05-4836 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
05-00004836
80205 NORTH RESIDENCE CLUB DR
775-380-999-20 -31627 --
DWELLING - SINGLE FAMILY DETA
MEDIUM DENSITY RES
287914
11_�Chitect or Enginee
7 rya
--------------------
ENSFD CONT CTOR'S DECLARATION
I hereby affirm under penalty ofperjuryt I a licensed n er provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busi s an rofes ' s Code, and my License is in full force and effect.
Licen Class: B LicenseNo.: 799449
,Date: / ��IL tractor.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt 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).:
(_ 1 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 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.).
(_ 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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
(_) I am exempt under Sec. , B.&P.C. for this reason
Owner:
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Date:
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 ISec. 3097, Civ. C.1'.
Lender's Name: n
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011 .
INSPECTIONS (760) 777-7153
Date: 10/31/05
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
WORKER'S 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 and policy number are:
Carrier HRH INSUR P 'cy Number 176983305.
I certify that, in the perfor/Iallrk for w ' this permit is issued, I shall not employ any
person in any manner ssubject a workers' compensation laws of California,
and agree that, if I shoc to - orkers' compensation provisions of Section
3700 of the Labor Cody with those provisions.
pplicant:
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.
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 per , or cessation of work for 180 days will subject
permit to cancellation. '
I certify that I have read this application and state that the inf rmation ' rrect. I agree to comply with all
city and county ordinances and state laws relating to buildi s uctio ereby authorize representatives
of this=countyenter�upo a above-mentioned grope r in io p es.
ignature (Applicant or Agent):
�2
LQPERMIT
Application Number
05-00004836
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
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
4/29/06
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
4/29%06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
4'.00 9.0000
EA MECH FURNACE <=100K
36.00
9.0000
EA MECH B/C <=3HP/100K BTU
36.00
12.00 6.5000
EA MECH VENT FAN
78.00
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
Expiration Date
4/29/06
-Qty Unit Charge
Per
Extension
BASE FEE
15.00
3365.00 .0350
ELEC NEW RES - 1 OR 2.FAMILY
117:7.8
LQPERMIT
LQPERMIT
Application Number .
. . . . 05-00004836
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
4/29/06
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'
15.00
Permit GRADING PERMIT
Additional desc .
Permit Fee
15.00 Plan Check Fee:.
.00
Issue Date
Valuation
0 .
Expiration Date
4/29/06
Qty Unit Charge
.Per
Extension
BASE FEE
15.00
------------------------------------- --------------------------------------
Special Notes and Comments
SFD = LOT 20, 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
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
LQPERMIT
Application Number
05-00004836
---------------------.------------------------------------
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
05/15/2006 11:10 7145137555
H OR,
May 16, 2006
BORM ASSOCIATES INC.
PAGE 01/01
STRUCTURAL ENGINEERS
Mr. Peter Jacobs
Nadador, LLC
78-120 Calle Estado, #203
La Quinta, CA 92253
Re.: Framing - Lots 20, 21, Phase 7
Lot 20;_80-205 North Residence Club _Drive
Lot 21: 80-225 North Residence Club Drive
Subj.: Opinion of Construction
Dear Mr.r Jacobs;
VISAS were made to observe the work and determine if it was in general
conformance with the intent of the construction documents as prepared by our office.
Reports were provided to your firm detailing deviations from what the construction
documents had intended and recommendations were made as necessary to
remediate these deviations.
Based on our observations, it is our opinion that framing`for Lots 20 and 21, Phase 2
was constructed in general conformance with the intent of the construction,
documents prepared by our office.
The content of this letter is understood to be an expression of professional opinion by
this engineer which is based on his/her best knowledge, information and belief. As
such, it consists of neither, a guarantee nor a warrantee expressed or implied,
If you have any questions, please contact us.
Very truly yours,
BORM ASSQ4IATES, NC. �� pn
"I
Mohalhmad Douroudian
Director, Field Operations
jaa;/5424 051606 Opin of Construction Frm Ph 7
cc: (3) Addressee via mail
(1) Craig Williams via Fax (760) 777-9923
(1) File # 5424
C.nalj) Mvt;u, CA
Wtim;to, CA
PI—ronlou, CA
Hosp4lu, CA
Lus Vcyns, NV
Phoenix, AZ
Turnnn, A/
oonver, Co
Heglna, PRG
1
e rtl �l cra-e•� � •�� c c u a n c •,� , -
o'FT����puildinga &Safety Department - - •_
-_This. Certificate is issued pursuant to• the requirements of Section ,1,09 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 d the various ordinances• of the City regulating building
construction and/or use.
BUILDING ADDRESS: 80-20.5 NORTH RESIDENCE CLUB DR •
Use classification: SFD -' • .-Building Pe rmit,No.: 05-4836
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
V ` •- By: DAVID GATICA -
Date: 2-22-2007-
-22-2007•Building
BuildingOfficial . - -
• •i':,;,� '.• POST IN A CONSPICUOUS PLACE
1