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04-7102 (SFD)i T4hf 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 . . . . .I 04=0-0007102 Date 11/23/04 Property Address . . . . . . 80859 VIA PUERTA AZUL APN: 762-240-003-81 -300962- Application description . . . DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . . . . MEDIUM DENSITY RES Application valuation . . . . 112634 Owner ------------------------ PUERTA AZUL PARTNERS 17700 SW UPPER BOONES FERRY RD SUITE 100 PORTLAND OR 97224 Contractor DAVIS/REED CONSTRUCTION INC 16.9 SAXONY ROAD, STE 4105 ENCINITAS CA -92024 (760) 634-2350 WCC: STATE FUND WC: WC298892003 06/12/05 CSLB: 813480 10/31/06 CCC: B -------------------------- Structure Information ------------------------- Construction.-T-ype . . . . .—TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/CONG <=10 Flood Zone NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 CRC # BEDROOMS 1.00 FIRE SPRINKLERS NO GARAGE SQ FTG 250.00 PATIO SQ FTG 617.00 NUMBER OF UNITS 1.00 1ST FLOOR SQUARE FOOTAGE 1740.00 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 685.00 Plan Check Fee 111.31 Issue Date Valuation . . . . 112634 Qty Unit Charge Per Extension BASE FEE 639.50 13.00 3.5000 THOU BLDG 100,001-500,000 45.50 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL Additional desc Permit Fee . . . . 78.50 Plan Check Fee 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 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: Applicant: Applicant's Mailing Address: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: Engineer: . R M �,3 or Engineer's Address: Lic. No.: C�Z'_53i+7 cl MUILUINU I'LKMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perl'ury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code— and my Lic `r> is in full force and effect. / �& 13 ` Q0 License Class i15� License No. �-1 J Date Q -V1 -p4 ✓contractor 1. /_ C.L�i 1 S 1 i e 2� �V" % A_1C_C_TLO� OWNER -BUILDER DECLARATION I hereby affirm 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 fora 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.). (, 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 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' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issue . My workers' co m ensatio;n carrier and policy ape re: Carrier c c�k� ��(� o� licy Number 1.�� C`(gqiZQ[�'� _ I certify that, in the performance of the work for which•this permit is issued, 154@11 not employ any person in any manner so as to become subject to the workers' compensation laws of California, andaoree`tg t, if I shout corpa�Ti t to t orkers' mpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provi.5i s. WARNING: FAILURE TO SECURE WORKERS'Cg&ENSATION COVERAGHS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAN OLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTERIR�§_f, 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 ACKNOWLEDGEMENTAPPLICANT IMPORTANT Application is hereby made to the Director of Building and Safetyfor permiit uo 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-f6r`w ose ene i w ormed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each_agrees'to, and shall, defend, indemnity and hold ha s the City of La Ouinta, its •officers, agents and employees for any act or omission related to the"work being performed under or following issuance of this pe 2. Any permit issued as a result of,this application becomes 90t-a—nd void if work is n mme within 180 days from date of issuantce 0f such permit, or cessation of work for 180 days will subject permit to ca ellation. I certify that I have read this application and state that the abov nformation is come ag y with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county' nter upon abov d prop or inspection purposes. f S/ignafure (Applicant or Agent): Page 2 Application Number . . . . . 04-00007102 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 _ 80.90 Plan Check Fee 5.06 Issue Date . . . _ Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1740.00 .0=50 ELEC NEW RES - 1 OR 2 FAMILY 60.90 250.00 .0100 ELEC GARAGE OR NON-RESIDENTIAL 5.00 ------------------------------------------------------------------'---------- Permit . . . . . PLUMBING Additional desc Permit Fee . . . . 146.25 Plan Check Fee 9.14 Issue Date Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 13.00 6.0)00 EA PLB FIXTURE 78.00 1.00 15.0D00 EA PLB BUILDING SEWER 15.00 1.00. 7.5D00 EA PLB WATER HEATER/VENT 7.50 1.00 3.0300 EA PLB WATER INST/ALT/REP 3.00 1.00 9.0300 EA PLB LAWN SPRINKLER SYSTEM 9.00 5.00 .7-000 EA PLB GAS PIPE >=5 3.75 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 81. PLAID 4AR, 1740 SF. PERMIT DOES NOT INCLUDE FLOCK WALLS, POOL, SPA . OR DRIVEWAY APPROKCH. 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 04-00007102, Date 11/23/04 ---------------------------------------------------------------------------- Other Fees . . . . . . . . .. DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER'- RES 366.00 ENERGY REVIEW FEE 11.13 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 11.26 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION -.RES 1098.00 Fee summary ----------------- Charged Paid Credited Due Permit Fee Total ---------- 1005.65 ------------------------------ .00 .00 1005.65 Plan Check Total 130.42 .00 .00 130.42 Other Fee Total 2427.39 .00 .00 2427.39 Grand Total 3563.46 .00 .00 3563.46