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04-5926 (SFD)tal�l'"A"'�Q•� ot, BUILDING & SAFETY DEPARTMENT zO B,ox 1504 (760).777-7012 �`OFT9 ��78-495° CALLS TAMPICO FAX (760) 777-7011 CT 0,� �LA QUINTA, CALIFORNIA 92253 INSPECTION: REQUESTS. (760) 777-7153 BUILDING PERMIT Application Number . . . . .%.04-00005926 Date 8/12/04 Property Address . . . . 56745 VILLAGE DR APN: 764 -050 -001 - Application description DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . . . LOW DENSITY RESIDENTIAL Application valuation . . . . 3.01865 Owner ------------------------ HOWARD ROBERT F 5228 LUBOA AVE WOODLAND HILLS CA 91364 Contractor. ---------------- SANTA ROSA BUILDERS, INC. P.O. BOX 11335. PALM DESERT CA 92255 Qty Unit ChargePer Extension WCC: STATE FUND WC: 177037904 01/01/05 CSLB: B 10/31/04 CCC: 814110 ------ Structure Information 3406 SQ. FT SFD ----- Construction Type . . . . . TYPE V - NON RATED Occupancy Type . . . . DWELLG/LODGING/CONG <=10 Flood Zone NON -AO -FLOOD ZONE Other struct info CODE EDITION 2001 CBC # BEDROOMS 3.00 FIRE SPRINKLERS NO GARAGE SQ FTG 774.00 PATIO SQ FTG F. 8.64..,0.0 NUMBER OF UNITS 1:00 FIRST FLOOR SQ FTG 3406.00 Permit . . BUILDING PERMIT Additional desc Permit Fee . . . . 1346.50 Plan Check .Fee.. 15.23 Issue Date Valuation 301865 Qty Unit.Charge Per Extension BASE FEE 639.50 202.00 3.5000 THOU BLDG 100,001-500,000 707.00 Permit . . . . . . ELEC-'NEW RESIDENTIAL Additional desc Permit Fee . . . 164.69 Plan Check Fee 28.51 Issue Date . . . . Valuation . . . . 0 Qty Unit ChargePer Extension s P.O. Box 1504 Tay, VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Date: Applicant: I Architect or Engineer: 0/✓"LZJ4-r:Lo 2.— Applicant's Mailing Address: Architect or Engineer's Address: Lic. 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 Lice ps� is in full force and effect. �! �. License Class fS License No. l ho Date !. 7 �� Contractor 54 9&010-q hJt-L! tG� lJf , 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 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 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' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is C�i ued. J�oddy workers' compensation insurance carrier and polic number are: Carrier sk� t'K0 of Policy Number_1 7 % 7 qol _ 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. Date—"0/7/191 Applicant 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 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. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. Date 10/1/0 A Signature (Applicant or Agent): ;�1 Page 2 Application Number . . . 04-00005926 Date 8/12/04 Qty- Unit Charge Per Extension BASE FEE 15.0.0 3406.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 1-19.21 774.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 15.48 1.,00 15.0000 EA ELEC TEMPORARY POWER POLE 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 Permit . . . . MECHANICAL Additional desc Permit Fee . . 108..00 Plan Check Fee 2700 Issue'Date . . . . Valuation 0 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 .5.00 6.5000 EA MECH VENT FAN 32.50 1:00 6.5000 EA MECH EXHAUST HOOD 6.50 Permit PLUMBING Additional desc Permit Fee 264.75 'Plan Check Fee 66.19 Issue Date . . Valuation 0 Qty : Unit Charge' 'Per Extension - BASE FEE 15.00 20.00 6.0000 EA PLB FIXTURE 120.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 12.00 6.0000 EA' PLB ROOF DRAIN - 72:00' 1.00 7.50.00 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 11.00 .7500 EA; PLB GAS PIPE >=5 8.25 1_..00 15.0000 EA PLB GAS METER 15.00 Page. 3 Application.Number . . . 04.-00005926 Date 8/12/04" ------------------ Special Notes and Comments 3406 SF. FT. SFD. THIS PERMIT DOES NOT INCLUD.E.POOL & SPA , BLOCK WALLS OR DRIVE APPROACH.PERMIT WAS ADJUSTED'TO SHOWJ$872.66 PAID FOR PLAN CHECK,PAID ON APR'. 09 2004 Other Fees . . . . . . . ART IN PUBLIC PLACES -RES,' 254.66 DIF COMMUNITY CENTERS -RES 97.00-. DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 1.52 DIF FIRE'PROTECTION-RES o " GRADINGPLAN CHECK FEE 00 • ,DIF LIBRARIES'- RES 225.00 DIF PARK MAINT-FAC - RES 5.00 DIF PARKS/REC.