04-5066 (SFD)I
T4hf 4 4 a"
1P.O. Box 1504
F8-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING PERMIT
BUILDING & SAFETY DEPARTMENT
(760).777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760') 777-7153
Application Number .
. . . . 04-00005066 Date 10/22/04
Property Address . .
. . . . `.77225-AVENIDA_ARTEAGA
APN:
658-210-026- - -
Application description
. . . DWELLING - SINGLE FAMILY
DETACHED
Property Zoning . . .
. . . . LOW DENSITY RESIDENTIAL
Application valuation
. . . . 403406
Owner
Contractor
------------------------
SIBERT SAM
-------------------=----
SOUTHERN HILLS DEVELOPMENT INC
LA QUINTA
CA 92253
(760) 771-3497
WCC: EXEMPT.
WC: EXEMPT
05/31/05
CSLB: 838041
05/31/06
CCC: B
------ Structure Information
4563 SQ. FT. SFD
-----
Construction Type . .
. . . TYPE V - NON.RATED
Occupancy Type . . .
. . DWELLG/LODGING/LONG <=10
Flood Zone . . . . .
. .. . NON -AO FLOOD ZONE
Other struct info . .
. . . CODE EDITION
2001 CBC
# BEDROOMS
4.00
FIRE SPRINKLERS
NO
GARAGE SQ FTG
887.00
PATIO SQ FTG
1303.00
NUMBER OF UNITS
1.00
FIRST FLOOR SQ FTG
4563.00
-----------------------------------------------------------------------------
Permit . . . . . .
BUILDING PERMIT
Additional desc
Permit Fee . . . .
1703.50 Plan Check Fee
1107.28
Issue Date
Valuation . . .
. 403406
Qty Unit.Charge
Per
Extension
BASE FEE
639.50
304.00 3.5000
THOU BLDG 100,001-500,000
1064.00
----------------------------------------------------------------------------
Permit
ELEC-NEW RESIDENTIAL
Additional desc . .
Permit Fee
207.45 Plan Check Fee
51.86
Issue Date . . . ..
. Valuation . . .
. 01
Qty Unit Charge
Per
Extension
BASE FEE,'
15.00
4563.00 .0350
ELEC NEW RES - 1 OR 2 FAMILY
159.71
887.00 .0200
ELEC'GARAGE OR NON-RESIDENTIAL 17.74
1.00 15.0000
EA ELEC TEMPORARY POWER POLE
.15.00
P.O. Box 1504 VOICE (760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: q-5 7 .Date: -
Applicant: Architect or Engineer:
Applicant Mailing Address: Architect or Engineer's Address:
tic. 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 full force and effect. D
License Class LicensePip
Date t/d - i2 - D 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).):
U 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
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.).
U 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 contractors) licensed pursuant to
the Contractors' State License Law.).
U I am exempt under Sec. , BA P.C. for this reason
Owner
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
ue My rkers' ompensation insurance carrier and policy number are:
Carrier 5 -e_ Policy Number
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 ag a that, if I sho ecome subject to the workers' compensation provisions of Section 3700 of the Labor Code, 1 shall
forthwith comply with those provisions.
Date /P ' 2'Z ' O q Applicant
WARNING: FAILURE TO SECURE WOR ERS' 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
1 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.).
Lenders 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 cancellatio
I certify that I have read this application and state that the above inform ti is correct. agree t mply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this county to enter on a abo e d property for inspection purposes.
Date LO ' Z -Z ` 04 Signature (Applicant or Agent):
Page
2
Application Number .
. . . . 04-00005066 Date
10/22/04
----------------------------------------------------------------------------
Permit . . . . . .
GRADING PERMIT
Additional desc
Permit Fee . . .'.
15.00 Plan Check Fee
.00
Issue Date . . . .
Valuation . . . .
0
Qty Unit Charge
Per
Extension
BASE FEE
15.00
----------------------------------------------------------------'-------------
Permit . . . . . .
MECHANICAL
Additional desc
Permit Fee . . . .
132.50 Plan Check Fee
33.13
Issue Date . . . .
Valuation
0
Qty Unit Charge
Per.
Extension
BASE FEE
15.00
4.00 9.0000
EA MECH FURNACE <=100K
36.00
4.00 9.0000
EA MECH B/C <=3HP/100K BTU
36.00
6.00 6.5000
EA MECH VENT FAN
39.00
1.00 6.5000
EA MECH EXHAUST HOOD
6.50
----------------------------------------------------------------------------
Permit . . . . . .
PLUMBING
Additional desc . .
Permit Fee . . . .
229.50 Plan Check Fee
57.38
Issue Date . . . .
Valuation . . . .
