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04-5093 (SFD)l.,r_� ::V BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760):777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA:QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT --Application'Number 34_ Date 2/02/05 ess-_1 g9ROBLADAProperty.'Addr APN: 772-270-010-1 -3112317 _. Application description DWELLING --SINGLE FAMILY DETACHED Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL Application valuation 142902 Owner Contractor ` -------------- .------------ .. �. ------------------------ VISTA LA QUINTA PARTNERS WASSERMAN CONSTRUCTION, RA 223 E:.DE LA GUERRA 45520 STONEBROOK COURT SANTA BARBARA CA 93140 LA QUINTA CA 92253' (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/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 c 207.00 NUMBER OF UNITS 1.00 1ST FLOOR SQUARE FOOTAGE 2297.00 -Permit BUILDING -PERMIT a Additional desc Permit Fee . . 790.00 Plan Check Fee 513.50 Issue -Date Valuation 142902 Qty Unit -Charge _Per Extension BASE FEE 639.50 43.00 3.5000 THOU. BLDG 100,001-500,000 150.50 Permit . . . . . . MECHANICAL Additional`desc Permit Fee 90.00 Plan Check Fee 22.50 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 2:00 9.0000 EA_ MECH FURNACE <=100K �M�_ti _18.00 2.00 9.0000 EA MECH.:B/C-:<=3HP/100K BTU I` 18.00 5.00 6.5000 EA MECH VENT FAN 32.50 P.O. BOX 1504 VOCE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: GZZ- 50 93 Date: a• (G • O Applicant: Architect or ngin��r 1 ce l cwsf Applicant's Mailing Address: rchitect or Engineer's Address: 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 Co , and my License . full force and effect.IG�O -cense Class -cense No. ,---bate ontractor (al -4>41 IA; G 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 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 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 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 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 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.). U I am exempt under Sec. , BA P.C. for this reason Date Owner 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. VL 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 issue��corrlpensation ins ce carrier andp,Qli yumbar are: -Gamer �S yg[JJ icy Number / %7 0/ 7– I 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, 1 shall forthwith comply with those provisions. ,W z 6[05--pplia cant E6 /671 5 0 �'ts'1ti �S IINC�_ �, 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.). Lender's Name Lender's 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 Ouinta, 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. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby au=ignature entatives of this county to ent on a above- ntioned property for inspection purposes. ate 2/ic ` pplicant or Agent): 9 ) Page :, 2 Application Number . . . 04-00005093 Date 2/02/05 - Qty Unit Charge Per Extension 1.0.0 6.5000 EA MECH EXHAUST HOOD 6.50 Permit ELEC-NEW RESIDENTIAL Additional. desc Permit Fee 108.•48 Plan Check Fee 27.12 Issue Date .Valuation . . 0 Qty Unit Charge Per Extension BASE FEE" 15.00' 2297.00_ .0350 ELEC NEW RES - 1 OR,2 FAMILY. 80..40 654.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 13.08 ---------------------------------------------------------------------------- Permit PLUMBING Additional desc :Permit. Fee . . . . 160.50 Plan Check Fee 87.38 Issue Date . . Valuation 0. 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 C, 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 Qty Unit Charge_ Per Extension BASE FEE 15.00 . ----------------------------------------------------------------------------- Special Notes and Comments SFD - LOT 1,PLAN 1BL, 2297 SF " (ATTACHED CASITA).2297 SQ:FT. PERMIT DOES'NOT INCLUDE POOL, SPA, BLOCK WALLS OR DRIVEWAY APPROACH -------------------------------------------------------------------------- Other Fees : ART IN PUBLIC PLACES -RES .00 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC"CENTER - RES 366.00 Page 3 Application' Number 04-00005093 Date 2/02/05 Other Fees ENERGY REVIEW FEE - 51.35 : DIF FIRE PROTECTION -RES 97.00 ' GRADING PLAN CHECK FEE 00 DIF LIBRARIES - RES 225.005 DIF PARK MAINT FAC - RES 5-00 r DIF PARKS/REC - RES 502:00 1 STRONG MOTION (SMI) - RES 14.29 DIF STREET MAINT FAC -RES 15,.00 N DIF.TRANSPORTATION - RES."'s• 1098.00 Fee summary . Charged Paid Credited Due Permit Fee Total 1163.98•- 00 .00 1163.98 Plan Check Total 650.50 ".00 .00 650.50 'Other Fee Total .2470.64 .00 00 2470.64 Grand Total, '4285.12 ': .00 00 4285.12 t a f . .. , 5R Certific''ald of Occu anCY p OF T Building & Safety Department 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. t' BUILDING ADDRESS: 51-865*VIA ROBLADA Use classification: SINGLE FAMILY DWELLING Building Permit No.: 04-5093 - Occupancy Group: R3' Type of Construction:'V-N Land Use Zone:.RL Owner of Building: VISTA LA QUINTA PARTNERS, LLC' Address: 223.E. DE LA GUERRA ` City, ST, ZIP,: SANTA BARBARA-, CA 93140 "By: GARY SHOWALTER -� . Date:, SEPTEMBER 28, 2005 .Building Official, ` + POST IN A CONSPICUOUS PLACE