12-0819 (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:
112'-00000.8 9. _r
.81891 SEABISCUIT WY
767-200-999-40 -312023-
DWELLING - SINGLE FAMILY
LOW DENSITY RESIDENTIAL
185633
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
DESERT CHEYENNE, INC. Y
78401 HIGHWAY 111
DETACHED LA QUINTA, CA 92253
Architect or Engineer:
aIP
Contractor:
GJH DEVELOPMENT INC
27636 YNEZ ROAD C7
TEMECULA, CA 92591
(760)578-3545
Lic. No.: 916227
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/30/12
e
AUG 2 0 2012
CITE`( OF t -P` ®coY1 H 1
-------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
-------------------------------------
WORKER'S COMPENSATION DECLARATION _
• I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
1 hereby affirm under penalty of perjury one of the following declarations: -
Section 7000) of Division 3 of the Business and Professionals Code, 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 License No.: 916227
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
Date: Contractor: -
_ 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
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier EMPT ' . Policy Number . EXEMPT
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
I certify that, in the perf a ce of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner to become subject 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 sho ecome subject 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
X700 of the Labor Co
,, hall forthwith 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).:
(_ 1 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 de: The Contractors' State License Law does not apply to an owner of
property who builds or improves h n, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' Stat Li nse Law.l.
(_) I am exempt under Sec. , I P .for this reason
Date:
ONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that therq 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
44-
WARNING:
4
WARNING: FAILURE TO SECURE WOR ERS' 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 applicati n becomes null and void if work is not commenced
within 180 days from date of issuance of s..h rmit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that 1 have read this application and state thlbdi
a information is correct. I agree to comply with all
city and county ordinances and state laws relating tonstruction, and hereby authorize representatives
of this co ty to nter u/port the above-mentioned prnspection purposes.
Date: / nature (Applicant or Agent):
Application Number .
. . . . 12-00000819
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
2010 CBC
# BEDROOMS
3.00
FIRE SPRINKLERS
YES
GARAGE SQ FTG
634'.00
PATIO SQ FTG
263.00
NUMBER OF UNITS
1.00.
1ST FLOOR SQUARE FOOTAGE
2863.00
Permit . . .
BUILDING PERMIT
Additional desc .
Permit Fee . . . .
940.50 Plan Check Fee
611.33
Issue Date . . .
Valuation . . .
. 185633
Expiration Date
1/26/13
Qty Unit Charge
Per
Extension
BASE FEE
639.50
86.00 -3.5000
7
THOU BLDG 100,001-500,000
01.00-
301.00-
Permit MECHANICAL
Additional desc .
Permit Fee
90.00 Plan Check Fee
5.63
Issue Date . . . .
Valuation
0
Expiration Date
1/26/13
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00 9.0000
EA MECH FURNACE <=100K
18.00
2..00 9.0000
EA MECH B/C <=3HP/100K BTU
18.00
5.00 6.5000
EA MECH VENT FAN
32.50
1.00 6.5000
----------------------------------------------------------------------------
EA MECH EXHAUST HOOD
6.50
Permit . . . ELEC-NEW RESIDENTIAL
Additional desc
Permit Fee . . .
127.89 Plan Check Fee
7.99
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
1/26/13
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2863.00 .0350
ELEC NEW RES -.1 OR 2 FAMILY
100.21
LQPERMIT
Application Number .
. . . . 12-00000819
Permit . . . . ELEC-NEW RESIDENTIAL
Qty Unit Charge
Per
Extension
634.00 .0200
ELEC GARAGE OR NON-RESIDENTIAL
12.68
Permit_ . . . PLUMBING
Additional desc .
Permit Fee . . . .
172.50 Plan Check Fee
10.78
Issue Date
Valuation.
0
Expiration Date
1/26/13
Qty Unit Charge
Per
Extension.
BASE FEE
15.00
17.00 6.0000
EA PLB FIXTURE'
102.00
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
8.00 .7500
EA ."'PLB GAS PIPE >=5
6:00
1.00 15.0000
EA PLB GAS METER
15.00
Permit GRADING PERMIT
Additional desc .
Permit Fee . . . .
15.0.0 Plan Check Fee
.00
Issue Date . . .
Valuation . . .
0
Expiration Date
1/26/13
Qty Unit Charge
Per
Extension
BASE FEE
15.00
----------------------------------------------------------- 7 ----------------
Special Notes and Comments
SFD - LOT 40, PLAN 3B,
2863 SF. PERMIT
DOES NOT INCLUDE POOL,
SPA, BLOCK WALLS
OR DRIVEWAY APPROACH.
7596 REDUCTION TO
PLAN CHECK FEES DUE TO
MULTIPLE ISSUANCE
OF SAME PLAN TYPE. 2010
ENERGY CODES
---------=------------------
Other Fees . . . . .
