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07-2694 (MFD5)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: lJ 07-00002694 47795 DUNE PALMS RD 600-020-030- - DWELLING - 5 OR MORE REGIONAL COMMERCIAL 8121618 P BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: COACHELLA VALLEY 45701 MONROE ST FAMILY INDIO, CA 92201 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 HOUSING COALI 1-G Contractor: Architect or Engineer: BROWN CONSTRUCTION, INC. PO BOX 980700 r-01 WEST SARAMENTO, CA 95798 (916)373-9300 Lic. No.: 396120 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 License is in full force and effect. License Class: B License No.: 396120 Date: Contractor: 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 0500).: I _) 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.). (_) 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. , 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 Address: Date: 2/07/08 WORKER'S 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 issued. My workers' compensation insurance carrier and policy number are: Carrier AMER INC Policy Number 3424477 I certify that, in the performance of the work for which this permit is issued, 1 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 provi.mns„�. Date: Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS NLF)WFUL, APfO-SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO, E WUNDRED THOUSAND � -•` �_ 1)�tl DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, D , AQ)ES AS�PRgyIDED FOR IN 1% i SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.i ;"";•.' APPLICANT ACKNOWLEDGE N NT t.-.._ _., IMPORTANT Application is hereby made to the Director of Building and Saf t for a - PP Y 9 Y P��h:sub�ectlo�ihe ' conditions and restrictions set forth on this application.'"`-°� 1. Each person upon whose behalf this application is made, each person at whoSEr'�Cft�i5f aitds�or whose benefit work is performed under or pursuant to any permit issued as a result of ihtspollieation, 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: Signature (Applicant or Agent): V ( I Application Number . . . . . 07-00002694 Permit . . . . . . ELEC-NEW RESIDENTIAL Qty Unit Charge Per Extension BASE FEE 15.00 81191.00 .0300 ELEC NEW RES - MULTI FAMILY 2435.73 56455.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL ---------------------------------------------------------------------------- 1129.10 Permit . . . PLUMBING Additional desc . Permit Fee . . . . 5445.00 Plan Check Fee 1361.25 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 8/05/08 Qty Unit Charge Per Extension BASE FEE 15.00 574.00 6.0000 EA PLB FIXTURE 3444.00 2.00 15.0000 EA PLB BUILDING SEWER 30.00 20.00 6.0000 EA PLB ROOF DRAIN 120.00 68.00 7.5000 EA PLB WATER HEATER/VENT 510.00 68.00 3.0000 EA PLB WATER INST/ALT/REP 204.00 136.00 .7500 EA PLB GAS PIPE >=5 102.00 68.00 15.0000 EA PLB GAS METER ---------------------------------------------------------------------------- 1020.00 Permit . . . GRADING PERMIT Additional desc . . Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 8/05/08 Qty Unit Charge Per Extension ' BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments 144,751SF .[TYPE:J-1/J-2/GARAGE]/V-1HR, I-FR/RES-1, S-3/68 - DWELLING UNITS - ALLOWABLE AREA INCREASES: MULTISTORY / FIRESPRINKLERS / SIDEYARD [3STORIES./ 49,140SF MAX] CBC311.2.2.1 - GROUP S-3 WITH GROUP R-1 ABOVE, MIXED USE. THIS PERMIT DOES NOT INCLUDE SITEWALLS, SITE LIGHTING, CARPORTS OR TRASH ENCLOSURES. 