- RES 502.00 STRONG MOTION'(SMI) - RES 30.18 'DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Paid Credited Due Permit Fee Total 1898.94 .00 .00 1898.94, Plan Check Total 136.93 .00 .00 136.93 Other Fee Total 2691.36 .00 .00 2691.36 Grand Total 4727.23 00 '' .00, 4727.23 iY.P'3 c&ty/,4, P.O. BOX 1504 Building xZ495 CALLE TAMPICO Address NTA, CALIFORNIA 92253 Owner�� Mailing Address fj�ifipve- City yZip Tel. p I) s. 8f0 Contractor Address 70 � City Cod e ms✓ Cit )l . / Zi AA 22 T/el.. { 0U 1 h p State Lic. City & Classif.ROW r h Engr., II 11 signer 5CAAatn F� y� 1i ews ArLtT I cc W3 C.41111,141A Vr- 16;L07/7-4977 ity Zip State =os v 196,066 Lic. # 6-032Z8 LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Secti 7000) of Division 3 of the Business and Professions Code, and my license is in full force lid effect. OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the'•Contractor's License Law for th following reason: (Sec. 7031.5.Business and Professions Code: Any city or county whi requires a permit to construct, alter, improve, demolish, or repair any structure, prior to it Issuance also requires the applicant for such permit to file a signed statement that he is lice ed pursuant to ,requires provisions or the Contractor's License Law, Chapter 9 (commencing with action 7000) of wsron 3 .1 the Business and Professions Code, or that. he is exempt there m, and the basis to the alleged exemption. Any violation of Section 7031.5 by 'any licant for a permit sub' qts the applicant to a civil penalty of not more than live hundred dollars ($ 00). I -:s owner of the property, or my employees with wages as their le compensation, will do th work, and the structure is not intended or offered for sale. ec. 7044, Buisness and Profess ns Code: The Contractor's License Law does not apply to n owner of property who builtls or improves thereon and who does such work himself or t rough his own employees, provided 1 t such improvements are not intended or offered for e. 11, however, the building or improve nt is sold within one year o! completion, the own r -builder will have the burden o! proving fAa a did not Duild or improve for the purpose oI sale.) - I I I, as owner f the property, am exclusively contracting ith licensed contractors to con- struct the project. (Sec. 7044, Business and Professions de: The Contractor's License Law does not apply fob$n owner o! property who builds or impr ves thereon, and who contracts for such projects will, a iontracfor(s) licensed pursuant to the Co tractor's License Law.) 7 I am exempt under\ec. B. & P.C. for his reason Date WORKERS' COMPEN ATION DECLARATION I hereby affirm that I haves terrific a of consent to self -insure, or a certificate of Worker's Compensation Insurance, ora ce ified copy thereof. (Sec. 3800, Labor Code.) Policy No. Comp ny (7 Copy is filed with the city. ❑ • rtified copy is hereby furnished. CERTIF ATE F EXEMPTION FROM WORKE 'COMP NSATION INSURANCE (This section need not be compl ed if the p if is for one hundred dollars ($100) valuation or less.) I certify that in the perfor ante of thg wor for which this permit is issued, I shall not employ any person in any liner so as to bec a sublect to the Workers' Compensation Laws of California. Date Owne NOTICE TO APPLICANT If, after making this Certifi to of Exemption you should become subject to'the Worke Compensation provisions of Qe Labor Code, you must forthwith comply with such pro vi ons or this permit shall be deemed re ked. / CONSTRUCTION LENDING AGENCY\ I hereby a tum that there is a construction lending agency f the performance of the work for whi. This permit is issued. (Sec. 3097, Civil Code.) Lender's N me Lender's ddress This i a building permit when properly filled out, signed and validated, nd is subject to expira1. if work thereunder is suspended for 180 days. I cer4(fy that I have read this application and slate that the above informab n is correct. I agr to comply with all city and county ordinances and state laws relating to building con;ruction, and hereby authorize representatives sof this city to enter t above - me boned property for inspection purposes. gnalureof applicant Date ailing Address City, State, Zip Sq2� APPLICATION ONLY BUILDING: TYPE•CONST. OCC. GRP. A.P. Number U4 - 05 O — 00/ Legal Description n ©,0I 10+e T A Project Description 5-F17- &J 9 *'R 3.P.4 Q ? Sq. Ft. Size New,( No. No. Dw. Stories Units Add ❑ Alter ❑ Repair ❑ Demolition ❑ itimated Valuation PERMIT AMOUNT Plan Chk. Dep. — Plan Chk. Bal. Const. 