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05-4924 (SFD)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 c&t!t 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: C05-00004924 Property Address: 51955 VIA ROBLADA APN: 772-270-010-15 -311232- Application description: DWELLING - SINGLE FAMILY DETACHED Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 158078 Applicant: rchitect or Engineer: -scrar- G -2(1g09 ------------------ LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am rider provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business one d d License is in full force and effect. License Cla B e go at�l2 /t � ntractor. 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.). (_ ) 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: Lender's Address: LQPERMIT Owner: VISTA LA QUINTA PARTNERS 223 E. DE LA GUERRA SANTA BARBARA, CA 93140 Contractor: WASSERMAN CONSTRUCTION, RA 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 U Date: 11/04/05 DEC 13 2005 --------------------------------------------- WORKER'S COMPENSATION DECLARATION 1 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. X 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 insurance carrier and policy number are: Carrier STATE FUND Policy Number 0014586-2005 _ 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 om subject to the workers' compensation laws of California, and agree that, if 1 shout a je t e orkers' compensation provisions of Section $700 of the Labor Cod f p with those provisions. e 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. 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 bo or!�'P,"by ion is cor t. I agree to comply with all city and county ordinances and state laws relating t0 buildin s authorize representatives of this cou y enter upo the above-mentioned pr pert n Clete: Signature (Applicant or Agent): Application Number . . . . . 05-00004924 Permit . . . Additional desc . . Permit Fee . . . . Issue Date . . . . Expiration Date . . Qty Unit Charge 2408.00 .0350 LQPERMIT ELEC-NEW RESIDENTIAL 124.26 Plan Check Fee Valuation 5/03/06 Per BASE FEE ELEC NEW RES - 1 OR 2 FAMILY 7.77 0 Extension 15.00 84.28 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 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 137.48 Issue Date . . . . Valuation . . . . 158078 Expiration Date . . 5/03/06 Qty Unit Charge Per Extension BASE FEE 639.50 59.00 3.5000 ---------------------------------------------------------------------------- THOU BLDG 100,001-500,000 206.50 Permit . . . MECHANICAL Additional desc . Permit Fee 96.50 Plan Check Fee 6.03 Issue Date . . . . Valuation . . . . 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 6.00 6.5000 EA MECH VENT FAN 39.00 1.00 6.5000 ---------------------------------------------------------------------------- EA MECH EXHAUST HOOD 6.50 Permit . . . Additional desc . . Permit Fee . . . . Issue Date . . . . Expiration Date . . Qty Unit Charge 2408.00 .0350 LQPERMIT ELEC-NEW RESIDENTIAL 124.26 Plan Check Fee Valuation 5/03/06 Per BASE FEE ELEC NEW RES - 1 OR 2 FAMILY 7.77 0 Extension 15.00 84.28 Application Number . . . . . 05-00004924 Permit . . . . ELEC-NEW RESIDENTIAL Qty Unit Charge Per Extension 1249.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 24.98 ---------------------------------------------------------------------------- Permit . . . PLUMBING Additional desc . . Permit Fee . . . . 180.00 Plan Check Fee 11.25 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 5/03/06 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 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 15, PLAN 2BR (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. 75% REDUCTION TO PLAN CHECK FEE DUE TO MULTIPLE ISSUANCE OF SAME PLAN TYPE -------------------- Other Fees ------------------------------------------------------- . . . . . . DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER - RES 480.00 ENERGY REVIEW FEE 13.75 DIF FIRE PROTECTION -RES 140.00 DIF LIBRARIES - RES 355.00 DIF PARK MAINT FAC - RES 22.00 DIF PARKS/REC - RES 892.00 LQrERMrr Application Number . . . . . 05-00004924 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STRONG MOTION (SMI) - RES 15.80 DIF STREET MAINT FAC -RES 67.00 DIF TRANSPORTATION - RES 1666.00 Fee summary Charged Permit Fee Total 1261.76 Plan Check Total 162.53 Other Fee Total 3725.55 Grand Total 5149.84 LQPERMIT Paid Credited Due .00 .00 1261.76 .00 .00 162.53 .00 .00 3725.55 .00 .00 5149.84 Certificate of Occupancy0 o T&f ot C� OFT9w 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 jhe various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 51-955 VIA ROBLADA Use classification: SINGLE FAMILY DWELLING Building Permit No.: 05-4924 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 Jb J Date: JANUARY 11, 2007 Building Official POST IN A CONSPICUOUS PLACE