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