04-7921 (SFD)BOX 1504
)3 CALLE TAMPICO
UINTA, CALIFORNIA 92253
BUILDING PERMIT
BUILDING & SAFETY DEPARTMENT
. (760).777-7012
FAX (760) 777-7011
INSPECTION -REQUESTS (760) 777-7153
Application Number
J04=00007921-- Date
3/25/05
Property Address
-52790 AVEN IDA RAMIREZ
APN:
773 -323 -002 -25' -000G00 -
Application description DWELLING - SINGLE FAN`ILY DETACHED
Property Zoning
COVE RESIDENTIAL
Application valuation
119753
Owner
Contractor
MOSMITH DEV LLC
BARRILE CONSTRUCTION
,
51-300 AVE. DIAZ
P 0 BOX 1155
LA QUINTA
CA 92253 LA QUINTA
CA 92247
(760) 771-2984
WCC: EXEMFT
WC: EXEMFT
03/31/06
CSLB: 378318
06/30/06
CCC: B
------ Structure Information
SINGLE FAMILY DWELLING
-----
Construction Type . .
. . . TYPE V - NON RATED
Occupancy Type . . .
. . . DWELLG/LODGING/CONE <=10
Flood Zone
NON -AO FLOOD ZONE
Other struct info . .
. CODE EDITION 2001
CBC.
# BEDROOMS
3.00 .
FIRE SPRINKLERS NO
GARAGE SQ FTG
447.00
PATIO SQ FTG
19.00
NUMBER OF UNITS
1.:00
1ST FLOOR SQUARE FOOTAGE
1936.00
Permit . . . . . .
BUILDING PERMIT
Additional desc
Permit Fee . . .
709.50 Plan Check Fee
461.18
Issue Date
Valuation .'.
119753
Qty Unit Charge
Per
Extension
.BASE FEE
639.50
20.00 .3.,5000
THOU BLDG 100,001-500,000
70.00
Permit . . . . . .
ELEC-NEW RESIDENTIAL
Additional desc
Permit Fee
106.70 Plan Check Fee
26.68
Issue Date
Valuation
0
Qty _Unit Charge
Per
Extension
BASE. FEE
15.00
1936.00 035:0,.
ELEC NEW RES - 1 OR 2 FkMILY67.76
447.00 .0200,
ELEC'GARAGE OR NON-RESIDENTIALj'°
8.94
1.00 15.0000
EA ELEC TEMPORARY POWER POLE
15.00
r..
P.O. Box 1504 •/// VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011 ,
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 0 Date:
Applicant:
Applicant's Mailing Address:
Architect or Engineer:
Architect or Engineer's Address:
Lic. 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
ode, and my License is in full force and effect. , �� 3A�
License Class License Nor/ `
Da 10 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 contractor(s) licensed pursuant to
the Contractors' State License Law.).
(_) I am exempt under Sec. , BA P.C. for this reason
Date
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
issued. My workers' compensation insurance carrier d policy number are:
mer P cy Number
I certify that, in the performance of re wolk 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 Califomi : and a ree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
a� to Applica
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.
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 n /a
Lenders 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 employeesfor 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 nulla d 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 cancel ion.
1 certify that I have read this application and state that the above info on
i correct. I agree to comply with all city and county ordinances and state laws relating to building
Zat.—I
;tlonand, hereby authorize representatives of this county t nt up tide ov tioned property for' pection purposes.
Signature (Applicant or Agent):
a
Page
2
Application
Number .
.
04-00007921 Date
3/25/05 -
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
. . . .
59.00 Plan Check Fee
14.75
Issue Date
. . . .
Valuation
0
Qty
Unit Charge
Per
Extension
BASE PEE
15.00
1.00
9.0000
EA
MECH FURNACE <=100K.
9.00
1.0,0
9.0000
EA,
MECH B/C <=3HP/100K BTU_
9.00
3.00
6.5000
EA
MECH VENT FAN
19.50
1.00
6.5000
EA
MECH EXHAUST HOOD
6.50
Permit
PLUMBING
Additional
desc
Permit Fee
..
