05-4902 (SFD)P.O. BOX 1504 '
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
f.
BUILDING & SAFETY DEPARTMENT
`BUILDING PERMIT
Application Number:
05-00004902
Property Address:
80676 VIA GEORIETA
APN:
772-270-010-16 -311231-
Application description:
DWELLING - SINGLE-FAMILY DETACHED
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
175101
Applicant:.
Architect or Engineer:
04
---------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am lic ed rider provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business an nals Co and my License is in full force and effect.
License Cla B • 681660
L?WDate: 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 Coder 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.).
(_ 1 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 projecis with a coMractor(s) licensed
pursuant to the Contractors' State License Law.).
(_) 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: ! t
LQPERMIT:.
Owner:
'VISTA LA QUINTA•PARTNERS,
223 E. DE LA GUERRA
LA QUINTA, CA 92253
F1
Contractor:
WASSERMAN CONSTRUCTION,
45520 STONEBROOK COURT
LA QUINTA, CA 92253.
(760)771-8191
Lic. No.:. 681660
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/03/05
LLC
DEG 13 2005
CITY OF LA QUINTA
-----------------
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.
Y� 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 0014586-2005
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 the workers' compensation laws of California,
and agree that, if I should be bject to t��ovisions. pensation provisions of Section
//�/ 00 of th abor Code c
D, e(A Applicant: - -
/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 . Lach peison upon w11646 Bow? tn15 appijcallon is mace, earn persun al wnuse ieyuest anu IUr
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 dateof 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*informa ion is correct. I agree to comply with all
city and county ordinances and state laws relating to buildings by authorize representatives
of this bunt �rupo above-mentioned propate: Z�(Applicant or Agent): -
Application Number
05-00004902
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
2001
# BEDROOMS
4.00
FIRE SPRINKLERS
NO
GARAGE SQ FTG
470.00
PATIO. SQ FTG
3'06.00
NUMBER OF UNITS
1.•00
1ST FLOOR SQUARE FOOTAGE
2829.00
Permit
BUILDING PERMIT
Additional desc .
Permit Fee . . . .
905.50 Plan Check Fee
147.15
Issue Date . . . .
-Valuation
175101
Expiration Date
5/02/06
Qty Unit,Charge
Per
Extension
BASE FEE
639.50
76.00 3.5000
THOU BLDG 100,001-500,000
266.00
Permit
MECHANICAL
Additional desc .
Permit Fee
121.00 Plan Check Fee
7.56
Issue Date . . . .
Valuation
0
Expiration Date
5/02/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
3.00 9.0000
EA MECH FURNACE <=100K
27.00
3.00 9.0000
EA MECH B/C <=3HP/100K BTU
27.00
6;00 6.5000
EA MECH VENT FAN
39.00
1.00 6.5000
EA MECH OTHER VENT SYSTEM
6.50
1.00 6.5000
EA MECH EXHAUST HOOD
6.50
Permit
ELEC-NEW RESIDENTIAL
Additional desc
PeiwiC Foe
129.5 Plan Chock Pee
R In
Issue Date
Valuation
0
Expiration.Date
5/02/06
Qty Unit Charge
.Per
Extension"
BASE FEE
15.00
LQPERMIT -
_
Application Number 05-00004902
Permit . . . . . . ELEC-NEW RESIDENTIAL
Qty Unit Charge .Per'
Extension
2829.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY
99.02
776.00 :0200 ELEC GARAGE OR NON-RESIDENTIAL
----------------------------------------------------------------------------
15.52
Permit PLUMBING
Additional desc
Permit Fee- 174.00 Plan Check Fee
10.88
Issue Date Valuation . . .
0 '
- Expiration Date 5/02/06
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
10.00 .7500 EA PLB GAS'PIPE >=5
7.50
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 5/02/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
" Special Notes and Comments
SFD - LOT 16, PLAN 3AL (W/ DETACHED'
CASITA)
2829 SQ.FT. LIVING, R..-3 OCC. TYPE V -N
CONSTRUCTION, 2001 CODES. PERMIT DOES
- NOT INCLUDE POOL, SPA, BLOCK WALLS OR
DRIVEWAY APPROACH. 75% REDUCTION TO
PLAN.CHECK FEES DUE TO MULTIPLE .
