04-5094 (SFD)'qty o� .�tar�ra
BUILDING & SAFETY DEPARTMENT.
(760).777-7012
FAX (760) 777-7011
k 92253 INSPECTION REQUESTS (760) 777-7153
_DING PERMIT
APN:
Application description
Property Zoning . . . . . .
Application_ valuation . . .
04-00005094 Date. 2/02/05
51845 VIA ROBLADA
772 -270 -010 -2 -311231 -
DWELLING - SINGLE FAMILY DETACHED:
LOW DENSITY RESIDENTIAL
158078
Owner
Contractor
VISTA LA QUINTA PARTNERS WASSERMAN CONSTRUCTION, RA
-223 E. DE LA GUERRA
45520 STONEBROOK
COURT
SANTA BARBARA
CA 93140 LA QUINTA
CA 92'253
(760).,771-8191
WCC: STATE FUND
WC: 1795012
07/01/05
CSLB: 681660
06/30/06
CCC: B
----------------=-----=---
Structure Information _--_----
Construction.Type
TYPE V - NON RATED
Occupancy Type . . .
. . . DWELLG/LODGING/CONG <=10
Flood Zone . '. 1.
. . . NON -AO FLOOD ZONE
.Other s.truct info .
. . CODE EDITION
2001
# BEDROOMS
3.00
FIRE.SPRINKLERS
NO
GARAGE SQ FTG
5920.00.
PATIO SQ FTG
657.00
NUMBER OF UNITS
1.00
1ST FLOOR SQUARE FOOTAGE
2408.00
Permit . . . .
BUILDING PERMIT.
Additional desc
Permit Fee
846.00 Plan Check Fee
549'.90
Issue Date
Valuation . .
. . 158078
Qty Unit Charge
Per
Extension
BASE FEE
639..50
59.00 3.5000
THOU•. BLDG.100,001-500,000
206.50
-------------------------------------------------------------
Permit . ... . . .
MECHANICAL
--------------
Additional de_sc
Permit Fee
96.50 Plan Check Fee
24.13
Issue Date . . .
Valuation
0
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
6.00 6.5000
EA MECH VENT FAN
39.00
P.O. BOX 1504 • /: •
w VOICE (760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: (SZ/- 5o9� Date: 02-10.05
Applicant: Architect or Engineer:
Applicant's Mailing Address: chitect orgin is Address* y
ic. No.:
BUILDING PERMIT DECLARATIONS
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 and Professionals
Code, and my ntie/is in full force and effect.
/license Class Lice6 --- /incense No.
61��&D
/„/ Date � ractor C'C tiL'� mta i�
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 stricture, 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 Contractors' 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).):
U 1, 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 or 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.).
U 1, 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.).
U I am
exempt under Sec. , BA P.C. for this reason
d
Date 0y ) Owner CA 0 az—,st' x -man
WORKERS' 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' compensatio 'nsurence, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
iss ed. N�,workers' compensation in nce carrier air d policy umber are:
�aamery�Q e Tw Cu XQL oIicv Number I9 t Old
!' 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 become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
1/� �
pplicant
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.
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.).
Lend'er's Name
Lenders Address `
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 information is correct. 1 agree mply with all city and county ordinances and state laws rotating to building
construction, and hereby authorize repres ntatives of this county to enter nrl-ioned property for inspection purposes.
ate – �� Q� ignature(ApplicantorAgent):
Page
2
Application Number 04-00005094 Date
2/02/05
Qty Unit Charge Per -
Extension
1.00 6.5000 EA MECH EXHAUST HOOD
6.50
Permit . . . . ELEC-NEW RESIDENTIAL,
Additional desc
Permit Fee . . . 124.26 Plan Check Fee
31.07
Issue`Date Valuation . . . .
0
Qty Unit Charge Per
Extension
BASE FEE
15.00
2408:00` .0350 ELEC NEW RES - 1 OR 2 FAMILY
84.28
1249.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL
24.98
Permit° PLUMBING
Additional desc
Permit Fee 180.00 Plan Check Fee
45.00
Issue Date . . Valuation
0
Qty Unit;Charge Per-
Extension
BASE FEE
15.00
18.00_ 6.0000 EA PLB FIXTURE
108.00
• 1..00 15.0000 EA PLB BUILDING SEWER
15.00
1.00 7.5000 EA .' PLB WATER HEATER/VENT
7.5-0
1.00 3.0000 EA PLB WATER INST/ALT/REP
3.00
1.0.0 9.0000 EA PLB LAWN SPRINKLER SYSTEM
10.00 .7500 EA PLB GAS PIPE >=5
,9.00
7.50
1.00 15.0000 EA PLB GAS METER-
15.0.0
----------------------------------------------------------------------------
Permit GRADING PERMIT
Additional desc
Permit Fee 15..00 Plan Check Fee
.00
Issue Date ., Valuation.
0
Qty Unit Charge Per
Extension.
BASE FEE
15.00
Special Notes and Comments
SFD --LOT 2, PLAN 2 (DETACHED
CASITA W/ SKY DECK). 2408 SQ.FT. LIVING,
R-3 OCC., TYPE V -N CONSTRUCTION, 2001
CODES. PERMIT DOES NOT INCLUDE POOL, '
SPA,- BLOCK WALLS OR DRIVEWAY APPROACH
F- - - - - - - - - - - - - - - - - - - - - - - - - -------------------- ------------------ ----------------
----------'---Other Fees DIF COMMUNITY CENTERS -RES'
Other
97.-00
DIF CIVIC CENTER °=" RES
366.00
Page 3
Application Number
.. . . . .
04-00005094 Date
2/02/05
-----------------------------------------------------------------
Other Fees
. . . .
ENERGY REVIEW FEE
54.99
DIF FIRE PROTECTION -RES
97.00
DIF LIBRARIES - RES
225.00
DIF PARK MAINT FAC - RES
5.00
DIF PARKS/REC - RES
502.00„
STRONG MOTION (SMI) - RES
15.80
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
Charged;
Paid Credited
Due
Permit Fee Total
1261.76
.00 .00
.1261.76
Plan Check Total
650.10
.00 .00
650.10'
Other Fee Total
2475.79
00 .00
2475.79
Grand Total
4387.65
.00 :.00
4387.65
,- Ce'dificate Of Occu anCY
p
4
C� OF 11 9w Safety Building. & Department
Y
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 City regulating building .
construction and/or use.
BUILDING ADDRESS: 51-845 VIA ROBLADA
• a
Use classification: SINGLE FAMILY DWELLING Building Permit No.: 04-5094
Occupancy Group: R3 Type of Construction: V -N Land Use Zone: RL
Owner of Building: VISTA LA QUINTA PARTNERS, LLC Address: 223 E. DELA GUERRA
City, ST, ZIP: SANTA BARBARA, CA 93140
�.... — By: GARY HARTMAN
l�
Date: FEBRUARY 8, 2006
Building Official
POST IN A CONSPICUOUS PLACE.
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