04-8430 (MFD5)r IIIIIIIIVIIIIIIVIIIIIII 05 4
•
P.O. BOX 1504 IE
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78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
04-00008430
86175—AVENUE-52
772 -410 -018 -
DWELLING - 5 OR MORE FAMILY
HIGH DENSITY RESIDENTIAL
373026
BUILDING PERMIT
11_�r Chitect or Engineer:
/ OF
C-1(3 r -
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 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:
B License No.: - 774293
/Date: I �Z / A ' Contractor: •'_
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).:
(_ 1 I, as owner of the property, or my employees with wages as their sale 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 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: 1 V.
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
�j 3700 of the La or 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 qate laws relating to building construction, and hereby authorize representatives
of this county to enter upon above-mentioned property for inspection purposes.
"Z �� ignature (Applicant or Agent):
Application Number . . . . . 04-00008430
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 YES
FLOOD ZONE NO
PATIO SQ FTG 841.00
NUMBER OF UNITS 6.00
1ST FLOOR SQUARE FOOTAGE 3222.00
2ND FLOOR SQUARE FOOTAGE 3191.00
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Permit . . .
Additional desc .
Permit Fee
Issue Date . . . .
Expiration Date . .
BUILDING PERMIT
1598.50
3/22/06
Plan Check Fee 1039.03
Valuation 373.026
Qty Unit Charge Per Extension
BASE FEE 639.50
274.00 3.5000 THOU .BLDG 100,001-500,000 959.00
----------------------------------------------------------------------------
Permit . . . MECHANICAL
Additional desc .
Permit Fee 227.00 Plan Check Fee 56.75
Issue Date . . . . Valuation . . . 0
Expiration Date . . 3/22/06
Qty Unit
Charge
Per
Extension
BASE
FEE
15.00
6.00
9.0000
EA MECH
FURNACE <=100K
54.00
6.00
9.0000
EA . MECH
B/C <=3HP/100K BTU
54.00
10.00
6:5000
EA MECH
VENT FAN
65.00
6.00
---------------------------=--------------
6.5000
EA MECH
EXHAUST HOOD
----------------------------
39.00
------
Permit ..
. .
ELEC-NEW RESIDENTIAL
Additional desc
.
Permit Fee
224.21
Plan Check Fee
56.05.
Issue Date
Valuation . . . .
0
Expiration Date
3/22/06
Qty Unit
Charge
Per
Extension
BASE
FEE.
15.00.
LQPERMIT
V'
LQPERMIT
Application Number .
. . . . 04-00008430
Permit .
. . . . .
ELEC-NEW RESIDENTIAL
Qty Unit Charge
Per
Extension
6413.00
.0300
ELEC NEW RES - MULTI FAMILY
192.39
841.00
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.0200
ELEC GARAGE OR NON-RESIDENTIAL
16.82
Permit
. . .
PLUMBING
Additional
desc . .
42
Permit Fee
. . . .
450..00 Plan Check Fee
112.50
Issue Date
. . . .
Valuation
0
Expiration
Date
3/22/06
Qty Unit Charge.
Per
Extension
BASE FEE
15.00
42.00
6.0000
EA PLB FIXTURE
252.00
1.00
15.0000
EA PLB BUILDING SEWER
15.00
6.00
7.5000
EA PLB WATER HEATER/VENT
45.00
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
18.00
.7500
EA PLB GAS PIPE >=5
13.50
6.00
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15.0000
EA. PLB GAS METER
90.00
-
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 t
BUILDING TYPE 4 - 6413 SF - 2 STORY - 6 �'
UNIT ('APT #711,712,713,
721,722,723) MULTI -FAMILY APARTMENTS,
R-1 OCCUPANCY, TYPE V-1 HR CONSTRUCTION,
2001 CODES. [PLAN TYPES (4 QTY)B.-1.4 AND
(2 QTY) E-1.2 COMPRISE BUILDING TYPE 4)
PERMIT DOES NOT INCLUDE BLOCK WALLS,
POOL, SPA, TRASH ENCLOSURES, MAIL KIOSK
AND SITE LIGHTING.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . ACCESSIBILITY PLAN REVIEW 103.90
ART IN PUBLIC PLACES -RES 432.56
DIF COMMUNITY CENTERS -RES 534.00
Application Number
. . . . .
04-00008430
----=-----------------------------------------------------------------------
Other Fees . . . .
. . . . .
IDIF CIVIC CENTER - RES.
264.00
ENERGY REVIEW FEE
103.90
DIF FIRE PROTECTION -RES
192.00
DIF LIBRARIES - RES
1236.00
DIF PARK MAINT FAC - RES
24.00
DIF PARKS/REC - RES
2760.00
STRONG MOTION (SMI) - RES
37.30
DIF STREET MAINT,FAC-RES
48.00
DIF TRANSPORTATION - RES
3846.00
Fee summary
Charged.
Paid Credited
------------------------------
Due
-----------------
Permit Fee Total
----------
2514.71
.00 .00
2514.71
Plan Check Total
1264.33
.00 .00
1264.33
Other Fee Total
9581.66
.00 .00
9581.66
Grand Total
13360.70
.00 .00
13360.70
0
LQPERMIT
Certificate of Occupancy
T4&t 4 XP auArw
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 # 7
Use classification: MULTI -FAMILY APARTMENTS
Occupancy Group: R-1
Owner of Building: CLUBHOUSE ASSOC
Building Official
Type of Construction: VN
POST IN
Building Permit No.: 04-8430
Land Use Zone: RH
Address: 160 NEWPORT CENTER DR. 250
City, ST, ZIP: NEWPORT BEACH, CA 92660
By: STEVE TRAXEL
Date: 06-29-2007
E