04-4658 (SFD)0)
F u�l�t,�6v
a0. �
BUILDING & SAFETY DEPARTMENT
x 1504 (760).777-7012
p CALLS TAMPICO FAX (760) 777-7011
f LA qTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
jLN 14 2004
BUILDING PERMIT
OF LA QUENTA
FM1,e1;NC-F DEPT,
Application Number . . . . . 04-00004658 Date 6/01/04
Property Address . . . . . . 77907 GREY WOLF TR
APN: 658-140-999-98 -29436 -
Application description . . . DWELLING - SINGLE FAMILY DETACHED
Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL
Application valuation . . . . 199884
Owner
IVANHOE LA QUINTA COVE
C/0 R BARRY MCCOMIC
7979 IVANHOE'AVE STE 550
LA JOLLA CA 9 2 0-3 7
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/LONG <=10
Flood Zone . . . . .
. . . NON -AO FLOOD ZONE
Other struct info
CODE EDITION
2001 CRC
# BEDROOMS
3.00
FIRE SPRINKLERS
NO
GARAGE SQ FTG
704.00
PATIO SQ FTG
315.00
NUMBER OF UNITS
1.00
FIRST FLOOR SQ FTG
3180.00
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Permit . . . .
BUILDING PERMIT
Additional desc
Permit Fee
989.50 Plan Check Fee
160.80
Issue Date . . . .
Valuation
199884
Qty Unit Charge
Per
Extension
BASE FEE
639.50
100.00 3.5000
THOU BLDG 100,001-500,000
350.00
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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 _ e
78-495 CALLELLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Applicant:
Applicant's Mailing Address:
C_�p /i
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT DECLARATIONS
I Add
VOICE (760) 777-7012
FAX (760) 777-701 1
INSPECTIONS (760) 777-7153
Date: & ' 1z/. o4
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 ig full force and effect.
frlcense Class [ `1 License No- I
�� DateV�nMS they infi
OWNER -BUILDER DECLAOTION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5, Business and Pmfessons Code. Any
city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, poor to its Issuance, also requires the applicanl fort permit to file a signed
statement that he or she is licensed pursuant to the provisions of the Contractors' Stale License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Buarness
and Professions Code) or that he or she is exempt therefrom and the Basis for the alleged exemption, Any viola fion of Saction 7031.5 by any applicant for a permit subjects
the applicant to a civil penalty of not more than rive hundred dollars (5500)•)-
�) 1, as owner of the property, or my employees with wages as tharr sole compensation, will da the work, and the structure Is not Intended a offered for sale Sec. 7044,
Busrneas and Professions God e• 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 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 owner -builder will have the burden of proving that he or she did not build or improve For the purpose of sale.).
U I, as owner of the property, am exclusively contra cling with licensed contractors to construct the projec! (Sec. 7044, 8uslness and Professions Code: The Contraulars'
State License Law does not apply to an Owner of properly who builds or improves thereon, and who contracts for the projects with a conlractor(s) licensed pursuant to
fhe Contractors' State License Law),
U I am exempt under Sec. , a,& P_C for this reason
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 performance
of the work for which this permit is issued.
t1h ave 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
My ors' c pensa ii IrMce carter and p licy a
art,
Policy Number
I certify that, in the pee ante of the work for which this Permit isl issued, If shall not employ an
y person in any compensation laws of California, and agree that, if I should become subject tot workers' compensation previsions ro of so as to become
of t subject
Code, to the workers'
shall
forthwith comply with those provisions.
Date �� C) � nt
WARNI G: F ILURE 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 Application is hereby made to the Director of Buildln AP 3a eANT ty for ACKNOWLEDGEMENT
Permit 1. Each person upon whose behalf this appticalon is made, each person at whosesrue
qu st a dthe }o whose benefit work unperformed under or pulrsuant to an
issued as a resull Of this application, the owner, and the applicant, each agrees to, and sha11, defend, indemnify and hold harmless the City of Le Guinta, it inert
officers, agents and employees for any act or omission related to the work being performed under or }atlo,vimg issua
2. Any permit issued as a result of this applrcalion becomes null and void if work is not commenced withnce of This permit.
in 180 days from date of issuance of such permit or
cessation of work for 180,days will subject permit to canceIlaHen.
1 certify that I have read this application and state that the above information is corecL I agree to comply with all city and county ordinances and state laws relating to building
construction, and raby auftnze�representatives of this county to enter upon the abore{nentioned property for inspection purposes.
ate Signature (Applicant or Agent): 4,
Page
2
Application
Number
04-00004658 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
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Permit .
. . . . .
ELEC-NEW RESIDENTIAL
Additional
desc . .
Permit Fee
. . . .
140.38 Plan Check Fee
8.78
Issue Date
. . . .
Valuation . . . .
0
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
3180.00
.0350
ELEC NEW RES - 1 OR 2 FAMILY
111.30
704.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
14.08
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Permit .
. . . .
PLUMBING
Additional
desc .
Permit Fee
178.50 Plan Check Fee
11.16
Issue Date
. . . .
Valuation
0
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
18.00
6.0000
EA
PLB FIXTURE
108.00
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
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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
98 PLAN lA
3180
SF. PERMIT
Page 3
Application Number
. . .
04-00004658 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.
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Other Fees . . .
. . . . . .
ART IN PUBLIC PLACES-RES
.00
DIF COMMUNITY CENTERS-RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
16.08
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
19.98
DIF STREET MAINT FAC-RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
Charged
Paid Credited
Due
Permit Fee Total
1413.38
.00 .00
1413.38
Plan Check Total
186.37
.00 .00
186.37
Other Fee Total
2441.06
.00 .00
2441.06
Grand Total
4040.81
.00 .00
4040.81