REVIEW FEE 44.53 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 521.67 .00 .00 521.67 Other Fee Total 2460.79. .00 .00 2460.79 Grand Total 3988.11 .00 .00 3988.11 ` INSULATION -CERTIFICATE Thisiohnne�U�that inou�Uonhas been installed \nconformance w�hthe ounentenergy regulation, ( iadnn.�Ca\^xurniaAdminiohativeCoda. T�e24.State of{�o\�ornka.inthe buUdingot , ----—�-�� -- 12 �ELE��E8 PH��E2 L�C�U|NTA'CA � �/W�pUE�T��A�UL,L0T ' . . , CEI-INGS: MAUNFACTURER: Owens Corning THICKNESS: F-11 TYPE: BLOW �ANUFACTURERLCe�ainteed THICKNESS: R-19 TYPE:BATTSGENERAL CONTRACTOR: DAVIS—REED C ONSTRUCTION LICENSE BY: TITLE: PARAGON SCHM|OBUILDING PRODUCTS AMASCO Company LICENSE #221517 TITLE: ACCOUNT REPRESENTIVE DATE: 0 0 �-a- ��c Certificate of Occupancy 0 0 V _ � OF'T� Building & Safety Department This Certificate is issued pursuant to the requirements of Section 109 of the California Building Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 80-818 VIA PUERTA AZUL Use classification: SINGLE FAMILY DWELLING Building Permit No.: 04-7082 Occupancy Group: R-3 Type of Construction: V -N Land Use Zone: R -M Owner of Building: PUERTA AZUL PARTNERS, LLC Address: 8905 SW NIMBUS AVE. STE. 400 City, ST, ZIP: BEAVERTON, OR 97008 By: GARY HARTMAN ---'-' Date: OCTOBER 20, 2005 Building Official POST IN A CONSPICUOUS PLACE