ISSUANCE OF SAME PLAN TYPE
----------------------------
Other Fees . . . . . . DIF}COMMUNITY CENTERS -RES
75.00
DIF CIVIC CENTER - RES
480.00 -
ENERGY REVIEW FEE
14.72
DIF FIRE PROTECTION -RES
140.00
- DIF LIBRARIES - RES
355-.00
.LQPE.RMIT -
.
' Application, Number
05-00.004902
-- -----_---------.
' -----Other Fees-
-- ----DIF
PARKrMAINT FAC - RES ------22.0------
0
DIF PARKS/REC - RES.
892.00 ,
STRONG MOTION (SMI) - RES
17.51
-
DIF STREET MAINT;FAC-RES
67.00 '
DIF'TRANSPORTATION - RES
1666.00
., - Fee summary
Charged
Paid Credited
Due
- ��
----------------- "
-r „._ r •. , "
---------;-
--------=---------------------
,_ „ y -
' Permit Fee Total-
1345.04
.00 .00
1345.04
Plan Check Total
173.69
.00 .00
173.69
Other Fee Total
3729.23
.00 .00
3729.23
Grand Total
5247.96
.00 00
.5247.96
LQPERMIT
y
AUG -2-2006
09:36A FROM -LA CANTERA JOB TRAIL 7607776516 TO:777711:2 P.3
FLA QUINTA
�a G & SAFETY DEPARTMENT
�h`B
OF ,f 777"7012
Q SPECTION REQUEST UNE
O
777.7153
Owner e
Contractor a
.
Permit NumbOr 05-4902
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 0-676 VIA GL�ORi_ETA
SPD. LOT 16, PLAN 3AL- PERMIT DOES NOT INCLUDC,
POOL. SPA, BLOCK WALLS.OR''DRIVEWAY ['
'APPROACH.
r
TYPE OF INSPECTION DATE (NSP.
TEMPORARY POWER
SETBACKS
U/G PWMBING I WASTE // -OS
U/G ELECTRICAL I GROUNDING 2 : :8 -
FOOTINGS / STEEL
CONCRETE SLAB -
,j 00 NOT POUR CONCRETE UNT L A OVE SIGNED
r ROnF NAIL/ PRE -ROOF
OKAY TO WRAP >,
FRAMING (COMBINATIO
ROUGH ELECTRIC
ROUGH PLUMBING zaz
ROUGH MECHANICAL I
INSULATION
COVER NO WORK UNI IL ABOVE SIGNED
" INTERIOR GYP. BD. DRYWALL
�.
EXTERIOR LATH
.
I GAS TEST
'
SEPTIC ABANDONMENT
SEWER CONNECTION • Al. oG
SEPTIC ! GREASE INTERCEPTOR ! .
MASONRY INSPECTIONS I
FOOTINGS / STEEL
BOND BEAM
A
i
POOL ! SPA / WATER FEATURE INSPECTIONS
PRE•GUNITE 1 SETBACKS I
U/G PLUMBING
U/G GAS
U/G ELECTRICAL `
PRE -PLASTER ALARMS / BARRIERS
FINAL INSPECTIONS
TEMP. USE OF PERMANENT POWER
ELECTRICAL
PLUMBING -
...,...MECHANICAL
PUBLIC WORKS DEPARTMENT -p «�-
'
COMMUNITY OE'VELOPMENT DEPT. - -
...FINAL JOB COMPLETED
}
C.,rtificate of Occupancy0
,-
`
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•
ot
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_
OF Building &Safety Department
3
4
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This Certificate is issued pursuant to the requirements of Section 109 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 Cit regulating buildin
P g y g g g
r
construction and/or use.
I:
4
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BUILDING ADDRESS: 80-676 VIA GLORIETA
1
Use classification: SINGLE FAMILY DWELLING Building Permit No.: 054902
i
Occupancy Group: R3 Type of Construction: V -N Land Use Zone: RL
k .k
Owner of Building: VISTA LA QUINTA PARTNERS, LLC Address: 223 E. DE LA GUERRA
Q ,
City, ST, ZIP: SANTA BARBARA, CA 93140::
t
-. By: STEPHEN WILLETT
`w
Date: AUGUST 2, 2006
e
Building Official
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POST IN A CONSPICUOUS PLACE
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