2001 CBC, CPC, CMC, 2004 CEC, 2005 ENERGY CODE. [BUILDING: 9100/9200 - TYPE: J-2, 9300/9400 - TYPE: J-1, PARKING GARAGE] January 31, 2008 11:11:12 AM.AORTEGA Application Number . . . . . 07-00002694 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ACCESSIBILITY PLAN REVIEW 1155.93 ART IN PUBLIC PLACES-RES 19804.04 DIF COMMUNITY CENTERS-RES 4964.00 DIF CIVIC CENTER - RES 15572.00 ENERGY REVIEW FEE 1155.93 DIF FIRE PROTECTION-RES 2176.00 DIF LIBRARIES - RES 23664.00 DIF PARK MAINT FAC - RES 1428.00 DIF PARKS/REC - RES 59568.00 STRONG MOTION (SMI) - RES 812.16 DIF STREET MAINT FAC-RES 2652.00 DIF TRANSPORTATION - RES 76636.00 Fee summary ----------------- Charged Paid Credited Due Permit Fee Total ---------- 29141.33 ------------------------------ .00 .00 29141.33 Plan Check Total 14394.99 .00 .00 14394.99 Other Fee Total 209588.06 .00 .00 209588.06 Grand Total 253124.38 .00 .00 253124.38 C Application Number . . . . . 07-00002694 ------ Structure Information 97,076SF/V-lHR,I-FR/R-1,S-3(J-1/J-2+GAR]----- Other struct info . . . CODE EDITION 2001/2004/200S # BEDROOMS 148.00 FIRE SPRINKLERS FULLY FLOOD ZONE NO GARAGE SQ FTG 43778.00 PATIO SQ FTG 7105.00 NUMBER OF UNITS 68.00 1ST FLOOR SQUARE FOOTAGE 29954.00 2ND FLOOR SQUARE FOOTAGE 29098.00 3RD FLOOR SQUARE FOOTAGE 22139.00 ---------------------------------------------------------------------------- Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 17783.50 Plan Check Fee 11559.28 Issue Date . . . . Valuation 8121618 Expiration Date . . 8/05/08 Qty Unit Charge Per Extension BASE FEE 3539.50 7122.00 2.0000 THOU BLDG 1,000,001 - UP 14244.00 ---------------------------------------------------------------------------- Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 2318.00 Issue Date Expiration Date 8/05/08 Plan Check Fee 579.50 Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 68.00 4.5000 EA MECH VENT INST/ DUCT ALT 306.00 68.00 9.0000 EA MECH B/C <=3HP/100K BTU 612.00 2.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 33.00 70.00 6.5000 EA MECH AH <=10K CFM 455.00 70.00 6.5000 EA MECH VENT FAN 455.00 66.00 ---------------------------------------------------------------------------- 6.5000 EA MECH EXHAUST HOOD 442.00 Permit . . . ELEC-NEW RESIDENTIAL Additional desc . Permit Fee . . . . 3579.83 Plan Check Fee . Issue Date . . . . Valuation Expiration Date . . 8/05/08 Qty Unit Charge Per 894.96 0 Extension 04 La v_u�Q c�o CITY OF LA-_QUINTA �F 5� BUILDING & SAFETYbEPAR7MENT oe (760) 777-7012,- INSPECTION REdU bt—ljNE (760) 777-7154� � g; rUJ Owner COA('HN_1 I AyAtst.N:Y Hull llNtT Contractor RROWN C'ON$TRLTCTION Permit Number 07-1694 - I POST ON JOB IN CbNt$ftWOUS GLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES JOB ADDRESS (OVER) TYPE OF INSPECTION DATE INSP. TEMPORARY POWER SETBACKS U/G PLUMBING"/ WASTE U/G ELECTRICAL / GROUNDING FOOTINGS / STEEL CONCRETE SLAB DO NOT POUR CONCRETE UNTIL ABOVE SIGNED ROOF NAIL / PRE -ROOF "Z- - Z• •a OKAY TO WRAP O FRAMING COMBINATION ROUGH ELECTRIC ROUGH PLUMBING D ROUGH MECHANICAL 1 INSULATION COVER NO WORK UNTIL ABOVE SIGNED INTERIOR GYP. BD. DRYWALL 3 O EXTERIOR LATH GAS TEST SEPTIC ABANDONMENT SEWER CONNECTION SEPTIC / GREASE INTERCEPTOR � I I MASONRY INSPECTIONS FOOTINGS / STEEL BOND BEAM POOL / SPA / WATER FEATURE INSPECTIONS PRE-GUNITE / SETBACKS U/G PLUMBING U/G GAS U/G ELECTRICAL PRE -BLASTER (ALARMS / BARRIERS)I 1 'Y- _ d / �i 6I - CIIJAI IAICDC!