BRES2017-021578 Y495.CALLE TAM P.1CQ r
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
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DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/8/2017
BUILDING RESIDENTIAL/DWELLING - SINGLE FAMILY DETACHED Owner:
BRES2017-0215 MICHAEL BEF MAN
52355 ROSS AVE 297 PILGRIM DR
767670027 EDWARDS, CO 81632
BERMAN / 5,325 SF DWELLING/VB/RES-3/CLASS A-FR/13D
$464,041.80
Applicant:
FEDDERLY & ASSOCIATES
78206 VARNER ROAD STE D #248
PALM DESERT, CA 92211
DEC 0 8 2017
CITY OF LA OUINTA
COMMUNITY DEVELOPMENT DEPARTMENT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9
(commencing with'Section 7000) of Division 3 of the Business and Professions Code, and
my License is in full force and effect.
License Class: B License No.: 762889
Date: Contractor: U
OWNER -BUILDER O GARATION
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).:
(_J 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.).
( 11, 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 I am exempt.under Sec. B.&P.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 Addre:
Contractor:
FEDDERLY & ASSOCIATES
78206 VARNER ROAD STE D #248
PALM DESERT, CA 92211
(760)773-5205
Llc. No.: 762689
WORKER'SCOMPEOSATION DECLARATION
hereby affirm under penalty of perjury ore of the following declarations:
I have and will maintain a certificate of consentto self-insure.for workers'
ompensation, as provided for by Section -2700 of the Labor Code, for the performance
f the work for which this permit is issued.
eia I have and will maintain worker:' compensation insurance, as required by
ection 3700 of the Labor Code, for the pe-formance of the work for which this permit is
;sued. My workers' compensation insurance carrier and policy number are: .
:arrier: SECURITY NATIONAL INSURANCE COMPANY Polity Number: 762889
_ I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any marine. so as to become subject to the workers'
compensation laws of California, and agre a that, if I should become subject to the
workers' compensation provisions of Secti :)n 3700 of -the -Labor Code, I shall forthwith
comply with those provisions: r _
Date: Applicant:
WARNING: FAILURE TO SECURE WORKERS COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRMINAL 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 ACYNOWLEDGEMENT
IMPORTANT: Application is hereby made no the Building Official for a permit subject to
the conditions and restrictions set forth or this application.
1. Each.person upon whose behalf this application is made, each person at whose
request and for whose benefit work is perormed 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 city to en pon . e above-
mention�ed�pro�pe�rrtyyfforr inspection purposas.
Date: Signature (Applicant or Agent): -
w
Date: 12/8/2017
Application Number: BRES2017-0215.
Owner:
PropeftV*fdrm-. /%'52355 ROSS AVE
MICHAEL BERMAN
APN: 767670027
297 PILGRIMIDR
Application Description: BERMAN/ 5,325 SF DWELLING/VB/RES-3/CLASS A-FR/13D
EDWARDS, CD 81632
Property Zoning:
Application Valuation: $464,041.80
Applicant:
Contractor:
FEDDERLY & ASSOCIATES
FEDDERLY & ASSOCIATES
78206 VARNER ROAD STE D #248
78206 VARNER ROAD STE D #248
PALM DESERT, CA 92211
PALM DESERT, CA 92211
-
(760)77375205
--------------------------------------------------------------------------------------------
Llc..No.`. 762889
Detail: 5,325 SF DWELLING - MADISON CLUB LOT 7 ]VB/RES-3/CLASS A-FR/13D] THIS PERMIT DOES NOT INCLUDE FIRE SPRINKLERS, POOL, SPA, BLOCK
WALLS OR DRIVEWAY APPROACH. 2016 CALIFORNIA BUILDING CODES.
r
t.,. ::,,�<DESCRIPTION -ACCOUNT QTY. AMOUNT
ART IN PUBLIC PLACES - RESIDENTIAL 270-0000-43201 0 $660.10
Total Paid for ART IN PUBLIC PLACES - AIPP: $660.10
DESCRIPTION
ACCOUNT
CITY
AMOUNT
BSAS SB1473 FEE
101-0000-20306
0
$19.00 .
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $19.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT,
DIF - CIVIC CENTER
252-0000-43200
0.