14 Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line ----- - j Side Setback from-Propert� I� FINAL DATE I NSPECTOR i I J n g� q Pppe&Pt 2094 '101 Issued by: DatetYlI a i ��r:�-'� Validation: ` CITY Cly i 'r E° Xr'tOE QEP WHITE = BUILDING DEPARTMENT YELLOW = APPLICANT PINK = FINANCE Coachella Valley Unified School District P.O. Box 847, Thermal, CA 92274 (760) 398-5909 — Fax (760) 398-1224 This Box For District Use Only DEVELOPER FEES PAID AREA: AMOUNT .. LEVEL ONE AMOUNT: LEVEL TWO AMOUNT: MITIGATION AMOUNT: COMWIND. AMOUNT: DATF: RFr..F.IPT- (:HECK B- INITIALS' , CERTIFICATE OF COMPLIANCE (California Education Code 17620) I Project Name: Village at the Palms . (private residence) Date October 7, 2004 Owner's Name: Robert & Susan Howard Phone 391-5574 Project Address: 56-745 Village Drive La Quinta;=CA 1 SFD Project Descri tion: APN 764-050-001 Tract Lot Irype of Development: Residential XXX Commercial XX Industrial Total Square Feet of Building Are 3,406 sq. ft. Certification of Applicant/Owners: The person signing certifies that the above information is correct and makes this statement under penalty of perjury and further represents that he/she is tho ' ed to sign on behalf of the owner/developer. * Date October 7, 2004 Silinature: SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN, ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE) , ,- Education Code Gov. Code 17620 65995 Project Agreement Existing Approval Prior to 1/1/87 Note: Number of Sq.Ft. 3,406. i Amount Collected $ 9,128.08 ` Building Permit Application Completed: Yes/No By: Carey M. Carlson, Asst. Supt., Business Services ' Amount per Sq.Ft. 2.68 issued by: I Elvira Mattson, Office Technician Not Subject to Fee Requirement r 1 � NOTICE OF 90 DAY PERIOD FOR PROTEST OF FEES AND STATEMENT OF FEES Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that this District provide (1) a written notice to the project appellant, at the time of payment of school fees, mitigation payment or other exactions ("Fees"), of the 90 -day period to protest the imposition of these Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Government code and other applicable law, this Notice shall serve to advise you that the 90 -day protest period in regard to such Fees or the validity thereof, commences `with the payment of the fees or performance of any other requirements as described in section 66020 of the Government code. Additionally, the amount of the fees imposed is as herein set forth, whether payable at this time or in whole or in part prior to issuance of a Certificate of Occupancy. As in the latter, the 90 days starts on the date hereof. This Certificate of Compliance is valid for thirty (30) days from the date of issuance. Extension will be granted only for good cause, as determined by the School District, and up to three (3) such extensions may be granted. At such time as this Certificate expires, if a building permit has not been issued for the project that is the subject of this Certificate, the owner will be reimbursed all fees that were paid to obtain this Certificate of Compliance. Ac r G of La uinta 7-7-7—'7//a' tY Q Building U Safety Division P.O. 'Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit,#� Project Address: 4 i ' Owner's Name: A. P. Number: Address: 5 Z 2. b . L Legal Description: Contractor: City, ST, Zip:k„�L Telephone: ' i Project Description: Address: ! 'S i zo E5=rA0C-, City, ST, Zip: (,p QA 9 zzs3 . f✓AA,_c `tom S`—C�EI_ T2J�S env--� .Telephone: (Scoq s State Lie. # : i q IVO City Lie. #: Arch., Engr., Designer: Sc -OTT AL14.,p 2- o 'o ze_ Address: y 3 Z 3 ' � ')e, - City, ST, Zip: [ _O.S C A dt3l�S� Telephone: 1, f O -711 y 9'7 Construction Type: Occupancy: State Lie. #'. 