`_TIANIC _ i/[1 \ '- MP. USE OF P RMANENT POWE ELECTRICAL PLUMBING MECHANICAL PUBLIC WORKS DEPARTMENT COMMUNITY DEVELOPMENT DEPT. 109 FINAL / JOB COMPLETED 174111 • 0 ABOVE APPROVALS DO NOT INCLUDE RIGHT TO TURN ON UTILITIES OR OCCUPY BUILDING m+kr rs Ll3 r>t7 F zs S41 ow ersz� . LJc�sT- L 7r Lc -u0aL� rvL, J�7.5 CO't CC •TS 5-tz cPc�1 144,751SF [TYPE:J-1/J-2/GARAGE]N-1HR, I-FR/RES-1, S-3/68 - DWELLING UNITS - ALLOWABLE AREA INCREASES: MULTISTORY / FIRESPRINKLERS / SIDEYARD 13STORIES / 49,140SF MAX] CBC311.2.2.1 - GROUP S-3 WITH GROUP R-1 ABOVE, MIXED USE. THIS PERMIT DOES NOT INCLUDE SITEWALLS, SITE LIGHTING, CARPORTS OR TRASH ENCLOSURES. 2001 CBC, CPC, CMC, 2004 CEC, 2005 ENERGY CODE. [BUILDING: 9100/9200 - TYPE: J-2, 9300/9400 - TYPE: J-1, PARKING GARAGE] January 31, 2008 11:11:12 AM AORTEGA Go LFoA)L�- a hp-evr 4'*ewe Ste. � s �2EA � g-rgc S -(8�a ;5Uag 51•A a �+� �' sue. a• at 7•®� 9/oo ?, (2,�7- 92.0.0 F1ac2 r34ju q . (u, o 57'p,1p-c.ei3t c'meL 'o K- '17, (g, T ,416 (�? °5 4 wF.sc S► 6 (0• (7.a(Y tr-(all- w AZI, 3 ego q-*m ( b -11 & U t r c1 q-0 Ile q1 fZ•fZ•o 47• It do em s . (at5v6'P- Qlap q2,10 'Pc•, u 3 0 oats L m S f. -A-7-o7 S7' O�pa � � GA S PJ.u� (' -7•07 6R (o 41 Z OO 9'�Q' �'� a-C(•o9 �-i Fm Y , �•(�� Special 000c* Application dorm Gib �►�� '.� CODECOUNCIL• CODE COUNCIL Fg' Mark J. Blakely Mark J. Blakely Spray -Applied Fireproofing Special Inspector Prestressed Concrete Special Inspector -Legacy The individual named hereon is CERTIFIED In the category shown, having been so certified pursuant to successful completion of the prescribed written requirem ts. Expiration date: Januar 30, 2009 No. 0840463-86 by cer ate holder. Not valid unl Sig ICC certification attests to competes knowledge of codes and standards. INTERNATIONAL ®� CODE COUNCIL' Mark J. Blakely Structural Steel & Welding Special Inspector The individual named hereon is CERTIFIED in the category shown, having been so certified pursuant to successful completion of the prescribed written requirements. Expiration date: January 30 2009 No. 0840463-85 Not v id u e signed by MrT " to holder. ICC certification attests to competes knowledge of codes d standards. The individual named hereon is CERTIFIED in the category shown, having been so certified pursuant to successful . :,mpletion of the prescribed written requirements. Expiration date: Januar 30,�nowvledge No. 0840463-89 Not v li certi to holder. ICC certification attests to compodes Vd standards. i\� t INTERNATIONAL CODECOUNCIL• Mark J. Blakely Reinforced Concrete Special Inspector -Legacy The individual named hereon is CERTIFIED in the category shown, having been so certified pursuant to successful completion of the prescribed written requireme Expiration date: January 30, 2 09 No. 0840463.88 Not valid unless Si d b rtific*dards. ICC certification attests to competent kno7 dge of codes an ��`� INTERNATIONAL CODE COUNCIL' Mark J. Blakely Structural Masonry Special Inspector The individual named hereon is CERTIFIED in the category' shown, having been so certified pursuant to successful completion of the prescribed written requiremen Expiration date: January 30, 2009 No. 0840463-84 %%%n. ` 1 / D a HAM I INTFhNATIONAL CUOE C'OIMCIC Mlles u vvooudru Reinforced Concrete Special Inspector The individual named hereon is CERTIFIED in the category shown, having been so certified pursuant to successful completion of the prescribed written requirements. Expiration date: June 11, 200 �&" No. 5077516-49 Not v id unless signed by ertlflcate holder. ICC certification attests to competent knowledge of codes and standards. 