04-5184 (SFD)54955 Avenida Alvarado
;c ik
P.O. Box 1504.
78-495 CALLE TAMPIC.O
LA QUINTA, CALIFORNIA 92253
BUILDING PERMIT
IIIIIII VIII III VIII IIII 57
IE
BUILDING & 'SAFETY DEPARTMENT
(760),777-7012
FAX (760) 777-701 T
INSPECTION REQUESTS (760).777-7153
Application Number .
. . . . 04-00005184 Date
10/04/04
Property Address
54955 AVENIDA ALVARADO
APN:
774 -292 -032 -12 -000000 -
Application description
DWELLING - SINGLE FAMILY DETACHED
Property Zoning
COVE RESIDENTIAL.-
Appl-ication-valuation
204231
Owner
Contractor
------------ ------ ----
BEN GILLMORE
------N,. __- ---------
.: OWNER1''`
Structure Information
:. Structure
3221 SQ. FT. SFD
----
.
Construction Type .,.. :.
'TYPE. 'V - NON RATED
Occupancy Type
DWELLG/LODGING./GONG <=10
Flood Zone:: ..
NON -AO FLOOD ZONE
Other struct info.
CODE EDITION 2001
CBC -
#. BEDROOMS
3:00
FIRE SPRINKLERS NO
GARAGE SQ FTG
971.00
'PAT.IO SQ FTG
72.00
NUMBER OF UNITS.
1.00
FIRST FLOOR SQ .FTG .3221.00..
Permit .BUILDING
PERMIT
.:Additi•ona.l..desc, .,
Permit Fee
1007.00._ Plan Check Fee
65:4.55
Issue Date
Valuation . .
204231
Qty` Unit Charge
Per
Extens-ion
BASE. FEE
639:50
105.00 3. 50*'00
THOU BLDG 100, 0.01-5001- 000
367 .50.
--------------------------------
.Permit .
----------------------------------------------
ELEC.-NEW RESIDENTIAL
Additional desc
Permit Fee
162.16 Plan Check Fee
40.54
Issue Date
Valuation
0
Qty. Unit Charge
Per
Extension
BASE FEE
1.5.00
3221.00 0350
ELEC NEW RES - 1 OR 2 FAMILY
..112.74
971.00 0200
ELEC GARAGE.OR'NON-RESIDENTIAL
..19.42
1.00 15:0.000:EA
ELEC TEMPORARY POWER POLE'
15.00
P.O. BOX 1504.- . • 4-' CWei
78-495 CALLE TAMPICO
TA
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
Application Number:
Applicant:
Applicant's Mailing Address:
Architect or Engineer:
ow
VOICE"(T60) 777-7ar2'
FAX (760) 777-7011
INSPECTIONS (760)'777-7153
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby ffirn under penalty of perjury that I am licensed;der p sions of chapter 9 (commencing with Section 7000) of Division 3 of the Business'and Professionals
u6 nd my License is In full force and effect.lass n No.
ate
7<ctor
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, atter, irtKxove, 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).):
1f 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 (Seo. 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 improveme.rds are not Intended or offered for sale. If, however: the budding or improvement Is
sold within one year of completion, the owner -builder will have the burden of WvAV'4at he or she did not build or Improve for the purpose of sale.).
U 1, 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 roperty who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
the Contractors' State License Law.).
U 1 am exempt under Sec. B. for reason
Date D Owner
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 sett4nsure 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 the performance of the.work for which this pem,it is
ty r w r}cels' compensation insurance carrier and pot are:
Carrier S'fA' F J 1JD Policy Number Pq r OS
_ I certify -that, in the performancW-7 rmit issued, I shall rot employ. any per's in any manner so as to become subject to the workers'
compensation laws of CalifoI should become subject ld the workers' compensation provisions of Section 3700 of the Labor Code. I shah
I(Iforthwith comply with those
Date I b Y b Applicant
WARNING: FAILURE TO SECURE WORKERS' MPENSATION COVERAGE IS UNLAWFUL`, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL RNES. UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the,performanee of the work for which this permit is issued (Sec. 3097, Civ. C.).'
Lenders Name
Lender's Address
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the concretions 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 shah, 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 nun 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 1 agree to comply with an city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this county to ent pon above-mentioned property for Inspection purposes.
Date 6 t) Signature (Applicant or Agent):
Page
2
Application,Number
04-00005184 Date
10/04/04
----------------------------------------------------------------------------
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
96.50 Plan Check Fee
24.13
Issue Date
. . . .
Valuation . .
