09-1284 (SFD)' • -10 1•
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Ti&t 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
09-00001284
Owner:
Property Address:
53760 AVENIDA CORTEZ
INCE TUFAN M & SIBEL
APN:
774-142-001-24-000000-
1159 S POSITANO AVE
Application description:
DWELLING - SINGLE FAMILY DETACHED
ANAHEIM, CA 92808
Property Zoning:
COVE RESIDENTIAL
(714) 299-5461
Application valuation:
106636
Contractor:
Applicant:
Architect or Engineer:
Owner
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 Icommencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: License No.:
Date: Contractor:
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).:
(_) 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.).
(_ 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.).
f _ I I am exempt under Sec. , B.&P.C. for this reason
Date: 31 2.4l1 1`20 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:
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/22/11
a n
I I
MAR 2 9 2011
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 Policy Number
_ 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 Cod e/� _��ith
provisions.
Date: 2- Z. tlApplicant:: ,%%
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 ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'$ 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 this county to enter upon the above -mentioned property for iQ&QeCUQaJ2ULQQae&
/_
'Date: Signature (Applicant or Agent):
LQPERMIT
Application Number . . . . . 09-00001284
------ Structure Information 1,682SF DWELLING/VB/RES-3/CLASS A
[CONV]-----
Other struct info
. . CODE EDITION 2007/2008
# BEDROOMS
2.00
FIRE SPRINKLERS NO
GARAGE SQ FTG
483.00
PATIO SQ FTG
72.00
NUMBER OF UNITS
1.00
----------------------------------------------------------------------------
1ST FLOOR SQUARE FOOTAGE
1682.00
Permit . . . BUILDING PERMIT
Additional desc . . BP OVERPAY SUBTRACTED FROM PC
Permit Fee . . . .
755.00 Plan Check Fee
340.60
Issue Date . . . .
Valuation . . . .
132600
Expiration Date . .
9/18/11
Qty Unit Charge
Per
Extension
BASE FEE
639.50
33.00 3.5000
----------------------------------------------------------------------------
THOU BLDG 100,001-500,000
115.50
Permit . . . ELEC-NEW RESIDENTIAL
Additional desc . .
Permit Fee . . . .
98.53 Plan Check Fee
24.63
Issue Date . . . .
Valuation . . . .
0
Expiration Date . .
9/18/11
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1682.00 .0350
ELEC NEW RES - 1 OR 2 FAMILY
58.87
483.00 .0200
ELEC GARAGE OR NON-RESIDENTIAL
9.66
1.00 15.0000
----------------------------------------------------------------------------
EA ELEC TEMPORARY POWER POLE
15.00
Permit . . . MECHANICAL
Additional desc . .
Permit Fee . . . .
77.50 Plan Check Fee
19.38
Issue Date
Valuation . . . .
0
Expiration Date
9/18/11
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 9.0000
EA MECH FURNACE <=100K
9.00
1.00 4.5000
EA MECH VENT INST/ DUCT ALT
4.50
1.00 16.5000
EA MECH B/C >3-15HP/>100K-500KBTU
16.50
4.00 6.5000
EA MECH VENT FAN
26.00
1.00 6.5000
EA MECH EXHAUST HOOD
6.50
LQPERMIT
Application Number . . . . . 09-00001284
Permit
PLUMBING
Additional desc
. .
Permit Fee .
. . . 134.25 Plan Check Fee
33.56
Issue Date .
. . . Valuation . . . .
0
Expiration Date
. . 9/18/11
Qty Unit
Charge Per
Extension
BASE FEE
15.00
11.00
6.0000 EA PLB FIXTURE
66.00
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
5.00
.7500 EA PLB GAS PIPE >=5
3.75
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
. . 9/18/11
Qty Unit
Charge Per
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes
and Comments
1,682SF DWELLING/VB/RES-3/CLASS
A-FR
[CONVENTIONAL]
THIS PERMIT DOES NOT
INCLUDE BLOCK
WALLS, POOL, SPA OR DRIVE
WAY APPROACH.
2007 CALIFORNIA BUILDING,
2008 CALIFORNIA
ENERGY CODES.
March 21, 2011
11:07:35 AM AORTEGA
----------------------------------------------------------------------------
Other Fees .
. . . . . . . . ART IN PUBLIC PLACES-RES
20.00
BLDG STDS ADMIN (SB1473)
5.00
DIF COMMUNITY CENTERS-RES
74.00
DIF CIVIC CENTER - RES
995.00
ENERGY REVIEW FEE
43.16
DIF FIRE PROTECTION-RES
140.00
GRADING PLAN CHECK FEE
.00
DIF LIBRARIES - RES
355.00
MULTI -SPECIES (MSHCP) FEE
533.00
DIF PARK MAINT FAC - RES
22.00
DIF PARKS/REC - RES
892.00
COVE PRECISE PLAN FEE
100.00
LQPERMIT
Application Number . . . . . 09-00001284
----------------------------------------------------------------------------
Other Fees . . . . . . . . . DIF STREET MAINT FAC-RES 67.00
DIF TRANSPORTATION - RES 1930.00
Fee summary Charged
Permit Fee Total 1080.28
Plan Check Total 418.17
Other Fee Total 5176.16
Grand Total 6674.61
Paid Credited Due
------------------------------
750.00 .00 330.28
.00 .00 418.17
.00 .00 5176.16
750.00 .00 5924.61
LQPERMIT