0
Qty Unit Charge
Per
Extension
BASE FEE
15.00'
26.00 6.0000
EA PLB FIXTURE
156.00
1.00 15.0000
EA PLB BUILDING SEWER
15.00
1.00 7.5000
EA PLB WATER HEATER/VENT
7.50
1.00 3.0000
EA PLB WATER INST/ALT/REP
3.00
1.00 9.0000
EA PLB LAWN SPRINKLER SYSTEM
9.00
12.00 .7500
EA PLB GAS PIPE >=5
9.00
1.00 15.0000
EA PLB GAS METER
15.00
-----------7----------------------------------------------------------------
Special Notes and Comments
4563 SQ. FT. SFD. THIS PERMIT DOES NOT
INCLUDE POOL & SPA, BLOCK WALLS OR
DRIVEWAY APPROACH.
-------------------.---------------------------------------------------------
Other Fees . . . . .
. . . . ART IN PUBLIC PLACES -RES
508.51
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
110:73
DIF FIRE PROTECTION -RES
97.00
Page 3
Application Number
. . . .
04-00005066
Date
10/22/04
Other Fees f. .
. . . . .
GRADING PLAN CHECK
FEE
.00
{
DIF LIBRARIES - RES
225.00
DIF PARK MAINT FAC
- RES
5.00
j
DIF PARKS/REC - RES
502.00
STRONG MOTION (SMI)
- RES
40.34
DIF STREET MAINT FAC
-RES
15.00
DIF TRANSPORTATION
- RES
1098.00
Fee summary
-----------------
Charged
----------
Paid Credited
--------------------
----------
Due
Permit Fee Total
2287.95
.00
.00
2287.95
Plan Check Total
1249.65
250.00
.00
999.65
Other Fee Total
3064.58
.00
.00
3064.58
Grand Total
6602.18
250.00
.00
6352.18
T4hf- 4 4Qaha
P.O. Box 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLS TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
(760)777-7012
FAX (760) 777-7011 '
To Customer: 1 D • 12! -
Permit #:
Public Works
Fugitive Dust Control (PM -10) Plan Approval
Instructions to Applicant:
Public Works Department approval of a fugitive dust control plan is required prior to Building
Permit issuance for the following project. Please:
1. Fill out the attached forms, then;
2. Submit this entire packet to the Public Works Department for review.
If you need help completing the forms, contact the Public Works Department at 760-777-7075.
The Public Works Department will review and, when approvable, forward the approved plan to
the Building & Safety Department, approving the issuance of Building Permit(s). If the Public
Works. Department has questions or concerns, an attempt will be made to contact the person
whose name and telephone number appear below.
Project to be permitted:
Project Street Address: 2z 1�ytC2TGj�
Applicant Contact & Telephone Number: 1�� �c Ll
Public Works Department Findings
To: Greg Butler, Building & Safety Manager
From John Freeland, Senior Engineer
The Public Works Department has reviewed the attached Fugitive Dust Control Plan for the
above-mentioned project and finds that:
O ... issuance of this Building Permit does not require Public Works Department approval.
CY/...issuance of this Building Permit is approved by the Public Works Department.
Freeland, Senior Engineer
to Zi o
Date
{
44Q
(760) 777-7012
FAX (760) 777-7011
FACSIMILE TRANSMITTAL
TO: -T) S L) S�
ATTENTION: ! � ► Lr r(, C-3
a
FAX NUMBER- 77/
ED RANDALL
FROM: COUNTER TECHNICIAN
BUILDING AND SAFETY DEPARTMENT
DATE: b( y/D3 PAGE 1 OF:
COMMENTS 'TRYA WF TZ 6 7TvWX J>
S 64 oo l- FEE: Rr-cicI2f
To o/1• 7 7- 2 2 s-
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PyENo i /flare R-G,d4 , APW 6Se Z /o - o 2 � . No Cd•�sT�t✓cy.o✓ �✓R1
vea Si^nrE D No Jr1wcrpa rs G/fi?£ 13 v. ci. Zr � �l�►E �1JE.�i
A NE w sE i or Pcws is s ribM.' 'F A� u !� �� S � a 7AE /9PAJ,2.µr
-o V oi/Z OF rlei u� g NEW I.iLT-si4,vF`� Sc.�aL fc'£ LF�E/Z,
TIiANks
MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253
/� o
-1 0%flab
i
BERMUDAOUNES r Desert Sands Unified School District
RANCHO MIRAGE O
i aotAN wESEuRTs w 47-950 Dune Palms Road • La guinta. California 92253 • (760) 777-4200
• VAIM OEY
• LA OUINTA �a
�Q Ur010 L�
June 17, 2003
Dan Culnane
RE: Refund of School Developer Fees for lot 21, APN 658-210-026, Tract #21120
77225 Avenida Arteaga in La Quinta, CA
Dear Mr. Culnane,
Enclosed you will find check #14511181 in the amount of $10,449.62 which is a full
refund of the developer fees you paid us on April 11, 2002 in order to acquire a permit
for building a single family residence on the above lot. As'you explained, you requested
cancellation of your permit with the city since a recent decision had been made not to
begin construction on this property. We received the original certificate of compliance
from you which had been on file with the City of La Quinta's Building and Safety
Department. i
Please call me at 760.771'8515 if you should have any questions.
