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