-------------------------=----------------------
. BLDG STDS ADMIN (SB1473)
1.00
DIF COMMUNITY CENTERS -RES
104.00
DIF .CIVIC CENTER - RES
1089.00
ENERGY REVIEW FEE
61.13
DIF FIRE PROTECTION=RES
612.00
DIF LIBRARIES - RES
334.00
MULTI -SPECIES (MSHCP) FEE
1254.00
DIF PARK MAINT FAC - RES
51.00
DIF PARKS/REC - RES
1773.00
LQPERMIT
Application Number
12-00000819
---------------------------------------------------------------------------
Other Fees
. . . .
-
STRONG MOTION (SMI) RES
18.56
DIF STREET MAINT FAC -RES
158.00
DIF TRANSPORTATION - RES
3592.00
Fee summary
Charged
Paid Credited.
Due
Permit Fee Total
1345.89
.00 .00
1345.89
Plan Check Total
635.73
.00 .00
635.73 -
Other Fee Total,
9047.69
.00 .00•
9047.69
Grand Total
11029.31
.00 .00
11029.31
LQPERMIT
Building Permit Number.
Project Description: SFR
Exempt 0
(Meterlals may contain hazardous wastes and
aro not at'l3ject to recycling provisions)
Construction Debris Management Plan
Plan Submittal Da 8/8/2012
Job Site Add 81807 Ave. 52
Owner's Nami
Number, Streek or PO Be
City, State, Postal Cod
Owners Phone Numbe
Ownses E -Mali Addres;
Project Manager's Nam
Project Manager's Phone Numbr
Project Managers Email Addres
Bulkier / Contracto
Number, Street or PO So
City, State, Postal Cod
Project Square Footag
City Approval By
Dab of City Approval
Materials To Be Discarded:
John Pedalino
78401 Hwy 111, Unit X
La Quinta, CA 92253
760-678.6915
Silver Castro
619.495,4624
john0thelandatewards.com
Desert Cheyenne, Inc.
78401 Hwy 111, Unit X
La Quinta, CA 92253
8,326 —�
Product
I
Tons
Trash
15.82 Not recyclable
Product
Asphalt
0.00 Recyclable
Masonry (broken)
Brick/Block
0.00 Recyclable
Plaster
Cardboard
2.75 Recyclable
Scrap Metal
Commingled
0.00 Recyclable
Tile (floor)
Concrete
0.67 "dabie
Tile (roof)
Drywall
0.49 Recyclable
Wood
Donated / Reuse*
0.00 Recyclable
Landscape Debris
*Describe Items I
Totals: Recycle Trash ProJected Diversion:
27.8 15.8 63.7Y.
I understand It Is the property ownses rssponsiblpty to submit copies of weight tickets or receipts to the District
Environmental coordinator as these hauls occur. l hereby certify that completion. Implementation and adherence of the
Debris Management Plan (OMP) for the above named project shall guarantee that at bast 50% of the jobalte waste is diverted
from landfilling. The remalNng material will be recycled or reused. I will divert, for recycling or re -use, rmnalning materials
generated from the first day of the project through the completion of the project in accordance with thio plan. This DMP Is
Issued In the name the property owners) and shag remain their property throughout the construction and/or demolition
project A contractor rving se agent of the owner may obtain a OMP for the owner. However, the DMP is still issued In the
name of the property a) and the owner retalrte legal responsibility for anaubtg that the provisions of the DMP aro adhered
to. The property owner d general contractor shall be kept informed of the diversion progress through bknonthy reports. N
serf -hauling, all refuse m rid from this project alto must be taken to an approved racyder �cr7er station.
V t,
,t
Owner / Developer / Pr" Manager / Superintendent Da
PROUDLY SERVING THE
UNINCORPORATED AREAS
OF RIVERSIDE COUNTY
AND THE CITIES OF:
BANNING
BEAUMONT
CALI M ESA
CANYON LAKE
COAC H E LLA
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
RIVERSIDE COUNTY FIRE DEPARTMENT
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.rvcfiee.org
July 9, 2012
Symons Fire Protection
1050 Pioneer Way Suite R
EI Cajon, CA 92020
Re: Residential Fire Sprinkler Plan Review
LQ -12 -RS -042 Rancho Santana Model Home Plan #3
81-891 Seabiscuit Way 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:
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. Atypical certificate is shown in Figure
10.10.1 NFPA13.
A warning sign, with minimum '/ 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) Fire Riser Flush: Prior to connection of above ground sprinkler system a
flush shall be witnessed.
(b) Overhead Rough and Hydro static test: All piping shall be visible and
pumped at normal operating pressure.
(c) 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 conditions should 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.
Sincerely,
Jason tubble
Fire Safety Specialist