05-3481 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant: .
OS -00003481 ;
-- ---
81790 VIDA BELLA DR
764-010-011-40 -30092 -
DWELLING - SINGLE FAMILY DETACHED
LOW DENSITY RESIDENTIAL
175041
,11 rchjtect or Engineer: D
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date
Owner:
K. HOVNANIAN FORECAST HOMES
4240 E. JURUPA ST. STE. 402
CHINO, CA 91710
Contractor:
® K. HOVNANIAN FORECAST HOMES
0 E. JURUPA STREET
ARID, CA.91761
09)937-3270
28
/
7 cNo.: 700788 '0
LICENSED CONTRACTOR'S DECLARATION
I 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 an Professionals Code, and my License is in full force and effect.
LicenseClnss: 1k LicenseNo.: 700788 -
,Date:, ontractor:
OWNER -BUIL R ECLARATION
I hereby affirm under penalty of perjury that I am exempt fro Contractor's State License Law for the
following reason (Sec. 70.31.5, Business and Professions Co : 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 Contractor's 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).:
(_ 1 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and loo
.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 theworkhimself or herself 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.).
(_ 1 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.)•
1 _) I am exempt under Sec. ,-B.&P.C. for this reason
Date: - Owner:
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:
LQPERMIT
—-----------------—
WORKER'S COMPENSATION DECLARATION
8/08/05
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. My workers' compensation
insurance carrier and policy number are:
Carrier ZURICH INS Policy Number WC343666302
_ 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
37 0 of the
5abor Code, I gfiall fo with'comply with those provisions.
ate/ plicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSA 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. • '
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, andthe applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission, related to the work being
performed under or following issuance of this permit.
2. Any permitissued as a result of this application becomes null and void if work is not commenced
within 180 daysfrom date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
certify that I have read this application and state that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby. authorize representatives
of t/his.dount to ent r upon above-mentioned property for ins p ec ion urposes.
at'
nature (Applicant or Agent,:
Application Number 05-00003481
Permit . . BUILDING PERMIT
Additional desc .
Permit Fee 905.50 Plan Check Fee 147.15
Issue Date . . Valuation . . 175041
Expiration Date 2/04/06
Permit
MECHANICAL
Additional
desc .
Permit Fee
77.00
Pian Check Fee
4.81
Issue Date
Valuation
0
Expiration
Date..'.
2/04/06
Qty Unit Charge
Per
Extension
BASE
FEE
15:00
2.00.
9.0000
EA MECH
FURNACE <=.100K
18.00
2.00
9..0000
EA MECH
B/C <=3HP/100K BTU
18.00
3.00
6.5000
EA MECH
VENT FAN
19.50
1.00
----------------------------------------------------------------------------
6.5000
EA MECH
EXHAUST HOOD
6.50
Permit
. . ELEC-NEW RESIDENTIAL
Additional
desc .
Permit Fee
. . . .
121.73
Plan Check Fee
7.61
Issue Date
. . .
Valuation
0
Expiration
Date
2/04/06
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
2690.00
.0350
ELEC
NEW RES - 1 OR 2 FAMILY
94.15
629.00
----------------------------------------------------------------------------
.0200
ELEC
GARAGE OR -NON-RESIDENTIAL
12.58
Permit
. . .
PLUMBING
Additional
desc .
' Permit Fee
. . . .
155.25
Plan Check Fee
9.70
Issue Date
. .
Valuation
0
Expiration.Date
2/04/06:
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
LQPERMIT
Application -Number
. . . . 05-00003481
Permit . . PLUMBING
Qty Unit Charge
Per
Extension
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 9.00.00
EA PLB LAWN SPRINKLER SYSTEM
9.00
9.0.0 .7500
EA •PLB GAS PIPE >=5
6.75.
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
Expiration Date
•2/04/06
Qty Unit Charge
Per
Extension
BASE FEE -
15.00
-- - ----------------------------------------------------------------
Special Notes and Comments
SFD - LOT 40,' PLAN 113
,2690 SF..
(PATIO 3-665 SF,GARAGE
3)PERMIT DOES
NOT INCLUDE,,POOL,SPA,•
BLOCK WALLS OR• ,
DRIVEWAY APPROACH. 75%•REDUCTION
TO
PLAN CHECK FEE DUE TO
MULTIPLE ISSUANCE
OF SAME PLAN TYPE
---------------------------
Other Fees . .
-----------------------------------
. ART IN PUBLIC PLACES -RES
--------------
20.00
DIF COMMUNITY CENTERS -RES
97.00
DIF.CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
14.72
DIF FIRE PROTECTION=RES
97.00
GRADING PLAN CHECK FEE
15.00
'DIF LIBRARIES - RES
225.00
DIF PARK MAINT FAC - RES
5.00
DIF PARKS/REC - RES
502.00
.
STRONG MOTION (SMI) - RES
17.50
DIF STREET MAINT-FAC-RES
15.00
DIF TRANSPORTATION— RES
1098.00
Fee summary Charged
Paid Credited
Due
Permit Fee Total
1274.48 •.00 .00.
1274.48 '
Plan Check Total
169.27 .00 .00
169.27
Other Fee Total.
2472.22 .00 .00'
2472.22
Grand Total
3915.97 .00 .00
3915.97
.. LQPERMIT
.. -