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05-4833 (SFD)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T,it!t 4 4& Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 05-00004833' Property Address: 53581. VIA BELLAGIO APN: 772-510-049- - - Application description: DWELLING - SINGLE FAMILY DETACHED D Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 404.728 Applicant: Architect or Engineer: Lic. No.: OOR SQUARE FOOT Owner: AL HILDE JR —_ENIUM LANE NORTH e JAN 2 7 2006 9 ..— GUMETTE CONSTRUCTION INC WY OF LAQUIIN7A743 FINANCE CEpT 0 HIGHWAY 111 DESERT, CA 92260 (760)346-3248 Lic. No.: 280103 -------------------------------------------------- LICENSED CONT CTOR'S DECLARATION I hereby affirm under penalty of perjury that .a license er provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Busines a Proles on s Cod and my License is in full force and effect. License Class: B Lice 280103 Date: Contractor: _ 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 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—) 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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/26/96 ----------------------------------------------- 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 STATE FUND ' Policy Number 0008398-2006 _ 1 certify that, in the performance of the work for w ' h this permit is issued, I shall not employ any person in any manner so aro become subjec to he workers' compensation laws of California, and agree that, if I shout a me subject to h workers' compensation provisions of Section 3700 of the Labor Code, 1 all forthwith co Iy with ovisions. Date: ^ �- —0.4 Applicant: WARNING: FAILURE TO SECURE WOR S' 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 Ouinta, 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 Ihave read this application and state that the above' formatigicorect. I agree to comply with all city and county ordinances and state laws relating to building n ruction,eby authori eof this county to enter upon the above-mentioned property fo ' pection p Date:�^i.6-0 Signature (Applicant or Agent): Application Number . . . . 05-00004833 Permit . . . . . BUILDING PERMIT Per Additional desc . Extension ---------------------------------------------------- Permit Fee . . . . 1707.00 Plan Check Fee 1109.55 Issue Date . . . . MECHANICAL Valuation . . . . 404728 Expiration Date 7/25/06 Qty Unit Charge Per . . Extension Plan Check Fee BASE FEE 639.50 305.00 3.5000 --------------------=------------------------------------------------------- THOU BLDG 100,001-500,000 1067.50 Permit . . . ELEC-NEW RESIDENTIAL Additional desc . Qty- Unit Charge Per Permit Fee . . . . 210.98 Plan Check Fee 52.75 Issue Date . . FEE Valuation . . . . 0 Expiration Date 7/25/06 FURNACE <=100K 54.00 Qty Unit Charge Per EA MECH Extension 54.00 BASE FEE 15.00 4712:00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 164.92 803.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 16.06 1.00 15.0000 ---------------------------------------- EA ELEC TEMPORARY POWER POLE --=-------------------------------- 15.00' Permit . . . . . GRADING PERMIT Additional desc . Permit Fee . . . . 15.00 Issue Date Expiration Date 7/25/06 Plan Check Fee . . .00 Valuation . . . . 0 Qty Unit Charge Per Extension ---------------------------------------------------- BASE FEE ------------------- 15.00 Permit . . . MECHANICAL Additional desc .. Permit Fee . . . . 181.50 Plan Check Fee 45.38 Issue Date . . . . Valuation . . 0 Expiration Date 7/25/06 Qty- Unit Charge Per Extension BASE FEE 15.00 6.00 9.0000 EA MECH FURNACE <=100K 54.00 6.00 9.0000 EA MECH B/C <=3HP/100K BTU. 54.00 8.00 6.5000 EA MECH VENT FAN 52.00 1.00 ---------------------------------------------------------=------------------ 6.5000 EA MECH EXHAUST HOOD 6.50 LQPMNIIT Application Number . . . . . 05-00004833 Permit . . . . . . PLUMBING Additional desc . Permit Fee . . . . 245..25 Plan Check Fee.. 61.31 Issue Date Valuation . . . . 0 Expiration Date 7/25/06 Qty Unit Charge Per . Extension BASE FEE 15.00 26.00 6.0000 EA PLB FIXTURE 156.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 1.00 6.0000 EA PLB ROOF DRAIN 6.00 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 15.00 ..7500 EA PLB GAS PIPE >=5 11.25 1.00 15.0000 EA PLB GAS METER 15.00 ---------------------------------------------------------------------------- Special Notes and Comments• 4712 SQ. FT. SFD. THIS PERMIT DOES NOT INCLUDE POOL & SPA BLOCK WALLS OR DRIVEWAY. APPROACN.January 19, 2006 2:30:23 PM JJOHNSON. 