11604 (BLCK)r
P.O. BOX 1504 No. 11604
Building 78-105 CALLE ESTADO
Address 52--440 obrefxon LA QUINTA, CALIFORNIA 92253
Owner
Mailing
W.E.S. Bevels stent BUILDING: TYPE CONST. SFD OCC: GRP.
Address 4102 Marble Ridge Fid. A.P. Number ?71_.2g4,e{ AQ
City zip Tel. Lot 9 of Block 12
Shingle Spas 95682 1(916)676-3300 Legal Description
Contractor Project Description P1zi.1 2 r'ever—ped
Stockman Homes
Address
ane as above
City Zip Tel.:
State Lic. City
& Classif. B1 642348 Lic. # 2531 Sq. Ft. No. No. Dw.
ArchSize 1471 Stories Units
.', Engr.,
Designer Studio o 4 New Q. Add ❑ Alter ❑ Repair ❑ Demolition ❑
a
Address T(
s9 University 0100 (916)920-1.159 Permit '.dries not .include block walls or,
City Zip State
Sacramento, CA Lic: # 22044
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
70 OO) of Division 3 of the Business and Professions Code, and my license is,in full force and
effect `e
SIGNATURE DATE
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following 8 5 . (�
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also -
requires the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for .the alleged exemption. Any violation of Section 7031.5 by any applicant for -a permit Plan Chk. Dep. _
subjects the applicant to a civil penalty of not more than five hundred'dollars ($500). ,
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. 494.63
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Const.Professions Code: The Contractor's License Law does not apply to an owner of. property who
builds or Improves thereon and who -does such work himself or through his own employees, M@Cil. .
provided that such improvements are not intended or offered for sale. If, however, the building :12
^f y
or improvement is sold within one year of completion, the owner -builder will have the burden. Electrical A23. 7 1
of proving that he did not build or improve for the purpose of sale.) y y n
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 14 Y . 00
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property* who builds or improves thereon, and who contracts for S:M,I. H. 60
such projects with a contractors) licensed pursuant to the Contractor's -License Law.)
Grading 20. 00
1 am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date Owner Infrastructure 1,913.57
reMtse. plan X45 1)
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
O Copy is filed with the city. O Certified copy is hereby furnished.
TOTAL , b ! . 91
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed If the permit is for one hundred dollars ($100) valuation _.rr5Y%`��}u>;All j� 1 YTrf A�j-1 ; r�,Tj, ,'fi `(
or less.)
I certify that in the performance of thg 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.
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become ZONE: BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked. -
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
Ihereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.) Side Setback from Property Line
Lender's Name
Lender's Address FINAL DATE INSPECTOR
This is'a building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct. Issued by: Date Permit
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives sof this city to enter the above-.
mentioned property for inspection purposes. Validated by:
Signature of applicant -Date-
Mailing
ateMailing Address. Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
t
2ND FL. SO. FT.
ROUGH PLUMB.
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO, FT, ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT. ®
FOUND. REINF.
DRAINAGE PIPING
WALL SO. FT.
HEATING (FINAL)
DRINKING FOUNTAIN.
SO. FT. ®
GAS (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
SERVICE
FLOOR DRAIN
MECHANICAL FEES
BOND BEAM
WATER SOFTENER
VENT SYSTEM. FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED.-
FINAL INSP.GS3
LAUNDRY TRAY
AIR HANDLING UNIT CFM
pet„/ (y l ala �1C
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED -GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
LATHING
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE /n PLUMBING ELECTRICAL HEATING S AIR COND. SOLAR
SETBACK
GROUND PLUMBING z
( UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE ri
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER AFLS6Pf16-�AWWf�
ROUGH WIRING.
DUCTWORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP. ! :!
FRAMING 1
FINAL INSP.GS3
ROOFING / d 3 sip
pet„/ (y l ala �1C
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION 3 L
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES11NITIALS
GARDEN WALL FINAL
N!
.i.
�EARTH SYSTEMS CONSULTANTS S.C.. ..� . . :
BUENA ENGINEERS'DIV, s
79-811 B Country Club Drive
Bermuda Dunes, CA 92201 • (619) 345-1588 j
Client Name `
Client Address
Client Phone
DATE
JOB NO.
%a 3
PROJECT/
TESTING
REFERENCE CURVE
MOISTURE
. DRY
LOCATION
MAXIMUM
L b (_ lGar
TEST
CONTRACTOR
O ER
NUMBER
WEATHER
TEMP.
° at AM
CONTENT
DENSITY
° at PM
PRESENT AT SITE -
MOISTURE
'a
%
Ibs./Cu. fl..
DENSITY
DENSITY
CLIENT REPRESENTATIVE SIGNATURE
..FIELD
TESTING
REFERENCE CURVE
MOISTURE
. DRY
MAXIMUM
MAXIMUM
OPTIMUM
TEST
TEST LOCATION
LOT
NUMBER
N
ELEVATION
CONTENT
DENSITY
DRY
DRY
MOISTURE
}!
%
Ibs./Cu. fl..
DENSITY
DENSITY
CONTENT
�x.lSSZ
1
"/
Ibslcu. ft.'
. r
f
$.
qy
I►,
✓ / / ✓
ti
61'v
O..S
Q
14
.
,3
✓ J
!:../-0-0d
Cp
- L -I
2
p;5
;�._.
.
.REMARKS:
CLIENT REPRESENTATIVE SIGNATURE
of 14a I�uint�
�utl�in� rind �S�fet� �t1�is inn
Thin Certificate issued pursuant to the requirements of Section 306 of the Uniform Building
Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating building construction. or use. For the following:
BUILDING ADDRESS 52-440 Obregon
Use Classification Single Family Dwelling Bldg. Permit No. 11604
Group R3 Type Construction VN Fre Zone Use Zone SR
Owner of Building w. .. S . D _v _ 1 o= ment Address 41 n 2 Ma rh 1 e R id4 a Road
City Shi ng1Q S= ri ngG _ rA
�� AL-
Building Official
By. Lonnie Day
Dote: March 31, 1993
POST IN A CONSPICUOUS PLACE