04-4686 (SFD)BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760),777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUJ S,TS (760) 777-7153
BUILDING PERMIT
Application Number 04-00004686 -� 'Date �`8�/26j.04
Property Address 78870 CITRUS
APN: 772-101-009-
z-,
Application description . . . DWELLING - SINGLE FAM -1 -LY" -]DETACHED,''
Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL
J
Application valuation . . . . 317352
Owner Contractor
------------------------ -------------------------
CAPITAL PACIFIC HOLDINGS CAPITAL PACIFIC HOLDING, INC.
4100 MACARTHUR BLV STE 200 200 SOUTH MAIN ST, STE #300
NEWPORT BEACH CA 92,660 CORONA CA 92882
(909) 279-2447
WCC: EAGLE PCF INS
WC: 1S0312202 09/12/04
CSLB: 740745 09/30/05
CCC: B
-------------------------- Structure Information -------------------------
Construction Type . . . . . TYPE V - NON RATED
Occupancy Type . . . . . . DWELLG/LODGING/CONG <=10
Flood Zone . . . . . . . NON-AO.FLOOD ZONE
Other struct info . . . . . CODE EDITION 2001 CRC
# BEDROOMS 4.00
FIRE SPRINKLERS NO
GARAGE SQ FTG 801.00
PATIO SQ FTG 895.00
NUMBER OF UNITS 1.00
FIRST FLOOR SQ.FTG 3586.00
--------------------------- ------------------------------------------------
Permit . . . . BUILDING PERMIT
Additional desc
Permit Fee . . . . 1402.50 Plan Check Fee 911.63
Issue Date . . . . Valuation . . . . 317352
Qty Unit Charge Per Extension
BASE FEE 639.50
218.00 3.5000 THOU BLDG 100,001-500,000 763.00
-------------------------------------------------------- ---------------------
Permit ... . . . . MECHANICAL
Additional desc
Permit Fee . . . . 108.00 Plan Check Fee 27.00
Issue Date Valuation . . . . 0
Qty Unit Charge Per Extension
P.O. Box 1504I4 4 CE VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 04- 4/49e& Date: q• leo •Oy
Applicant: chit ct or Engineer:
Applicant's Mailing Address: Architect or Enginder's Address:
ic. No.: 019 // �
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commend with Section 7000) of Division 3 of the Business and Professionals
Code, and my License is in full force and effect. —�� O ''JLyi
.,_ nse Class i'J icense No.
ce/ C
i Date �Yll ontractor
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 penally 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.).
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.
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 wo rs' c pensation ii 3surance carrier an policy r�u�nber are:
Carrier-S�F{1 tl� /policy Number
any person in any manner so as to become subject to the workers'
compensation laws of California, a d agr that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those pro v" ions.
Date _ pplicant
WARNING: FAILURE TO SECURE WORKERS'COMPENS6114N COVERAGE IS UNLOAFUL, 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 t�
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions 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 shall, 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 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 I have read this application and state that the above ' fo on is correct. I agree to comply with all city and county ordinances and state laws relating to building
construction,, andel hereby authorize representatives of this cou to nt r upon the above-mentioned property for inspection purposes.
Dat / �i� ature (Applicant or Age
Application Number . . . . . 04-00004686
Page 2
Date 8/26/04
Qty Unit
Charge
Per
Extension
BASE
FEE
15.00
3.00
9.0000
EA
MECH
FURNACE <=100K
27.00
3.00
9.0000
EA
MECH
B/C <=3HP/100K BTU
27.00
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 .
. . .
156.53
Plan Check Fee
39.13
Issue Date .
. . .
Valuation
0
Qty Unit
Charge
Per
Extension
BASE
FEE
15.00
3586.00
.0350
ELEC
NEW RES - 1 OR 2 FAMILY
125.51
801.00
.0200
ELEC
GARAGE OR NON-RESIDENTIAL
16.02
--------------------------------------------------
Permit . . .
. . .
PLUMBING
--------------------------
Additional desc
. .
Permit Fee .
. . .
198.75
Plan Check Fee
49.69
Issue Date .
. . .
Valuation-
0
Qty Unit
Charge
Per
Extension
BASE
FEE
15.00
21.00
6.0000
EA
PLB
FIXTURE
126.00
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
11.00
.7500
EA
PLB
GAS PIPE >=5
8.25
1.00
15.0000
EA
PLB
GAS METER
:
15.00
------------------------------------------------
. .
. . .
GRADING PERMIT
Additional desc
. .
Permit Fee .
. . .
15.00
Plan Check Fee
.00
Issue Date .
. . .
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
BASE
FEE
m
15.00
----------------------------------------------
Notes
and Comments
SFD - LOT 9 PLAN 1B W/CASITA
3586
SF.
Page 3
Application Number
. . . . .
04-00004686 Date
8/26/04
----------------------------------------------------------------------------
Special Notes and Comments
PERMIT DOES NOT INCLUDE
BLOCK
WALL,
POOL, SPA, DRIVEWAY
APPROACH
OR TEMP
POWER.
----------------------------------------------------------------------------
Other Fees . . . .
. . . .. .
ART IN PUBLIC PLACES -RES
293.38
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
91.16
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
31.73
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
----------------=
Charged
Paid Credited
Due
Permit Fee Total
----------
1880.78
------------------------------
.00 .00
1880.78
Plan Check Total
1027.45
.00 .00
1027.45
Other Fee Total
2821.27
.00 .00
2821.27
Grand Total
5729.50
.00 .00
5729.50
Earth Systems
Southwest
79-811 B Country Club Drive
Bermuda Dunes, CA 92201 • (760) 345-1588
Client Name
Client Address
Client Phone
sem,
DATE %
to/ ?,loci
JOB NO.
"7 4 77 0 3
PROJECT
LOCATION
CONTRACTOR
OWNER
WEATHER
TEMP Oat AM
Oat PM
PRESENT AT SITE
THE FOLLOWING WAS NOTED:
Subject: Observation of Footing Excavation
On o, -I, a representative of this firm observed the
foundation excavation for L oT
-.On the -_above project, based upon observations and or testing/probing
s =our opinion that the footings were bottomed to firm,
(,6o p ted).' soils and are / are not ready for placement
- of-con.crete.-
.Clean excavations -of any loose materials and debris, which may
have been blown in, prior ~to placing of concrete.
(AA e^ 41-P �G fr, +7tf7'?/�iv� Cie it, t 0S 7' �" P r7.+
r � �
V&lm
i 1 i CLIENT REPRESENTATIVE SIGNATURE
BD -FS -014 (09/00)
r
FOOTING OBSERVATION REPORT
TURE