0
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 . .
. . . .
PLUMBING
Additional
desc
Permit Fee
227.25
Plan Check Fee
56.81
Issue Date
. . . .
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
. BASE FEE
15.00
-15.00
6.0000
EA
PLB FIXTURE
90.00
1.00
15.0000
EA
PLB BUILDING SEWER
15.00
11.00
6.0000
EA
PLB ROOF DRAIN
66.00
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
9.00
.7500
EA
PLB GAS PIPE >=5
6.75
1.00
15.0000
EA
PLB GAS METER
15.00
------------------
Special Notes
----------------------------------------------------------
and Comments
3221 S.F. SFD
PERMIT
DOES
NOT INCLUDE
BLOCK WALL,
POOL/SPA
OR DRIVEWAY
APPROACH
STATE FUND
POLICY 1799216-2004/EXPIRES
Page 3
Application Number
. . . . .
.04-00005184 Date
10/04/04
-----------------------------------------------------------=----------------
Special Notes and
Comments
8/1/2005.
----------------------------------------------------------------------------
Other Fees . . .
. . . . . .
:ART IN PUBLIC PLACES -RES
20.00
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
65.46
DIF FIRE PROTECTION -RES
97.00
GRADING PLAN CHECK FEE
00
DIF LIBRARIES - RES
225.00
DIF PARK MAINT FAC - RES
5.00
DIF PARKS/REC - RES
502.00
COVE PRECISE PLAN FEE
100.00
STRONG MOTION (SMI) - RES
20.42
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
-----------------
Charged
----------
Paid Credited
------------------------------
Due
Permit Fee Total
1507.91
00 .00
1507.91
Plan Check Total
776.03
250.00 .00
526.03
Other Fee Total
2610.88
.00 .00
2610.88
Grand Total
4894.82
250.00 .00
4644.82
Comments
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under
500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile
homes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $2.24 X 3,155 S.F. or $7,067.20 have been paid for the property listed above and that
building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued.
Fees Paid By
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted b aron McGilvrey Payment Recd
$7,067.20 Over/Under
NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day approval period in which you may protest the fees or
other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which
those amounts are paid to the District(s) or to another public entity authorized to collect them on the Districtfs) behalf, whichever is earlier.
NOTICE: This Document NOT VALID if Duplicated
Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting
P.O. Box 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
I0IInIAll llll 59
IE
BUILDING & SAFETY DEPARTMENT
(760)777-7012
FAX (760) 777-7011
To Customer.
Permit #: O '
Public Works
Fugitive Dust Control (PM -10) Plan Approval
Instructions to Applicant:
Public Works Department approval of a fugitive dust control plan is required prior to Building
Permit issuance for the following project. Please:
1. Fill out the attached forms, then;
2. Submit this entire packet to the Public Works Department for review.
If you need help completing the forms, contact the Public Works Department at 760-777-7075.
The Public Works Department will review and, when approvable, forward the approved plan to
the Building & Safety Department, approving the issuance of Building Permit(s). If the Public
Works Department has questions or concerns, an attempt will be made to contact the person
whose name and telephone number appear below.
Project to be permitted. 15 IF,
Project Street Address: 5y—z— hVe'. A, V4' -'ex -;6 Q
Applicant Contact & Telephone Number: AK %
Public Works Department Findings
To: Greg Butler, Building & Safety Manager
From John Freeland, Senior Engineer
The Public Works Department has reviewed the attached Fugitive Dust Control Plan for the
above-mentioned project and finds that:
❑ ...issuance of this Building Permit does not require Public Works Department approval.
13 issuance of this Building Permit is approved by the Public Works Department.
oh Fre d, Senior Engineer Date
`"
ppil' . f r , . ` `..v .'. 1 , •. w ` ,,,j ti. ..1N\ . J ' `a"• - • .: ]' n7 . i :Pk,f-w Y `
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NUCLEAR GAUGE INFORMATION AND
DAILY STANDARD
CAIBRATION NUMBERS
VARIATION. PERCENT.+I- GAUGE ADJUSTMENT % VARIATION FROM
CALIBRATION
COUNTS
FROM SHEETS
LAST USE
GAUGE TYP :TROXLER/C"AMPBELL
MOISTURE:
MOISTURE:
MOISTURE: MOISTURE:
MODEL NO.: 3'13 C>
6
DENSITY: -'A (, l
DENSm:
DENSITY: DENSITY:
PROCTOR INFORMATION
TEST
NO.
