04-4654 (SFD)k
T4hf 4 4 a"
w BUILDING & SAFETY DEPARTMENT
~� fox 1504 (760).777-7012
F' j 78-4 CALLE TAMPICO FAX (760) 777-7011
j}j LA Q k-A, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
0!- IJ, rrr];F1 idl
1-7
App-lication Number 04-00004654 Date 6/01/04
Property Address . . . . . . 77914 GREY WOLF TR
APN: 658-140-999-90 -29436 -
Application description . . . DWELLING - SINGLE FAMILY DETACHED
Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL
Application valuation . . . . 217237
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
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
684.13
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
22.50
Issue Date . . . .
Valuation . .
. . 0
Qty Unit Charge
Per
Extension
P.O. BOX 1504 • VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-701 l
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: .] el Date: % y 01/
Applicant: Arc,�i�ec ❑ E ineerj'�
Applicant's Mailing Address:
or
ress:
0
Lic. No.: 7j�O
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
Code, and my Lice "T in full force and effect
1-1ieg71se Class tse No.
ate O o
OWNER43UILDER DEC ON
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 Professions Code: Any
city or county that requires a permit to construct, alter, improve, demollsh, 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 Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Prate ssions Cade) or that he or she Is exernpI tliefeRom and the basis far 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 (5500),):
( l I, as owner of the property, or my employees wlIh wages as their sole cam pen sail on. 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 nat 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.),
C) 1, 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 at, improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
the Contractors' State License Law.).
U I am exempt under Sec , BA P,C, 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.
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
My rker compensation in s4clInce
carrier an licy n r aF
er o icy Number
I certiry that, in the performance of the work for which this a it i sued. 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 Code, I shall
forth th comply with those provisions.
A// q �Dat@ A� t
WARNIN : FAI URE 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.
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.).
Lenders Name ,
Lenders Address AJ
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set torth 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 ar pursuant to any perrmil
issued as a result of this application, the owner, and [he applicant, each agrees to. end shall, defend, indemnify and hold harmless the City of La ❑uinta, its
officers, agents and employees for any art 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 appllcation 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 ere by authorize re�presentatives of this county to enter upon the above -mentioned property for inspection purposes.
fie' igna/5 ture (Applicant or Agent):
Page
2
Application Number
04-00004654 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
37.20
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
49.13
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 90 PLAN 3AR
3478
SF. PERMIT
4
Page 3
Application Number
. . . . .
04-00004654 Date
6/01/04
----------------------------------------------------------------------------
Special Notes and
Comments
DOES NOT INCLUDE BLOCK
WALLS,
POOL, SPA
OR DRIVEWAY APPROACH.
--------------------------------------------------------------------------------
Other Fees . . .
. . . . . .
ART IN PUBLIC PLACES-RES
43.09
DIF COMMUNITY CENTERS-RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
68.41
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
792.96
.00 .00
792.96
Other Fee Total
2538.22
.00 .00
2538.22
Grand Total
4833.97
.00 .00
4833.97