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04-8429 (MFD5)1111111111111111111111111 IE P.O. BOX 1504 — ---- 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 03 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number:_ 04-00008429 Property Address: 80175—AVENUE-52 APN: 772-410-018- - - Application description: DWELLING - 5 OR MORE FAMILY Property Zoning: HIGH DENSITY RESIDENTIAL Application valuation: 334372 Applicant: ..,�rchitect or Engineer: �j U£ Owner: CLUBHOUSE ASSOC 160 NEWPORT CENTER DR 250 10 -___&__T ---"PORT BEACH, CA 92660 SEP 28 2005 1 1 factor. R STONE MULTI -FAM BUILDERS OF6e�QUIPITA 4 BAYSIDE DRIVE, #7 F'N NCEOeAT NE PORT BEACH, CA 92660 9)566-9230 Lic. No.: 774293 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 Professional's Code, and my License is in full force and effect. Lice se Class: B License No.: 774293 Date:�'2 os ontractor: � OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I 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).: (_) 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 workhimself 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.). (_) 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.). I—) 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: LQPERMff 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 3700ofthe L Code, I shall forthwith comply with those provisions. Y - ..ece ZJ O l Pplicant: (� L � 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 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 countytoenter upon th ove-mentioned property for inspection purposes. nature (Applicant or Agent): •,._ LQPERMIT Application Number . . . . . 04-00008429 Structure Information Construction Type TYPE V - 1 HR Occupancy Type . . . . . HOTEL/APT/LONG HSING >10 Flood Zone . . . . . NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 # BEDROOMS . 10.00 FIRE SPRINKLERS 6575 FLOOD ZONE NO PATIO SQ FTG 853.00 NUMBER OF UNITS 5.00 -------------------------------- 1ST FLOOR SQUARE FOOTAGE -------------------------------------------- 5722.00 Permit BUILDING PERMIT Additional desc . Permit Fee . . . . 1462.00 Plan Check Fee 950.30 Issue Date . . . . Valuation . . . . 334372 Expiration Date 3/22/06 Qty Unit Charge Per Extension BASE FEE 639.50 235.00 3.5000 ---------------------------------------------------------------------------- THOU BLDG 100,001-500,000 822.50 Permit MECHANICAL Additional desc . Permit Fee . . . . 202.50 Plan Check Fee 151.88 Issue Date Valuation 0 Expiration Date .3/22/06 Qty Unit Charge Per Extension BASE FEE 15.00 .5.00 9.0000 EA MECH FURNACE <=100K 45.00 5.00 9.0000 EA ' MECH B/C <=3HP/100K BTU 45.00 10.00 6.5000 EA -MECH VENT FAN 65.00 5.00 6.5000 ---------=--------------------------------- EA MECH EXHAUST HOOD --------------------------------- 32.50 Permit Additional desc . Permit 'Fee . . . . Issue Date . . . . Expiration Date . . Qty Unit Charge 5722.00 .0300 ELEC-NEW RESIDENTIAL 203.72 Plan"Check Fee . Valuation . . . . 3/22/06 Per BASE FEE ELEC NEW RES - MULTI FAMILY 50.93 0 Extension 15.00 171.66 Application Number . . . . . 04-00008429 Permit . . . . ELEC-NEW RESIDENTIAL Qty Unit Charge .Per Extension 853.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 17.06 ---------------------------------------------------------------------------- Permit PLUMBING Additional desc . . Permit Fee . . . . 383.25 Plan Check Fee 93.94 Issue Date . . . . Valuation 0 Expiration Date . . 3/22/06 Qty Unit Charge Per Extension BASE FEE 15.00 35.00 6.0000 EA PLB FIXTURE 210.00 1.00 15.000'0 EA PLB BUILDING SEWER 15.00 5.00 7.5000 EA PLB WATER HEATER/VENT 37.50 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 15.00 .7500 EA PLB GAS PIPE >=5 11.25 5.00 15.0000 EA --------------------------------------------------------------- PLB GAS METER 75:00 ------------ Permit GRADING PERMIT Additional desc.. Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . Valuation 0 Expiration Date 3/22/06 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments -BUILDING TYPE 3 - 5722 SF - 5 UNIT (APT #611, 612, 613, 614,615) MULTI -FAMILY APARTMENTS, R-1 OCCUPANCY, TYPE V-1 HR CONSTRUCTION, 2001 CODES. (PLAN TYPES (2 QTY) A-1.3, (2 QTY) B-1.1 & (1 QTY) B-1.2 COMPRISE BLDG. TYPE #31 **PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL, SPA, TRASH ENCLOSURES, MAIL KIOSK AND SITE LIGHTING.** ---------------------------------------------------7------------------------ Other Fees . . . . . . . . . ACCESSIBILITY PLAN REVIEW 95.03 ART IN PUBLIC -PLACES -RES 335.93 DIF COMMUNITY CENTERS -RES 445.00 DIF CIVIC CENTER - RES 220.00 LQPERMTT Application Number . . . . . 04-00008429 ---------------------------------------------------------------------------- Other Fees . . . . . . . . ENERGY REVIEW FEE 95.03 DIF FIRE PROTECTION -RES 160.00 DIF LIBRARIES - RES 1030.00 DIF PARK MAINT FAC - RES 20.00 DIF PARKS/REC - RES 2300.00 STRONG MOTION (SMI) - RES 33.43 DIF STREET MAINT FAC -RES 40.00 DIF TRANSPORTATION - RES 3205.00 Fee summary ------------------ Charged ---------- Paid Credited ------------------------------ Due Permit Fee Total 2266.47 .00 .00 2266.47 Plan Check Total 1247.05 .00 .00 1247.05 Other Fee Total 7979.42 .00 .00 7979.42 Grand Total 11492.94 .00 .00 11492.94 LQPERMIT oU, Certificate of Occupancy QUM& 4 I•.casrovnrm �i��� OFBuilding & 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 # 6 Use classification: MULTI -FAMILY APARTMENTS Building Permit No.: 04-8429 Occupancy Group: RR=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: 06-13-2007 Building Official NJ POST IN A CONSPICUOUS PLACE I