05-3640 (SFD)P.O." BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: =05-00003640
Property Address: 54125-EAST_RESIDENCE CLUB
APN: 775-380-999-22 -31627 -
Application description: DWELLING - SINGLE FAMILY
Property Zoning: MEDIUM DENSITY RES
Application valuation: 287914
Applicant:
�Chitect or Eng
. Tit!t 4 4 "
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
DR
Owner:
NADADOR, LLC
78120 CALLE ESTADO, SUITE 203
LA QUINTA,.CA 92253
Contractor:
JACOBS HOMES INC, PETER
P.O. BOX 692
LA QUINTA, CA 92247
(760)777-9921
Lic. No.: 799449
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/16/05
----------=--------------------------------------------------------------------------------------
LICE SED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that 1 licensed unde provisions of Chapter 9 (commencing with'
I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business Pr essio Is ode, and my License is in full force and effect.
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: B n No.: 799449
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
E-2 ontractor:
issued.
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
e OWNER- ILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exemp from the Contractor's State License Law for the
Carrier HRH .INSUR Policy Number 176983305
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
— 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 a becomes ject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if I should co esu ' to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labor Code//Svjo comply with those provisions.
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).:
'
ate: �r2 Ppplicant:
(_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
00
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
WARNING: FAILURE TO SECURE WORKERS' C PENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
' improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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 contractors) licensed
pursuant to the Contractors' State License Law.).
( ) 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:
LQPERMIT
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.
1 certify that I have read this application and state that the ve inform is correct. I agree to comply with all
city and county ordinances a "state laws relating to buil stru , and hereby authorize representatives
ofthis/ untt�y fu -enter u n the above-mentioned prope f i o purposes.
date: ' P_ % Signature (Applicant or Agent):
Application Number . . . . 05-.00003640
Permit
Additional desc .
Permit Fee
Issue Date
Expiration Date
Qty Unit Charge
3365.00 .0350
LQPERMIT
ELEC-NEW RESIDENTIAL
145.60 Plan Check Fee .
Valuation
2/12/06
Per
BASE FEE
ELEC NEW RES - 1. OR 2 FAMILY
9.10
.0
Extension
15.00
117.78
Structure Information
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
3.00
FIRE SPRINKLERS
NO
GARAGE SQ FTG
531:00
PATIO SQ FTG
422.00
NUMBER OF UNITS
1.00.
--------------------------------------------------------
1ST FLOOR SQUARE FOOTAGE
-------------------
3365.00
Permit BUILDING PERMIT
Additional desc .
Permit Fee . . . .
1297.50 Plan Check Fee
210.85
Issue Date . . . .
Valuation . .
. . 287914
Expiration Date
2/12/06
Qty Unit Charge
Per.
Extension
BASE FEE
639.50.
188.00 3.5000
-=---------------------------------------------------------------------------
THOU BLDG 100,001-500,000
658.00
Permit MECHANICAL
Additional desc .
Permit Fee
171.50 Plan Check Fee
10.72
Issue Date . . . .
Valuation
0
Expiration Date
2/12/06
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
c 36.00
12.00 6.•5000
EA MECH VENT FAN
78.00
1.00 6.5000
EA MECH EXHAUST.HOOD
6.50
Permit
Additional desc .
Permit Fee
Issue Date
Expiration Date
Qty Unit Charge
3365.00 .0350
LQPERMIT
ELEC-NEW RESIDENTIAL
145.60 Plan Check Fee .
Valuation
2/12/06
Per
BASE FEE
ELEC NEW RES - 1. OR 2 FAMILY
9.10
.0
Extension
15.00
117.78
Application Number . .
. . . .. 05-00003640
Permit . . . . . . ELEC-NEW RESIDENTIAL
Qty Unit Charge
Per
Extension
641.00 .0200
-----------------------------------------------------------------------------
ELEC,GARAGE OR NON-RESIDENTIAL
12.82
Permit . . . . . . . PLUMBING
Additional desc
Permit*Fee . . . .
185.25 Plan Check Fee
.11.58
Issue Date . . . .
Valuation . . . .
0
Expiration Date
2/12/06
Qty Unit Charge
Per
Extension.
BASE FEE
15.00.
