04-4668 (SFD)BUILDING & SAFETY DEPARTMENT
1504 (760).777-7012
OF T -4 5E CALLE TAMPICO FAX (760) 777-701 1
�� •'' LA TA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
�'N 14 2004 l
BUILDING PERMIT
CITY OF LA QUINTA
FINAt4CF E]EPT.
Application Number
Property Address . . .
APN:
Application description
Property Zoning . . . .
Application valuation .
Owner
------------------------
IVANHOE LA QUINTA COVE
_C/O R BARRY MCCOMIC
7979 IVANHOE'AVE STE 550
LA JOLLA CA 92037
04-00004668 Date 6/01/04
77879 GREY WOLF TR
658-140-999-96 -29436 -
DWELLING - SINGLE FAMILY DETACHED
LOW DENSITY RESIDENTIAL
217237
Contractor
TRANS WEST HOUSING, INC.
9968 HIBERT STREET, STE #102
SAN DIEGO CA 92131
(858) 653-3003
WCC: STATE FUND
WC: 1648813
10/01/04
CSLB: 701039
01/31/05
CCC: B
--------------------------
Structure Information ------------------
Construction Type . .
. . . TYPE V - NON RATED
Occupancy Type . . .
. . . DWELLG/LODGING/CONG <=10
Flood Zone . . . . .
. . . NON -AO FLOOD ZONE
Other struct info . .
. . . CODE EDITION
2001 CRC
# BEDROOMS
4.00
FIRE SPRINKLERS
NO
GARAGE SQ FTG
603.00
PATIO SQ FTG
487.00
NUMBER OF UNITS
1.00
FIRST FLOOR SQ FTG
3478.00
----------------------------------------------------------------------------
Permit . . . . BUILDING PERMIT
Additional desc
Permit Fee . . . .
1052.50 Plan Check Fee
171.03
Issue Date
Valuation
217237
Qty Unit Charge
Per
Extension
BASE FEE
639.50
118.00 3.5000
THOU BLDG 100,001-500,000
413.00
----------------------------------------------------------------------------
Permit . . . . . . MECHANICAL
Additional desc . .
Permit Fee
90.00 Plan Check Fee
5.63
Issue Date . . . .
Valuation
0
Qty Unit Charge
Per
Extension
P.O. BOX 1504�
78-495 CALLS TAMPICO VOICE (760) 777-7012
LA QUINTA, CALIFORNIA 92253 44FAX (760) 777-701 1
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
Application Number: 0Y !p Date: • / �' G
Applicant: --Arcb�ecJ or aoinee r
Applicant's Mailing Address:
r
ress:
DU CA, z o
Sic. No.: g
G
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of penury that I am licensed under provisions of Chapter 9 (commenting with Section 7000) of Division 3 of the Business and Professionals
e, and my License i full force and effect -
License Class License No. O f
e-- Date � ctor 2P
OWNER-BUILDER
I hereby affirm under penalty of penury that l am exempt from the Contractors' State Lraanso 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, aISO requires the applicant for the permit to file a signed
statement that he or she is licensed pursuant to the provisions of the Conlractors' Stale License Law (Chantnr s rrnrr" g . -th Saejan 7Qw, of Drvr�ion S OF file nuainess
"^d P .-1cssiari, Code) ui tird1 ire or she is exempt therefrom and the basis for the alleged exemption. Any violation Of SeChon 7031 .5 by any applicant for a permit subleas
the applicant to a civil penalty of not more than rive hundred dollars ($500).),
U I, as owner of the property, or my employees with wages a Iheir sole compensation, will do the work, and the structure is not intended or offered for said (Sec 7tD"
Business and Professions Code The COntraclors' State License Law does no; 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 Dwner•builder will have the burden of proving that he or she did not build or improve for" purpose of sale.)
