04-7078 (SFD)T-af 4 4 a"
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 . . . . .004-00007078 Date 11/16/04
Property Address . . . . . . 8 -0830 -VIA PUERTA AZUL
APN: 62-240-003-10 -300962-
Application description . . . DWELLING - SINGLE FAMILY DETACHED
Property Zoning .. . . MEDIUM DENSITY RES
Application valuation . . . . 87296
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: 81.3480,
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 CBC
# BEDROOMS
2.00
FIRE SPRINKLERS NO
GARAGE SQ FTG
244.00
PATIO SQ FTG
269.00
NUMBER OF UNITS
1.00
FIRST FLOOR SQ FTG
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 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:
Applicant: Architect
Applicant's Mailing Address: Architect
ic. No.:
or Engineer:
or Engineer's
BUILDING 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 II force and effect.
�CicensetClass �ce No.
Date / ` contractor
OWNER -BUILDER DECLARATION
1 he y affirm under penalty of perjury that 1 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 rive 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 1, 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 1 am exempt under Sec. , B.& 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 intain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance
of th orkf whi permit is issued.
g 1 have nd wi aint n workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance 0-6 of the for which this permit is
ed v 0 com a tion insurance carrier-and-polis*number are: Z—
�rier /Folic arti>f e
e ify that, in the perfornfance of ork for which this pe ssued, I sh I nQt employ any personnany manner so as to become subject to the workers'
co pensati • n laws of Calif a, and agre at, if I sh eco ubject to the . orkers' compensation provisions of Section 3700 of the Labor Code, I shall
f th _ply with t e provisions.
mete Ant
WAR G F LUR TO SECURE VV6 KERS' C PENSATION COVERAGE IS UNLA L A_ND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVI FINE PTO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST -OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SE TION 706 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 A
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-foTWho nefit 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, mdemnify,and hold harmless the City of La Quinta, its
officers, agents and employees for any act or omission relatedt he work being performed under or following iss'"nce of this permit.
2. Any permit issued as a result of this application becomes nu I -and void if work is no m d within 180 days frb date of issuance of such permit, or
cessation of wo for 180 days will subject permit to ca9pallation.
I certify that I he a read t s application and state that the above iriiformat' is rrect. comply w, city and county rdinances and state laws relating to building
construction, d hM
representatives of this cou y to r the tion rty for inspection pu ses.
t ateture (Applicant or Agent):
0
Page 2
Application Number . . . . . 04-00007078 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
. . . .
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
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
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.10.
PLAN -1B,
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
Page 3
Application Number
. . . . .
04-00007078 Date
11/16/04
---------------------------------------------------------'-------------------
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
INSULATION CERTIFICATE
This is to certify that insulation has been installed in conformance with the current energy
regulation, California Administrative Code, Title 24, State of California, in the building at
80-830 VIA PUERTA AZUL, LOT 10, RELEASE 8, PHASE 2, LA QUINTA, CA
CEILINGS:
TYPE: BLOW MAUNFACTURER: Owens Corning THICKNESS: R-11
WALLS:
TYPE: BATTS MANUFACTURER: Certainteed THICKNESS: R-19
GENERAL CONTRACTOR: DAVIS—REED CONSTRUCTION LICENSE #
BY: TITLE:
PARAGON SCHMID BUILDING PRODUCTS A MASCO Company LICENSE # 221517
BY: �t� TITLE: ACCOUNT REP.RESENTIVE DATE: OS
0
•
CITY OF LA QUINITA
BUILDING & SAFETY DEPARTMENT
•OPT 777-7012
INSPECTION REQUEST UNE
777-7153
Owner PUERTA.AZUL PARTNERS
Coy tractor DAVIS REED CONSTRUCTION
Permit Number-.•ja"7078
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 80-830 VIA PUERTA AZUL
SFD - LOT 10, PLAN IB. PERNIT DOES NOT
INCLUDE POOL, SPA, BLOCK WALLS OR
DRIVEWAY APPROACH
WE
a
Z0/Z0 39Vd iSN00 Q33dSIAVG LSPTLLL09L ES:ST 5002/LT/0T
,- Certificate of Occupancy000
0 o
nom.^,m 4
OF 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: 80-830 VIA PUERTA AZUL
Use classification: SINGLE FAMILY DWELLING Building Permit No.: 04-7078
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
-mob' Date: OCTOBER 12, 2005
Building Official
POST IN A CONSPICUOUS PLACE