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04-4671 (SFD)T44f 4 4Q" 1504 LLE TAMPICO 1, CALIFORNIA 92253 BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 77.7-7011 INSPECTION REQUESTS (760) 777-7153 Application Number . . . . . 04-00004671 Date 6,/01/04 Property Address . . . . . . 77893 GREY WOLF TR APN: 658-140-999-97 --29436 - Application description DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL Application valuation 224878 Owner IVANHOE LA QUINTA COVE C/O R BARRY MCCOMIC 7979 IVANHOE'AVE STE 550 LA JOLLA CA 92037 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 5.00 FIRE SPRINKLERS NO GARAGE SQ FTG 445.00 PATIO SQ FTG 705.00 NUMBER OF UNITS 1.00 FIRST FLOOR SQ FTG 3615.00 ---------------------------------------------------------------------------- Permit . . . . . BUILDING PERMIT Additional desc . Permit Fee 1077.00 Plan Check Fee 700.05 Issue Date Valuation 224878 Qty Unit Charge Per Extension BASE FEE 639.50 125.00 3.5000 THOU BLDG 100,001-500,000 437.50 Permit . . . . . . MECHANICAL Additional desc . . Permit Fee 95.00 Plan Check Fee 23.75 Issue Date Valuation 0 Qty Unit Charge Per Extension P.O. Box 1504 78-495 CALLE TAMPICO VOICE (760) 777-7012 cu LA QUINTA, CALIFORNIA 92253 QUW(FAX (760) 777-701 1 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: - Date: 7 % I • /4-_, 0 Applicant: Applicant's Mailing Address: A MA ar E glneer� Architect or Erma r' dress: 't. 2-1 oI -tic. No. BUILDING PERMIT DECLARATIONS 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 �QBe, and my License n full force and effect icense Class �.-tfcense No Date char f uvyt OWNER -BUILDER DEC TION I hereby affirm under penalty of perjury that I am exempt from tie Contractors' Stag License Law for the lot]Owing Feason (Sec, 7031.5. Business and Prpless+ons Code Any city ❑r County that fequires a permit 10 Construct, Eller, improve, damn€ish. or repair any structure, odor to its Issuance, also requires the applicant for the permit 10 file a Sig nad 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 BV31nasS and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption Any VOlaliOn of Section 7031.5 by any applicant for a permit subleurs the applicant to a civil penalty of not more than five hundred dollars ($500).)m U 1, as owner of the property. a my employees with wages as Iheir SOIa AMP--nsati0n. will do the vrork, and the Structure is not intencod or offered for sale (Sec 70". Business and Professions Cade The Contractors' Slate License Law does not apply to an owner of property who builds or improves thereon, and woo does the work himselt or herself Or through his 0r her own employees, provided that the improvements are not Intended or offered for sale. 11. however. the building or improvement is sold within one year of completion, the Owner -builder will have the burden of provinp that he dr she did not build or improve For She purpose Of safe.). U I, as owner of the property, am exclusively Contracting with licensed contractors to construct the project (Sec. 7044. Business and hisourse Code The Contractors' State License Law does not apply Id an owner of property who builds Or improves thereon, and who contracts fur the prefects with Professions coode Ilce e C pt actor t to the Contractors' Stale License Law } U I am exempt under Sec. , B.& P.0 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 for which this permit is issued. IN 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 -�sa wo mp nsatipn in uce camer�d�p,, a{u ber reer1� , ,, ,_��adlecNumb! certify that, in�lh perh Shi is e , 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 Code, 1 shall forthwith comply with those provisions. ;I C Dale pplrcant WARM G: F !LURE 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'S FEES. I 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 IMPORTANT APPLICANT ACKNOWLEDGEMENT Application is hereby made to the 0ireclor of Building and Safety for a permit subject to the conditions and restrictions set foron this application. 1. Each person upon whose behalf Ihis application is made, each person aI whose request and for whose benefit work is performed under or pursuant 10 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 Quints, its Officers. agents and employees for any act or Omission related to the work being performed under or following issuance of this permil. 2. Any permit issued as a result of Ihis applicalion becomes null and void if work is not commenced within 180 days from date 01 issuance of such permit or cessation of work for 180 days will subject permit to cancellalion. f certify that l have read this appiicalrari and state that the above information is cored. I agree Ip comply with a1f illy and county oidrnancas and state laws relating to building odnstrrucltonn. an hereby authorize representatives of Ihis county to enter upon the above-riee 10 c43 prIy with alr try andon purposes. -6ata ( gi9nature (Applicant or Agent): Page 2 Application Number 04-00004671 Date 6/01/04 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 9.0000 EA MECH FURNACE <=100K 27.00 3.00 9.0000 EA MECH B/C <=3HP/100K BTU 27.00 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 150.43 Plan Check Fee 37.61 Issue Date Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 3615.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 126.53 445.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 8.90 ---------------------------------------------------------------------------- Permit . . . . PLUMBING Additional desc Permit Fee . . . . 215.25 Plan Check Fee 53.81 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 24.00 6.0000 EA PLB FIXTURE 144.00 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 9.00 .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 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments SFD - LOT 97 PLAN 2AR/CASITA 3615 SF. Page 3 Application Number . . . 04-00004671 Date 6/01/04 ---------------------------------------------------------------------------- Special Notes and Comments PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL, SPA OR DRIVEWAY APPROACH. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES-RES 62.19 DIF COMMUNITY CENTERS-RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 70.01 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 22.48 DIF STREET MAINT FAC-RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Paid Credited Due Permit Fee Total 1552.68 .00 .00 1552.68 Plan Check Total 815.22 .00 .00 815.22 Other Fee Total 2559.68 .00 .00 2559.68 Grand Total 4927.58 .00 .00 4927.58