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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- _ a�� c„�w�+�r 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