04-7089 (SFD)BUILDING & SAFETY DEPARTMEIJT
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
. . . E0_4-00007089 Date 11/23./04
. . . 80871 VIA PUERTA AZUL
762-240-003-83 -300962-
. . . DWELLING - SINGLE FAMILY DETACHED
. . . MEDIUM DENSITY RES
. . . 85886
Owner,---�
Contractor
��
PUERTA AZULIt�iVERS
` ��" DAVIS/REED CONSTRUCTION INC
.F
17700 SW UPP',ff-R4 BOONES--FERRY RD 169 SAXONY ROAD, STE
#105
SUITE 100 `a
T^' ENCINITAS
CA 92024
PORTLAND �'' '`�,GRI 9722,_4.. (760) 634-2350
WCC: STATE FUND
;-
WC: WC298892004
06/1'2/05
CSLB: 813480
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
163.00
NUMBER OF UNITS
1.00
1ST FLOOR SQUARE FOOTAGE
1380.00
-=--------------------------------------------------------------------------
Permit . . . . . . BUILDING PERMIT
Additional desc . .
Permit Fee . . . .
576.50 Plan Check Fee
93.68
Issue Date . . . .
Valuation . . . .
85886
Qty Unit Charge
Per
Extension
BASE FEE
414.50
36.00 4.5000
THOU BLDG 50,00'1-100,000
162.00
------------------------------------------------------------`----------------
Permit . . . . . MECHANICAL
Additional desc
Permit Fee . . . .
78.50 Plan Check Fee
4.91
Issue Date
Valuation . . . .
0
Qty Unit Charge
Per
Extension
BASE' FEE
1S.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 VOICE (760) 777-7012
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 4vol INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: d �' 70 8 y' Date: /o� •/'D
Applicant: hitect or Engineer:
6
Applicant's Mailing Address:rchitect or Engineer's Address:
. Vr --1
.Lic. No.,
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penally- perjury that I am licensed under provisions of Chapter 9 (commern ing with Section 7000) of Division 3 of the Business and Professionals
Co , and my License is in f Il orce and effect. ^ 1
icense Class cense No. v
ate t7 ontractor i
OWNER -BUILDER DECLARATION
I hereby affirm and r 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 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 f perju a of the following declarations:
I have aridwill aintain certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance
of th work f r whit this permit is issued.
I have nd will ainta' workers' c pensa n insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
ss o pe on ' urance carrier anted Pili rare:
arner olicy Number / (%��
/(c e/tff tat, in the performan of the work for is this permit is issued, I shall not employ �Wanganirn sous come subject to the workers'
c99mpensation laws of California, and agree t I s�6uld become subj1ect to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
J6rth4th corpply with those DrovisionsJ %
ate �ETO
pplicant
WARNIN : F ILU SECURE WOR COMPENSATIO OVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FI ES UP TO ONE HUNDRED T OUSAND 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
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 a request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application, the owner, and pp icant, each agrees to, ndshall, defend, indemnify and hold harmless the City of La Ouinta, its
officers, agents and employees for any act or, sion related to the work being performed under or following issuance of this permit.
2. Any permit issued as a result of this applica ' n becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or
cessati of work for 180 days will subject p r�,nf.
it t
I certify that I hav read this application and state that the rr ee to mply with all city and county ordinances and state laws relating to building
construction, a hby�gthorize rep talives of this.me or inspection purposes.
//
Signature (Applicant or Agent):
Page 2
Application Number . . . . . 04-00007089 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
68.18 Plan Check Fee
4.26
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
8.72
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
83. PLAN 1AR,
1380 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
. . . . .
04-00007089 Date
11/23/04
----------------------------------------------------------------------------
Other Fees . . . .
. . . . .
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
9.37
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
8.58
DIF STREET MAINT FAC -RES
.15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
-----------------
Charged
----------
Paid Credited
Due
Permit Fee Total
877.68
------------------------------
.00 .00
877.68
Plan Check Total
111.57
.00 .00
111.57
Other Fee Total
2422.95
.00 .00
2422.95.
Grand Total
3412.20
.00 .00
3412.20