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SFD (09067)Building Address 50 Owner mailing Address Cjty Contractor W.. ; P.O. BOX 1504 No . 78-105 CALLE ESTADO rJ Mtn. Shadows Komi LA QUINTA, CALIFORNIA 92253 ` LJ _ BUILDING: TYPE CONST. OCC: GRP.: 79-811 Country Club Zip ITO Aaaress ;I _ City Zip Tel. State Lic. City & Classif. 476-007' Lia #. 564. . Arch., Engr:; Designer ; Address Tel. City Zip State PC. # LICENSED CONTRACTOR'S DECLA ATION I hereby affirmkthat I am licensed unde . provisions of Chap 7000) of Division 3 of tD6 Business and rofessions.Code, aid er 9 (commencing with Section my license is in full force and. I hereby affirm that I am exempt from the Contractor's Licen\e Law for the following 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 the provisions or the Contractor's License Law, Chapter 9 (commencing with Section 7000) or 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 subjects the applicant io a civil penalty of not more than rive hundred dollars ($500). ❑ 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, Buisness and 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, provided that such 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 did not build or improve for the purpose of sale.) - - ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- 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 such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner 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.. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATIONINSURANCE (This section need not be completed if the permit is- for one hundred dollars ($100) valuation or less.) 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. Date Owner NOTICE TO APPLICANT: If, atter making this Certificate. of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address 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. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter the above-. mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip Number 9067 Legal Description Zot 5 Painted Cove Project Description Sq. Ft. No. No. Dw. Size 1101D Stories Units New 0,'. Add ❑ Alter ❑ Repair ❑ Demolition ❑ U PERMIT Plan Chk. Dep. Plan Chk. Bal Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS. 0 AMOUNT ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: " CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ 2ND FL. SQ. FT. POR. SO. "FT. ® GAR. SQ, FT. ® CAR P. SO. FT. WALL SQ. FT. SO FT ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN. URINAL WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER DUCT WORK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM HEATING (FINAL) KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE,TEMJPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER. B.T.U. SQ. FT. @ c BATH TUB BOND BEAM SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1+/a c SEWAGE DISPOSAL LUMBER GR. SQ.FT.GAR ® 3/ec HOUSE SEWER (/�EAAMINGJ �(J�d FINAL INSP. 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 PLUMBING ELECTRICAL HEATING J3 AIR COND. SOLAR SETBACKvi ROUND PLUMBINGjf2Z-j0 UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE /- ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING. DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. 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.G-11 (/�EAAMINGJ �(J�d FINAL INSP. R OFING 2-1100-4 4 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INS - TIONJSOUN� Vv FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL Iuilding tddress d dess7,dr T4&f 4 A BOX 1504 LDO Y , ALLE ESTADO CALIFORNIA92253 o ]BUILDING: TYPE CONST. oaz OCC. GRP. 'I No. No. Dw. Stories Units Zip Tel. on r ss ity Z' T .. tate LIC. Classif. DD City Lic. # rch., Engr., asigner L TCG% idress Tel. Ly 1Zip (State Lic. # LICENSED CONTRACTOR'S DECLARATION herebyy affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section 100) of Divislon 3 of the Business and Professions Code, and my license is in full force and fact. NATURE. . DATE OWNER -BUILDER DECLARATION' I hereby affirm that I am exempt from the Contractors License Law for the following son: (Sec. 7031.5,Buslness and Professions Code: Any city or county which repu mil to construct, alter, Improve, demolish, or repair any structure, prior to Its Issuanclree s alseo ulres the applicant for such permit to file a signed statement that he Is licensed pursuant to provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) or cion 3 of the Business and Professions Code, or that. he Is exempt therefrom, and the basis the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit (acts the applicant to a civil penalty of not more than five hundred dollard,($500). I, as owner of the property, or my employees with wages as their sole compensation, will the work, and the structure is not Intended or offered for sale. (Sec. 7044, Bulsness and fessions Code: The Contractor's License Lew does not apply to an owner of property who as or Improves thereon and who does such work himself or through his own employees, Tided that such Improvements are not Intended or offered for sale. If, however, the building improvement is sold within one year of