135.00
Plan Check Fee
33.75
Issue Date
Valuation . . .
0
Qty
Unit.Charge
Per
Extension
BASE FEE
15.00
11.00
6.0000
EA
PLB FIXTURE-
66'.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
6.00
.7500
EA
PLB GAS PIPE >=5
4.50
1.00
15.0000
EA
PLB GAS METER
15.00
Other Fee's
. . . . .
. .
. ART IN PUBLIC PLACES -RES
..00
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER -' RES
366.00
ENERGY REVIEW FEE
46.12
DI,F FIRE PROTECTION -RES
97.00
GRADING 'PLAN CHECK .FES
00
DIF LIBRARIES - RES
225.00
DIF PARK MAINT FAC - RES
5.00
DIF PARKS/REC - RES
502..00'
STRONG MOTION -(SMI) - RES
11.97
Page 3
Application Number
. . .
04-0.0007921
Date 3/25/05
----------------------------------------------------------------------------
Other Fees . .
. . . .
DIF STREET
MAINT FAC -RES
15.00
`
DIF TRANSPORTATION
-:RES
1098.00
Fee summary
Charged
Paid
Credited
Due
Permit -Fee Total
1025.20
.00
.00
1025.20
Plan Check Total
536.36
250.00
.00
286.36
Other Fee Total
246.3.09
00
.00
2463.09
Grand Total
4024.65
250.00
.00''
3774.65
•
J
Building -5-2
2_ WO -WE
Address � f '"
Mailing
Address
City Zip
u�
Contracto
Address
City l Zip
��I fl 5 zl
RO. BOX 1504 APPLICATION ONLY
I 78-495 CALLE TAMPICO
'F"7fi1L�ZLA QUINTA, CALIFORNIA 92253
•
5/-3bD
r -C , BUILDING: TYPE CONST. P.
OCC. GR
-4VE 2)%j4L A.P. Number 3 HOZ
ZGC, Legal Description 0 '4-1 LT
Project Description topsS
N �C/
& Classif. ILic. #
Arch., Engr., / 01
Designer (��
SliE--
;, Address Tel: - _ U,
41a, 1 �722,r'3 ILic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am, exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5, Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that he 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, 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 forsale. (Sec. 7044, Business and Profes-
sions Code: The Contractor's License Law does not apply to an owner of property who builds
or improves thereon and who does such work himself or through his own employees, provided
that such improvements are not intended or offered for sale. If, however, the building or im-
provement is sold within one year of completion, the owner -builder will have the burden of .
proving that he 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 Contractor's License Law does
not apply to an owner of property who builds or Improves thereon, and who contracts for such
projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date-Owner-
WORKER'S
ate Owner
WORKER'S COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's
Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less).
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 Workers' Compensation Laws of
California.
Date Owner
NOTICE TO APPLICANT If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the work
for which this permit is issued. (Sec. 3097, Civil Code.)
Lerider's Name
Lender's Address
This is a building permit when properly filled out; signed end Validated, and is subject to
expiration if work thereunder is suspended for 180 days. '
I certify that 1 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 city to enter the above-mentioned
property for inspection purposes.
Signature of applicant Date
Mailing Address'
City, State, Zip
y
Sq. Fl -NO. No. DIN.
Size Stories Units
New Add ❑ Alter ❑ Repair O Demolition ❑
Estimated Valuation
PERMIT AMOUNT L7)
Plan Chk. Dep. r --
Plan Chk. Bal. Ir
Const.
Mech.
Electrical
Plumbing
S.M.I. r
Grading*
Driveway Enc.
