07-0686 (SFD)�1.
PCCTI o14S oN T s
,56 rd CQ
P.O. BOX 15044 R�� VOICE 760 777-7012
.78-495 CALLE TAMPICO FAX (760)777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
..Date: 8/01/07
Application Number: r 07=00000686 Owner:
Property Address: 81411 PEARY PL LARSEN
APN: 767-200-998-61 -330761- 81-411 PEARY PL
Application description: DWELLING - SINGLE FAMILY DETACHED HI
Property Zoning: LOW DENSITY RESIDENTIAL LA QUINTA, CA 92253 0 a
Application valuation: 627716.
Contractor: 2 n 2007
Applicant: � Architect or Engineer: STOKER CONSTRUCTION, IN AUGUU 7
56471 TWENTYNINE PALMS W
YUCCA VALLEY, CA 92284 CITY OF�gQUINTq
(760) 365-8691 FINANCE DEPT
LiC. No.: 435033
--------------------------------------------------
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 and Professionals Code, and my License is in full force and effect.
LicenseClags: B jC9 C53 LicenseNo.: 4x5033 . '
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 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 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 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.).
(_) 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
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 NIC INS Policy Number 75600005307
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
3 0 of the Labor Code I shall forthwith comply with those provisions.
<e: Al URE Tscant:
NING:. O 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. -
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 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 permit issued as a result of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation. .
I 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 thisy/�� my to enter upopthe aWtc.
ntioned property f inspection p rp es.
ate: V gnature 1r Agentl:
Application Number 07-00000686
Permit
BUILDING PERMIT
Additional
desc .
Permit Fee
. . . .
2423.50
Plan"Check Fee
1575.28"
Issue Date
. . . .
Valuation
627716
Expiration
Date
1/28/08
Qty Unit Charge
Per
Extension "
BASE
FEE
2039.50
128.00
----=----------
3.0000
-----------
THOU BLDG
-----------
500,001-1,000,'000
---------------------------
384.00
------------
Permit
. . .
MECHANICAL
Additional
desc .
Permit Fee
. . . .
199.50
Plan Check Fee
49.88
Issue Date
Valuation . . . .
0
Expiration
Date
1/28/08
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
7.00
9.0000
EA MECH
FURNACE <=100K
63.00
7.00
9.0000
EA MECH
B/C <=3HP/100K BTU
63.00
8.00
6.5000
EA MECH
VENT FAN
52.00
1.00
----------------------------------------------------------------------------
6.5000
EA MECH
EXHAUST HOOD
6.50
Permit
. . .
ELEC-NEW RESIDENTIAL
Additional
desc .
Permit Fee
. . . .
309.46
Plan Check•.Fee
77.37
Issue Date
Valuation . . .
0
Expiration
Date
1/28/08
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
7237.00
".0350
ELEC
NEW RES - l OR 2 FAMILY
253.30
1308.00
.0200
ELEC
GARAGE OR NON-RESIDENTIAL.
26.16
1.00
------------------------------------------------------
15.0000
EA ELEC
TEMPORARY POWER POLE
-:---------------------
15.00
Permit
. . .
PLUMBING
Additional
desc .
Permit Fee
. . . .
476.25
Plan Check Fee
119.06
Issue Date
. . . .
Valuation . . . .
0
Dxpiiatiiin
D&L,=
1/28/08
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
27.00
6.0000
EA PLB FIXTURE
162.00
LQPERMIT
13
Application Number
. . . 07-00000686
Permit . . . . . .
PLUMBING
Qty Unit Charge
Per
Extension
1.00 15.0000
EA PLB BUILDING SEWER
15.00
37.00 6.0000
EA PLB ROOF DRAIN
222.00
4.00 7.5000
EA PLB WATER HEATER/VENT
30.00
1.00 3.0000
EA PLB WATER INST/ALT/REP
3.00
19.00 .7500
EA PLB GAS PIPE >=5
14.25
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
1/28/08
Qty Unit Charge
Per
Extension
BASE FEE
15.00
-------------------------------------------7----------------------------------
Special Notes and Comments
7237 sq. ft.' sfd this
permit does not
include pool & spa block walls or
driveway approach.
------------------------------------------------------------------=---------
Other Fees . . . .
. . . . ART IN PUBLIC PLACES -RES
1069.29
DIF COMMUNITY CENTERS -RES
74.00
DIF CIVIC CENTER - RES
995.00
ENERGY REVIEW FEE
157.53
DIF FIRE PROTECTION -RES
140.00
GRADING PLAN CHECK FEE
15.00
DIF LIBRARIES - RES
355.00
DIF PARK MAINT FAC - RES
22.00
PARKS/REC - RES
892.00
.DIF
STRONG MOTION (SMI) - RES
62.77
DIF STREET MAINT FAC -RES
67.00
DIF TRANSPORTATION - RES
1930.00
Fee summary Charged Paid Credited
---------------------------
Due
Permit Fee Total
-----------------=------_-----
3423.71 .00 .00
3423.71
Plan Check Total
1821.59 750.00 .00
1071.59
Other Fee Total
5779.59 .00 .00
5779.59
G.Ldnd TULal IIU24.8y '/SU.UU .00
10174.89
LQPERMIT