Regards,
haron McGilvrey
Office Technician
pet Ed Randall, Counter Technician
City of La Quinta Building & Safety Department
/sm
Owner
CITY OF LA .QUINTA
DIN.- fC DEPARTMENT
12
INSPECTION 11 UEST LINE
OCT. 25 200 7 7i 3
_ I
PMENT INC
Permit Number 04-5066
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 77225 AVENIDA ARTEAGA
T
4563 SQ. FT. SFD. THIS PERMIT DOES NOT
INCLUDE POOL & SPA, BLOCK WALLS OR
DRIVEWAY APPROACH.
TYPE OF INSPECTION DATE INSP.
TEMPORARY POWER
SETBACKS / c1
U/G PLUMBING / WASTE
U/G ELECTRICAL/ GROUNDING -16- O
FOOTINGS / STEEL i
CONCRETE SLAB
-?AD g
DO NOT POUR CONCRETE. UNTIL ABOVE SIGNED
ROOF NAIL/ PRE -ROOF JJ'
OKAY TO WRAP.j
FRAMING COMBINATION - C7 6J
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH MECHANICAL
INSULATION l
COVER NO WORK UN ILABOVE SIGNED
INTERIOR GYP. BD. DRYWALL 6 j
EXTERIOR LATH I
GAS TEST _
SEPTIC ABANDONMENT
SEWER CONNECTION • ,2 -
SEPTIC / GREASE INTERCEPTOR
MASONRY INSPECTIONS
FOOTINGS / STEEL
BOND BEAM
POOL / SPA / WATER FEATURE INSPECTIONS
PRE-GUNITE / SETBACKS
U/G PLUMBING
U/G GAS
U/G ELECTRICAL
PRE -PLASTER ALARMS / BARRIERS
FINAL INSPECTIONS
TEMP. USE OF PERMANENT POWER ,
ELECTRICAL - !
PLUMBING j
MECHANICAL
PUBLIC WORKS DEPARTMENT
COMMUNITY DEVELOPMENT DEPT.
FINAL / JOB COMPLETED e A7
i
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
R F STRUCTURAL CONSULTANTS, INC.
75-153 MERLE DRIVE, STE. B, PALM DESERT, CA 92211
PHONE (760) 836-1000 FAX (760) 836-0856
E- MAIL RAYMOND@RFSTRUCTURAL.COM
APRIL 5, 2006
SOUTHRN HILLS DEVELOPMENT
81-070. CHANTICLEER DRIVE
LA QUINTA, CA. 92253
Attn.: Mr. JON KATZ
Re.: THE SIBE_RT RESIDENCE
"77-225 _AVEN_IDA ARTEAGA
LA QUANTA, CA. 92253
FOLLOW-UP TO WALK THROUGH
JOB NO.: 4230
DEAR JON
THIS LETTER ADVISES THAT WE HAVE OBSERVED THE STRUCTURAL
REQUIREMENTS THAT ARE VISIBLE DURING CONSTRUCTION AT THE TIME OF
OUR SITE VISIT.
WE'BELIEVE THAT THE AS -BUILT CONSTRUCTION AT THE TIME OF OUR VISIT IS
IN GENERAL CONFORMANCE WITH OUR STRUCTURAL PLANS AND RELEVANT
CORRESPONDENCE ISSUED BY OUR OFFICE.
WE OBSERVED THE BUILDING IN ITS FRAMED CONDITION PRIOR TO
INSTALLATION OF DRYWALL AND STUCCO. WE OBSERVED THE VISUAL AND
ACCESSIBLE STRUCTURAL REQUIREMENTS. ( EXCLUSIONS ARE ITEMS SUCH AS:
FOOTING SIZE AND REINFORCEMENT, TOP PLATE SPLICES, ROOF SHEATHING,.
AND ANY STRAPS ABOVE THE ROOF SHEATHING.).
RESPECTFULLY SUBMITTED
oQROFESS�O^✓
�Q� yPp M.
m
No -57958
Exp. 06-30-* .*
CIVL
I�P
\TF OF CALIFp��
ZEYAD FAQIH, PE'
Certificate of Occupancy
G� OF�ti Building Y & 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: 77225 AVENIDA ARTEAGA
Use classification: SFD Building Permit No.: 04-5066
Occupancy Group: R3 Type of Construction: VN Land Use Zone: RL
Owner of Building: SAM SIBERT Address: 77225 AVENIDA ARTEAGA
City, ST, ZIP: LA QUINTA CA 92253
By: K KIRKLAND
&4--L Date: 3-8-2007
Building Officia
POST IN A CONSPICUOUS PLACE