Infrastructure
TOTAL
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setbac% from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by:
Validated by:
Date Permit
Validation:
WHITE = BUILDING DEPARTMENT YELLOW = APPLICANT PINK = FINANCE
s
_I
f
Unit 2
Unit 3
Unit 4
Unit 5
Unit 7
Unit 8
Unit 9
Unit 10
Comments Per City no tract #: known as Santa Carmalita at Vale La Quinta
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patiostwalCtways, residential additions under 5
00 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooldng, eating or sanitation) or replacement mobile ho
mes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of —$2.24 X 1,936 S.F. or $4,336.64 have been paid for the property listed above and that
building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued.
Fees Paid By CC/PDNB-Dan Barrile Check No. 090136
Name on the check Telephone 760-219-3184
ftnding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Yolanda Garcia Payment Recd
$4,336.64 Over/Under
Signature 2
�-�
NOTICE: Pursuant to Government Code Section 66IM(d)(1), this will serve to notify you that the 90 -day approval period in which you may protest the fees o
r other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which
those amounts are paid to the District(s) or to another public entity authorized to collect them on the District(s) behalf, whichever is earlier.
,
NOTICE: This Document NOT VALID if Duplicated
Embossed Original -Building Department/Applicant Copy -Applicant/Receipt Copy -Accounting
CERTIFICATE OF COMPLIANCE�Fts
�! "
Desert Sands Unified School District
o�rto
47950 Dune Palms Road
BERMUDA DUNES O
Date
4/7/05
La Quinta, CA 92253
Cr RANCHO MIRAGE tJ
INDIAN WELLS
No.
27057
(760) 771-8515
d PALM DESERT
,�`� LA INDIQ O
-yv
.
1
y�`
U
Owner
Mosmith Dev. LLC
APN #
773-323-002
Address
52-790 Avenida Ramirez
Jurisdiction
La Quiota
City
La Quinta Zip 92253
Permit #
Tract #
Study Area
Type
Single Family Residence
No. of Units
1
Lot # No. Street
S.F. Lot # No.
Street S.F.
Unit 1
52790 Avenida Ramirez
1936 Unit 6
Unit 2
Unit 3
Unit 4
Unit 5
Unit 7
Unit 8
Unit 9
Unit 10
Comments Per City no tract #: known as Santa Carmalita at Vale La Quinta
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patiostwalCtways, residential additions under 5
00 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooldng, eating or sanitation) or replacement mobile ho
mes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of —$2.24 X 1,936 S.F. or $4,336.64 have been paid for the property listed above and that
building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued.
Fees Paid By CC/PDNB-Dan Barrile Check No. 090136
Name on the check Telephone 760-219-3184
ftnding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Yolanda Garcia Payment Recd
$4,336.64 Over/Under
Signature 2
�-�
NOTICE: Pursuant to Government Code Section 66IM(d)(1), this will serve to notify you that the 90 -day approval period in which you may protest the fees o
r other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which
those amounts are paid to the District(s) or to another public entity authorized to collect them on the District(s) behalf, whichever is earlier.
,
NOTICE: This Document NOT VALID if Duplicated
Embossed Original -Building Department/Applicant Copy -Applicant/Receipt Copy -Accounting
, RC DISTRICT - PLANNING REVIEW FORM
This form is to be used by CDD staff for review of single family dwellings in the RC (Cove
Residential) District per Section 9.50.090 of the Zoning Code. Its purpose is to determine: 1)
that the proposed housing design does not duplicate the same architectural style of any house
within 200 feet of.the applicant, .and/or 2) if there is a need for the applicant to.file for Master
Design Guidelines. If the applicant does need to file .a Master Design Guideline, please transmit
this information to the Building. and Safety Department a& part of your correction list. Please
attach additional explanations as necessary.
APPLICANT: Mosmith Development, .LLC:
.SITE ADDRESS: 52-790 Ave. Ramirez -
APN 773 - 323 - _002 CASE NO.: 1050
LEGAL: LOT 25 BLOCK 15. UNIT 16' S.C..@V.L.Q.
CHECK AND APPROVED BY:T DATE:
Inform the assigned Building plan. checker upon your assignment to this case. The CDD
Executive Secretary maintains a log book to trackapplications. and assign case numbers.