803SQ. FT. A/C GARAGE ------------------------------------------------------------ Other Fees . . . . .. --------------- . . . . ART IN PUBLIC PLACES -RES 511.82 DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER - RES 480.00 ENERGY REVIEW FEE 110.96 DIF FIRE PROTECTION -RES 140.00 GRADING PLAN CHECK FEE .00 DIF LIBRARIES - RES 355.00 DIF PARK MAINT FAC - RES 22.00 DIF PARKS/REC - RES 892.00 STRONG MOTION (SMI) - RES 40.47 DIF STREET MAINT FAC -RES 67.00 DIF TRANSPORTATION - RES 1666.00 Fee summary Charged Permit Fee Total 2359.73 Plan Check Total 1268.99 Other Fee Total 4359.25 Grand Total 7987.97 LQPERn1IT Paid Credited Due .00 .00 2359.73 750.00 .00 518.99 .00 .00 4359.25 750.00 .00 7237.97 � n Building Address OO O 2�L�[s f-- It i"'m P0 ZiP Con ctor V1�a7s Address -7 3o o 5W9 Z19� z6o State Lic. & Classif. Arch., Engr., Designer Address Tel. c&tT 4 4 " 06-- 3 P.O. BOX 1504 APPLICATION ONLY ,U C CALLE O QUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST. OCC.'GFIR ;Gs �1q� A.P. Number a _ fi� —p�0 7' / Tel. Legal Description 9�2 - y9 34/9 C Project Description ­� c, 3 2 v City Lic. # /00 ` Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that he 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 Profes- sions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or, im- provement is sold within one year of completion, the owner -builder will have the burden of proving that he 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 Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKER'S COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less). 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 Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT. If, after making this Certificate of Exemption you should become subject to the Workers' Compensation Provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. 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 construction, and hereby authorize representatives of this city to enter the above-mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip WHITE = BUILDING DEPARTMENT ISq. Ft.(���D No. No. Dw. coo Q+„ i- 1 mite New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. 4 Infrastructure Ciry FINA _ QUIN TOTAL pr REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE Issued by: Validated by:— Validation: YELLOW = APPLICANT INSPECTOR Date Permit PINK = FINANCE Coachella Valley Unified School District 83-733 Avenue 55, Thermal, CA 92274 (760) 398-5909 — Fax (760) 398-1224 This Box For District Use Only DEVELOPER FEES PAID AREA: - AMOUNT LEVEL ONE AMOUNT: LEVEL TWO AMOUNT: MITIGATION AMOUNT: COMM/INID. AMOUNT: - DATE: RECEIPT: CHECK #: INITIALS: CERTIFICATE OF COMPLIANCE (California Education Code 17620) Project Name: Al Hide Jr. (Resi_dence_@ The Hideaway) Date: January 27, 2006 Owner's Name: Al Hide Jr. Phone No. (760) 346-3248 Project Address: 53-581 Via Bellago Project Description: 1 Single Family Residence APN: 772-510-043 Tract #: Type of Development: Residential XX Commercial Lot #'s: Industrial Total Square Feet of Building Area: 4,717 sq. Ft. Certification of Applicant/Owners: The person signing certifies ffiatthe above informQon s correct and makes this statement underpenalty of perjury and further represents that he/she is authorized o sign on behalf of ther/developer. Dated: 01/27/06 Signature: SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE) Education Code Gov. Code Project Agreement Existing Not Subject to Fee 17620 65995 Approval Prior to 1/1/87 Requirement Number of Sq.Ft. 4,717 Amount per Sq.Ft. $ 2.88 Amount Collected $ 13,584.96 Building Permit Application Completed: Yes/No By: Carey M. Carlson, Asst. Supt., Business Services Certificate issued by: Leticia C. Torres, Facilities Clerk NOTICE OF 90 DAY PERIOD FOR PROTEST OF FfES-AND STATEMENT OWEES Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that this District provide (1) a written notice to the project appellant, at the time of payment of school fees, mitigation payment or other exactions (G°Fees"), of the 90 -day period to protest the imposition of these Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Government code and other applicable law, this Notice shall serve to advise you that the 90 -day protest period in regard to such Fees or the validity thereof, commences with the payment of the fees or performance of any other requirements as described in section 66020 of the Government code. Additionally, the amount of the fees imposed is as herein set forth, whether payable at this time or in whole or in part prior to issuance of a Certificate of Occupancy. As in the latter, the 90 days starts on the date hereof. This Certificate of Compliance is valid for thirty (30) days from the date of issuance. Extension will be granted only for good cause, as determined by the School District, and up to three (3) such extensions may be granted. At such time as this Certificate expires, if a building permit has not been issued for the project that is the subject of this Certificate, the owner will be reimbursed all fees that were paid to obtain this Certificate of Compliance. ivlV":c/mydocs/devfees/certificate ol'compliance form tablesTO USE.doc 1/16/03 T Coachella Valley Unified School District 83-733 Avenue 55, Thermal, CA 92274 (760) 398-5909 — Fax (760) 398-1224 Project Name: Art H Owner's Name: Al Hide This Box For District Use Only DEVELOPER FEES PAID AREA: AMOUNT LEVEL ONE AMOUNT: LEVEL TWO AMOUNT: MITIGATION AMOUNT: COMMAND. AMOUNT: DATE: RECEIPT: CHECK #: INITIALS: CERTIFICATE OF COMPLIANCE (California Education Code 17620) Project Address: 53-581 Via Bellagio, La Quinta, CA 92253 Project Description: Addition While Under Construction Date: July 17, 2006 Phone No. (760 ) 346-2348 APN: 772-510-049 