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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 ` h , ,' 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 I 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' $ +.