01 MMIS M1 INtfPJupp*j�jpi 041LES D WOODARD capitnvRcle STRUCTURAL MASONRY SPECIAL INSPECTOR The individual named hereon Is CERTIFIED in the category Shown, having been so certified pursuant to successful completion prescribed written examinations, of the Expiration date' April 4 01l No.5077518-84 �} )CC certification atlosts 10 carripetant know edg of codes andRtaMdards ROOF CONSULTANTS INSTITUTE 150o Sunday Drive, Suite 204 * Raleigh, NC 27607 Tel. (919) 859-0742 Faz (919) 859.132E hereby recognizes Miles Woodard, RRO as a Registered Roof Observer (RRO) *TYpe(s): 1,3 0472 12/31106 1EXPIRATION DATE AEGISTRA7ON NUMBER *Explanation on back of card a_ T.0 -RENEWAL DE -PT A 5360 WORKMAN MILL RD WHITT R, CA 9060), 0INTERNATIONAL COOECOMCIP Miles D Woodard . Prestressed Concrete Special Inspector The individual named hereon is CERTIFIED in the category shown, having been so certified pursuant to successful completion of the prescribed written requirem ts. Expiration date: June 11, 2 No.5077516-92 i Not lid unless signed y certificate holder. ' ICC certification attests to competent knowledge n% codes and standards. Miles D Woodard c Building Inspector UBC The Individual named hereon is CERTIFIED in the category -awn, having been so certified pursuant to successful completi 'of the prescribed written requirements. Expiration date: July 23, 2010 'A' No.5077516-10 0 ]CC certification attests to competent knowledge of co es and stun 'rde Older. Daily Inspection Log Permit #07-2694 Steve Traxel. & A.J. Ortega Building Inspector II DUNE PALMS NEIGHBORHOOD 4 7- 79 5 DUNE PALMS, B UIILDING J Date Inspection 3/6/08 Inspected East FTG for building "J". Elevator pit and shear wall footings not ready at this point. By ST & AJ 3/17/08 Elevator pits (2) and shear wall footings OK for East wall Building J. West wall footing OK minus all locations for stem wall footings. 3/24/08 North/East Basement Wall — lst Lift Bond Beam OK 3/27/08 Inspected first 4' high grout lift at 2 elevator pits on east wall and 2 sections (60 If) of high lift grout north east corner. Inspected remainder of footings at west side of building, including all colum footings. 4/2/08 Inspection for sand clarifier at south end of parking garage OK 4/3/08 Bond Beam inspection @ east wall of building for bottom 4 foot height plus elevator pit I" lift 4/408 colum steel OK for interior colums only. 4/7/08 Bond beam for west wall bottom 4' only INsrlsluvs ew fIL6 ® wrree, 5`t5'� C2� Lxuwals � Z' {cam ��i 41bl?=6 2mp t w (lift Sir&) �kf3 #3� 190jr- (PW St i)G) Q� 9-6AB CI) " U eTA11% I&W UAIZ 04bf. SIM 120CS ' �� Lt" 0) ag Uarnouref 15"t.pS , 5 I10 �? - 111akt [' A)r t c�[tf � I L 5TA tz6VUWjW C4) act- 4tJD 1 4'�/" _ 6 6 0�T BUILDING DEPARTMENT CITY OF LA QUINTA OFFICE: (760) 777-7012 INSPECTION REQUESTS: (760) 777-7153 TO: CO. DATE: 3.2q • zv ADDRESS: g07.115 P*w fkmAib e4ft CORRECTION NOTICE INSPECTION: PERMIT NO.: r'( STATE OF CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS DIVISION OF OCCUPATIONAL SAFETY AND HEALTH TEMPORARY PERMIT TO OPERATE AN ELEVATOR (Sections 7300-7322 