.18.00 6.0000
EA PLB FIXTURE
108.00
.1.00 15.0000
EA PLB BUILDING SEWER
15.00
2.00 7.5000
EA PLB'WATER HEATER/VENT
15.00
1.00 3.0000
EA PLB WATER INST/ALT/REP
3.00
1.00 9.0000
EA PLB LAWN SPRINKLER SYSTEM
9.00.
7.00 .7500
EA PLB GAS PIPE >=5
5.25
1.00 15.0000
------------------------------------
EA PLB GAS METER
-------------- 7 -------------------
15.00
Permit . . . . ... GRADING PERMIT
Additional desc
Permit Fee . . . .
15.00 Plan Check Fee..
.00
Issue Date* . . . .
Valuation . . . .
0
Expiration Date
.2/12/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
-----------------------------------------------------------------------------
Special Notes and Comments
SFD - LOT 22, PLAN CR.
PERMIT DOES -NOT
INCLUDE POOL, SPA, BLOCK WALLS, OR
DRIVEWAY APPROACH. 75%
REDUCTION TO
PLAN CHECK FEE DUE TO
MULTIPLE ISSUANCE
OF SAME PLAN TYPE
I -------------------------------------
Other Fees
7 -----------------------------------
ART IN PUBLIC PLACES -RES
222.74
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES.
366.00.
ENERGY REVIEW FEE.
21.09
DIF FIRE PROTECTION -RES
97.00'
GRADING PLAN CHECK FEE
.00
DIF LIBRARIES - RES
225.00
DIF PARK MAINT FAC RES
5.00
DIF PARKS/REC - RES
502.00
LQPERMIT
Application Number
05,-00003640
------------------------------------------
Other Fees . . .
. . . . .
----------------------------------
STRONG MOTION (SMI) - RES—
28:90 -.
DIF STREET MAINT FAC -RES
15.00 .
DIF TRANSPORTATION - RES
1098.00
Fee summary
Charged
Paid Credited
Due
Permit Fee Total
1814.85
.00 .00
1814.85
Plan Check Total
242.25
.00 .00
242.25
Other Fee Total
2677.73
00 .00
2677.73
Grand Total
4734.83
..00 .00
4734.83
LQPERMTT
04/25/2006 07:54 7145137555 BORM ASSOCIATES INC. PAGE 02/02
_ BCJRM
STRUTE CXURALJOB SIOHSZRVATION `�� STNUOTURAe. ENOINEEPS
Protect Name: G L v Project Number: (r"Z-
Obsetver.&y mate of Observation:_,
V
A visit to the project site was made on the above date to:
0 Address specific elements of the work.
AAssist the field personnel with complying with the intent of the con"mcgon documents.
0 Assist the Field personnel with complying with the findings from a previous structural job site observation.
O
At the daft of our visit, worts had progressed to the point of :
Pbonec 714-513.7500
F= 714-S 13.7555
Phases
Pbone: 916-774-7597
Adm:
/- 57r/ -,(ZS'
EAST
e2�$rL ,.nCEGe,eci3D2
LAS VEGAS, NEVADA
Phones: 702-740-5427
Bldg. / Lot Numher:
{ '
Pboae: 623.669-0607
Fax: 623-6694)609
Bldg. / Plan Type elk Elevation:
Foundation Trenched
re/
0
0
❑
p
Foundation Poured
��
❑
o
❑
❑
Roof Sheathng.Covered
t�/
O
O
0
0
Roofing Material Slodced and Loaded
fl/
0
❑
❑
0
Exterior walls Covered
0
❑
❑
0
❑
Interior Wali Covered
0
❑
❑
0
0
Insulation Installed
0
❑
0
0
0
Bleurical, Mechanical, Plumbing Complete
0
❑
❑
❑
0
Final Framing Pick-ups Completed
0
0
❑
0
❑
Building Complete
0
0
❑ '
0
0
Based upon our visit -
13 Refer to the attached field notes to bo addressed by the constmetion personnel.
O Additional information will be sant from our office which will need to be addressed by the construction personnel.
It is our opinion that this building is being constructed in gen ral confbtmance with the intent of the construction documents prepared by
our office.
0 Site Observation ceased, fanning was not at a stage of completion in which site observation could be performed.
a Concerns brought to the Mention of field pe rectmel based on previous site observation made on have yet to be addressed.
