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04-7643 (SFD). ° BUILDING & SAFETY DEPARTMENT P.O. Box "1504 :. (760),777-7012 495 C E TAMPICO" s : FAX (760) 777-701.1 D .; CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-71.53 ?r,tA 0 X005 BUILDING PERMIT . a CITY OF L9►QUIM7A Ap licaty "O�N�u�`rnk�-e 04-00007643 Date 12/13/04 Proper tyt,Address•:�. 57420 VIA VISTA - APN: 762-240-003771 -30.0962- Application description DWELLING — SINGLE FAMILY DETACHED Property Zoning MEDIUM DENSITY RES , Application'valuation 99.599 - Owner i Cont,racto'r ------------------------ --- ---.------------- PUERTA AZUL,PARTNERS DAVIS/REED CONSTRUCTION INC 17700 SW.UPP�ER'BOON,ES FERRY RD 169 SAXONY ROAD, STE #105 SUITE 100 ENCINITAS CA 92024 PORTLAND OR 97224 (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 _ ? ' t,, 255.00 PATIO "SQ FTG. 4=51:00 :�.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 ,Expiration Date 6/13/05 Qty Unit Charge Per Extension BASE FEE 414.50. 50.0,0 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 Expiration Date 6/13/05- Qty. Unit Charge Per Extension. BASE FEE.'. 15.00 P.O. Box 1504 78-495 CALLS TAMPICO qV VOICE (760) 777-7012 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 7&q5Date: / • S• oS Applicant: Applicant's Mailing Address: chltect or Engineer: chitect or Engineer's Address: Lic. No. MUILUING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under enalty of perjury that I am licensed under provisions of ter 9 (co with Section 7000) of Division 3 of the Business and Professionals �C e, and my Lic in 11 force and effect. / nse Class License No. OWNER43UILDER 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 1, 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�++4)ich this permit is issued. I have andd�fi I maintain workers' compensation insurances as rea action 37 0 of the Labor Code, for the -pe rnance of work for which this permit is issrkers' compensation ' renc r anted policy number are�� er o umber � _ I ce11My that, in the performance o work for which this permit is issued, I shall not amp anyoRrn any manner so as to become subject to the workers' compensation laws of Calif ia, and agre�thaI. if I sho me lect to the works 'compensation provisions of Section 3700 of the Labor Code, l shag forthwith COmD:v with thos mvisinns 'd Ile ,Date pf{ plicant / WARNING: FAILURE TO SECURE KERS' 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 hereby affirm under penalty of perjury that there isa 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 pe req for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the ap each agrees to, and shall, end, indemnity and hold harmless the City of La Ouinta, its officers, agents and employees for any act or omission ated to the work being performed under r following issuance of this permit. 2. Any permit issued as a result of this application be es null and void if work is not commenced " in 180 days from date of issuance of such permit, or cessation of work for 180 days will subject peri o cancellation. I certify that I have read this application and state that the ab a information is co agree to comply with al city and county ordinances and state laws relating to building construction, and hereby pollIv TM -representatives of this coun s on purposes. Date �/ �'� e (Applicant or Agent Page 2 Application Number 04-00007.643 Date:, 12/13/04 Qty,, Unit Charge Per Extension 1.00 9.0`000 'EA`_-- MECH `:FURNACE .<=100K 9.00 1:,00 9.0000 EA,, MECH B/C <=3HP/ 00K BTU 9.00 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 Expiration Date..'. 6/13/05 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= Plaft Check Fee 9..28 Issue Date Valuation 0 Expiration Date 6/i3/05' 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. 500.0. 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 1 3.00 1.00 15.0000 EA.:: PLB GAS, METER 15.00 Permit GRADING PERMIT Additional desc Permit Fee 15.00 Paan Check Fee 00 Issue Date ...:. .,' Valuation 0. Expiration Date.. 6/13/05 Qty_:'Unit Charge Per. Extension BASE.FEE 15.00 Special Notes and Comments ---------------- SFD - LOT 71. PLAN 2RA, 1549 SF. PERMIT, DOES NOT INCLUDE BLOCK: -WALLS., POOL, SPA Page 3 Application Number 04,-00007643. Date12/13/04 Special Notes'and+Comments OR DRIVEWAY APPROACH. 75%.PLAN CHECK -FEE REDUCTION APPLIED FOR .MULTIPLE ISSUANCE ". + OF *ISAME PLAN . TYPE -------------- Other,Fees- ART IN-PUBLIC`PLACES-RES 00 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 LIBRARIES - RES 225.00 ` '•DIF PARK MAINT FAC - RES 5.00 ` r 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 Paid,' ,Credited Due Permit. Fee` -Total 965:32. :00 .00 965.32 b. Plan Check Total =123.16 00 00 123.1.6 Other Fee- Total. ;` 2425.34' :0000 •2425.34 Grand Total, .:00 �.•: -.00, '_ ." 3513.82' 41, n