of the Labor Code) Responsible Party: k Elevator Number `��g�\ Z.' o l ` — �Q Date of Inspection Void After Location ?' t- l `�7 �yll'�'�� 1�g �[t . g_L,, y� Street and Number City or Town Load Permissible ISO n t. " -r' Pounds Persons Inspector (01/9s) Passenger, Freight? etc. STATE OF CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS DIVISION OF OCCUPATIONAL SAFETY AND HEALTH THIS TEMPORARY PERMIT MUST BE POSTED IN ELEVATOR CAR 97 37013 ThyssenKrupp Elevator ACCEPTANCE Branch: Los Angeles Job No.: 041- C State No.: Q 0 Serial Number. ' S- -0 On this day -/-/22Ld the undersigned has received the possession and use of C elevator(s), designated as elevator �'J furnished and installed b- ThyssenKrupp Elevator Corporation (TKE) in the building known aS�tq Ludc� �'- /g and located atI' - S- - f D2 California pursuant to a contact between anA4KE, dated /, Z � 1 Recognizing this agreement will be relied upon by TKE in releasing custody and control of the elevator, the undersigned, who is authorized to do so by his/her firm, hereby accepts the elevator equipment noted above which has been fully inspected and examined by the undersigned, and certifies that such equipment is satisfactory and in all respects in accordance with the terms and conditions of said contract, and that the final contract price will be paid on time without back charges, withholds or other offset to full payment. This acceptance does not relieve either party of any remaining obligations or responsibilities to be performed under said contract. Free maintenance service and/or defective parts warranty included in said contract providing for a later effective date for such service and/or warranty is hereby expressly amended so that service and warranty commence from the date of this acceptance. On Board Service Tool YES N0 — Battery Lowering YES — NO HDPE Casing YES d NO _ Vista Monitoring YES ` NO _ KEYS ISSUED O Y. Company: -?--)ZUuN\ Lock Outs - H 1848 Independent - H2395 Title: a Fan & Light - H2395 Fire Service - DH2389 .2o y Signature: Car Stop/run= H2M _ Printed name � ThyssenKrupp Elevator ACCEPTANCE Branch: Los Angeles Job No.: 041- C State No.:. ZS"Z 64y j Serial Number v On this day Ir-2-02 the undersigned has received the possession and use of elevator(s), designated as elevator furnished and installed by Thyssen Krupp Elevator Corporation (TKE) in the building known as,14-f _ 7 / and located at y 9 9/9-e.X /z; 14, Califomia pursuant to a contact between and TKE, dated Recognizing this agreement will be relied upon by TKE in releasing custody and control of the elevator, the undersigned, who is authorized to do so by his/her firm, hereby accepts the elevator equipment noted above which has been fully inspected and examined by the undersigned, and certifies that such equipment is satisfactory and in all respects in accordance with the terms and conditions of said contract, and that the final contract price will be paid on time without back charges, withholds or other offset to full payment. This acceptance does not relieve either party of any remaining obligations or responsibilities to be performed under said contract. Free maintenance service and/or defective parts warranty included in said contract providing for a later effective date for such service and/or warranty is hereby expressly amended so that service and warranty commence from the date of this