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04-8427 (3&4)�t_ _;a 111111111111 III11111(III 19 IE P.O. BOX 1504 _ _____ 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: C04-0 0008427 Property Address: 80175 AVENUE APN: 772 -410 -018 - Application description: DWELLING - 3 Property Zoning: HIGH DENSITY Application valuation: 192314 Applicant: C', 52- & 4 FAMILY RESIDENTIA 11-o'chite''c//t or �Vi!� CGl(/./ . 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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. Licensee Class: B License No.: 774293 Date:/ �Z �� Contractor: OWNER -BUILDER DECLARATION. I hereby affirm under penalty of perjury that) am.exempt from the Contractor's 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 Contractor's 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).: (_ 1 1, 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 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.). (_ 1 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 contractorls) licensed pursuant to the Contractors' State License Law.). (_ 1 I am exempt under Sec. , B.&P.C. for this reason Date: . Owner: 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: LQPERMIT Owner: GREYSTONE CLUBHOUSE ASSOC LLC 341 BAYSIDE DR STE 7 NEWPORT BEACH, CA 92660 Contractor: GREYSTONE MULTI -FAM BUILDERS 341 BAYSIDE DRIVE, #7 NEWPORT BEACH, CA 92660 (949)566-9230 Lic. No.: 774293 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/23/05 WORKER'S.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 issued. My workers' compensation insurance carrier and policy number are: Carrier AJ GALLAGHER Policy Number Z066293903 I 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 provisions. 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. 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 Ouinta, 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 unty to enter upon above-mentioned property for inspection purposes. at(/1. D nature (Applicant or Agent): s C4, Application Number . . . . . 04-00008427 LQPERMIT Structure Information Construction Type . . . . . TYPE V - 1 HR Occupancy Type . . . . HOTEL/APT/CONG HSING >10 Flood Zone ... . . . NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 # BEDROOMS 5.00 FIRE SPRINKLERS YES FLOOD ZONE NO PATIO SQ FTG 693.00 TOT ELIGIBLE NO NUMBER OF UNITS 3.00 ---------------------------------------------------------------------------- 1ST FLOOR SQUARE FOOTAGE 3237.0.0 Permit . . . BUILDING PERMIT Additional desc . Permit Fee.. . . . . 965.00 Plan Check Fee 627.25 Issue.Date . . . . Valuation 192314 Expiration Date 3/22/06 Qty Unit Charge Per Extension BASE FEF 639.50 93.0.0 3.5000 ---------------------------------------------------------------------------- THOU BLDG 100,001-500,000 325.50 Permit . . . MECHANICAL Additional desc . Permit Fee. . 121.00 Plan Check Fee.. 30.25 Issue Date . . . . Valuation . . . . 0 Expiration Date 3/22/06 Qty Unit Charge Per Extension BASE FEE .15.00 3.00 9.0000 EA MECH FURNACE <=LOOK 27.00 ,. 3.00 9.0000 EA MECH B/C <=3HP/100K BTU 27.00 5.00 6.5000 EA MECH VENT FAN_ 32.50 3.00 6.5000 ------------7-----7------------------------------7-------------------------- EA MECH EXHAUST HOOD 19.50 Permit . . . ELEC-NEW RESIDENTIAL - Additional desc . Permit Fee . . . . 125.97 Plan Check Fee 28.03 Issue Date Valuation 0 Expiration Date 3/22/06 Qty Unit Charge Per Extension BASE FEE 15.00 LQPERMIT Application Number 04-00008427 Permit . . . . . . ELEC-NEW RESIDENTIAL Qty Unit Charge Per Extension 3237.00 .0300 ELEC NEW RES - MULTI FAMILY 97.11 693.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 13.86 ---------------------------------------------------------------------------- Permit . . . PLUMBING Additional desc . Permit Fee . . . . 249.75 Issue Date . . . . Expiration Date . . 3/22/06 Plan Check Fee . . 60.56 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 3.00 7.5000 EA PLB WATER HEATER/VENT 22.50 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER.SYSTEM 9.00 1.00 7.5000 EA PLB OTHER BACKFLOW <=2.INCH 7.50 9.00 .7500 EA PLB GAS.PIPE >=5 6.75 3.00 ---------------------------------------------------------------------------- 15.0000 EA PLB GAS METER 45.00 Permit . . Additional desc . Permit Fee Issue Date Expiration Date . GRADING PERMIT 15.00 3/22/06 Plan Check Fee .00 Valuation 0 Qty Unit Charge Per. Extension BASE FEE 15.00 ------------------ --------------------------------------------------------- Special Notes and Comments BUILDING TYPE 1 - 3237 SF - 3 UNIT_ (#511, 512, 513) MULTI=FAMILY APARTMENTS, R-1 OCCUPANCY, TYPE V-1HR CONSTRUCTION,'2001 CODES.[PLAN TYPES (2 QTY)B-1.1, (1 QTY) E-1.1 COMPRRISE BLD TYPE #11 **PERMIT DOES NOT-INCLUDE.BLOCK WALLS, POOL, SPA; TRASH ENCLOSURES,.MAIL KIOSK AND SITE LIGHTING.** --=------------------------------------------------------------------------- Other Fees . . . . . . . . ACCESSIBILITY PLAN REVIEW 62.73 ART IN PUBLIC PLACES -RES. .00 DIF'COMMUNITY CENTERS -RES 267.00 LQPERMTT cap, Application Number . . . . . 04-00008427 ----------------------------------------------- Other Fees. . . . . . . . . . -----------=----------------- DIF CIVIC CENTER - RES 132.00 ENERGY REVIEW FEE 62.73 DIF FIRE PROTECTION -RES 96.00 DIF LIBRARIES - RES 618.00 DIF PARK MAINT FAC - RES 12`.00 DIF PARKS/REC - RES 1380.00 STRONG MOTION (SMI) - RES 19.23 DIF STREET MAINT FAC -RES 24.00 DIF TRANSPORTATION - RES 1923.00 Fee summary Charged ---------- Paid Credited ---------- ---------- ---------- ---------- Due ----------------- Permit Fee Total Permit 1476.72 .00 .00 1476.72 Plan Check Total 746.09 .00 .00 746.09 -Other Fee Total 4596.69 .00 .00. 4596.69 Grand Total 6819.50 .00 .00' 6819.50 LQPERMIT 101 o icate of OccupancyCertif of 9w5 Building & Safety Department This Certificate is issued pursuant to the requirements of Section 109 of the California Building Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 80-175 AVENUE 52 BUILDING # 5 Use classification: MULTI -FAMILY APARTMENTS Building Permit No.: 04-8427 Occupancy Group: R-1 Type of Construction: VN Land Use Zone: RH Owner of Building: CLUBHOUSE ASSOC Address: 160 NEWPORT CENTER DR. 250 City, ST, ZIP: NEWPORT BEACH, CA 92660 By: STEVE TRAXEL Date: 06-15-2007 Building Official POST IN A CONSPICUOUS PLACE