04-5742 (SFD)w
v� P.O. Box 1504
OFT '9 `78-495FCALLE TAMPICO
A-Q'UINTA, CALIFORNIA 92253
p i 7W1 BUILDING PERMIT
w4hi 4 4 Q"
BUILDING & SAFETY DEPARTMENT
(760).777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
Application Number. . . . . 0404�0�0005742 Date 12/16%04
Property Address . . . . �5_1225: AVENhDA RUBIO
APN: 773-044-029- - -
Application description . . . DWELLING - SINGLE FAMILY DETACHED
Property Zoning . . . . . . . MEDIUM DENSITY RES
Application valuation . . . . 193110.
Owner
Contractor
------------------------
CHARLES POH
------------------------
DEBONIS & FAUBION
CONSTRUCTION
78-242 VINEWOOD DR.
P.O. BOX 306
PALM DESERT
CA 92260 MT. BALDY
CA -91759
(90 9) 223-2030
WCC: EXEMPT
WC: EXEMPT
09/30/05
CSLB: 737479
06/30/05
CCC: B, C39
------ Structure Information
3033 SQ. FT. SFD
--.---
Other struct.info . .
. . CODE EDITION
2001 CBC
# BEDROOMS
3.00
FIRE SPRINKLERS
NO
GARAGE SQ FTG
632.00
PATIO SQ FTG
544.00
NUMBER OF UNITS
1.00
-------------------------------------------------------------------------'---
1ST FLOOR SQUARE FOOTAGE
3033.00
Permit . . . . . .
BUILDING PERMIT
Additional desc
Permit Fee
968.50 Plan Check Fee
629.53
Issue Date.
Valuation
193110
Qty 'Unit Charge
Per
..Extension
BASE FEE
639.50
94.00 3.5000
THOU BLDG 100,001-500,000
329.00
------------------- --------------------------------------------------------
Permit . .
MECHANICAL
Additional desc
Permit Fee . . . .
114.50 Plan Check Fee'.
28.63
Issue Date . . . .
Valuation . .
. . 0
Qty Unit Charge
Per
Extension
BASE FEE
1.5.0 0
3.00 9.0000
EA MECH FURNACE <=100K
27.00
3.00 9.0000
EA MECH B/C <=3HP/100K BTU
27.00
6.00 6.5000
EA MECH VENT FAN
39.00
1.00 ;6.5000
EA MECH EXHAUST HOOD
6.50
----------------,--------------------------7--------------------------------
Permit
ELEC-NEW RESIDENTIAL
P.O. BOX 1504 T -VY
78-495 CALLE TAMPICD
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
Application Number: 041- 5 % C�
Applicant:
Applicant's Mailing Address:
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: O
Architect or Erigineer:
Architect or Engineer's Address:
0 JA
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 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.
i'License Class License No.
Date Contractor
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 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 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.).
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 �� /�— ner��
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
issued. My workers' compensation insurance carrier and policy number are:
Cartier Policy Number
I 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.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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.
I herebyaffirm under CONSTRUCTION LENDING AGENCY
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 Buildingand Safetya
1. Each upon whose behalf this application is made. each person atwhose request rmit a d for whose benefit work snperfo forth
under or pursuant to an
person u y permit
issued as a result of this application, the owner, and the applicant, each agrees to, and shall, defend, indemnity 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.
1 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.
Bate —Z�j2jg nature (Applicant or Agent):
Application Number
Additional desc .
Permit Fee . . .
Issue Date . . .
i":W.11 [f
Page ' 2
04-00005742 Date 12/16/04
Plan Check Fee . . 37.2,0
Valuation . . . . 0
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
3033.00,
.0350
ELEC NEW RES - 1 OR 2 FAMILY
106.16
632.00
.0200
ELEC GARAGE. OR NON-RESIDENTIAL
12.64
1.00
----------------------------------------------------------------------------
15.0000
EA ELEC TEMPORARY POWER POLE.
15.00
Permit . . .
. . .
PLUMBING
Additional desc..
Permit Fee
205.50 Plan Check Fee
51.38
Issue Date .
. . .
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
17.00
6.0000
EA PLB FIXTURE
102.00
1.00
15.0000
EA PLB BUILDING SEWER
15.00
4.00
6.0000
EA PLB ROOF DRAIN
24.00
2.00
7.5000
EA- 'PLB WATER HEATER/VENT
15.00
1.00
3.0000
EA PLB WATER INST/ALT/REP
3.00
1.00
9.0000
EA PLB LAWN SPRINKLER SYSTEM
9.00
10.00
.7500
EA PLB GAS PIPE >=5
.7.50
1.00
--------------------------------------7-------------------------------------
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
3033 SQ.FT. SFD. THIS
PERMIT DOES NOT
INCLUDE POOL &
SPA, BLOCK
WALLS 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
62.95
DIF FIRE PROTECTION -RES
97.00
GRADING PLAN CHECK FEE
22.50
DIF LIBRARIES - RES '
225.00
Page 3
Application Number
04-00005742. Date
12/16/04
Other Fees . . .
