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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