Conmaents: � A�t=D �a �� tlLr�tlFlErb���,�@� N/'�4GC"�/t 4��tS/
Please note:
Our findings and recommendations tray have other than structural raniflestions which we have not addressed. Be advised that changes to the
construction documents need approval of the building official. Our firm is not emthorized to act as the OeemWa agent. Our findings shall not be
conserved as anthoriZing the tccpenditnro of additional fonds.
Site Observation was made only to dchmnine general conformance with the inf I of the construction doh. Observation was made of those
portions of rho wndt whieb would beet repremn the intent of Ote conennetion documents, not each and every clement of the work. Site observation
did not include review, approval or observation o4 among other iteum:
1. The contractors safety precautions, procedures, designs, methods or techniques.
2. Arq shaea& scaffolding, underpinning, temporary retaining of excavations, or atgr otber erection methods at temporary bracing.
3. Any soils at the sift, their adequacy to support the building, expansivones% or any other oil related conditions.
4.. Any drainage courses or devises of a temporary nanne or as a permanent part of the structure, including roof and floor elopes, drains and
Pipes,
The findings of this obsuvadon eine undmtood to be an expa¢ssion of professional opinion by the engineer based or his QggFESS�
inforoation and belieE An such, it eolm3ft of nManor a wwrmfee expressed or implied.Field Superintendent (third copy) Data la �'
Client (second copy via mato -37096
Plod Engineer (fiat COPY) i irk / Date* -/d f"o x/30706 �
If you Tune mW gmfloas please contact our office.
COSTA MESA, CALIFORNIA
Pbonec 714-513.7500
F= 714-S 13.7555
ROSEVtiiJ;, CALIFORNIA
Pbone: 916-774-7597
Fac 916.774.7599
P18A8 MUN, CALIFORNIA
Phos. 92SA74-1180
Fos: 925.067.1760
LAS VEGAS, NEVADA
Phones: 702-740-5427
Fac: 702-74OM31
PHOENIX ARIZONA
Pboae: 623.669-0607
Fax: 623-6694)609
I
:. G -1. -VO -LA_ t I NTA
BUILDING & SAFETY " ARTMENT
C ✓ t7112r,70 (�
�NP-EiCT.I. , RE ! U .ST LINE
Owner NADADOR, LZC"•'---'�
Contractor PETER JACOBS HOMES
Permit Number 05-3640
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 54-125 EAST RESIDENCE CLUB
SFD — LOT 22, PLAN CR. PERMIT DOES NOT
INCLUDE POOL, SPA, BLOCK WALLS OR
DRIVEWAY APPROACH
TYPEOF INSPECTION DATE INSP.
TEMPORARY POWER
SETBACKS
U/G PLUMBING / WASTE/2- 116 or- "
U/G ELECTRICAL / GROUNDING
FOOTINGS'/ STEEL
CONCRETE SLAB zD
DO NOT POUR CONCRETE UNT L ABOVE SIGNED
ROOF NAIL / PRE -ROOF 3
OKAY TO WRAP
FRAMING COMBINATION
ROUGH ELECTRIC
ROUGH .PLUMBING
` ROUGH MECHANICAL
INSULATION
COVER NO WORK UNTIL AROVESIGNED
INTERIOR GYP. BD. (DRYWALL)-
EXTERIOR
DRYWALL EXTERIOR LATH
GAS TEST
SEPTIC ABANDONMENT
SEWER CONNECTION L3
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 I f, p -- o
ELECTRICAL
PLUMBING
MECHANICAL
PUBLIC WORKS DEPARTMENT
COMMUNITY DEVELOPMENT DEPT. ( O , - O
FINAL./ JOB COMPLETED J - .$-
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
Certificate' ®f Occupancy
r 2
•
�- e,a: Inc•_.>,z� -�'
G��>1 0�9w. 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: 54-125 EAST RESIDENCE CLUB DR
Use classification: SFD Building'Permit No.: 05-3640
Occupancy Group: R3 Type of Construction- VN Land Use Zone: RM
Owner of Building: NADADOR, LLC Address: 78120 CALLE ESTADO, SUITE 203
City, ST, ZIP: LA QUINTA CA 92253
By: DAVID GATICA
Date: 1-8-07
Bui ding Officla
POST IN A CONSPICUOUS PLACE