completion, the owner -builder will have the burden roving that he did not build or Improve for the purpose of sale.) I, as owner of the property, am exclusively contracting with licensed contractors to con- ict the project. (Sec. 7044, Business and Professions Code: The Contractor's License Lew ,s not apply to an owner or property•who builds of improves thereon, and who contracts for h projects with a contractor(s) licensed pursuant to the Contractor's License Law.) am exempt under Sec. B. & P.C. for this reason — '—Owner WORKERS' COMPENSATION DECLARATION iseI hereby affirm that I have a certificate of consent to self -Insure, or a certificate of ,rr's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Icy No. .Company O Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE s section need not be completed If the permit is for one Hundred dollars ($100) valuation ass.) I certify that in the performance of the work for which this permit Is'issued, I shall not )toy any parson in any manner so as to become subject to the Workers' Compensation is of California. e —Owner TO APPLICANT: 11, after making this Can Cate of Exemption you should become act to the Workers' Compensation provisions of the Labor Code, you must forthwith P/y with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY hereby affirm that there is a construction lending agency for the performance of the for which this permit is issued. (Sec. 3097, Civil Code.) lens Name let's Address his is a building permit when properly filled out, signed and validated, and is subject to atlon It work thereunder is suspended for 180 days. srtify, that I have read this application and state that the above information Is correct. ee to comply with all city and county ordinances and state laws relating to building ltruction, and hereby authorize representatives -of this city to enter the above-. Toned property for inspection purposes. ature of applicant A.P. Number Legal Description Project Description ��ilr ��� Qy� Sq. Ft. Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc, Infrastructure P 90 i4 TOTAL r REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: y -1 bb I State, Zip Validation: DESERT SANDS UNIFIED SCHOOL DISTRICT 82-879 Highway 111 NOTICE: Indio, CA 92201 Document Cannot Be Duplicated (619)347-_8631 Date 12/19/90 1 Type of Permit I La Quinta No. 10339 Permit # Owner Name Don Howard Log # No. 50-205 street Mtn. Shadows Road City La Quinta Zip 9225253 Study Area 117 APN # Tract # Lot # Square Footage 3300 Type of Development 16ingle Family Residence No. of units Comments At the present time, the Desert Sands Unified School. District does not collect fees on garages/carports, covered patios/walkways, residential additions under 500 square feet, detached accessory structures or replacement mobilehomes. It has been determined the above-named owner is exempt from paying school fees at this time due to the following reason: EXEMPTION NOT APPLICABLE t This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 1.58 I X ® or $ 5,214.00 have been paid to D.S.U.B.D. 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 Cherokee Homes Name on the check Telephone 3445.6225 By Richard M. Beck 1� Os ' -, Director, Facilities Planning & Development` M - � k Fee collected /exempted by Shelley D. Bennett PaymP*it Re�'gi Signature !' - No.,ge C% 'F Collector: Attach a copy of County or City plan check application form to Di'stx'i'cti Embossed Original- Building Dept./Applicant Copy -Applicant/Receipt Copy - Accounting R - Buena Engineers, Inc. DATE -7� J08 NO. -' 79-8118 Country Club Drive PROJECT Bermuda Dunes, CA 92201 • (619) 345.1588 r._ LOCATION Client Name CONTRACTOR OWNER CilentAddrwQc WEATHER TEMP. oat AM L oat PM_ PRESENT AT SITE Client Phone - 77' TEST TEST LOCATION FIELD TESTING REFERENCE CURVE NUMBER LOT NO. MOISTURE ELEVATION CONTENT DRY DENSITY MAXIMUM DRY MAXIMUM OPTIMUM DRY 1 % lbs/Cu. ft DENSITY MOISTURE DENSITY CONTENT % IbsJCu. fL % 4 v125L 07 L: Z4 Aj x.17 6, FIELD REPORT L Buena Engineers, Inc. 79-8118 Country Club Drfire Bermuda Dunes, CA 92201 • (619) 345-1588 Client Name Client Address Client Phone DATE TEST LOCATION JOB NO. PROJECT 1-1d (1, FIELD TESTING LOCATION MOISTURE CONTENT 9'o CONTRACTOR � v MAXIMUM DRY DENSITY % OWNER WEATHER TEW .� o at AN D oat PA PRESENT AT SITE �F v TEST NUMBER TEST LOCATION LOT NO. ELEVATION FIELD TESTING REFERENCE CUR MOISTURE CONTENT 9'o DRY DENSITY- IbsJCu. tL MAXIMUM DRY DENSITY % MAXIMUM DRY DENSITY IbsJcu.fL OPTIM MOIST! CONTE Yo Y ►�� ��,� 6�15.0 '; - vv 157 3$•CJ r/. I a,� �� ISI. _A� g REMARKS: N- 3 S� 1 1c -/�/ D ? �0U �/C vL L - q1 65 X Ali1 57'., _ S iE4,4i S t- `_ L ri r S E `2 g 720 mac 414 r ,c/ \/s'hf? 6 F_. ,4 /4 t� FIELD REPORT Un v OF C r of �� Wit, t* n t a , • .�url�tnrt �n� �'��P�t . �r�r�iun i This 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: 50-205 Mt. Shadows BUILDING, ADDRESS 50 Use Classification Single ,Family Dwel-ling 'Bldg. Permit NO. 0906.7 Group R3 Type Construction VN Fire Zone = Use.Zone SR Owner of Building Don Howard Address 79-811 Country Club Dr. City ermudaDunes,' C& Richard Kirkland BY'. March 12, 1993 Date; Building Official' POST IN A CONSVI . WOUS PLACE