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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