05-4911 (SFD)F ,r
P.O. BOX 1504
78495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
� �4urHrw
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
00004911 i
51576—VIA'ROBL'ADA
772-270-010-21 .-311231-
DWELLING - SINGLE-FAMILY DETACHED
LOW DENSITY RESIDENTIAL
14.2902
rchjtect or Engineer:
Owner:
VISTA LA QUINTA PARTNERS
223 E. DE LA GUERRA
SANTA -BARBARA, CA 93140
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: 11/04/05
Lj
J "1 ;
„ 1 LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am lic nsed under provisions of Chapter 9 (commencing' with
I hereby affirm under penalty of perjury one of the following declarations:
.. Section 7000) of Division 3 of the Business an als Cod and my License is in full force and effect.
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Cla : B o.: 681660
_
', for by Section 3700 of the Labor Code,'for the performance of the work for which this permit is "
ontractor: _
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
OWNER -BUILDER DECLARATION
insurance carrier and policy number'are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier STATE FUND I Policy Number 0014586-2005
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also. requires the applicant for the
person in any manner so as to become subject to the workers' compensation laws of California;
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's. State
and agree that, if I should be bjec to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
the Labor Code t comp) w' those provisions.
that -he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
/Z700,of
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars 1$500).:
ate:! pplicant:
(_) 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
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.).
APPLICANT ACKNOWLEDGEMENT
1 _ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
J044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.).
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
1 I am exempt under Sec. B.&P.C. for this reason
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 omissionrelated to the work being
performed under or following issuance of this permit. '
Date: - Owner:
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
CONSTRUCTION LENDING AGENCY
permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
I certify that I have read this application and state that the above infor 's correct. I agre comply with all
work for which this permit is issued (Sec. 3097, Civ. C.).
city and county ordinances and state laws relating to building cons thorize r resentatives
are
of thi to nter upo eabove-mentioned property for ' p
Lender's Name:
/ofunt
Date '
4 1 Signature (Applicant or Agent):
Lender's Address:
LQPERMIT•-
Application Number
. . . 05-00004911
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
3.00
FIRE SPRINKLERS
NO
GARAGE SQ FTG
447.00
PATIO SQ FTG
207.00
NUMBER OF UNITS
1.00
1ST FLOOR SQUARE -FOOTAGE
2297.00
Permit . ..
BUILDING PERMIT
Additional•desc .
Permit Fee . . .
790.00 Plan .Check Fee
128.38
Issue Date . . . .
Valuation . .
. 142902
Expiration Date .
' 5/.03'/06
Qty;.. Unit Charge
Per
Extension
BASE FEE
639.50
43.00 3.5000
THOU BLDG.100,•001-500,000
15.0.50
Permit . . .
MECHANICAL;
Additional desc
-
Permit Fee
90•.0.0 Plan Check Fee-
5.63
Issue DateValuation
0
Expiration Date
5/03/06
Qty Unit Charge
Per
Extension .
BASE FEE
15.00
2.00 9.0000
EA MECH FURNACE <=100K
18.00
2.00 9.0000
EA MECH B/C <=3HP/100K'BTU
18.00
5.00 6.5000
EA MECH VENT FAN
32.50
1.00 6.5000
EA MECH EXHAUST HOOD
6.50
Permit . . .
ELEC-NEW RESIDENTIAL
Additional desc .
Permit Fee
108,.48 Plan Check Fee
6.78
Issue Date
Valuation . .
. 0
Expiration Date
5/03/06
Qty' Unit Charge
Per
Extension
BASE FEE
15.00
2297.00 .0350
ELEC NEW RES - 1 OR 2.FAMILY
80'.40
LQPERMIT
OWL
Application Number .
. . . . 05-00004911
Permit . . . . . . ELEC-NEW RESIDENTIAL
QtyUnit Charge
Per
Extension
.654.00 .0200
ELEC GARAGE OR NON-RESIDENTIAL
13.08
Permit . . PLUMBING
Additional deso .
Permit Fee
160.50. Plan Check Fee
21.85
Issue Date . . . .
Valuation . . . .
0
Expiration Date
5/03/06
Qty Unit .Charge.
Per _
Extension
BASE FEE
15.00
15.00 6.0000
EA PLB FIXTURE
90.00
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
8.00 .7500
EA PLB GAS PIPE >=5
6.00
. 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
5/03/06
Qty Unit Charge
Per
Extension .'
BASE FEE
15.00
-----------------------------------------------------------------------------
Special Notes and Comments
SFD - LOT 21, PLAN 1AL, 2297 SF
(ATTACHED_CASITA). PERMIT
DOES NOT INCLUDE POOL,
SPA, BLOCK WALLS
OR DRIVEWAY APPROACH.
75% REDUCTION TO
PLAN CHECK FEE DUE TO
MULTIPLE`ISSUANCE
'OF SAME PLAN TYPE .
Other Fees.
. . _ . ART.IN PUBLIC PLACES -RES
.00
_
DIF COMMUNITY CENTERS -RES
74.00
DIF CIVIC CENTER - RES
480.00
ENERGY REVIEW FEE
12.84
DIF FIRE PROTECTION -RES
140.00
GRADING PLAN CHECK FEE
.00
DIF LIBRARIES.- RES
355.00
•
DIF PARK MAINT FAC - RES
22.00
LQPERMIT,
Application Number
05-00004911 .
--.----------------------
Other Fees . .
-----------
. . . .
---------------------------
DIF -PARKS/REC - RES
--------------
892.00
STRONG MOTION (SMI) - RES
14.29
DIF STREET MAINT FAC -RES
67.00
DIF TRANSPORTATION -:RES
..1666.00
Fee summary
Charged
Paid Credited
Due
Permit Fee Total
1163.98
:00 .00
1163.98
Plan Check Total
162.64-
:00 .00
162.64
Other Fee Total
3723.13
.00 :00
3723.13
Grand Total
5049.75
.00 ..00
5049.75
LQPERMIT -• .. -
- ..
,-
F LA QUINTA
clul`� & SAFETY DEPARTMENT
777-7012
PECTION REQUEST LINE
53
mit Number
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPIJCABLE SPACES
I ADDRESS 51-576 VIA ROBLADA
I. LOT 21, PLAN IAL. PERMIT DOES NOT INCLUDE
)L, SPA, BLOCK WALLS, OR DRIVEWAY
'ROACH.
TYPE OF INSPECTION DATE IN6P.
PLUMBING / WASTE— /L r
ELECTRICAL / GROUNDING — —
TINGS / STEEL
CRETE SLAB
DO NOT POUR CONCRET>; UNTIL ABOVE SIGNED
F NAIL / PRE -ROOF
(TO WRAP _ `e
RING COMBINATION
iUGH ELECTRIC
lUGH PLUMBING
iUGH MECHANICAL
U1 I IVN iI —I —DG 1O
COVER NO WORK UNTIL ABOVE SIGNED
RIOR GYP. BD. DRYWALL
:RIOR LATH
TEST
'IC ABANDONMENT
=R CONNECTION
'IC / GREASE INTERCEPTOR
MASONRY INSPECTIONS
PINGS / STEEL
7 BEAM
POOL / SPA / WATER FEATURE INSPECTIONS
3UNITE / SETBACKS
'LUMBING
'AS
:LECTRICAL
'LATER ALARMS /BARRIERS
FINAL INSPECTIONS
USE OF PERMANENT POWER1 '1- 4,—b 6
1ANICAL "
IC WORKS DEPARTMENT
AUNITY DEVELOPMENT DEPT.
L / JOB COMPLETED - 2 —oG G—
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING