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12-0504 (SFD)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 I. c&t!t44Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 12-000 00504 Property Address: 52535 HUMBOLDT BLVD APN: 767-200-091-19 -34968 - Application description: DWELLING - SINGLE FAMILY DETACHED Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 438661 Architect or Engineer: 1pr _ 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 Division 3 of the Business a ofe nals Code, and my License is in full force and effect. License I s: B ense No.: 915336 ate: Z ontracto - NEA -BUILDER DECLARATION I hereby affirm under penalty of perjury that I a xempt 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)•: (_) 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.). (_ 1 1, as owner of the property, am exclusively contracting with licensed contractors to construct the prbject (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: LQPERMIT Owner: EAST OF MADISON•LLC PO BOX 1482 LA QUINTA, CA 92247 Contractor: DBCA INC P.O. BOX 1482 LA QUINTA, CA 92247 (760)393-5271 Lic. No.: 915336 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 5/09/12 D I MAY �3 201 1i ,_ — pInrAMCM 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 TRAVELERS Policy Number YJUB282D7797-12 I certify that, in the performance of the work for which this permit is issued, I shall not employ any persMTH anner so as t b come subject to the workers' compensation laws of California, and , if I should b e su ec he workers' compensation provisions of Section / 70or Code, I s a o It comp with those provisions. fDate• .WARNING: FAILURRE WORKERS' MPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLCRIMINAL PEN IES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,00DITION TO TH COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706OF 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 I have read this application and state that the above n o mation is correct. I agree to comply with all city an ounty ordinances and state laws relating to building co t do hereby authorize representatives of co gtyy t enter upon toe above-mentioned property for in ion urpos . Date: (/"' ature (Applicant or Agen Application Number . . . . . 12-00000504 Permit .". . BUILDING PERMIT Additional desc . Permit Fee 1826.00 Plan Check Fee 1186.90 Issue Date . . . . Valuation 438661 Expiration Date 11/05/12 Qty Unit Charge Per Extension BASE FEE 639.50 t 339.00 ---------7------------------------------------------------------------------ 3.5000 THOU BLDG 100,001-500,000 1186.50 Permit . . . MECHANICAL ` Additional desc . . Permit Fee . . . . 176.00 Plan Check Fee 44.00 Issue Date . . . . Valuation . . . . 0 Expiration Date 11/05/12 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 2.00 11.0000 EA MECH FURNACE >100K 22.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 3.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 49.50 1.00 6.5000 EA MECH AH <=10K CFM 6.50 9.00 6.5000 EA MECH VENT FAN 58.50 1.00 ----------------------------------------------------------------------------- 6.5000 EA MECH EXHAUST HOOD 6.50 Permit ELEC-NEW RESIDENTIAL Additional desc . Permit Fee . . . . 203.51 Plan Check Fee ... 50.88 Issue Date . . . . Valuation 0 Expiration Date 11/05/12 Qty Unit Charge Per Extension BASE FEE 15.00 4859.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 170.07 922.00 ---------------------------------------------------------------------------- .0200 ELEC GARAGE OR NON-RESIDENTIAL 18.44 Permit PLUMBING Additional desc . Permit Fee . . .289.50 Plan Check Fee 72.38 Issue Date . . . . Valuation 0 Expiration Date . . 11/05/12 Qty Unit Charge Per Extension LQPERMIT LQPERMIT Application Number . . . . . 12700000.504 Permit . . . PLUMBING r Qty. Unit Charge Per Extension BASE FEE 15.00 34.00 6.0000 EA PLB FIXTURE 204.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 6.0000 EA PLB ROOF DRAIN 12.00 ,2.00 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 ` 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 11/05/12 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------=------------ Special Notes and Comments SFD - LOT 19, PLAN 2 WITH CASITA, 4859 S.F. PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS,OR DRIVEWAY APPROACH. 2010 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES 596.65 BLDG STDS ADMIN (SB1473) 18.00 DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER - RES 995.00 ENERGY REVIEW FEE 118.69 DIF FIRE PROTECTION -RES 140.00 GRADING PLAN CHECK FEE .00 DIF LIBRARIES - RES 355.00 MULTI -SPECIES (MSHCP) FEE 1.254.00 DIF PARK MAINT FAC - RES 22.00 DIF PARKS/REC - RES 892.00 STRONG MOTION (SMI) - RES .43.87 DIF STREET MAINT FAC -RES 67.00 DIF TRANSPORTATION - RES 1930.00 Fee summary Charged Paid Credited --------------------------------------------------------- Due Permit Fee Total 2510.01 .00 .00 2510.01 Plan Check Total 1354.16 .00 .00 1354.16 Application Number 12-00000504 Other Fee Total 6506.21 00 .00 6506.21 Grand Total 10370.38 .00 .00 10370.38 LQPERMIT PROUDLY SERVING THE UNINCORPORATED AREAS OF RrvERs16E COUNTY AND THE CITIES OF: BANNING BEAUMONT CALIMESA CANYON LAKE COACHELLA 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.rvcfire.org December 11, 2012 Holland Fire 1600 Meadowlark Way Roseville, CA 95661 Trj J lhe 4� L Od, ve P �Vr. �}pP�ovec� -u-vU�- p1✓,t S Re: Residential Fire Sprinkler Plan Review LAQ-12-RS-066 Madison Villas -Gatsby 52-535 Humboldt Blvd. 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: NOTE: As required by the State of Califomia Business and Professions Code and the Contractors State Licensing Board (CSLB) only a C-16 Fire Protection Contractor may install fire sprinklers. 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. A typical 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) Overhead Rough and Hydro static test: All piping shall be visible and Pumped at.normal operating pressure: (b) 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. Applicantlinstaller shall be responsible to contact the Fire DepartmelAt to schedule inspection. r Sincerely, Jaso tubble Fire Safety Specialist L 4� 7 1 -WAS 61�r gjz/ ru�r�a�I% Eng i%nmeletj-din) ff- 78080 Calle Amigo, Suite 102 Phone: (760) 771-9993 Palm Desert, CA 92260 Fax: (760) 771-9998 Cell: (760) 808-9146 STRUCTURAL OBSERVATION REPORT FOR FRAMING ONLY December 11, 2012 City Of La Quinta Building And Safety Department RE: Modison Club, Lot 19 at 52535 Humboldt Blvd., La Quinta, Ca. Gentlemen We have performed structural observation per 2010 C.B.C. section 1710 for the framing condition prior to drywall and stucco. Based on our visual observation and to the best of our knowledge and experience, we believe that the framing that were completed at the time of our visit, per approved plans. Please note that this letter does not include or waive the responsibility for the City or the Special Inspectors from determining compliance with the approved plans. Please contact me should you need additional information regarding this approval. Respectfully, �p`�PSGHgRA � Reza Asgharpour, P.E. G w NO. C 67613 sr civ%V OF CA��� Field Observation Letter for N-1 1dison Club Lot 19 to 525335 Humboldt Blvd. hi Ouinta. CA. - (Fim it Framing)