04-7631 (SFD)BUILDING & SAFETY DEPARTMENT '
. •P.O'.. Box 1504;
(7,60).777-7012
OF $-49. CALL �MPICO' FAX (760) 777-7011
TA,
IFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
.IAN 061005
BUILDING PERMITLAQuj14TA
Appl catio�
'A
04-00.007631 Date 12/13/04
Prop ress
•, 57-41'0 VIA VISTA
APN:
762-240-003-70. -300962-
Application description..
'.'DWELLING =.SINGLE FAMILY DETACHED
Property Zoning ,.
MEDIUM DENSITY RES
Application valuation
85886'
Owner
-
Contractor
- y ...
------------------------
PUERTA AZUL PARTNERS
} r ' -- -4-Y--=------ .. ..•.:
= DAVI'S/REED CONSTRUCTION INC
17700•,SW'UPPER'BOONE&
FERRY RD..16.9.1SAXONY ROAD, STE #105.
SUITE 100' „"
'. ENCINITAS CA 92024
"PORTLAND',.
OR 97224"" (760) 6347235.0
WCC:1. STATE FUND.
WC:' WC298892004 06/12/05
,.
CSLB: 813480 10/31/06
CCC: B
-=--'--==-='-----=----------
Structure''Information --------------------------
Construction Type
TYPE V - NON RATED
Occupancy Type
DWELLG/.LODGING/LONG <=10'
Flood Zone'
NON -AO FLOOD,ZONE
�:.
Other struct info
; .'N.. " CODE EDITION 2001 CBC
# BEDROOMS.. 2.00
FIRE SPRINKLERS NO
fi
GARAGE 'SQ FTG 244.00
r _� M1-
�.t 4PATI0 SQ FTG. �. 163.00 -
`. NUMBER OF:.UNITS '1.00
-
'1ST"FLOOR-SQUARE FOOTAGE 1380.00
---------------------
Permit . . .°.
--------'>.--`-- 7 -------- --------------------
BUILDING'PERMITy -», '•
�r-�'
Additional desc
Permit Fee
.576.50 Plan Check Fee 93.68
Issue. Date ..
Valuation . . 85886
Expiration Date
6/13/05
Qty. Unit Charge.
Per Extension
r
BASE FEE.>t'. ;q 414.5.0
36.00 4..5000
----------------=--------=--=--'-------------=-----------=--------------------
THOU BLDG 50,001-100.,000'. 162.0'0
Permit
MECHANICAL
Additional'desc
Permit Fee
1_ 78.50 Plan Check Fee .. .4.91
Issue Date
- Valuation 0
..Expiration Date
-6./13/.051
Qty Unit' Charge
Per Extension
}
..
' "`-BA$E:'1,F.EE l "� ...15.00
P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
Application Number: d y Vp3
Applicant:
Applicant's Mailing Address:
r •t
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: l S D
chitect or Engineer:
Architect or Engineer'sAddress:
ic. No.: �" Z 3 2 2
t3UILUINU PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
hereby affirm under pen y of egury that I am licensed under provisions of C pter 9 ( g �prith Section 7000) of Division 3 of the Business and Professionals
Code, and my License i full rce and effect. /3 U
icense Class q,-&6e`nse No. `1
Dai�� v � �ontractor_��
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 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
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 andintain workers' compensation insurance, as required by Section 3700 of the Labor Code for the erforrnance of the work for which this permit is
issyed. (Vty workers' compensation ' rance carrier and policy number a�
�rtier � ytr— —policy Number
_Ice y tha , in the performance of the work for which thi shall not employ an person m any manner so as tg �c,Ome subject to the workers'
compensation laws of California, and agree t uld become he workers' compensation provisions of Section 3700 of the Labor Code, I shall
p forthwith comply with those provisions.
WARNING: FAILURE TO SECURE WOOER§'fOMPENSATION COVERAGE IS UNLAWFUL, AND SRALL 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 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 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, each eorkiFtEcommencedwithin
emnify and hold harmless the City of La Quinta, its
officers, agents and employees for any actor omission related to the wo under or following ce of this permit.
