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04-4653 (SFD)4 BUILDING & SAFETY DEPARTMENT Box 1504 (760).777-7012 r 7 495 E TAMPICO FAX (760) 77777011 A UIN I� CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 1004 1BUILDING PERMIT Ap ion Number 04-00004653 Date 6/01/04 Property Address . . . . . . 77928 GREY WOLF TR APN: 658-140-999-89 -29436 - Application description . . . DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL Application valuation 199884 Owner Contractor IVANHOE LA QUINTA COVE TRANS WEST HOUSING, INC. C/O R BARRY MCCOMIC 9968 HIBERT STREET, STE 4102 7979 IVANHOE AVE STE 550 SAN DIEGO CA 92131 LA JOLLA CA 92037 (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 ---------------------------------------------------------------------------- Permit . . . . . BUILDING PERMIT Additional desc . Permit Fee 989.50 Plan Check Fee 643.18 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 ----------------------------------------------_--------____---------------------- 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 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: - 4(o Date: Applicant: Applicant's Mailing Address: Arc ct or Engineer• iV1 tAil . Architect or En in er's Address: 5 2d Lic. No.: 01 CO-3 C BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION 1 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 ode, and my Liken s in full force and effect. } License Elass License No V �OateIWO ractor V, [� OWNER43UII DER DECLARATION I hereby affirm under penally of perjury that I am exempt from the Contractors' State License Law for the fallowing reason (Sec. 7031-5, Business and Professions Code: Any city a county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to As issuance, also requires fhe 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 8usiness and Pmfescinnc Code) or the{ he or she is exempt therefrom and the basis for the alleged exuunptioo. Any vioiabon of Section Jo31,3 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500),)I U 1, as owner of the property, or my employees wish wages as their sale compensation, MIl 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 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.) �} !, as owner of She property, am exclusively contracting with licensed contractors to construct the project (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 contracts for the projects with a contractors) licensed pursuant to the Contractors' Stale License Law-). ( j I am exempl under Sec. , SA P-C, for this reason WORKERS' COMPENSATION DECLARATION I hereby affrn 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 orkerscompensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is u v worke anon nce carrier and pgli nu be a artier Policy Number I c rtify that, in the pe ormance of the work for which this pe it s issued, s all 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 forthwith comply with those provisions. Date f.` 142 ppficanl, WARNIN 'FAIL'LIRL TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CNIL 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.). Lender's Name Lender's Address IN APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to tha Director of BuBdinu and Safety for a permit subject to the ccnditlans and restrictions set forth on this application, 1- Each person upon whose behalf Ihis application is made, each person at whose request and for whose benefit work is performed under a pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to. and shall, defend, indemnity and hold harmless the City of La quints, its officers. agents and employees far any act or amission related to the work being performed under or following issuance of this permit. 2- Any permit issued as a result of this applicaIIan becomes nu11 and void if work is not commenced within 190 dayi from date of issuance of ch permit, or cessation of work for 180 days will subject permit to cancellation. su I certify that I have read this application and state that the above information is correct. f agree to comply with ail city and county ordinances and state laws relating to building con structio %and h reby auIhonxe representatives of this county to enter upon the above-fnentionad property for inspection purposes. �Sle l ignature (Applicant or Agent): Page 2 Application Number 04-00004653 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 . . . . 140.38 Plan Check Fee 35.10 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 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING Additional desc . . Permit Fee 178.50 Plan Check Fee 44.63 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 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 89 PLAN 1CR 3180 SF. PERMIT Page 3 Application Number . . . . . 04-00004653 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 .00 DIF COMMUNITY CENTERS-RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 64.32 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 745.41 .00 .00 745.41 Other Fee Total 2489.30 .00 .00 2489.30 Grand Total 4648.09 .00 .00 4648.09