05-0446 (RER)P.O. Box 1504
78-495 CALLE TAMPICO
LA QUIN TA, -CA LIFORNIA 92253
BUILDING PERMIT
� 1
Application Number
Property Address . . . .
APN:
Application description
Property Zoning . . .
Application valuation . . .
Owner
------------------------
PGA WEST RESIDENTIAL HOA
54.320 SOUTHERN HILLS
LA QUINTA CA •92253
BUILDING & SAFETY DEPARTMENT
(760) 777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
n 5 ;
OS-0"� 6'000446 Date 2/07/05
4925 RIVIERA
775-153-024- - -
'REMODEL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
8000
Contractor
------------------------
OWNER
------ Structure Information VOLUNTARY SEISMIC•RETROFIT
• -----
Construction Type ... . . . TYPE.V - NON RATED
Occupancy Type . . . . . DWELLG/LODGING/LONG <=10
Other•struct info CODE EDITION
2001
-------------------------------------------
Permit . . . . . BUILDING PERMIT
Additional desc
Permit Fee_ . . . . 99.00 Plan Check Fee
:•QO
Issue Date Valuation . . .
. 8000
Qty Unit Charge Per
Extension
BASE FEE
45.00
6..00 9.0000 THOU BLDG 2,001-25,000
-----------.-----------------------------------------------------------------
54.00
Special Notes and Comments
Phase 1 Fairways Units Voluntary Seismic
Retrofit. Voluntary seismic upgrade &
selected construction defect repairs
constructed -to the 1985 UBC allowable
design values,.applided loads conform to
the 1997 UBC.
Other Fees . . . . . . . . STRONG MOTION (SMI) --RES
.80
Fee summary Charged Paid Credit:ed'�
Due
Permit Fee Total 99-.00 .00 .00
99.00
Plan Check Total .00 .00 .00
.00
Other Fee Total .80 .00 .00
.80
Grand Total 99.80 .0.0 .00
99:80
FEB E
2005 _
CITY OF LA QUINTA
FINANCE DEPT.
P.O. Box 1504 • " VOICE (760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-701 1
LA QUINTA, CALIFORNIA 92253 4 4 a
INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 051 4;14& Date: oZ • �' OS
Applicant: I Architect or Engineer:
Applicant's Mailing Address:
a
Architect or Engineer's Address:
0 !A
Lic. 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
Code, and my License is in full force and effect.
License Class License No.
Contractor
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).):
L) 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
Isold 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.).
L 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.).
L) I am exempt under under Sec. , BA P.C. for
,this
�reason
1 �• �r✓ c61
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
Zisrkers' compensation insurance carrier and policy number are:
Carrier 11 �S Policy Number
V��ss
certify that, in the performance of the work for which this permit is issued, 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
forthwith comply with those provis' ns.
r
' pplicant
WARNING: FAILURE 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
Lender's Address
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth 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 or pursuant to 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 Quinta, its
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 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 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 hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes.
ate �Signature (Applicant or Agent).
4� 1rt .y r : iE x ,K�; �k : aw•�e �T. etf l d� 8 4r# wig • �i� 1 $ ° lit ';r §r�*w y -.
-Page f of
-• DAVE STEAVENS
ri Inspection Services '
PROJECT A-,.Al.JtiS i A �� W �`f` S PROJECT # 0 00 °a - t
ADDREss St - �k�_5 CLIENT 6 A W t.S'r b-1 a to
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BLDG. PERMIT # Of- O 4 4 G ARCHITECT fjy L 13 A A 11 LW
ENGINEER .iN u.N to SIR o 1 e >J CONTRACTOR ? A c.% c- c,, iQ51-Z c>
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INSPECTION TYPE
INSPECTION REPORT
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CERTIFICATION OF COMPLIANCE: To the best of our knowledge, all of the reported work, unless otherwise noted,
substantially complies with approved plans, specifications `arid applicable sections of •the building codes. This report covers
the locations of the work inspected only and does not constitute engineering opinion or project control.
CERT. NO. 09>'59 3"�I �.' 50 INSPECTOR NAME S' � U G +tel rj
-�E � (P.i I Clearly)
DATE l Si��%r 2-045_5" INSPECTOR SIGNATURO.a �.� c Na�•.e R�
a
Dwm Sawwo Inc.
Structural Engineers
908 S. Cleveland St.
Oceanside, CA, 920rx&
Ta: (7e0) 989.8566
Fax UGO) 9664
To: Stove HaftK Reconstruction Manager
of PGA-Ui est RiteMentlerAseacislorr
From: RHErr M. SAY OiE
VA.19ZZ F: 1
Few "G -FT -W& Pages 2 mdudMc ow s
Phorag- M236dr- Date.' Tuesday, 2005 -
s..���a ��✓
Re:
Iftef-ANOMM. R3osrm now.. CC:-- n -
A &,c t
WUf9unt EY For DPlem�£o . Cr P O- Ra el t
Rt GAPDMG-. RFH#� Phtmef2A, at*w -Retrofr¢,arork
4�s
It is understood brat the twnsoer w at the address above ttas reftael to aow ttm
for Prtmrn- r i -ease -&-ter attic
and dining room,
and rroted.
Please- Nyou hove Wim- RheM I
.Jll oll,
*i-Avj
Wit.,