04-4678 (SFD)I ,
LUU IU BUILDING & SAFETY DEPARTMENT
P. I . B760Ox•I'1�504'—�J 777-7012
�. �,a QUINrn ( ) .
78-4-95 CnL-L-`P�n�"ivsP�I�cO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number .
. . . . 04-00004678 Date 7/13/04
Property Address . .
. . . . 78900 CITRUS
APN:
772-101-006-• - -
Application description
. . . DWELLING - SINGLE FAMILY
DETACHED
Property Zoning . . .
. . . . LOW DENSITY RESIDENTIAL
Application valuation
. . . . 3173521
Owner
Contractor
------------------------
CAPITAL PACIFIC HOLDINGS
------------------------
CAPITAL PACIFIC HOLDING,
INC.
4100 MACARTHUR BLV STE
200 200 SOUTH MAIN ST,
STE #300
NEWPORT BEACH
CA 92660 CORONA
CA 92882
(90 9) 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/LONG <=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 1504ICE 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: ' y 1p 78 Date:
Applicant:
Applicant's Mailing Address:
02 4
t or
M
,�chitect or Engineer's Address:
/fC? 2 CdTka1 1A10 L A9!�MAwe
/00
a^v()
-tic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
1 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
C9de, and ss License] n full force and effect. / / `�� f .n „
icense Class i[, License No. r7
Date /4 e6ntractor C'/1 -i'17 -1A `/OZ -101A -3; fWC
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.).
U 1, 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
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
u d. A workers' compensat' nsurance carrier
/-Came, Policy Number % "/
_ I certify that, in the performance of the work for which it�i s permit is idsued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of Califomi , and 'a ree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those ovisio
WARNING: FAILURE TO SECURE WORKERS' COMPE SATION COVERAGE 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.).
Lenders Name 0.
Lenders 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 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 canc Ilation.
I certify that I have read this application and state that the above i ormati s correct. I agree to comply with all city and county ordinances and state laws relafing to building
construction, and hereby authorize representatives of this coup to ent on the above-mentioned property for inspection purposes.
,,Z'ate �10��1 Signature (Applicant or Agent
4
5
Page
2
Application
Number .
. .
. . 04-00004678 Date
7/13/04
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/1001< 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
----------------------------------------------------------------------------
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
6 PLAN 1B W/CASITA
3586 SF.
(4
Fee summary Charged
Permit Fee Total 1880.78
Plan Check Total 1027.45
Other Fee Total 2821.27
Grand Total 5729.50
11
Paid Credited Due
---------- ---------- ----------
.00 .00 1880.78
.00 .'00 1027.45
.00, .00 2821.27
.00 .00 5729.50
Page
3
Application Number . . . . .
04-00004678 Date
7/13/04
----------------------------------------------------------------------------
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
Permit Fee Total 1880.78
Plan Check Total 1027.45
Other Fee Total 2821.27
Grand Total 5729.50
11
Paid Credited Due
---------- ---------- ----------
.00 .00 1880.78
.00 .'00 1027.45
.00, .00 2821.27
.00 .00 5729.50
JCM Inspections
• 39725 Garand Lane Suite F •
Palm Desert, CA 92211
INSPECTIONS Phone: 760-345-5554 - Fax: 760-772-3895
INSPECTIONS
REINFORCED CONCRETE INSPECTION REPORT Date:
Project Name: Project No:
Capital Pacific Homes - Citrus Course Collection 04-928
Project Address: City:
Phases1-5 Tract # 24890-4 La Quinta, CA
Q✓ IBC
Title 24
Other:
Client: Sub -Contractor:
Owner Desert Communities Concrete Const. Corp.
General Contractor: Architect: Structural Engineer:
Capital Pacific Homes BBG Gouvis Engineering
Slump (inches): ,�» Supplier:lz:Weather:
.fin r; .,tom
Time Sampled: --7—, y Mix Design:
Time in Mixer (min.): 23 � Specified Strength (PSI): t4 b(i
Water Added @ Jobsite (gals.): ,r1 far➢ C Addmixture: Vh7 - _3.3a:
Concrete Temperature (F): '7.=;„ Truck #: S3 Ticket #^�?}'_"_r
Ambient Air Temperature (F): --71 Field ID Marking: 0
U t1 f+
Unresolved It s:
None
❑ See Below
Location of Sample: ':5\ 1\7 ,., , t - ft— — t t,_y..1 r% a.�
No Samples Taken
Description of Work Inspected: � A �c C111 -'A_ L1+ IL Q\ �
Ct�.lrfnr1 Ci•d�n w.�r ,t' •f..
1�
eu.J- \nrX" C; i'\rICeC%n.�,rINJiV�tmV� vJn•. t -e Q"in
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C r%.n 'r Q�
`(.
,:N .'.....�,� L�f ,. Ar. .. -n�� •t r --*Nr rr, n_ 4itt �s� n\ *,rr Ti .�.�t'�\ �A�Ce
ke+ n , -1. e%�
Ck J e. � '1, C. � �a .s'� V � �n r e+ % rl" .rl C' C i,n� P n A n . ,n V, n . a �� \w�� I
,reJ\i a,i�1r_i1J f �^�
\\�C'�nr`
t
Xt1 its\ t, r1.�.n.'S4� �.+ kC\ t�f rr.n.t i ,
,
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: Jib k C.Millin ICC Certt1fication o: 0842216-80
Contractor's Representative: ( /
(/
Copy 1 JCM Inspections Copy 2 Project Superintendent Copy Governing Agency
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