acceptance. On Board Service Tool YES NO _-"� Battery Lowering YES — NO v HDPE Casing YES P NO _ Vista Monitoring YES / NO _ KEYS ISSUED Lock Outs - 1206 Independent -1-203 Fan & Light - L203 Fire Service - L204 Car Stop/run- L208 ire Company: i�c_2 l"[1Ai'��(l� Title: Signatu Printed �J Riverside County Fire Department Fire Protection Planning Section Riverside Office: 2300 Market St., Ste. 150. Riverside, CA 92501 Ph. (951) 955-4777 Fax (951) 955-4886 Murrieta Office: 39493 Los Alamos Rd., Ste A. Murrieta, CA 92563 Ph. (951) 600-6160 Fax (951) 600-6164 Palm Desert Office: 77-933 Las Montanas Rd., 4 201 Palm Desert, CA 9221 1.4 131 Ph. (760) 863-8886 (760) 863-7072 Fire Department Clearance/Release Date: r U I ( f Fax: Tract/Parcel Map #: 40 -01- b Permit/Lot #: Lo 6 4 q3 Job Site Address: q 7-Ws No Pd t%►S L0 Final For Recordation Release For Building Permit(s) —I--- _J 'A Shell Final Only (No Tenant) Final For Occupancy Building Plan Check Fees Paid Building Plan Check Fees Not Paid Other Fees Fees Not Required If you should have any questions, please contact the appropriate Riverside County Fire Planning office for further assistance. A WV-V Auth zing Sig ture For Re ease Print Name Form C — Revised 8/27/2009 Riverside County Fire Department Fire Protection Planning Section Riverside Office: 2300 Market St., Ste. 150, Riverside, CA 92501 Ph. (951) 955-4777 Fax (951) 955-4886 Murriela Office: 39493 Los Alamos Rd.. Ste A. Murrieta, CA 92563 Ph. (951) 600-6160 Fax (951) 600-6164 Palm Desert Office: 77-933 Las Momanas Rd., # 201 Palm Desert, CA 9221 1.4 131 Ph. (760) 863-8886 (760) 863-7072 Fire Department Clearance/Release Date: ! U f To: Sly Fax: Tract/Parcel Map #: 14a —01- ap -1 U b Permit/Lot #: ' I � - b a U 'i Job Site Address: �-WS fi� he PdInls L0, Final For Recordation Release For Building Permit(s) Shell Final Only (No Tenant) Final For Occupancy Building Plan Check Fees Paid Building Plan Check Fees Not Paid Other Fees Fees Not Required If you should have any questions, please contact the appropriate Riverside County Fire Planning office for further assistance. A Auth7ing Sig4��lture For Release 6 Print Name Form C — Reviaad A/2719nnQ CONTRACTOR'S MATERIAL & TEST CERTIFICATE FOR ABOVEGROUND PIPING Factory Additional copies of this form are Loss Prevention Publications - Traininl- Resource Center Mutual System av able to insured from: Factory Mutual EnIgineering and Research. 1 151 Boston -Providence Turnpike. P.O. Box 9102, Norwood MA 02062 P EDURF- Upon completion of work, inspection and tests shall be made by the contractor's representative and witnessed by an owner's representative. All defects shall be corrected and system left in service before contractor's personnel finally leave the job. A certificate shall be filled out and signed by both representatives. Copies shall be prepared for approving authorities, owners and contractor. It is understood the owner's representatives signature in no way prejudices any claim against the contractor for faulty material, poor workmanship, or failure to comply with aDnrovina nuthnritv'c rennirPmPnrc — 1n 1 -];-- PROPERTY NAME: La Quinta Dune Palms Neighborhood v JOB# 07205 DATE: July 21, 2008 PROPERTY ADDRESS: 47795 Dune Palms Road, La Quinta, Ca ACCEPTED BY APPROVING AUTHORITY'(S) NAMES: Riverside County Fire Dept. Indio/Palm Desert Office ADDRESS: 77-933 Las Montanas Rd. #210 PLANS INSTALLATION CONFORMS TO ACCEPTED PLANS YES X NO EQUIPMENT USED IS APPROVED (IF NO, STATE DEVIATIONS BELOW) YES X NO INSTRUCTIONS HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN INSTRUCTED AS TO LOCATION OF CONTROL AND VALVES THE CARE AND MAINTENANCE OF THIS NEW EQUIPMENT? PES X NO IF NO, EXPLAIN: HAVE COPIES OF APPROPRIATE INSTRUCTIONS AND CARE AND MAINTENANCE CHARTS BEEN LEFT ON YES X NO PREMISES? 