12-1240 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
°f �wa�rw
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 12-00001240
Property Address: 80085 NORTH RESIDENCE CLUB DR
APN: 775-380-999-9 -31627 -
Application description: DWELLING - SINGLE FAMILY DETACHED
Property Zoning: MEDIUM DENSITY RES
Application valuation: 294537
Owner:
NADADOR, LLC
78120 CALLE ESTADO, SUITE 203
LA QUINTA, CA 92253
Contractor:
Applicant: Architect or Engineer: JACOBS HOMES INC, PETER
P.O. BOX 692 -
LA QUINTA, CA 92247
U SED ClN RACTOR'S DECLARATION
I hereby affirm under penalty of perjury the am Iicens � under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busine n Prof s' nals Code, and my License is in full force and effect.
Licens Class: B
License
799449
ate: lV �e/�L ntractor:
OWN .BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exe pt from the Contractor's 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 Contractor's 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).:
(_) 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 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.).
(_) 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. , 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
(760)
Lic. Noo..:: 799 799449
i
VOICE 760' f 1112
FA �'" x'777 011
INSPECTIOT'.�'( -7153
Date: 10/18/12
P
°
OCT 3 o 2012
CITY OF LA QUINTA
FINANCE DEPT.
WORKER'S COMPENSATION DECLARATION
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.
1�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 and policy number are:
Carrier STATE FUND Policy Number 90136332012
I certify that, in the.performa a of the work for which this permit is issued, I shall not employ any
person in any manner so to ecome s ject to the workers' compensation laws of California,
and agree that, if I shou a me s t to the workers' compensation provisions of Section
3700 of the Labor Cod 11 o h comply with those provisions.
8'5te: 7 //A ' ant:
VO
WARNING: FAILURE TO SECURE ORKERS' CO PENSATION 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.
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 abov fo matio i correct. I agree to comply with all
city and county ordinances and state laws relating to building st ction, hereby authorize representatives
of thic m
s y to enter upon the above-mentioned property fo ' s tion oses.
te: 10� /7� ure (Applicant or Agent):
Application Number . . . . . 12-00001240
Structure Information
Construction Type . .
. . . TYPE V - NON RATED
Occupancy Type . . .
. . . DWELLG/LODGING/CONG <=10
Flood Zone . .
NON -AO FLOOD ZONE
Other struct info . .
. . . CODE EDITION
2010 cbc
# BEDROOMS
3.00
FIRE SPRINKLERS
yes
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
843.38
'Issue Date . . . .
Valuation . .
. . 287914
Expiration Date
4/16/13
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
42.88
'Issue Date
Valuation . .
. . 0
Expiration Date
4/16/13
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
1.0.0 6.5000
----------------------------------------------------------
EA MECH EXHAUST HOOD
------------------
6.50
Permit ... . ELEC-NEW RESIDENTIAL
Additional desc .
Permit Fee
145.60 Plan Check Fee
36.40
Issue Date . . . .-
Valuation . .
. . 0
Expiration Date
4/16/13
Qty Unit Charge
Per
Extension
BASE FEE
15.00
3365.00 .0350
ELEC NEW RES - 1 OR 2 FAMILY 117.78
LQPERMIT
Application Number .
. : . . 12-00001240
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
46.31
Issue Date . . . .
Valuation . . . .
0
Expiration Date
4/16/13
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/AL'T/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
Expiration Date
4/16/13
Qty Unit Charge
Per
Extension
`
BASE FEE
=----------------------------
-15.00
-----------------------------------------------
Special Notes and Comments
SFD - LOT 9, PLAN A,
3365 S.F. PERMIT
DOES NOT INCLUDE POOL,SPA,BLOCK
WALLS,
OR DRIVEWAY APPROACH.
2010 CODES.
EXISTING SLAB - SEE OLD
PERMIT #
05-4841.
----------------------------------------------------------------------------
Other Fees .. . . . .
