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04-7094 (SFD)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 X0-4-00007.0.94\'� Date 11/23/04 Property Address . . . . . . 80841 VIA PUERTA AZUL APN: 762-240-003-80 -300962- Application description . . . DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . . . . MEDIUM DENSITY RES Application valuation . . . . 99599 Owner. Contractor PUERTA AZUL PARTNERS DAVIS/REED CONSTRUCTION INC 17700 SW UPPER BOONES FERRY RD '169 SAXONY ROAD, STE #105 SUITE 100 ENCINITAS CA 92024 PORTLAND OR�� 972,24 e (760) 634-2350 WCC: STATE FUND WC: WC298892003 06/12/05 CSLB: 813480 10/31/06 CCC: B ---------------------'---- -- Structure--I-nformation Construction Type . . . . . TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/LONG <=10 Flood Zone . . . . . . . . NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 CRC # BEDROOMS 2.00 FIRE SPRINKLERS NO GARAGE SQ FTG 255.00 PATIO SQ FTG 451.00 NUMBER OF UNITS 1.00 1ST FLOOR SQUARE FOOTAGE 1549.00 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 639.50 Plan Check Fee.. 103.92 Issue Date . . . . Valuation . . . . 99599 Qty Unit Charge Per Extension BASE FEE 414.50 50.00 4.5000 THOU BLDG 50,001-100,000 " _ 225.00 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL Additional desc . . Permit Fee . . . . 85.00 Plan Check Fee 5.31 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 ��/�� C&f 78-495 CALLS TAMPICO Y VOICE (760) 777-7012 LA QUINTA, CALIFORNIA 92253 4FAX (760) 777-7011 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 04- 70g4 Date: 1.2- ( -0q Applicant: Applicant's Mailing Address: Engineer:M Architect or Engineer's Address: Lic. No.: C2,33 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 �nd my Licensov in full force and effect. 2�l icense Class_ A /License No.—'Ell .TZ ligZ� ✓Date — I-�ontractor cCGa.2 C—Vk , OWNER -BUILDER DECLARATION I hereby 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 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 Owner WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 1 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. I have and will maintain workers' compensation insurance�quired-bySect' 3700 of the Labor Code, for the performance of the work for which this permit is • �� is d. � workgrs' compensation insurance c n olicy n e r /carrier ' `-'lr��- Uc�c3� /folic tuberL _ I certify that, in the performance of work for whit is �ermitied, I shall not employ ny person in any manner so as to become subject to the workers' compensation laws of Ca f ia, and agree t if I shoubject to the worker 'compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with ose provisions. I -0(A WARNING: FAILURE TO SECURE RICERS' CO SATION CO EV RAGE IS UNLAWFUL, A LL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUND D THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF C PENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. CONSTRUCTION I hereby affirm under penalty of perjury that there is a construction lending agency orVthe peAGENCY performance of he work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name Lenders Address ` APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Sa Safety for 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 perm 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 it officers, agents and employees for any act or omission related to the work being performed under or foliov�ng issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit t9.c66cellation. I certify that I have read this application and state that the above ' formation is correct. I a e comply wit�al c-,ty and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to en e i ed p ins ection purposes. Date �—�� Sim 9nature (Applicant or Agent): Page 2 Application Number . . . . . 04-00007094 Date 11/23/04 Qty Unit Charge Per Extension 7.00 6.5000 EA MECH VENT FAN 45.50 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 ----------------------------------------------------- Permit . ... . . . ----------------------- ELEC-NEW RESIDENTIAL Additional desc Permit Fee . . . . 74.32 Plan Check Fee 4.65 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1549.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 54.22 255.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 5.10 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING Additional desc Permit Fee . . . . 151.50. Plan Check Fee 9.28 Issue Date . . . . Valuation 0 Qty Unit Charge Per Extension. BASE FEE 15.00 14.00 6.0000 EA PLB FIXTURE .84.00 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 80. PLAN 2BR, 1549 SF. PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL, SPA OR DRIVEWAY APPROACH. 75% PLAN CHECK FEE REDUCTION APPLIED FOR MULTIPLE ISSUANCE OF SAME PLAN -TYPE. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART -IN PUBLIC PLACES -RES .00 Page 3 Application Number . . . . . 04-00007094 Date 11/23/04 ---------7------------------------------------------------------------------ Other Fees . . . . . . . . . DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 10.39 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 9.95 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary ------------------ Charged Paid Credited Due Permit Fee Total ---------- 965.32 ---------- ---------- ---------- .00 .00 965.32 Plan Check Total 123.16 .00 .00. 123.16 Other Fee Total 2425.34 .00 .00 2425.34 Grand Total 3513.82 .00 .00 3513.82