04-5097 (SFD)a,
s ���✓��� BUILDING & SAFETY DEPARTMENT
w P.Os BOX 1504
(760).777-7012
758-4i9 �CALLE TAMPICO FAX (760) 777-7011
F� LQUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number 04�000�0_509_7 Date 2/02/05
Property Address . . . 51880 VIA ROBLADA
APN: 772-270-010-27 -311231-
Application description DWELLING - SINGLE FAMILY DETACHED
Property Zoning . . . . . .LOW DENSITY RESIDENTIAL_
Application valuation 210784
Owner Contractor
VISTA LA QUINTA PARTNERS; LLC WASSERMAN CONSTRUCTION, RA
223 E. DE LA GUERRA 45520 STONEBROOK COURT
LA QUINTA. CA 92253 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/CONG <=10
Flood Zone . . . . NON-AO.FLOOD ZONE
Other struct info . . CODE EDITION 2001
# BEDROOMS 4.00
FIRE SPRINKLERS NO
GARAGE SQ FTG 455.-00
PATIO SQ FTG 207.00
NUMBER.OF UNITS 1.00
1ST FLOOR SQUARE FOOTAGE 2281.00
2ND FLOOR SQUARE FOOTAGE 1200.00
Permit . . . . BUILDING PERMIT
Additional desc
Permit Fee . . . . 1028.00 Plan Check Fee 6.68.20
Issue Date . . . . Valuation 210784
Qty -.Unit Charge Per Extension
.BASE FEE P 639.50
111.00 3.5000 THOU BLDG 100,001-500,000 " 388.50
---------------------------------------------------------------------7------
Permit . . . . . . MECHANICAL
Additional desc
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
P.O. BOX 1504 4 4 �I,I�G�
DIY VOICE (760) 777-7012
78-495 CALLE CALIFORNIA FAX (760) 777-7011
LA QUINTA, LIFORN92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: U 41 -nail— Date:. to - O
Applicant:I Architect or Engineer:.
Applicant's Mailing Address:
—Architect or Engineer's Address:
u-�-� C'°IY�s, N,ha`-ycals I ne-
No.: (2�_�aq `coq
tSUILUING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of he Business and Professionals
Code,And my Licggse is in full force and effect. . R (0
nse Class D nse No.
/ate O Contractor �� W 5� � (11�n6,AM &tw—
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the allowing 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 he 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 he 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 he 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 V D5- Owner _ ak . W jj%ta%�
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.
lel 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
.ssu d. My rkers' mpensation ' rance carrier a po_lii n tuber are:
erQ� Policy Number t�T O U)'�
— 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 he workers'
compensation laws of California, and agree that, if I should become subject to he workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
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.
I hereby affirm under penalty of perjury that there is a construction lending I age cyfor the AGENCY LENDING
the performance of he work for which this permit is issued (Sec. 3097, Civ. C.).
Lenders Name
Lenders Address
APPLICANT IMPORTANT Application is ereby made to the Director of Buildingand Safety or ACKNOWLEDGEMENT
the
conditions and s set forth on this
1. Each person upon whose behalf this application is made. each person at we whose reqrmit ue t and for whose benefit work isnperformed under or pulrsuant 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 employeesfor 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 his application and state that the above information ' r I ag o comp with all city and county ordinances and state laws relating to building
construction, and
lannd hereby authorize representatives of this county to enter o me ed operty for inspection purposes.
Date . C l V Q)ySignature (Applicant or Agent):
Page
2
Application Number. '.
. . . . 04-00005097 Date
2/02/05
Qty Unit Charge
Per
Extension
6.00 6.5000
EA 'MECH VENT FAN
39.00
1.00 6.5000
EA MECH EXHAUST HOOD
6.50•
Permit' . . ... . ELEC-NEW RESIDENTIAL
Additional.desc
Permit Fee . . . .
150.08 Plan Check Fee
37.52
Issue`Date . . . .
Valuation
0
Qty Unit Charge
Per
Extension
BASE FEE
15-:00
3481:00 .0350
ELEC NEW RES -,1.OR 2 FAMILY
121.84
662.00 .0200
ELEC GARAGE OR NON-RESIDENTIAL
13.24
Permit PLUMBING
Additional desc..
Permit Fee . . . .
178.50 Plan Check Fee
44.63
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 ..
7.50
1.00 3.0000'
EA PLB WATER INST/ALT/REP
3...'00
.1.00 9.0000
EA PLB LAWN SPRINKLER SYSTEM
9.00
8.0.0 .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 PEE
15.00
Special Notes and Comments
SFD - LOT 27,.PLAN 5AR
3481 SQ.FT. LIVING, R73
OCC. TYPE V -N
CONSTRUCTION, 2001 CODES.
PERMIT DOES
NOT INCLUDE POOL, SPA,
BLOCK WALLS OR DR
VEWAY APPROACH
Other Fees :.
ART IN PUBLIC PLACES -RES.'
26.96
Page
3
Application Number
. . .
04-00005097 Date
2/02/05
Other Fees
. . . . .
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER -`RES
366.00
ENERGY REVIEW FEE,
66.82
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
21.07
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
Charged
Paid Credited
Due
Permit Fee Total
1468.08
:00 .00
1468.08
Plan Check Total
774.48
.00 .00
774.48
Other Fee Total
2519.85.
.00 .00
2519.85
Grand Total
4762.41
00 .00
4762.41
t
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�- � Certificate of Odcupanpy
4.�
4
tas 1 r
`
, ...
OF 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:
_ BUILDINGADDRESS: 51-880 VIA ROBLADA
Use.classification: SINGLE FAMILY DWELLING Building Permit No.: 04-5097
Occupancy Group: R3 '_ Type of Construction: -V-N Land Use Zone: RL
`Owner ofBuilding:,VISTA LA QUINTA PARTNERS, LLC ' Address: 223 E. DE LA GUERRA
y City, ST, ZIP: SANTA BARBARA, -CA 93140
l d' By: GARY SHOWALTER
`
- Date: SEPTEMBER 29, 2005
Building Official
POST IN A CONSPICUOUS PLACE t
ILF;M
.... i• NI:.H.ih' r"-.TiR . a.R �2..: '. r.. '. •. f'.�.z'.iT.