. . . . BLDG STDS ADMIN (SB1473)
12.00
ENERGY REVIEW FEE
84.34
MULTI -SPECIES (MSHCP) FEE
1254.00
Fee summary Charged Paid Credited
--------------------
Due
---------------------------
Permit Fee Total
-----------
1814.85 .00 .0.0
1814.85
Plan Check Total
968.97, .00 .00
968.97
Other Fee Total
1350.34 .00 .00
1350.34
LQPERMIT
LQPERMIT
Application Number . . . . . 12-00001240
1 -
Grand Total 4134.16 .00 .00 4134.16
PROUDLY SERVING THE
UNINCORPORATED AREAS
OF RIVERSIDE COUNTY
AND THE CITIES OF:
BANNING
BEAUMONT
CALIMESA
CANYON LAKE
C OAC H ELLA
DESERT HOT SPRINGS
EASTVALE
INDIAN WELLS
INDIO
LAKE ELSINORE
LA QuINTA
.MENIFEE
MORENO VALLEY
PALM DESERT
PERRIS
RANCHO MIRAGE
RUBIDOUx CSD
SAN JACINTO
TEMECULA
WILDOMAR..
BOARD OF
SUPERVISORS:
BOB BUSTER
DISTRICT 1
JOHN TAVAGLIONE
DISTRICT 2
JEFF STONE
DISTRICT 3
JOHN BENOIT
DISTRICT 4
MARION ASHLEY
DISTRICT 5
Y-
RIVERSIDE COUNTY FIRE DEPARTMENT
r` IN COOPERATION WITH
THE CALIFORNIA DEPARTMENT OF FORESTRY AND FIRE PROTECTION
77-933 Las Montanas Rd., Ste. #201, Palm Desert, CA 92211-4131 • Phone (760) 863-8886
• Fax (760) 863-7072
www.rvcfire.org
December 11, 2012
Holland Fire
1600 Meadowlark Ways-=—`---'
Roseville, CA 95661
Re: Residential Fire Sprinkler Plan Review
LAQ-12-RS-064 The Residence 80-85 N. Residence Club Dr. La Quinta, CA
The sprinkler plans you submitted for the above referenced project have been reviewed by
Riverside County Fire Department Planning & Engineering personnel and are approved with
the following conditions:
NOTE: As required by the State of California Business and Professions Code
and the Contractors State Licensing Board (CSLB) only a C-16 Fire Protection
Contractor may install fire sprinklers.
A.minimum of three spare fire sprinklers of each type and temperature rating along with a
sprinkler wrench should be located in a spare head cabinet at the system riser or other
approved location.
Permanently. marked identification signs shall be attached to all control valves.
The completed Contractor's Material and Test Certificate for Aboveground Piping shall be
provided to the fire inspector prior to a final inspection. A typical certificate is shown in Figure
10.10.1 NFPA13.
A warning sign, with minimum Y< inch letters, shall be affixed adjacent to the main shutoff valve
and shall state the following:
WARNING: The water system for this home supplies fire sprinklers that require certain flows and pressures to fight a
fire. Devices that restrict the flow or decrease the pressure or automatically shut off the water to the fire sprinkler
system, such as water softeners, filtration systems, and automatic shut-off valves, shall not be added to this system
without a review of the fire sprinkler system by a fire protections specialist. DO NOT remove this sign.
The following inspections/tests are required to be witnessed by the Fire Department Planning
Division staff:
(a) Overhead Rough and Hydro static test: All piping shall be visible and
pumped at normal operating pressure.
(b) Final inspection. .
The Fire Department job card, approved plans and conditions letter must be at the job site or
NO inspection will be. performed. Applicant/installer shall be responsible to contact the Fire
Department to schedule inspection(s) a minimum of 72 hours prior to the requested. inspection
date.
All questions regarding the meaning of these conditionsshould be referred to the Fire
Department Planning & Engineering staff at (760) 863-8886.
Applicant/installer shall be responsible to contact the Fire Department to schedule inspection.