. . . . . .
DIF PARK MAINT FAC - RES
5.00
DIF PARKS/REC - RES
502.00
COVE PRECISE PLAN FEE-
100.00
STRONG MOTION (SMI) - RES
19.31
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION _ RES
1098.00
Fee summary
Charged
Paid Credited
Due'
Permit Fee Total
1452.30
.00 .00
1452.30
Plan Check Total
746.74
250.00 .00.
496.74
Other Fee Total
2609.76
.00 .00
2609.76
Grand Total
4808.80
250.00 .00
4558.80
CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District
A--47950.Dune. Palms Road <BRMUDA DUNES �
U RANCHO MIRAGE d
Date 12/16/04 La Quinta, CA 92253 INDIAN WELLS
No. 26709
PALM LA QUINTA
(760) 771-8515 �QINDIO L�~�
Owner Charles Poh r APN # 773-044-029
Address Jurisdiction La Quinta
City Zip Permit #
Tract # Study Area
Type Single Family Residence No. of Units 1
Lot # No.
Unit 1 _52+"
Unit 2/•ZZS
Unit 3
Unit 4
Unit 5
Comments
Street S.F.
Avenida Rubio 3033
Unit 6
Unit 7
Unit 8
Unit 9
Unit 10
Lot # No. Street S.F.
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 5
00 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile ho
mes. 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 3,033 S.F. or $6,793.92 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 CC/Downey Savings - Charles Poh Check No. 54500031441
Name on the check Telephone 200-5140
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Sharon MCGilvrey c Payment Recd
$6,793.92 Over/Under
Signature
NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the Wday approval period in which you may protest the fees o
r 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 District('s) behalf, whichever-is:earlier.
NOTICE: This Document NOT VALID if Duplicated
Embossed Original -Building Department/Applicant Copy -Applicant/Receipt Copy -Accounting
CITY OF LA QUINTA
PLAN CHECK CORRECTION LIST
Young Engineering Services
77-804 Wildcat Dr. #C
Palm Desert, CA 92211
PLAN CHECK NO. 04-5�
22S
ADDRESS 51,025 Ave. Rubio
December 8, 2004
SECOND/FINAL CHECK
OCCUPANCY : R3/U1
SCOPE OF WORK New SFD TYPE -OF -CONST. :V -N
3137(R)/528(U)
The submitted plans and specifications have been reviewed by the VCA CODE GROUP. In our
professional opinion the plans are in substantial conformance with the building codes and regulations
adopted by the CITY OF LA QUINTAand the State of California Amendment.
APPROVAL FOR A BUILDING PERMIT IS HEREBY RECOMMENDED SUBJECT TO OBTAINING
APPROVALS/CLEARANCES FROM ALL APPLICABLE CITY DEPARTMENTS, AGENCIES, AND
ASSOCIATIONS.
Plans checked by:
Hue C. Luu , PE
VCA CODE GROUP
2200 W Orangewood Ave, Ste 155
Orange, CA 92868
(714) 363-4700 ext. #752
1
VCA File No. LQ -16612
PUBLIC WORKS/ENGINEERING DEPARTMENT
CLEARANCE SHEET FOR BUILDING PERMITS
Date: �',� -- Developer: �2Z�
The following are the requirements for Green Sheet clearance to issue a building permit
for the subject building lot(s):
m Proposed building locations are legal lots, final map recorded.
'1 Attach or previously submitted (current within 6 months). Pad Elevation
Certificates in compliance with the approved design elevation or building pad
�l (deviations of + 0.1 foot).
E Attach a complete Fugitive Dust Control (PM -10) Plan andP acket.
COMMERCIAL BUILDINGS (additional requirements to the above):
mise grading plan approved.
I have reviewed and confirmed the requirements listed above and find the improvements to be sufficiently
complete, except as specially pro ided ow, for construction of the proposed structure(s) on the subject
lot(s). Pursuant to findings find the abo ay be released for building permit issuance.
meq( Recommended Dated:_
lN� SPECIAL PROV SI NS: Building & Safety has been advised that it is appropriate to issue the Building
Permit; however, a Certificate of Occupancy should not be authorized until the following issues have
been addressed:
F068 REV 1 1104 Folder 11
SITE PLAN
CER
TIFICA TE OF PARCEL MERGER NO. XX XX
E:• T
NO
OPLAT WAS PREPARED FROM RECORD DATA AND
THISDOES NOT REPRESENT A SURVEY OF 7H£ PROPERTY
SHOW HEREON. THIS MAP HAS BEEN APPROVED
UPON THE EXPRESSED CONDITION THAT BUILDING
PERMITS SHALL NOT BE ISSUED FOR ANY DEV£L-
OPMENT Ml7HIN THIS ADJUS7MEN1 PLAT UNAL NECES-
SARY DEOICAAOK IF ANY, HAVE OCCURED.
