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04-4652 (SFD)Li C11-y i; r LA 011714TA T-Vf 4 4Q" 1504 1LLE TAMPICO A, CALIFORNIA 92253 Application Number . . Property Address . . . APN: Application description Property Zoning . . . . Application valuation . Owner BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 . . . 04-00004652 Date 6/01/04 . . . 77942 GREY WOLF TR 658-140-999-88 -29436 - . . . DWELLING - SINGLE FAMILY DETACHED . . . LOW DENSITY RESIDENTIAL . . . 224494 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 CBC # BEDROOMS 5.00 FIRE SPRINKLERS NO GARAGE SQ FTG 410.00 PATIO SQ FTG 487.00 NUMBER OF UNITS 1.00 FIRST FLOOR SQ FTG 3671.00 Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 1077.00 Plan Check Fee 700.05 Issue Date . . . . Valuation 224494 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 . . . . 114.50 Plan Check Fee 28.63 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 1 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Date: a Applicant: a or E ineer: ' A- Applicant's Mailing Address: PI)tect or ngi eer' Address•. Lic. No.. vqbo 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 Licens i in full force and effect. �c ense Class ce�o r-- i ' OWNER -BUILDER DECLARATION 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, demolish, 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 Professions Code) or that he or she is exempt therefrom and the basis for 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 ($500).): U I, as owner of the property, or my employees with wages as their sole compensation, 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 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 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 or 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 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 performanoe of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the tabor Code, for the performance of the work for which this permit is e . coo com ensatien�artco -crier and i'4"., uCartier "+ oiicy NumberI c ify that, in the performs a of the work For which this pe ted,11tIll not empley 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 37D0 of the tabor Code, I shall forthwith comply with those provisions, ate IN 1b)plicant 1" l?%7 WARNIN : FAIL RE 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.). Lender's Name 1 Lender's Address APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of 8uildin a d 5a ety fa a 1. Each person upon whose behalf this application rs made. each person at whose requ st a defor hoti se benef work snperformed unde Sor pursuant to an issued as a result of this appircation, She owner, and the applicant, each agrees to, and shall, defend, indemnify and hold harmless the City of La Ouinta, its permit officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this app] icalian becomes nu11 and Mold if work is not commenced within 1110 days from data of issuance of such permit, or cessation of work for 180 stays wi11 subject permit to cancellation. I certify that 1 have read this application 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 he by authorize representatives of this county to enter upon the above -mentioned property for inspection purposes. ate L 5 nature (Applicant or Agent): Page 2 Application Number . . . . . 04-00004652 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 6.00 6.5000 EA MECH VENT FAN 39.00 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 ---------------------------------------------------------------------------- Permit . . . . . . ELEC-NEW RESIDENTIAL Additional desc . . Permit Fee . . . 151.69 Plan Check Fee 37.92 Issue Date Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 3671.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 128.49 410.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 8.20 ---------------------------------------------------------------------------- Permit . . . . . PLUMBING Additional desc . Permit Fee 221.25 Plan Check Fee 55.13 Issue Date Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 25.00 6.0000 EA PLB FIXTURE 150.00 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 .00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS .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 88, PLAN 3B/CASITA 3671 SF. Page 3 Application Number . . . . . 04-00004652 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 61.23 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 22.44 DIF STREET MAINT FAC-RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Paid Credited Due Permit Fee Total 1579.44 .00 .00 1579.44 Plan Check Total 821.73 .00 .00 821.73 Other Fee Total 2558.68 .00 .00 2558.68 Grand Total 4959.85 .00 .00 4959.85