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04-8365 (SFD)d BUILDING & SAFETY DEPARTMENT. �B6 - (7,60).777-7012 495 ��jL AnMsPI '� FAX (760) 777-7011 QUp0' �A3L� �R 2253 INSPECTION REQUESTS (760) 777-7153 CITY 00 LA Q4 INTA F1ANC oEr T_ B__. ING PERMIT Application Number . . Property Address:.. APN: Application description Property Zoning . . . . . Application valuation . . %04-00008365 ,.Date 4/05/05 54525 EAST RESIDENCE CLUB"DR 775-390-999-29 -31627 - DWELLING - SINGLE FAMILY DETACHED MEDIUM DENSITY RES 287914 Owner Contractor NADADOR, LLC JACOBS.HOMES INC, PETER 78120 CALLE ESTADO, SUITE 203 P.O. BOX 692' _ 0 U d BUILDING & SAFETY DEPARTMENT. �B6 - (7,60).777-7012 495 ��jL AnMsPI '� FAX (760) 777-7011 QUp0' �A3L� �R 2253 INSPECTION REQUESTS (760) 777-7153 CITY 00 LA Q4 INTA F1ANC oEr T_ B__. ING PERMIT Application Number . . Property Address:.. APN: Application description Property Zoning . . . . . Application valuation . . %04-00008365 ,.Date 4/05/05 54525 EAST RESIDENCE CLUB"DR 775-390-999-29 -31627 - DWELLING - SINGLE FAMILY DETACHED MEDIUM DENSITY RES 287914 Owner Contractor NADADOR, LLC JACOBS.HOMES INC, PETER 78120 CALLE ESTADO, SUITE 203 P.O. BOX 692' LA QUINTA CA 92253 LA QUINTA CA 92247 (760) 777-9921 WCC: HRH INSUR WC: 176983304 06/01/05 CSLB: 799449 04/30/05 CCC: B -------------------=------ 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 Qty Unit Charge Per Extension BASE FEE 639.50 188.00 3.5000 THOU BLDG 100,001-500,000 r: 658.00 ----.--------------------------------------------------------•-,--------------- Permit . . ... . . MECHANICAL Additional desc - .Permit Fee 171.50 Plan Check Fee 10.-72 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 12.00 6.5000 EA MECH VENT FAN 78.00 P.O. Box 1504 • :�I ��I VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 4INSPECTIONS (760) 777-7153 .BUILDING & SAFETY DEPARTMENT Application Number: 0q— 83(o SDate:g • � Applicant: I Architect or Engineer: Z� . O C Applicant's Mailing Address: U IV— or Engineer's Address: tic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed udder provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License ' 'n full force and effect. a Class ense No. 1___ Date J 2!0 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 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 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.). L) 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 followingi 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 I j i ue I y workers' compensation�llranoe carrier and polic n er are: \ 1�=v �^ c ✓Policy Number Z � (o _ 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 :hat, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, 1 shall forthwith comply with those provisions.. L ate 2 [ Vr Applicant�t%L}D�$j�� 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 cons -ruction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's 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 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 state laws relating to building constructio ,and hereby authorize representatives of this county to re,pon 7;the�-!entioned property for inspection purposes. (0�_�Sgnature (Applicant or Agent): t � ray,, {dr '�i' Application Number . . . . . 04-00008365 Page 2 Date 4/05/05 Qty Unit Charge Per Extension 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 ---------------------------------------------------------------------------- Permit . ... . . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee . . . . 145.60 Plan Check Fee 9.10 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per' Extenss'16 BASE FEE 15:00 3365.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 117.78 641.00 .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 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 T.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 15.00 -------------------------------------------------------------- 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 --------------------------------------_------------------.-------------------- Special Notes and Comments SFD - LOT 29, PLAN BR. 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 ---------------------------------------------------------------------------- Other Fees . . . . . .. . ART IN PUBLIC PLACES -RES 222.74 DIF COMMUNITY CENTERS -RES 97.00 r� ,s Page 3 Application Number 04-00008365 Date 4/05/05 ---------------------------------------------------------------------------- Other Fees . . . . . 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 502.0'0 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 Cali ,- Certificate of Occupanc0 Y I'll LHCO"ON c� OF'I9� 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. 1 • { a BUILDING ADDRESS: 54-525 EAST RESIDENCE CLUB DRIVE a Use classification: SINGLE FAMILY DWELLING Building Permit No.: 04-8365 Occupancy Group: R3 Type of Construction: V -N Land Use Zone: RM 3 ,. Owner of Building: NADADOR, LLC Address: 78-120 CALLE ESTADO, STE. 203 City, ST, ZIP: LA QUINTA, CA 92253 - By: GARY HARTMAN Date: FEBRUARY 28, 2006 Building Official POST IN A CONSPICUOUS PLACE