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,