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04-4024 (SFD).- �_ _'.] 't T -df 4 4 Q" AMPICO .IFORNIA 92253 BUILDING PERMIT APN: Application description Property Zoning . . . . . Application valuation . . Owner PUERTA AZUL PARTNERS 17700 SW UPPER BOONES FERRY RD SUITE 100 PORTLAND OR 97224 BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 04-00004024 Date 5/11/04 80944 VIA PUERTA AZUL 762-240-003-5 -300961- DWELLING - SINGLE FAMILY DETACHED MEDIUM DENSITY RES 87296 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-HIC -------------------------- 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 50,001-1001000 171.00 Permi.t . . . . . . MECHANICAL Additional desc Permit Fee . . . . 78..50 Plan Check Fee 19.63 Issue Date . . . . Valuation 0 Qty Unit Charge Per Extension P.O. BOX 1504 • '�� 78-495 CALLS 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: - � Ic th ect,o Engirt � Archit g%,f� r Enc�1 ear' `AAAZress: 7'1V10,'7- ---t-0c. No.: Z,� %7� tsUILUING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION 1 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 Ceense d -my Licences is i� full force and effect. L — r, cense Class - License No. V e �� eta _ ontrector di iT� �/ .l�t'�-fes I e" 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 stricture, 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 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 issued. pAy w rkers' compensation ' nce racier and policy number are: , �arrierC.(�I ycaUS't r "-r�r umber �.-L1 &8 _ I certify that, in the performance of the work for which this permit is issued, 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 workers' compensation provisions of Section 3700 of the Labor Code, I shall f )rthwith comply with those provisions. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES 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 here y affirm undeyr�penalt�of perjury t/h�at�there r construction lendi agency f r the performance of the work for which this permit is Issued (Sec. 3097, Civ. C.). Lender`s Name r7 Trc��/ "�i,L"��, Ler•s Address C= -Z) -9, l Ah 44 -74/ 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, a shall, defend, indemnity and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission rel o he work being performs der or following issuance of this permit. 2. Any permit issued as a result of this application bec s null and void if work is men within 180 days from date of issuance of such permit or cessation of work for 180 days will subject perm o cancellation I certify that I have read this application and state that th above info Is cor comp all city and county ordinances and state laws relating to building construction, apid he.r96y authorize representatives of t s county to to upon / ntion roperty for inspection purposes. /te 2 Signature (Applicant or Age -11 Application Number . . . . . 04-00004024 Page 2 Date 5/11/04 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 ---------------------------------------------------------------------------- Specia.l Notes and Comments - SFD - LOT 5. PLAN 1B. PERMIT DOES NOT Page 3 Application Number . . . . . 04-00004024 Date 5/11/04 ------------------------------------------- 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 �: • mA: ✓ ... ". 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