08-0400 (SFD)r <. i
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
C08-000OQ400
Property Address:
52905 HUMBOLDT BLVD
APN:
767-200-091-7 -34968 -
Application description:
DWELLING - SINGLE FAMILY
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
508083
Applicant:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
EAST OF MADISON LLC
PO BOX 1482
DETACHED LA QUINTA, CA 92247
Contractor:
Architect or Engineer: A & M CONSTRUCTION
P.O. BOX 366
LA QUINTA, CA 92241
(760)564-4832
Lic. No.: 746198
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Divisiuri 3 of the Business and Professionals Code, and my License Is in full force and effect.
License Class: B C10 License No.: 746198
Date:3-12-y&ntractor. I 1� `J
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 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.l.
(_) 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.).
(_ 1 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: JOPT
LQPERD11T
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
u
MA'N 12 4UiJj
CI :y 2F Lq
`NgNc� QUINTA
------------------
WORKER'S COMPENSATION DECLARATION
Date: 3/11/08
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 044-0028137-07
I certify that, in the performance of the work for which this permit is issued, 1 shall not employ any
person in any manner so as to become subject to the workers' compensation laws of California,
and agree that, if I should become subject to the workers' compensation provisions of Section
3700 of the Labor Code, I shall forthwith comp with those provisions.
ate: 3'1 Z-L1�pImam:�-"
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 permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that 1 have read this application and state that the above information is correct. 1 agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this -county to enter upon the bove-mentioned property for inspection purposes.
DaDate: �Z-L�S Si ore (Applicant or Agent):
.. .
LQPERNIIT
Application Number
. . . .. 08-00000400
Permit . . . . . .
BUILDING PERMIT
Additional desc .
Permit Fee
2066.50
Plan Check Fee
335.81
Issue Date . . . .
Valuation . . . .
508083
Expiration Date ..
9/07/08
Qty Unit Charge
Per
Extension
"BASE
FEE
2039.50
9.00 3.0000
---------------------------------------------------------
THOU BLDG
500,001-1,000,000
--------------
27.00
-----
Permit . . .
MECHANICAL
Additional desc .
Permit Fee .
192.50
Plan Check Fee
12.03
Issue Date . .
Valuation
0
Expiration Date
9/01/08
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
4.00 11.0000
EA MECH
FURNACE >100K
44.00
1.00 9.0000
EA MECH
B/C'<=3HP/100K BTU
9.00
4.00., 16.5000
EA MECH
B/C >3-15HP/>100K-500KBTU
66.00
8.00 6.5000
EA MECH
VENT FAN
52.00
1.00 6.5000
----------------------------------------------------------------------------
EA MECH
EXHAUST HOOD
6.50.
Permit . . .
ELEC-NEW RESIDENTIAL
Additional desc .
Permit Fee . . . .
239.37
Plan Check Fee
14.96
Issue Date . . . .
Valuation
0
Expiration Date
9/07/08
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
5831.00 .0350
ELEC
NEW RES - 1 OR 2 FAMILY
204.09
1014.00 .0200
-------------- -------------------------------------------------------------
ELEC
GARAGE OR NON-RESIDENTIAL
20.28
Permit PLUMBING
Additional desc .
Permit Fee . . . . 285.00
Issue Date . . . .
Expiration Date 9/07/08
Qty Unit Charge Per
BASE FEE
34.00 6.0000 EA PLB FIXTURE
Plan Check Fee 17.81
Valuation 0
Extension
15.00
204.00
LQPERAIIT
Application Number . .. . . . 08-00000400
Permit . . . . . PLUMBING
Qty Unit Charge Per
Extension
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
12.00 .7500 EA. PLB GAS PIPE >=5
9.00
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 9%07/08
Qty Unit Charge Per
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes and Comments
SFD - LOT 7, PLAN 2AR/CASITA, 5831 SF.
PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK
WALLS OR DRIVEWAY APPROACH. 7S%
REDUCTION TO PLAN CHECK FEES DUE TO
MULTIPLE ISSUANCE OF SAME PLAN TYPE.
2001 CBC, CMC, CPC, 2004 CEC, 2005
ENERGY CODES
----------------------------------------------------------------------------
Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES
770.20
DIF COMMUNITY CENTERS -RES
74.00
DIF CIVIC CENTER - RES
995.00
ENERGY REVIEW FEE
33.58
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
50.80
DIF STREET MAINT FAC -RES
67.00
DIF TRANSPORTATION - RES
1930.00
Fee summary Charged Paid Credited
---------------------------
Due
------------------------------
Permit Fee Total 2798.37 .00 .00
2798.37
Plan Check Total 380.61 .00 .00
380.61
Other Fee Total 5329.58 .00 .00
5329.58
Grand Total 8508.56 .00 .00
8508.56
LQPERAIIT
Certificate of Insulation
Your home has been insulated with Knauf or Guardian insulation products, which are designed
for today's safety standards and tomorrow's energy requirements. All products used meet current
standards for safety and effectiveness and were installed in a professional and proper manner.
This certifies that insulation has been professionally installed in this project to provide the following thermal
performance as required by California Energy Standards, Title 24.
A & M Construction
Job Name: The Villas at Madison Club Tract:
Lot No: 7 , Job Address
Plan# 2 Phase:
SFR - 52-905 Humboldt Blvd., La Quints, CA
Ceiling Area: R-30 Batt Insulation Garage Ceiling: R-19 Batt Insulation Other C/A:
With Living Above
Exterior Walls R-19 Batt Insulation Overhangs: R-19 Batt Insulation
With Living Above _
Raised Floor: Interior Walls:
Access Attic:
1
- Pro Insulation, Inc.
2983 W. Lincoln St., Ste. 304, Banning, CA 92220
I
1
Signed: rn • t
Mike Dickerson
R -means resistance to heat flow. The higher the R -value, the greater the insulating power.
Ask your; builder for the fact sheet on R'values. Keep this certificate with your other
valued papers. If you ever sell this home, this certificate should be passed on to the buyer.
Certificate of Occupancy
0
r.
r.
INW
OF Building & Safety Department
This Certi�•�`a-i7► Q�-� ficate is issued pursuant to the requirements of Appendix Chapter 1 Section 110.1 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 the various ordinances of the City
regulating building construction and/or use.
BUILDING ADDRESS: 52-905 HUMBOLDT BOULEVARD
Use classification: SINGLE FAMILY DWELLING Building Permit No.: 08-400
Occupancy Group: R3 Type of Construction: VN Land Use Zone: RL
Code Edition: 2007 Occupant Load: - Sprinkler Installed: NO Required: NO
Owner of Building: EAST OF MADISON, LLC Address: PO BOX 1482
City, ST, ZIP: LA QUINTA, CA 92253
By: KIRK KIRKLAND
Date: JUNE 2, 2009
Building Official
POST IN A CONSPICUOUS PLACE
amt
Certificate of Occupancy
0
r.
r.
INW
OF Building & Safety Department
This Certi�•�`a-i7► Q�-� ficate is issued pursuant to the requirements of Appendix Chapter 1 Section 110.1 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 the various ordinances of the City
regulating building construction and/or use.
BUILDING ADDRESS: 52-905 HUMBOLDT BOULEVARD
Use classification: SINGLE FAMILY DWELLING Building Permit No.: 08-400
Occupancy Group: R3 Type of Construction: VN Land Use Zone: RL
Code Edition: 2007 Occupant Load: - Sprinkler Installed: NO Required: NO
Owner of Building: EAST OF MADISON, LLC Address: PO BOX 1482
City, ST, ZIP: LA QUINTA, CA 92253
By: KIRK KIRKLAND
Date: JUNE 2, 2009
Building Official
POST IN A CONSPICUOUS PLACE