$942.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DIF - COMMUNITY CENTERS
254-0000-43200
0
$129:00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DIF - FIRE PROTECTION
257-0000-43200 `
0
$433.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DIF - LIBRARIES
253-0000-43200
0
$344.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DIF - PARK MAINTENANCE
256-0000-03200 0
$40.00
DESCRIPTION
ACCOUNTQTY
a
AMOUNT
DIF - PARKS/REC
251-0000-43200 0
$2,048.00
DESCRIPTION
ACCOUNT QTY
AMOUNT
DIF - STREET MAINTENANCE
255-00001-43200 0
$116.00
DESCRIPTION
ACCOUNT QTY
AMOUNT
DIF -TRANSPORTATION '
250-0000-43200 0
$2,842.00
Total Paid for DIF - SINGLE FAMILY DWELLING: $6,894.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TEMP POWER SERVICE
101-0000-42403
0
$25.33
` DESCRIPTION
ACCOUNT
QTY
AMOUNT
TEMP POWER SERVICE PC
101-0000-42600
0
$17.73
Total Paid for ELECTRICAL: $43.06
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RESIDENTIAL, EA ADDITION 1,000SF
101-0000-42403
0
$77.52
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RESIDENTIAL, EA ADDITION 1,000SF, PC
101-0000-42600
0
$31.92
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RESIDENTIAL, FIRST 1,000SF
101-0000-42403
0
$152.00
DESCRIPTION
ACCOUNT
QTY
:AMOUNT
RESIDENTIAL, FIRST 1,000SF, PC
101-0000-42600
0
•$50..16
Total Paid for ELECTRICAL - NEW CONSTRUCTION: $311.60
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RESIDENTIAL PRECISE GRADING - CUSTOM HOME LOT>7KSF
101-0000-42408
0
$38.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
v
RESIDENTIAL PRECISE GRADING - CUSTOM HOME LOT>7KSF PC
101-0000-42600 I 0 I $190.00
Total Paid for GRADING: $228.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
CONDENSER/COMPRESSOR
101-0000-42402
0
$152.00
DESCRIPTION
ACCOUNT -
QTY
AMOUNT
CONDENSER/COMPRESSOR PC
101-0000-42600
0
$101.32
DESCRIPTION
ACCOUNT
QTY
AMOUNT
EXHAUST HOOD
101-0000-42402
0
$12.67
DESCRIPTION
ACCOUNT
QTY
AMOUNT
EXHAUST HOOD PC
101-0000-42600
0
$5.07
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FURNACE
101-0000-42402
0
$152.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FURNACE PC
101=0000-42600
0
$101.32
DESCRIPTION
ACCOUNT
QTY
AMOUNT
VENT FAN
101-0000-42402
0
$126.70
DESCRIPTION
ACCOUNT
QTY
AMOUNT
VENT FAN PC
101-0000-42600
0
$50.70
Total Paid for MECHANICAL: $701.78
DESCRIPTION
ACCOUNT
QTY
AMOUNT
NEW CONSTRUCTION PERMIT
101-0000-42400
0
$765.87
Total Paid for NEW CONSTRUCTIONIPERMIT: $765.87
DESCRIPTION
ACCOUNT
QTY
AMOUNT .
NEW CONSTRUCTION PLAN CHECK .
101-0000-42600
0
$1,500.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
NEW CONSTRUCTION PLAN CHECK
101-0000-42600
0
$144.35
Total Paid for NEW CONSTRUCTION PLAN CHECK: $1,644.35
DESCRIPTION
ACCOUNT
QTY
AMOUNT
BACKFLOW DEVICE
101-0000-42401
0
$12.67
DESCRIPTION
ACCOUNT
QTY
AMOUNT
BACKFLOW DEVICE PC
101-0000-42600
0
$5.07
DESCRIPTION
ACCOUNT
QTY
AMOUNT
BUILDING SEWER
101-0000-42401
0
$25.33
DESCRIPTION
ACCOUNT I
QTY
AMOUNT
BUILDING SEWER PC
101-0000-42600
0
$17.73
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FIXTU.RE/TRAP
101-0000-42401
0
$304.08
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FIXTURE/TRAP PC
101-0000-42600
0
$304.08
DESCRIPTION
ACCOUNT
QTY
AMOUNT
GAS SYSTEM, 5+ OUTLETS
101-0000-42401
0
$38.00
DESCRIPTION ACCOUNT QTY AMOUNT
5+ OUTLETS PC
101-0000-42600
.0
$25.33
101-0000-20308
DESCRIPTION
ACCOUNT
QTY
AMOUNT
'ROOF DRAIN
101-0000-42401
0
i
$190.05
DESCRIPTION
ACCOUNT
QTY
AMOUNT
ROOF DRAIN PC
101-0000-42600.
0
$190.05
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WATER HEATER/VENT
101-0000-42401,
0
$25.34,
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WATER HEATER/VENT PC
101-0000-42600
0
$15.20
` DESCRIPTION
ACCOUNT
QTY
AMOUNT
WATER SYSTEM INST/ALT/REP
101-0000-42401
0
$12.67
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WATER SYSTEM INST/ALT/REP PC
101-0000-42600
0 ,
$12.67
Total Paid for PLUM®NG FEES: $1,178.27
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$60.33
Total Paid for STRONG MOTION INSTRUMENTA-ION SMI: $6033
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00 .
k
I
Total Paid for TECHNOLOGY ENHANCEMENT FEE: .$5.00
DESCRIPTION ACCOUNT QTY AMOUNT
SINGLE FAMILY DETACHED 224-0000-20320 0 $1,837.44
Total Paid for TUMF - RESIDENTIAL $1,837.44