1F NO, EXPLAIN: LOCATION OF SYSTEM SUPPLIES BUILDINGS Building J 9300 MAKE TYCO MODEL YEAR OF MANUFACTURE ORIFICE SIZE QUANTITY TEMPERATURE RATING Concealed LF-II 2008 1/2" 169 1600 S RINKLERS Pendent TY-FRB 2008 1/z" 14 2000 PIPE & FITTINGS PIPE CONFORMS TO NFPA #13 STANDARD I'ES X NO FITTINGS CONFORM TO NFPA #13 STANDARD YES X NO ALARM ALARM DEVICE MAXIMUM TIME TO OPERATE THROUGH TEST PIPE VALVE OR TYPE MAKE MODEL MIN. SEC. FLOW INDICATOR WATERFLOW SWITCH POTTER VSR-F 0 60 DRY VALVE Q.O.D. MAKE MODEL SERIAL NO. MAKE AZODEL SERIAL NO. DRY PIPE OPERATING TEST TIME TO TRIP THRU TEST PIPE WATER PRESSURE AIR PRESSURE TRIP POINT AIR PRESSURE TIME WATER REACHED OUT. ALARM OPER- ATED PROPERLY MIN. SEC. PSI PSI PSI MIN. SEC. MIN. SEC. WITHOUT Q.O.D. �" WITH Q.O.D. IF NO, EXPLAIN: OPERATION PNEUMATIC ELECTRIC I HYDRAULIC PIPING SUPERVISED I YES NO DETECTING MEDIA YES NO SUPERVISED? DELUGE AND DOES THE VALVE OPERATE FROM THE MANUAL TRIP AND/OR REMOTE CONTROL? YES NO PREACTION IS THERE AN ACCESSIBLE FACILITY IN EACH CIRCUIT FOR TESTING? YES NO VALVES IF NO. EXPLAIN: DOES EACH CIRCUIT OPERATE DOES EACH CIRCUIT MAXIMUM TIME TO MAKE MODEL SUPERVISION LOSS ALARM? OPERATE VALVE RELEASE. OPERATE RELEASE YES NO YES NO MIN. SEC. HYDROSTATIC: HYDROSTATIC TESTS SHALL BE MADE AT NOT LESS THAN 200 PSI (13.6 BARS) ABOVE STATIC PRESSURE IN EXCESS OF 150 PSI (10.3 BARS) FOR TWO HOURS. DIFFERENTIAL DRY - TEST DESCRIPTION PIPE VALVE CLAPPERS SHALL BE LEFT OPEN DURING TEST TO PREVENT DAMAGE. ALL ABOVE -GROUND PIPING LEAKAGE SHALL BE STOPPED. PNEUMATIC: ESTABLISH 40 PSI (2.7 BARS) AIR PRESSURE AND MEASURE DROP WHICH SHALL NOT EXCEED 1-1/2 PSI (0.1 BARS) IN PRESSURE TANKS AT NORMAL WATER LEVEL AND AIR PRESSURE AND MEASURE AIR PRESSURE DROP WHICH SHALL NOT EXCEED 1-1/2 PSI (0.1 BARS) IN 24 HRS. ALL PIPING HYDROSTATICALLY TESTED AT 200 PSI FOR 2 HRS. IF NO, STATE REASON: DRY PIPING PNEUMATICALLY TESTED? YES NO EQUIPMENT OPERATES PROPERLY? Lkl YES RNO . DRAIN READING OF GAGE LOCATED NEAR WATER SUPPLY TEST RESIDUAL PRESSURE WITH VALVE IN TESTS PIPE. TEST 200 PSI TEST PIPE OPEN WIDE 200 PSI UNDERGROUND MAINS AND LEAD-IN CONNECTIONS TO SYSTEM RISERS SHALL BE FLUSHED BEFORE CONNECTION MADE TO SPRINKLER PIPING. VERIFIED BY COPY OF THE FORM # 85B? YES NO OTHER EXPLAIN FLUSHED BY INSTALLER OF UNDERGROUND YES NO SPRINKLER PIPING? BLANK TESTING NUMBER USED LOCATIONS NUMBER REMOVED GASKETS WELDED PIPING? X YES NO IF YES... DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT WELDING YES X NO PROCEDURES COMPLY WITH THE REQUIREMENTS OF AT LEAST AWS D10.9. LEVEL AR-3? WELDING DO YOU CERTIFY THAT THE WELDING WAS PERFORMED BY WELDERS QUALIFIED YES X NO IN COMPLIANCE WITH THE REQUIREMENTS OF AT LEAST AWS D 10.9, LEVEL AR-3? DO YOU CERTIFY THAT WELDING WAS CARRIED OUT 1N COMPLIANCE WITH A YES X NO DOCUMENTED QUALITY CONTROL PROCEDURE TO INSURE THAT ALL DISCS ARE RETRIEVED, THAT OPENINGS IN PIPING ARE SMOOTH, THAT SLAG AND OTHER WELDING RESIDUE ARE REMOVED, AND THAT INTERNAL DIAMETERS OF PIPING