04-7400 (SFD)P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number . .
Property Address . . .
APIC:
Application description
Property Zoning . . . .
Application valuation .
Owner
PUERTA AZUL PARTNERS
BUILDING PERMIT
BUILDING & SAFETY.DEPARTMENT
(760).777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
(-0-4=0-00°0.740-0 ---� Date 11/23/04
80823 VIA PUERTA AZUL
762-240-003-75 -300962-
. . . DWELLING - SINGLE FAMILY DETACHED
. . . MEDIUM DENSITY RES
. . . 87296
17700 SW UPPER BOONE.S :FERRY -RD
SUITE 100 I("'>> _ _`
PORTLAND r. 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/LONG <=10
Flood Zone . .
. . . . . . NON -AO FLOOD ZONE
Other str.uct info
. . . . . CODE EDITION 2001 CBC
# BEDROOMS
2.00
FIRE SPRINKLERS NO
--
GARAGE SQ FTG
244.00
PATIO SQ FTG
269.00
NUMBER OF UNITS
1.00
1ST FLOOR SQUARE FOOTAGE
1380.00
----------------------------------------------------------------------------
Permit . . .
. . BUILDING PERMIT
Additional desc
Permit Fee . .
. . 585.50 Plan Check Fee
380.58
Issue Date . .
. . Valuation . . . .
87296
Qty Unit
Charge Per
Extension
BASE FEE
414.50
38.00
4.5000 THOU BLDG 50,001-100,000
171.00
----------------------------------------------------------------------------
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 • 44"
VOICE (760) 777-7012
78-495 CALLS NO FAX (760) 777-7011
LA QUINTA, CALIFORNIAFO 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: D-4- '1400
Applicant:
Applicant's Mailing Address:
Date: O �(
chitect or Engineer: ,��J
—Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Cha r 9 (com ep 'rlg wish Section 7000) of Division 3 of the Business and Professionals
e, and my License is in full force and effect.
c/
co
nse Class �i ense No.
ate` o�C ntractor
Qw, _(:�,
OWNER -BUILDER DECLARATIO
I hereby a i 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 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 Owner
WORKERS' COMPENSATION DECLARATION
1 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 the work for which this permit is issued.
T� I have nd ain workers' compensation insurance, as required b Section 3700 of the Labor Co ,,for the performance of the work for which this permit is
is ed." ly w cers' compensation i nce carrier a cy numb r
Carrier olicy Numbe
_ I certK th , in the performance of the work hich this permit is issdWd, I shall of emp oy any person in any rr er so as to become subject to the workers'
7c6 p� nsation laws of California, an ree thy, I shout !_me subject to tide workers' compensafion provisions of Section 3700 of the Labor Code, I shall
rtq ith comply with those Prov' ons. / / /�" — 1
WAR NI G:/FAILURE TO SECURE WORIE�RS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL INES 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
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
Lenders Address L) tift
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the condifions and restricfions set forth on this application.
1. Each person upon whose behalf this application is made, each person at w se regQest ar�i r whose benefit work is performed under or pursuant to any permit
issued as a result of this application, the owner, and the applicant agrees to, and shall, de d, indemnity and hold harmless the City of La Ouinta, its
officers, agents and employees for any act or omissionfrelat the work being performedunder o ollowing issuance of this permit.
2. Any permit issued as a result ofthis application becbmnd void if work is not co encedwithi 180 days from date of issuance of such permit, or
cessaf n f work for 180 days will subject permit t a�seicit.'
I certify that I ha r d this application and state that the a veinoato comply with all city and county ordinances and state laws relating to building
constructiona reby authorize representatives of this couentioned•proper onspection purposes.
..
�Signature (Applicant or Agent):
w
Application Number . . . . . 04-00007400
Page 2
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 .
. . .
68.18 Plan Check Fee
17.05
Issue Date .
. . .
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
1380.00
.0350
ELEC NEW RES - 1 OR 2 FAMILY
48.30
244.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
4.88
----------------------------------------------------------I------------------
Permit . . .
. . .
PLUMBING
Additional desc
. .
Permit Fee .
. . .
139.50- Plan Check Fee
34.88
Issue Date .
. . .
Valuation
0
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
12.00
6.0000
EA PLB FIXTURE
72.00
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
1.00
3.0000
EA PLB GAS PIPE 1-4 OUTLETS
3..00
1.00.
15.0000
EA PLB GAS METER
w
15.00
--------------------------------------------------
. . .
. . .
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 75.
PLAN 1RA, 1380 S.F. 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
.i
Page 3
Application Number
. . . . .
04-00007400 Date
11/23/04
----------------------------------------------------------------------------
Other Fees . . . .
. . . . .
ENERGY REVIEW FEE
38.06
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
8.72
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
-----------------
Charged
Paid Credited
Due
Permit Fee Total
----------
886.68
------------------------------
.00 .00
886.68
Plan Check Total
452.14
.00 .00
452.14
Other Fee Total
2451.78
.00 .00
2451.78
Grand Total
3790.60
.00 .00
3790.60