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04-7108 (SFD)T-Wf 4 4 a" P.O. Box 1504 78-495 CALLE TAMPICO LA-.QUINTA, CALIFORNIA 92253 BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760) .777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 Application Number . . .._ 04-0 007-10-8— Date 11/23/04 Property Address . . . . . . 80853 VIA PUERTA AZUL APN: 762-24,0-00.3-82 -300962- Application description . . . DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . . . . MEDIUM DENSITY RES Application valuation . . . . 98984 Owner ------------------------ PUERTA AZUL PARTNERS 17700'SW UPPER BOONES FERRY RD SUITE 100 Contractor ------------------------ DAVIS/REED CONSTRUCTION INC 169 SAXONY ROAD, STE #105 ENCINITAS CA 92024 PORTLAND OR 9.,,7_22:4-7 (760) 634-2350 WCC: STATE FUND !,---� WC: WC2.98892003 06/12/05 CSLB: 813480 10/31/06 CCC: B Information -------------- ----------- 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 251.00 PATIO SQ FTG 316.00 NUMBER OF UNITS 1.00 ---------------------------------------------------------------------------- 1ST FLOOR SQUARE FOOTAGE 1571.00 Permit . . . . . BUILDING PERMIT Additional desc Permit Fee . . . . 635.00 Plan Check Fee 103.19 Issue Date . . . . Valuation . . . . 98984 Qty Unit Charge Per Extension BASE FEE 414.50 49..00 4.5000 THOU BLDG 50,001-100,000 220.50 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL Additional desc . . Permit Fee . . . . 78.50 Plan Check Pee 4.91 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 78-495 CALLS TAMPICO TWyl 4 LA QUINTA, CALIFORNIA 92253 BUILDING &t SAFETY DEPARTMENT Application Number: Applicant: Applicant's Mailing Address: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: /. ( • / • 011 / 14ekm or Engineer's Address: No.: C�Z33%7� 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 Licen�e� in full force and effect. O ` icense Class_ ►� i/C cense No._ \ J (J ,,�ate aiam cor 1 J(3.V iS��Uns CUC�tJ� OWNER -BUILDER DECLARATION I hereby affirm under penalty of perl'ury 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 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)Jicensed pursuant to the Contractors' State License Law.). U I am exempt under Sec. , B.& P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I 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. I have and will maintain workers' compensayon insurance, as required by Section 3700 of the Labor Code, for the'performance of the work for which this permit is ed. My w ers' compensatio urance caner and olic be ar mer JtG }RC� Policy N _ I certify that, in the performance of t for which this nevmit is iecnpri r �tipn nnf p I ,. -. - _- - ------�7 .. ••-• -.. • --y P--- ,,, any mannc� au as w uecume suplecr io me worKers' compensation laws of Calif and agree that ' I should become lect to the work"' ork rs' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with t e provisions. Date �- I -O plicant WARNING: FAILURE TO SECURE WO R COMPENSA O VERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED AND DOLLAR 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 1 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 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 Ouinta, its officers, agents and employees for any act or omission related eing performed un er o issuance of this permit. 2. Any permit issued as a result of this application be null and void if work is not commenced within 180 da om date of issuance of such permit, or cessation of work for 180 days will subjec it to cancellation. I certify that I have read this application and st at the above inform i rhe amply with all city and co dinances and state laws relating to building construction, and hereby authorize represe lives of this county t vww araw �rmf 'tf .. a .: �___ ateSignature (Applicant or N, J Page 2 Application Number . . . . 04-00007108 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 . . . . 75.01 Plan Check Fee 4.69 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1571.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 54.99 251.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 5.02 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING Additional desc Permit Fee . . . . 145.50 Plan Check Fee 9.10 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 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 82. PLAN 3AR, 1571 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 r Page 3 Application Number . . . . . 04-00007108 Date 11/23/04 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 10.32 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 9.89 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary ----------------- Charged Paid Credited Due Permit Fee Total ---------- 949.01 ------------------------------ .00 .00 949.01 Plan Check Total 121.89 00 .00 121.89 Other Fee Total 2425.21 .00 .00 2425.21 Grand Total 3496.11 .00 .00 3496.11