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05-4909 (SFD)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property. Zoning: Appliootion voluotion. Applicant: C 05-00004909 51905 VIA ROBLADA 772-270-010-16 -311232- DWELLING - SINGLE FAMILY LOW DENSITY RESIDENTIAL 179101 c&t!t440" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: VISTA LA QUINTA PARTNERS, LLC 223 E. DE LA GUERRA DETACHED LA QUINTA, CA 92253 chitteect or Engineer: c - a yX09 -------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I i6sed sedsed un�isio of Chapter 9 (commencing with Section 7000) of Division 3 of the Business a sio my License is in full force and effect. License Class: 13 i s o.: 681660 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 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).: (_ 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 projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). 1 1 I am exempt under Sec. , BAP.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: I'I^� Lender's Address: P r ` LQPERMIT Contractor: WASSERMAN CONSTRUCTION, RA 45520 STONE13ROOK 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 DEC 13 2005 CITY OF LA QUINTA ------------------ WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: _ 1 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 1issued. 1 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 oft ork r which this ermit is issued, I shall not employ any person in any manner so as t ject to the ce compensation laws of California, and agree that, if I should ct 'compensation provisions of Section 3700 of the Labor Cod wi i hose Dr S. 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. 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�rot. I agree to comply with all city and county ordinances and state laws relating to building c sentatives of this court to enter upon the above-mentioned property f , 8ate, ignature (Applicant or Agent): f LQPERMIT Application Number . . . . . 05-00004909 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 470.00 PATTn SQ RTr; 306:00 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 . . 5/03/06 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 5/03/06 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 . Permit Fee . . . . 129.54 Plan Check Fee 8.10 Issue Date . . . . Valuation . . . . 0 Expiration Date 5/03/06 Qty Unit Charge Per Extension BASE FEE 15.00 LQPERMIT Application Number . . . . . 05-00004909 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 1.74.00 P1An Check Fee 10.00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 5/03/06 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 . . 5/03/06 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 LQPERMIT Application Number . . . . . 05-00004909 -------------------7-------------------------------------------------------- Other Fees . . . . . . . . . DIF PARK MAINT FAC - RES 22.00 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 ----------------- Permit Fee Total ---------- 1345.04 -------------------- .00 ---------- .00 1345.04 Plata Cheuk TuLal 193.69 .00 .00 173.69 Other Fee -Total 3729.23 .00 .00 3729.23 Grand Total 5247.96 .00 .00 5247.96 -0 Certificate of Occupancyo U - _ � • ��Ir f'I V1 C OF'T1'�9� 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. BUILDING ADDRESS: 51-905 VIA ROBLADA Use classification: SINGLE FAMILY DWELLING Building Permit No.: 05-4909 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: DAVID GATICA Date: JANUARY 11, 2007 Building Official POST IN A CONSPICUOUS PLACE