Tract #: Lot #'s: Type of Development: Residential XX Commercial Industrial Total Square Feet of Building Area: 72 Sq. Ft. Certification of Applicant/Owners: The person signing certifies tha b above info on is correct s statement under penalty of perjury and further represents that he/she is authorized to si on behalf of weer/de er. Dated: 07/17/06 Signature: SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE) Education Code Gov. Code Project Agreement Existing Not Subject to Fee 17620 65995 Approval Prior to 1/1/87 Requirement Number of Sq.Ft. 72 sq. ft. Amount per Sq.Ft. $ 3.75 Amount Collected $ 270.00 Building Permit Application Completed: Yes/No By: Carey M. Carlson, Asst. Supt., Business Services Certificate issued by: Leticia C. Torres, Facilities Analyst Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that this District provide (1) a written notice to the project appellant, at the'time of payment of school fees, mitigation payment or other exactions ("Fees"), of the 90 -day period to protest the imposition of these Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Government code and other applicable law, this Notice shall serve to advise you that the 90 -day protest period in regard to such Fees or the validity thereof, commences with the payment of the fees or performance of any other requirements as described in section 66020 of the Government code. Additionally, the amount of the fees imposed is as herein set forth, whether payable at this time or in whole or in part prior to issuance of a Certificate of Occupancy. As in the latter, the 90 days starts on the date hereof. This Certificate of Compliance is valid for thirty (30) days from the date of issuance. Extension will be granted only for good cause, as determined by the School District, and up to three (3) such extensions may be granted. At such time as this Certificate expires, if a building permit has not been issued for the project that is the subject of this Certificate, the owner will be reimbursed all fees that were paid to obtain this Certificate of Compliance. MV:c/mydocs/devfees/certificate of compliance form tablesTO USE.doc 1/16/03 T 06/14%2%706 113:57 714-835-2819 ESIFME STRUCTURALENG PAGE 01/02 ES1/FM'E.1nC.. STRUCTURAL ENGI VEERS & CONSULTANTS June 14, 2006 Gemette Construction '74300 Hwy 111 Palm Desert, California 92260 Attn: David Williams RE:"Hllde Residence �@, The Hideaway - Lot 318" built In La Quinta, California. ESI/FME 5344 Site Visit on June 6 S June 13 .S is ca �D Dear David, This letter Is to follow-up my site observations on the above named project. The purpose of the structural observations were to review the primary structure for general compliance with our structural design intent and the structural plans. Based on what was visible, it is our opinion the primary structure is in compliance with our structural plans andlor structural design intent, except for the following (1 I Provide Simpson A35's @, 8" o.c. over beam btwn Living Rm and Kit (2)-NaW2x blocking to ledge; per Detail X/SD1 (0 Kit Loggia; (3) Provide roof blocking over Casita; &(4)1, dd plywood shear panel at stair landing after insulation inspection. Cur field'observations and recommendations does not relieve the contractors, developers, and the building department from their responsibility to follow the plans and code. we are not certifying or guaranteeing the construction work. We did not check various item such as nailing of roof sheathing, foundation reinforcement or lumber species. Thank you for your attention to this mutter, please do not hesitate to contact us if we can be of further aselstance to you on this project. Sincerely, ESI/FME,Inc. STRUCTURAL ENGINEERS By: Danny Matsumoto, CE33307 For ESI/FMO:, INC. 1800 1;, 16th Street, Sahta Ana, CA 92701 9 (7'14) 835.2800 • Fox(714)835-2819 Bin # • S City of La Quinta Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet `�� Permit.# Project Address:'�°� ��� (��(� �s�,�}"(G U Owner's Name: A. P. Number: 7-27 _ O _ 069'. Address: 611 O Legal Description: City, ST, Zip: (-/,( -- Q� Contractor: dole rj Telephone: — 9 yq.ISM Address: a • / j Project Description: City, ST, Zip: /4Ll"qj�—��- 9� Telephone: 3% State Lic. # City Lic. #: Z-1�7- Arch., Engr., Designer: �fJ�l✓ J Yj , /7071V (rr�;, ., Address: D City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: �-D G' (tS- �Esp� Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: 72 # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING. PERMIT FEES Z Plan Sets /Z!C u ' Plan Check submitted 17 Z'% d Item Amount ZStructural Cal S� Reviewed, ready f corrections S Q� Plan Check Deposit Truss Calcs. Called Contact Pe Plan Check Balance Energy Calcs. Plans picked up ,a Construction' Flood plain plan Plans resubmitted 5 Z� Mechanical Electrical Plumbing Grading. plan 2°" Review, ready or correction issu Subcontactor. List Called Contact Per Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted L Grading IN HOUSE:- '"' Review, ready for correcti nsrssue 6L Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit i ue 7 School Fees n J. Total Permit Fees 6� Del& 5/3/06 0. � 5((2 PC/a/,),5 2�� if IrL c,