�} I, mas owner ❑f the progeny, am exclusively Contracting with licensed contractors to ccnstrucl the project (SeC. 7044. Business and Professions Code The Contractors'
Slate License Law does not apply to an owner of property who builds dr improves thereon, and who ccnImuts for the projects wish a Cant raCtor(s) licensed pursuant. to
the Contractors' State License Law )
U I am exempt under Sec . B.& P.0 for Ihis 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 hav and will mains workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
s wo rs' Omp nsab rance tamer and ti
�Eartier Policy Number
_Ire ify that, in the rforman a of the work for which this permit i is�ued,ail notemploy 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 Code, I shall
forthwith Comply with those provisions.
Date r �iffWARNING: ALLURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (3100.000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES -
CONSTRUCTION herebyaffirm under CONSTRUCTION LENDING AGENCY
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
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Appiication is hereby made to the Direclor of Building and Salety for a permit subject to the conditions and restrictions set forth on this applica[ion
.
1 Each person upon whose behalf Ibis application rs made, each person at whose request and for whose benaFii work is performed under or pursuant to any permit
issued as a result Of this application, the owner, and the applicant, each agrees 10, and shall, defend, indemnity and hold harmless the City of La Quinta, its
officers, agents and employees for any act or omission re la led to the work being performed under or fallowing Issuance of this permit,
2. Any permit issued as a result of this application becomes null and void if work is not commenced within 1So days from dale of i
cessation of work for 180 days will subject permit to cancellalion. ssuance of such permit, or
I Certify that I have read this applicaliori and state that the above information is correct I agree to Comply with 311 City and County ordinances and stale larva relating to building
construction. and hereby authorize representatives of this county to enter upon the above-rrrentinned property for inspection purposes.
�e alure (Applicant or Agent):
Page
2
Application Number
04-00004668 Date
6/01/04
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
5.00
6.5000
EA
MECH VENT FAN
32.50
1.00
6.5000
EA
MECH EXHAUST HOOD
6.50
----------------------------------------------------------------------------
Permit .
. . . . . ELEC-NEW RESIDENTIAL
Additional
desc . .
Permit Fee
148.79 Plan Check Fee
9.30
Issue Date
. . . .
Valuation
0
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
3478.00
.0350
ELEC NEW RES - 1 OR 2 FAMILY
121.73
603.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
12.06
Permit .
. . . . .
PLUMBING
Additional
desc . .
Permit Fee
196.50 Plan Check Fee
12.28
Issue Date
Valuation . . . .
0
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
21.00
6.0000
EA
PLB FIXTURE
126.00
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
8.00
.7500
EA
PLB GAS PIPE >=5
6.00
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
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
-----------------------------------------------------------------------------
Special Notes
and Comments
SFD - LOT
96 PLAN 3CR
3478
SF. PERMIT
Page 3
Application Number . . . . . 04-00004668 Date 6/01/04
Special Notes and Comments
DOES NOT INCLUDE BLOCK WALLS, POOL, SPA
OR DRIVEWAY APPROACH. 75% PLAN CHECK FEE
REDUCTION APPLIED FOR MULTIPLE ISSUANCE
OF SAME PLAN TYPE.
Other Fees . . .
. . . . .
ART IN PUBLIC PLACES-RES
43.09
DIF COMMUNITY CENTERS-RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
17.10
DIF FIRE PROTECTION-RES
97.00
GRADING PLAN CHECK FEE
.00
DIF LIBRARIES - RES
225.00
DIF PARK MAINT FAC - RES
5.00
DIF PARKS/REC. - RES
502.00
STRONG MOTION (SMI) - RES
21.72
DIF STREET MAINT FAC-RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
Charged
----------
Paid Credited
------------ ------------- -----------
Due
-----------------
Permit Fee Total
1502.79
.00 .00
1502.79
Plan Check Total
198.24
.00 .00
198.24
Other Fee Total
2486.91
.00 .00
2486.91
Grand Total
4187.94
.00 .00
4187.94