ARE NOT PENETRATED? HYDRAULIC DATA NAMEPLATE NAMEPLATE PROVIDED? YES IF NO, EXPLAIN: X NO DATE LEFT IN SERVICE NVITH ALL CONTROL VALVES OPEN: REMARKS NAME OF INSTALLING CONTRACTOR: CEN-CAL FIRE SYSTEMS, INC. TESTS WITNESSED BY FOR PROPERTY OWNER (Signed) TITLE DATE SIGNATURES FOR INSTALLING C NTRA R Signed) TITLE DATE ADDITIONAL EXPLA_P4TI9JNkTO: t- YNER ENGINEERI STRUCTURAL ENGINEERING January 8, 2009 City of La Quinta Building Department c/o Interactive Design Corp. 199 S. Civic Center Drive Palm Springs, CA 92262 RE: Dune Palms Neighborhood 47-795 Dune Palms Road La Quinta, CA 92253 Building Number: 9300 Building Official: As the Engineer responsible for the Structural Design, I have performed visual structural observations of the structural system in compliance with 2001 CBC, Section 1709. To the best of my knowledge, the construction is in substantial conformance with the Approved Structural Drawings and is approved to wrap. Thank you for your review of this written Statement. 41105 Vintage Circle . Temecula, CA 92591 Sincerely, 4 George H. XGrayner, S. E. Grayner Engineering oe�prESSlp 01 9 9 m xp. 30-09 `n srAUCTU INN, MI-qlF CF C A0i�Q` Telephone (951) 676-2529 . FAX (951) 699-3591 ® MOPFL,etter of Transmittal Date: June 26, 2008 Via: Hand Delivery Job #: 1786 To: Angelica'Zarco CITY OF LA QUINTA Public Works/Engineering 78-495 Calle Tampico La Quinta, CA 92253-1504 From: Chuck Harris Re: Form Certification Cam. Project: CVHC Dune Palms Neighborhood EC: Mike Troth ❑ Urgent ❑ For Review ❑ Please Comment ❑ As Requested ❑ Other QTY. ITEM 1 Original, wetsigned and stamped form certification letter, Parcel 4 of Parcel Map No. 33588, Building 9100 ® Comments: If you have any questions, or we can be of further assistance, please contact our office. Thank you. t :34200 Buti Hor� DRIVr Ni R,a»ciio ivtir:: CIr,',' M CALIFORNIA VA 92270 7An-11')0-c)1,1 I I m 76()_?) -7y()1 FAN 0�t>>t i'l C riti�� i t . vC;itit"X(M July 29, 2008 Ms. Angelica Zarco City of La Quinta 78-495 Calle Tampico La Quinta, CA 92252 RE: Form Certification — CVHC Dune Palms Neighborhood Parcel 4 of Parcel Map No.33588, Building 9300 "J" JN 1786 Dear Angelica: This letter is to verify that the locations and elevations of the building forms for building 9300 "J" of Parcel 4 of Parcel Map No. 33588 were field checked by MSA Consulting, Inc., and found to be in substantial conformance with the approved Precise Grading Plan. The results are as follows: Lot # Plan Field Difference Building 9300 "J" 58.50 58.49 -0.01 If you have any questions, please contact our office. Very truly yours, AND \ 6 �� CHAR ES R. 5: ge, e. e.'�\ (� HARRIS 0 Charles R. Harris, PLS 4989 No. 4989 Dj Director of Survey and Mapping tj? Exp.12/31/09 Q- CRH:tt T � EC: Mike Troth OF CALIF 34200 Doti HoCI; Diuve In Rr NC110 MIRAGE M Cr;Al..Irol;IJIA M 92270 760-V' O-Qkl 1 w7f,(1-i? i_7RC) r,ax M wvox COXI Certificate of Occupancy Tity/ 4 4 Q" 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: 47-795 DUNE PALMS ROAD (BUILDING #9100 - # 9400) Use classification: GARAGE PLUS 68 DWELLING UNITS (MIXED USE) Building Permit No.: 07-2694 Occupancy Group: S-3 / R-1 Type of Construction: I-FR / RES-1 Land Use Zone: CR Owner of Building: COACHELLA VALLEY HOUSING COALI Address: 45-701 MONROE ST 1-G Building Official City, ST, ZIP: INDIO, CA 92201 By: STEVE TRAXEL Date: December 10, 2009 POST IN A CONSPICUOUS PLACE