SFD (04-5533)78020 Lost Elk Tr
04-5533
P.O. Box 1504
78-495 CALLS TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number . .
Property Address . . .
APN:
Application description
Property Zoning . . . .
Application valuation
Owner
BUILDING PERMIT
BUILDING & SAFETY DEPARTMENT
(760).777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 77777153
. . . 04-00005533 Date 7/16/04
78020 LOST ELK TR
658-140-999-50 -29436 =
. . . DWELLING - SINGLE FAMILY DETACHED
. . . LOW DENSITY RESIDENTIAL
. . . 154159
IVANHOE LA QUINTA COVE
C/O R BARRY MCCOMIC
7979 IVANHOE AVE STE 550
LA JOLLA CA 92037
Contractor
TRANS -WEST HOUSING, INC.
9968 HIBERT STREET, STE #102
SAN DIEGO CA 92131
(858) 653-3003
WCC: STATE FUND
WC: 1648813
10/01/04
CSLB: 701039
01/31/05'
CCC: B
------------ = -------------
Structure Information -------------------------
Construction Type . .
. . . TYPE V - NON RATED
Flood Zone . . .
. . . NON -AO FLOOD ZONE
Other struct info
..-.___CODE EDITION
2001 CBC
FIRE SPRINKLERS.
NO
,GARAGE SQ FTG
672.00
PATIO SQ FTG
339.00
h i
NUMBER OF UNITS
1.00'
I{I
_ =FIRST FLOOR SQ FTG
2386.00
- ----------------
- - -: ------------------------------------------
Permit _ _BUILDIING--PERMIT
Additional des.c
Permit Fee . . . .
832.00 Plan Check Fee
540.80
Issue Date . . . .
Valuation . .
. . 154159
Qty Unit Charge
Per
Extension
BASE FEE
639.50
55.00 3.5000
----------------------------
THOU BLDG 100,001-500,000
192.50
Permit . . . . . .
-----------------------------------------------
MECHANICAL
Additional desc . .
Permit Fee . . . .
90.00 Plan Check Fee
22.50
Issue Date . . . .
Valuation . .
. . 0
Qty Unit Charge
Per
Extension
BASE FEE
15.00
P.O. Box 1504
78-495 CALLS TAMPICO VOICE (760) 777-7012
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: C'' 55 33 Date: • / •Dy
Applicant: hite or E j eer:
Applicant's Mailing Address: Architect or Engineer's A dress:
. No.: Q 0"2
t3UILUINU 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
Coen and License n full force and effect. /U3
icense Class
/> License No.
roaffAllh"l—A
C', * 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 1, 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 town 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 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 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
d Myy-- w w, / 1 c ss compensation i ce carrier 9d I' ,(yQ ber re-.
arrier, - /" f/r7 p Za1S`d
'Policy Number
_ 1 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.
or
WARNING: FAILURE TO SECURE WORKERS' C 51 IPENSATION 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 forthon 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 Ouinta, 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 1 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 re entatives of this county to enter upon the above-mentioned property for inspection purposes.
atel Cf 0'41 Signature (Applicant or Agent): ✓ `
Page
2
Application Number .
. . .
. 04-00005533 Date
7/16/04
Qty Unit
Charge
Per
Extension
2.00
9.0000
EA
MECH FURNACE <=100K
18.00
2.00
9.0000
EA
MECH B/C <=3HP/100K BTU
18.00
5.00
6.5000
EA
MECH VENT FAN
32.50
1.00
----------------------------------------------------------------------------
6.5000
EA
MECH EXHAUST HOOD
6.50
Permit . . .
. . .
ELEC-NEW RESIDENTIAL
Additional desc
Permit Fee .
. . .
111.95 Plan Check Fee
27.99
Issue Date .
. . .
Valuation . .
0
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
2386.00
.0350
ELEC NEW RES - 1 OR 2 FAMILY
83.51
672.00
----------------------------------------------------------------------------
.0200
ELEC'GARAGE OR NON-RESIDENTIAL
13.44
Permit . . .
. . .
PLUMBING
Additional desc
Permit Fee .
. . .
178.50 Plan Check Fee
44.63
Issue Date .
. . .
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
18.00
6;0000
EA
PLB FIXTURE
108.00
1.00
15.0000
EA
PLB BUILDING SEWER
15.00
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
8.00
.7500
EA
PLB GAS PIPE >=5
6.00
1.00
--------------------------------------
15.0000
EA
PLB GAS METER
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
Special Notes
and Comments
SFD - LOT 50,
PLAN 1AR
2386
SF. PERMIT
Fee summary
-----------------
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
Charged Paid
1227.45
Page
3
Application Number . . . . .
----------------------------------------------------------------------------
04-00005533 Date
7/16/04
Special Notes and Comments
.00
DOES NOT INCLUDE BLOCK WALLS,
POOL, SPA
OR DRIVEWAY APPROACH
----------------------------------------------------------------------------
Other Fees . . . . . . . . .
ART IN PUBLIC PLACES -RES
.00
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
54.08
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
STRONG MOTION (SMI) - RES
15.41
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
-----------------
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
Charged Paid
1227.45
.00
635.92
.00
2474.49
.00
4337.86
.00
Credited Due
.00
1227.45
.00
635.92
.00
2474.49
.00
4337.86
6'k
ti "(Ct^t "eMV!t'VW.
r
'
INSPECTIONS
JCM Inspections
39725 Garand Lane Suite F
Palm Desert, CA 92211
Phone: 760-345-5554 - Fax: 760-772-3895
--
INSPECTIONS
EPDXY INSPECTION REPORT '
Date -0,
Projec, Name:a
i c -e CQ n
Project No: V.
on v e J
Project Address:
J'" 50
J Cid:
, vl u;
BJtle 24
Other:
Client: Sub -Contractor:
11P)W Q 0 C
General Contractor:
Q
Architect: Structural Engineer,
nj.,
Epoxy Type:
Epoxy Shelf Life:
Hole Cleaning Methodls :
9 )wvJr7
Anchor BoltsRebar
1. \
Sz r►, S o S r o e) e..
—SA, `
C Po,
IM1 eathb
R
Unresolved Items:
None
See Below
Description of Work Inspected: i px y0A o o _ t1` &-t r '8 c-9— W e
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— ek Co 1 C `U
&_e Azso. - ,,,3care_ xt
RAI 1 nc cess(11
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Work complies with written approval from Structural Engineer and ICBO Evaluation Report # Sa
I hereby certify that I have inspected all of the above work, unless otherwise noted, and to the best of my ability I have found this work to comply with the approved
plans, specifications applicable building laws. Final report issued at project completion.
Inspector: Ja C. Millin ICC C ifi alio No:'0842216-49
G.
Contractor's Representative:
Copy 1 JCM Inspections Copy 2 Project Superintendent Copy 3 Governing Agency Page ___L of
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