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04-7095 (SFD)T-Vf 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 Application Number . . Property Address . . . APN: Application description Property Zoning . . . . Application valuation . BUILDING PERMIT . . .04-00007095 Date 11/23/04 . . . 80865 VIA PUERTA AZUL 762-240-003-84 -300962- . . . DWELLING - SINGLE FAMILY DETACHED . . . MEDIUM DENSITY RES . . . 99599 Owner ------------------------ PUERTA AZUL PARTNERS 17700 SW UPPER BOONES FERRY -D SUITE 100 PORTLAND 4 Contractor DAVIS/REED CONSTRUCTION INC 169 SAXONY ROAD, STE #105 ENCINITAS CA 92024 (760) 634-2350 WCC: STATE FUND WC: WC298892003 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 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 • VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 4INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 04- 70 95 Date: /a ' 7 -0 Applicant: --Architect or Engineer:ewig Applicant's Mailing Address:_Pvchitect or Engineer'i Address: No. BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions ofTy ing with Section 7000) of Division 3 of the Business and Professionals C ,and my Licens sin full force and effect. icense Class_ a `ense No. 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.). 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: _ I have and wil 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 wo orwhtch-ttis permit is issyed. hav and (ma ntain workers' ensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is s e w efs' co a atio rance carrier and "polic number are: arrier l l� Policy Number j &� Z Cj I cdrtiffthat, in the perfor ante of the work for ich this it is is ned, I shall not em to anon in any ` compensation laws o Califomia, and agre at, if I s Id bec a subject to the workers' compensation provisions of Sanner so aection 3700 of the Labor Code, s to ecome subject to the workers' shall fort with comply with those provisions. .,,�Date plicant WARNIN FAAURE TO SECURE WORk(&S' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FIWS 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 APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a 't-sadje the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each p at whose request and hose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the ap nt, each agr to, and shall, defen indemnify and hold harmless the City of La Ouinta, its officers, agents and employees for any act or omission r ated to the wo -being perform d un er or following issuance of this permit. 2. Any permit issued as a result of this application beco s null and voicPII work is not ced within f 0 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to caeQcellation/ /I I certify that I have re this application and state that the above infij i n is sect. o co h all qty and county ordinances and state laws relating to building cons/traction, and h eb a Iorize�representatives of this county t=th- operty�r inspection purposes. U[e/t� v Si✓ gnatureA licant or Agent): ent: 9. ) Application Number . . . . . 04-0000709.5 Page 2 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 ---------------------------------------------------------------7------------ Special Notes and Comments SFD - LOT 84. PLAN 2AR,, 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. : --------------------------- Fees . . . . . . . . . ART IN PUBLIC PLACES -RES .00 0 Page 3 Application Number 04-00007095 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 Permit Fee°`Total 965.32 Plan Check Total 123.16 Other Fee Total 2425.34 Grand Total 3513.82 Paid Credited Due ---------- ---------- ---------- .00 .00 965.32 .00 .00 123.16 .00 .00 2425.34 .00 .00 3513.82