LEGEND
— — — — = LOT UNE
To Of REUOWD
NOTE:
HERE MAY BE EASEMENTS OF
.RECORD DELIN£A7E0 AND REFERENCED
ON THE UNDERLNNG MAP OR NH£RE
MAYBE EASEMENTS WTHIN THE
AREA BEING ADAISTED THAT ARE
NOT SHOW ON THIS DOCUMENT
THAT COULD ENCUMBER SAID
PARCEL HEREIN.
P{N� A.
� FF
NO. 5479
Exp. 9/30/08
CALL- , YUCATAN
SS%\l / A Cr�,c?j L.LJ J A A ! VALE, LA r)JU\/ rA, UNIT I�IJ. 4
� c
i LOT I i
LOT 25
LOT 24$
LOT 23
—___1
LOT 24
I
30 0 15 50 60
1 tach 30 pl,
A.P.N. 773-044-029 g
AREA a 0.23 AC. g g
LOT 2
m
LOT UNE 70 BE REMOVED (TYP.)
N 8953'38' E 100.00
) g
LOT 3 11
N. 895J'38* E 100. 00'
LOT 4
i
moN
TEZUMA
AVE
DEPARTMENT USE OK Y
RECORQ OWNER CHARLIE POH _
ADDRESS
MAP PREPARED BY M°GEE SURVEYING, INC.
ADDRESS 79.T0T A9wmr aw ak, suTe log amwA pw4 CA y??cu
AREA/DISTRICT
THIS CERTIFICATE OF PARCEL MERGER NO IS
HEREBY APPROVED
BY
TITLE
DA TE
J
l
CITY OF LA QUINTA.SUB-CO TRACT-OR-LI.ST l��i�,s r
JOB AE7Di3ESS � %a'S dT"_``r`u6r"i� ` PERi 111 ;NU'MBEIR � UWAlI:R�t_Ch.. , ��_.p�� .F. «.. ' BUILDER
. � This form shall b� posted on the job with the Building Inspection Card � al�,mg-s- ink c�picuous Wace. Only persons appearing on this list or their employee, are authorized to work
an -this job. • Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of %)rk' and?or the voidance
0. of
building permit. For each applicable trade, all information requested below must be completed by applicant. `On File' isnot an acceptable response.
..._ • • .... _ ... ,. sg
LL
:. r .. .,.... :.. �. pts ......,.: .:_,.:,..:.-.::.....;::.....::.:��tat��iiii2f3c1'o'�s- :.?t -
�e ;Glxs. ... .: ^. _ ...lam ::...:
c�r
Y--• t�-
-
_
-Carrier-Name rrerTame
Policy Name Classification License Number Exp,,. Date Ex
A• Dais L .eirse
Number E
. Date
{e.g- A, H, C -8l Ixxxxxxl Ixxlxxfxxi .le.g. State Fund, CaKotnpi (Format Va►ies)' (xxlAxlxxl
gIxxxxl (xxfxxlxx)
-2-i
Pt„ f n 1� 'c
1
14,t MI f t s C1,2- C_ Lil- / y9 3'� '117! 5-- 5 to o . 060 511�
q� ,
I I
^-3^ 3 t) i
f C� �( I
h r t.GGr l Cv �� 1 1 I S r4 t' �, �� C 6- c c I 3--� ii_ c y O 1 /. & �- r
N
a
S
0 "J_
:IAA'03
s N L-15 •7 I (% ! .
nfaj+�a>iLL ler �I P C ,l �{No �'f t h - '7 ► 310 i `' / t� 7� fig. 4 v» cr .• / %.� S_G `� 5 — D y % 1. y
/ �f n YGiY
-,c 4- c aO S dz m 3 .�fflw -1
4-1
e. <<; F lest t� 3 � S7"G t� �� �, �f• O � � 1g 3 -•cry �� 'C L' �%� Ic cSs
aff
ate✓& G-
�4
?' `
.'..:VY7 — - --
� N
�AGE::Ti3'�'.:{C2�;;%. � !o-��'`" 671 paLo t
°t.t► 1 .
From
1 f 3 Phcm a 'Plwne
c elt�t rs e el �x a9o9 - 4,0f- oa 14 - --x•74,0 7 7-7 _7011 i
-367¢ �,
yi 5/31/2005 13:00
YOUNG ENGINEERING SERVICES _
77-ROd Wildcat Dr„ Ste. C, Palm f)wR, CA. 92211 (760) 360.5770 fax (760) 360-5770
7603605719
YOUNG ENGINEERING SE
PAGE 02
May 31, 2005
Tom Hartung
Building Official
City of La Quintat
RE: Poh Recidence� 51 225 Avenida Ruhio. La Ouinm CA 92253 1
Dear Tom,
We have performed Structural Observation per C.B.C. section 1702 for the above referenced project
and find it to be in General Conformance with the approved City plans and calculations.
