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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 'J.0 r o — ek Co 1 C `U &_e Azso. - ,,,3care_ xt RAI 1 nc cess(11 % c ow; '! i o a Q ,,,0 ' p sz .3) Nk .j 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 r