SOIL ID # VISUAL CLASSIFICATION OF SOIL MAX. DRY DENSITY, PCF OPTIMUM MOISTURE. %
9,_"JK 1523, s . 5
COMPACTION /
REQUIREMENTS, %I !
MOISTURE
REQUIREMENTS,
GENERAL LOCATION:
TEST
NO.
READING
QUOTIENT/
PCF
SOIL
ID NO.
TEST
DEPTH, IN
ELEVATION
OF TEST
MOISTURE
CONTENT,
%
WET
DENSITY,
PCF
DRY
DENSITY,
PCF
PERCENT
COMPACTION
COMMENTS
q
D lGV
I} - V 1
D y 9//0
,
. i •
• ``j
z .
Zy .
D-
M-
D-
M-
I
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D-
A
I
TECHNICIAN:14 !. I lw
NI•L /l' t A
Jr Cl,l la,M I IUI`IJ
2 = BACKFILL B : COMPACTION PERCENTAGE DOES NOT COMPLY WITH SPECIFICATIONS
3 =BASE COURSE C RETEST OF PREVIOUS TEST
a = SUBBASE D MOISTURE IN EXCESS OF SPECIFICATIONS
5 SOIL CEMENT E MOISTURE BELOW SPECIFICATIONS
6 = OTHER
WHITE -OFFICE YELLOW -INSPECT. PINK -FIELD FILE
;r "i• MAXIMUM DENSITY OF CONSTRuCTIc)N MATFRIAl c
PROJECT NAME (SECTION)
CONTRACT NUMBER
T 99
T 180
CONTRACTOR OR SUPPLIER PROJECT MANAGER
BID ITEM NUMBER
SOURCE NAME SOURCE NUMBER
0
MATERIAL SIZE
❑ B
❑
TEST NO. fDATE
DRY DENSITY
TIME SAMPLED AT MATERIAL DESCRIPTION E USED
TO B
- 0
29 t-I'S42-
TEST METHOD
TM 9
T 99
T 180
❑
❑
❑
A
❑ B
❑
C ❑ D ❑
MAX DRY DENSITY OF THE FINES
(DI) ll kg/m.
OPTIMUM MOISTURE % THE FINES
%
T, Lj
C/ Z/, 7
TEST
MA -Ss OF MOLD
MASS OF (M) (A) SPEEDY MOISTURE %
OVEN MOISTURE %
(D)
HARVARD (A) =(M) X 16.02
NO.
AND MATERIALS
MOLD MASS OF WET WET DENSITY
DRY DENSITY
101.6mmMOLO (A) =(M) X 1.060
MATERIAL kg/m' WET (B) DRY (C)
WET(a) DRY(b)
DRY(C)
kg/m'
152.4mmMOLD (A) =(M) X 0.471
SPEEDY MOISTURE
(C)= x100
1 3 `7 5
17/-
Q
2 0
1 N D, , 5 3(B)
3
y Q C1
11
J
100. (B)
3
(
OVEN MOISTURE
5
(a) - (b)
(C)= X100
6
(b)
(D)= X100
(C)•100
AASHTO T85 Oven Dry Mass SSD Mass Weight in Water GsbGsb SSD Gsa ABSORPTION
SPECIFIC GRAVITY OF (F) (G) (H) (F) / [(G) -(H)) (G)! ((G (H)j (F) / ((F}(H)) H(G)-(F)Y(F))x100
COARSE AGGREGATE
AGGREGATES P. = PERCENT COURSE PARTICLES
AASHTO T224 MAXIMUM COMBINED DRY DENSITY OPTIMUM COMBINED MOISTURE
COARSE PARTICLE 1.00-P. X DI + 0.9 X P. X 1000XGzb = k9/m' 1.00-P. X nM + P. X AssoRanoN - %
CORRECTION I l x • x = L_ x , x =
QUALITY CONTROL VE0.9 x
RIFICATION INDEPENDENT ASSURANCE
3468.2-99
11111111 IIIII III11111IIII _
1111111111111111111111111 ds
IE
�
Certificate of Occupancy
OF Il�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: 54955 AVENIDA ALVARADO
Use classification: SFD Building Permit No.: 04--5184
Occupancy Group: R3 Type of Construction: VN Land Use Zone: RC
Owner of Building: BEN GILMORE Address: 54955 AVE ALVARADO
City, ST, ZIP: LA QUINTA CA 92253
Jr..a By: KIRK KIRKLAND
Date: 10-14-2005
Building Official
POST IN A CONSPICUOUS PLACE
�. x
.f f'
$ +.