4�_= . Z L Z g� Name of Contact Person: [� ;�� Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: #Units: Telephone # of Contact Person: -7(64Z) %OZ Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACMG . PERMIT FEES Plan Sets Plan Check submitted 3 y 66 Itcm Amount Structural Calcs. Reviewed, ready focorrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted 0 Mechanical Grading, plan 2"" Review, ready or corrections/iss Electrical Subcontactor List Called Contact on Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 7r° Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees `'/3! /0lo bio ATL5 2 j. 2 10 -61 M E M 0 ANDU'M 5w of _TO: Gary Hartman, Building Inspector FROM:. Greg Butler, Building & Safety Manager " DATE: October 13, 2005 RE: Bevolo Gas & Electric Lights have reviewed the documentation that your customer provided in.the course of. seeking our approval for the installation of Bevolo gas light fixtures within the City of La Quinta. Based upon the manufacturer's installation and: lighting instructions and the. conditions of listing by Intertek ETL Semko; I find it permissible to use this natural -gas-fired lighting fixture under the following conditions: 1. The unit must be installed in strict.compliance with the conditions of the product listing (attached), and; .2: If the product is to be installed under a patio cover, the requirements for indoor installation must be followed: a. The unit must be equipped with a flame sensor; b. The unit must be provided with.a minimum of 12 clearance from the ceiling and 6". clearance from all walls. These measurements need .not betaken. from mounting bracket(s), but are to be taken from the fixture itself. This approval shall not extend to any other brand of lighting fixture. _ 1 rS •Directory of Listed Products Page 1 of 1 GAS-FIRED ILLUMINATING APPLIANCES BEVOLO GAS & ELECTRIC LIGHTS, LLC. New.Orleans, LA USA Natural Gas -Fired Outdoor Illuminating Fixtures, Model Nos. Coach House, Cotton Exchange, French Quarter B •racket, French Quarter Gooseneck, French Quarter�Yoke, French Quarter w/London Street Top and Bottom, Governor, London Street, Mailbox, Royal Sonesta, Spider Bracket, ,Square Hanging, Williamsburg Bracket, Williamsburg Flush. These units may be used indoors when equipped with a flame sensor and are provided with a minimum of 12" of clearance from the ceiling and 6" of clearance from all walls. No unit exceeds 5000 Btu/Hr. 'Evaluated. to the following... A representative sample of the listed devices have been tested, investigated -and found to comply with the requirements of the Standard(s) for Gas -Fired Illuminating Appliances (ANSI=Z21.42) and are identified with the ETL Listed Mark. http://etlwhidirectory.etlsemko.com/WebClients/ITS/DLP/products.nsf/6a421 efeead6f2l 6... 10/4/2005 AUTHORIZATION TO MARKr ' 'Dais- audwrizei the application of the. Certification Marks shown below to the. Product Covered (also to the multiple liistee "model identified on the correlation page of the ]Listing Report where . applicable) when. made in accordance with the Description and under the conditions set forth in the Ontil cation Agseewent and Listing Report: ; APPlflcant: Revolo.Gas and Electric Lights, LLC.. .� C t"� sal coaxa; Street New Orleans, LA 70130 Contact: Drew Bevolo Pt;9ne: (504) 522-9485 Manufactwrer: Bevolo Gas and Electric )tights; LLC_ - 1812 Enterprisc'Drive Harvey, LA 70058 Cmmtar&: 'Paul Russel Phone: (504)348-3842 l Party Aug.horized To Apply Marl- Manufacturer Report issn.ing Office: ' Duluth. GA Report No. J98*35322-001 . Product Covered: Natural Gas -Fired Outdoor illuminating Fixtures, models Coach House, Cotton Exchange, French Quarter Bracket, French Qua�rtes Gooseneck, French Quarter Yoke, French Quarter w/London Street top and bottom, Govemor, London Street, Mailbox, Royal . Sonesta, Spider Bracket, Square Hanging, Williamsburg Bracket, Williamsburg Flush: 'd'hese units may used imdoors when equipped with a dams sensor and are provided with a minimum ;of E2 inches of clearance from dw ceiling and 6 ince= of clearance from: all walls. No unit exceeds 5000 Btu/Hr Description: The products covered are ntly-coeur natural gas-fired illuminating fixtures ' . - intended for outdoor use, suitable for dry, damp.and wet locations. ` ' These units may be used for indoor use under the above conditions. Standard(s): Csas-Fared Illuminating Appliances (ANSIMI.42) This d t is P of and is not >t ivaerable. Only the Applicant:F y reproduce tlk d L ne tib (s) may be mppned only ag: above.not� 4 location of the Pu rty Andhorbed To apply Mark.' us .Authorized byr ���(/V/V/////"' n _ Date: William T. Starr, Certification Manag ler'-- , Control Number: intertek f 165 Main Street, Cortland, NY 13045 Telephone (800)345-3851 or (607) 753-6711 Fax (607) 756-6649