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04-4094 (SFD)P.O., Box 1504 78-495 CALLS TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number Property Address . . . APN: Application description Property Zoning . . . . Application valuation . Owner BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 _04-_00004094 i Date 5/17/04 . . . 80895 VIA PUERTA AZUL 760-240-003-18 -300961- . . . DWELLING - SINGLE FAMILY DETACHED . . . MEDIUM DENSITY RES . . . 87296 PUERTA AZUL PARTNERS 17700 SW UPPER BOONES FERRY RD SUITE 100 PORTLAND OR 97224 Contractor DAVIS/REED CONSTRUCTION INC 169 SAXONY ROAD, STE #105 ENCINITAS CA 92024 (760) 634-2350 WCC: STATE FUND WC: WC298892003 06/12/04 CSLB: 813480 10/31/04 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 269.00 NUMBER OF UNITS 1.00 FIRST FLOOR SQ FTG' 1380.00 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT, Additional desc Permit Fee . . . . 585.50 Plan Check Fee 380.58 Issue Date . . . . Valuation 87296 Qty Unit Charge Per Extension BASE FEE 414.50 38.00 4.5000 THOU BLDG 50,001-100,000 171.00 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL Additional desc Permit Fee . . . . 78'.50 Plan Check Fee 19.63 Issue Date Valuation . . . . 0 Qty Unit Charge Per Extension 0 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: chitect r in er: Architect or ngin er's ddressL74 r lcf : ic. No.: CSUILUINU t'EKMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby.affirtn under penalty 11 perjury that I am licensed undetsrovisions Chapter 9 (corer mencing with Section 7000) of Division 3 of the Business and Professionals Code, and my Lio se is, in full force and effect. �/ �`/j' rv\ License Class _ License No. l ' ContractorDate A �vv �. 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 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 sdle 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 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 an 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 i ue My a cgr�pensafon insurance carrier d- olicy rTum�rgare: &� /) r-arier 7_� 1 �O (�4lQ lr�n .,umber .0� iS3r Z� / _I certify that, in the performance of the work for which this permit isIs—sued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the w kers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. / pplicant i FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND :S UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN 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 ,� l Lender's Address YV 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 applica , htion. 1. Each person upon whose behalf this application is made each pe hose-rewhose benefit work is performed under or pursuant to any permit gnesLand for wh issued as a result of this application, the owner, and the cant, each agrees to, and shat -defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omis related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application comes null and void q is n - m ncedTall m'thin 180 days -from date of issuance of such permit, or cessation of work for 180 days will subject pe it to cancellation. / I certify that I have r ad this application and state that thea ve informati is port a to construct:74 nd reby authorize representatives of this county -to -en r,.0 n th Y city and county ordinances and state laws relating to building _ men pr Zerty for inspection purposes. D � ig'S nature (Applicant or Agent Page 2 Application Number . . . . . 04-00004094 Date 5/17/04 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 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 17.05 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 34.88 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 ---------------------------7------------------------------------------------ Special Notes and Comments SFD - LOT 18. PLAN 1BR. PERMIT DOES NOT Page 3 Application Number 04-00004094 Date 5/17/04 ---------------------------------------------------------------------------- . Special Notes and Comments INCLUDE BLOCK WALLS, POOL, SPA OR DRIVEWAY APPROACH. ---------------------------------------------------------------------------- Other Fees . . . . . . . ART IN PUBLIC PLACES -RES .00 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 38.06 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 8.72 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary ----------------- Charged Paid Credited Due Permit Fee Total ----------- 886.68 ------------------------------ .00 .00 886.68 Plan Check Total 452.14 .00 .00 452.14 Other Fee Total 2451.78 .00 .00 2451.78 Grand Total 3790.60 .00 .00 3790.60 Cedificate of Occupancy0 T-itf ot Luro�oenrn `'� OF Building y p & Safety Department This Certificate is issued pursuant to the requirements of Section 109 of the California Building Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 80-895 VIA PUERTA AZUL Use classification: SINGLE FAMILY DWELLING Building Permit No.: 04-4094 Occupancy Group: R3 Type of Construction: VN Land Use Zone: RM PUERTA AZUL PARTNERS, LLC. Address: 17700 SW UPPER BOONES FERRY City, ST, ZIP: PORTLAND, OR 97224 By: GARY HARTMAN Date: FEBRUARY 16, 2005 Building Official POST IN A CONSPICUOUS PLACE