2. Any permit issued as a result of this application becomes nulla if 160 days from to of issuance of such permit, or
cessation of work for 180 days will subject permit to can ion.
I certify that I have read this application and state that the abov formation i ct. I agree t afl city and county ordin ces and state laws relating to building
construction, and hereby authorize of this cou ter a above- operty, for inspection pu
–16ate i5 gnature (Applicant or Agent):
Page
2
Application Number
04-00007631 Date
12/13/04
Qty Unit-Charge
Per
Extension
1.00 9. 000;0'.
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
4.26
Issue Date
,.Valuation
0
Expiration .Date
:6/13/05
Qty Unit Cha"rge_'.Per..
Extension
BASE.FEE •'
15:00
138'0.00 .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
Expiration'Date
6/13/05
Qty Unite Charge..%Per
Extension
.-BASE, . FEE
15.00
1'2. 00 6,.0000
'.EA `"" : PLB'FIXTURE' '
72.00
1.00 15.0000-EA
PLB BUILDING SEWER
1.5.00
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
EA , . PLB GAS PIPE ,. 1- 4 OUTLETS
1-. 00 15':'0000'
EA F . PLB GAS : METER, _
15.00
-----------------------=---=-=-==-=--------=----"----------------------------
-
Permit .
GRADING PERMIT.
Additional desc
Permit Fee
15.0.0 Plan Check'Fee
00
Issue Date
Valuation
0
Expiration Date'
6/13/05
Qty Unit Charge-,
Per
Extension
BASE.FEE,
15.00
Speci.al..Notes and Comments
SFD. - LOT 70.. PLAN 1RA-, 1380 SF. PERMIT
DOES NOT INCLUDE BLOCK
WALLS,..POOL,.SPA
.. � 1.
� �.
.� `�
•,. ... • ..
-' ..
•,1
F
', ,,
•.
Page 3
Application Number.,
04-00007631- Date
12/13/04
--------------
Special Notes, and
,_f
Comments"
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _,
_ _ _._ _ _ _ _ _ _•_ _ _
OR DRIVEWAY APPROACH.' ,75 o PLAN
.CHECK` FEE
REDUCTION :APPLIED
FOR, MULTIPLE
ISSUANCE
OF SAME PLAN TYPE.
`
Other Fees -.,
{�. - --
ART -IN PUBLIC PLACES -RES'
_ ----.00`----
°-.DIF`COMMUNITY
CENTERS -RES
'97.00
i
rr
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 i
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
-- ------------
-'--
- - --
-------
Permi,t- Fee Total
• ,877..6800:
00
877.68.
. Plan Check Total..
°"111.57
.00''` .00
111.57
Other Fee • Total' •
" y 2422.95> :'
. 00 ` ` . 00
2422.95
' Grand Total3412`:20.
`.
:00 OOr:
3412.20
? _ '
Wil" �
y 4 •) .-
CERTIFICATE OF FIELD VERIFICATION &-DIAGNOSTIC TESTING.(Pap 17of.1), - : CF -4R
Project Address I Puerta Azul:]:
Builder /Installer ;
.57410 Via Vista/ La Quinti / CA / 92253' "
Puerta Azul Partners, c/o,Pacific Security Capital '
Builder./ Installer Contact
Telephone
Plan Number / Per'mit Number
Mike Kwaske
7607027215.'•
1 P-? 3,1 �.
HERS'Rater,
Telephone
Sample Group Number . 1
Dave Bricker = CjHjEjEjRjS® ID'#CCN99380828
7607743676
19 '
Com Bance Method (Presc ' tive )
Climate Zone 15
Certifying Signature
Date
Sample House Number
U
Firm
HERS Provider .
-Energy Driden Soluf�ons
CIHIEIEIRIS® -
Address :
City/State/Zip
48-755 still Water Street '
Indio LCA'/92201..