REQUIRED ITEM
Y
N
COMMENT/CORRECTION
Verify legal ,and APN information
NO 7 az—�� Q y 15L1-PC-
Cen•sist-ent-.w4h—
applicable)
since '9/3/98)
Architectural variety. within 200
feet of the surrounding area:
J
Architectural design features:
r (LI
Planning
M. Re -so
Commission
Other Requirements:
Comminity
Dev. Dept. I z 2 v
Initi
Is
Cas
No.
AC oy
Exh.
bit
CI
ith C
mditians
CITY OF LA QUINTA SUB -CONTRACTOR LIST
JOB ADDRESS � `0 R4,wi /'��,'� PERMIT NUMBER OWNER
This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place.r.Only persons appearin list or their employees are authorized to work
on this job. Any changes to this list must be approved by the Building Division prior.to commencement of work. Failure to comply will result in a stoppage of work.and/or the voidance
of building permit. For each applicable trade, all information requested below mint be completed by a0plicant. "On File" is not an acceptable response..
Trade / Classification
Contractor
:.
State::Contractor s. Lrcens9.: ;' ,.::.
W..orkeis.Com ensaUon:Irisurance"•:
Cit :Business License:
Company Name
Classification
(e.g. A, B, C-8)
License Number
(xxxxxx)
Exp. Date
(xx/xx/xx)
Carrier Name
(e.g. State Fund, CalComp)
Policy Number
(Format Varies)
Exp. Date
(xx/xx/xx)
License Number
(xxxx)
Exp. Date
(xx/xx/xx)
EARTHWORK IC -121 ';.
l
li �a
j` r
e
��
04
CONCRETE (C-8)
So
o,
f
Z�%"Zs
FRAMING I0-51
STRUCT. STEEL (C-51)
r---
'-
-
MASONRY (C-29)
57 1 TL
-ova S
PLUMBING(C-361
�.
9Z�
3 O6
LATH; PLASTER (C-35)
�.
DRYWALL (C-9) .::
5 -�
L- --�
a A1,0
5s Z) -W `
HVAC. I6-201
, s
!� "�
< `1! //
�5 i��
C�
ELECTRICAL. (C=101
_y
%Z ✓a n1 A,) , ►�! !C
� —1/�
�o c� �
� O
c5'�/�� Gf•�/+v
�(l� ' � d®'
! � �
L.
/%��/c�
ROOFING '(C=391 ;...':
L /'� lLL �-
C��
615
V l/LG a/ 2�I'-7
;SHEET METAL (C43)
T
r V
C�
21/ -OS'
FLOORING (C'=.15): '
GLAZING (C-171
INSULATION'.IC-21.
C
C- ZG
22
`-'�
l) i /,r (,
C !3 oZC�
G=3 �v�
SEWAGE DISP:- (C-42)
..
PAINTING (C-33)
C�.C( C'
34q -'?U
1112,010,Cc
; ou 6
ljog1 - Z:9c� ` f
,-3 0 3
11,1160
CERAMIC TILE (C-54)
q
33
CABINETS (C-6)
�l`%2/2I L�%.'�00i2jlcY
FENCING (C-13)
LANDSCAPING (C-27) '.
IPOOL (C-53) _
__ —. - ...
`
_- •.
' Certrfica to of Occupancy
, .
OF. �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 Jn compliance with the
provisions of the Building Code and the various* ordinances of the City regulating building
construction and/or use.
.BUILDING ADDRESS: 52-790 AVENIDA RAMIREZ
Use classification: SFD Building Permit No.: 05-7921
Occupancy Group: R3 Type of Construction: VN Land Use Zone: RC
Owner of Building: MOSMITH DEV LLC Address: 51-300 AVE. DIAZ
City, ST; ZIP: LA QUINTA CA 92253
By: KIRK KIRKLAND
Date. 3-31-06
Building Offici
POST IN A CONSPICUOUS PLACE
r