Please note that this letter does not relieve the City or the Special Inspectors from determining
compliance with the approved plans.
If you have any questions please call.
Sincerely,
Jeffrey B. Young, S.E.
-;a .
i
Mc GEE SUR VEYING, INC.
79-301 Country Club Dr., Ste. 102 — Bermuda Dunes, CA 92201
Phone (760) 345-3828 — Fax (760) 772-5705
February 1, 2005
City of La Quinta
78-495 Calle Tampico
La Quinta, CA 92253
Re: Pad Certification — Lots.2 & 3 ( merged lots)
Pursuant to your request a field survey was conducted on the above referenced project to
determine the vertical location of the building pad. The above mentioned was found as
follows:
ADDRESS PAD (DES) IPAD (FIELD)
51-225 Avenida Rubio 60.0'
Siiincer
P-a
Wayne A. McGee
L.S. 5479
•11
3 LS 5a»
� �
PESo�
' f
Sladden Engine" 014 519
e
6782 Stanton Ave., Suite A, Buena Park, CA 90621 (714) 523-0952 Fax (714) 523-1369
39-725 Garand Ln., Suite G, Palm Desert, CA 92211 (760) 772-3893 Fax (760) 772-3895
Date
Job No.
I=IEILD MEM
Project Name 4 -Ant t
Site Address _51 --
Job Phone
S
-W jgnt:
qaa B)
Work Done
Test Summary / Footings inspected
Test
No.
Location
Elev.
Dry
Density
Moist
%
% Relative
Compaction
Ref. Max
pcf
Moist
%
L
C— u –kz-C&I9 10
z 3�
I
I
I �
I
Comments
Field Tech. Super. o gent
I
24 hour notice requested to schedule Field Technician. Thank you for the opportunity to be of service.
014511
Sladden Engineering
6782 Stanton Ave., Suite A, Buena Park, CA 90621 (714) 523-0952 Fax (714) 523-1369
39-725 Garand Ln., Suite G, Palm Desert, CA 92211 (760) 772-3893 Fax (760) 772-3895
Date 7 6
> 5 Z -2 — � �—
Job No.
r
F=IELD MEM®
�;
Project Name C' lie :
Site Address — z- b (, 1 I 1 a." 1 o4
v
Job Phone
o
b C�
Work Doe �--- f
07 i t'
Test Summary / Footings Inspected
Test
No.
Location
Elev.
Dry
Density
Moist
%
% Relative
Compaction
Ref. Max
pcf
Moist
%
VU- i� 7
L/ 3,62.
/a7.4
y
115
. I
-/
q�
V
Comments
�¢V"
Field Tech. i Super. or �ent
24 hour notice requested to schedule Field Technician. Thank you for the opportunity to be of service.
I
014402
Sladden Engineering
6782 Stanton Ave., Suite A, Buena Park, CA 90621 (714) 529-0952 Fax (714) 523-1369
39-725 Garand Ln., Suite G, Palm Desert, CA 92211 (760) 772-3893 Fax (760) 772-3895
Date,
V blob No. �O
FIELD MEM% �Q���
I .T
Project Name u-� �` VClient:
Site Address 5 �h �G� -�S\ 1` rQy�`c �� CJY1
Job Phone
Work Done .?�
5
Test Summary / Footings Inspected
Test
No.
Location \
Elev.
Dry
Density
Moist
%
% Relative
Compaction
Ref. Max
pcf
Moist
%
I
1
Comments
i
24 hour notice requested to schedule Field Technician. Thank you for the opportunity to be of service.
'�W
SIadden Engineering
6782 Stanton -Ave., Suite A, Buena Park, CA 90621
39-725 Garand Ln., Suite .G, ,Palm Desert, CA 92211
Project Name i'
Site Address 5 — lD Ave
L. cit 0
� e
Job Phone OS
A
Work Done
Test Summary / Footings Inspected
014393
(714) 523-0952 Fax (714) 523-1369
(760) 772-3893 Fax (760) 772-3895
Date I tz /3 y _
Job No. 5ZZ
FIELD MEMO\��;
►'�� �Ma ► Off\
TestDry
No.
Location ,�1
Elev.
Density
Moist
%
% Relative
Compaction
Ref. Max
pcf
Moist
%
til 7
13.(e
96
/3.'7
1
►-
I
I
3 2 `
�S
Field Tech. Super. or Agent
I
24 hour notice requested to schedule Fieldchnician. Thank you for the opportunity to be of service.