06559 (SFD)A'
4
P.O. BOX 1504 N o. 06559
Building 54_180 Rubio LA QUINTA8-105 C
Address CALIFORNIA 92253
Owner
Mailing
Suncrown BUILDING: TYPE CONST. OCC. GRP.
Address P. 0. Tim 804 A.P. Number 774-202-009
City lZip ITel. -
Contractor I
SaT.z♦s
City
State Lic. I City
& Classif. Lic. #
Arch., Engr.,
Designer
Address Tel.
City I
Zip I
State _
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section
effect700 of Division 3 of the Business and Professions Code, and my license is in full force and
_SIGNATURE DATE
OWNER -BUILDER DECLARATION
hereby affirTn that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.S.Bushess 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 appicant for such permit to file a signed statement that he is licensed pursuant to
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
subjects the qupficant to a avi penalty or not more than rive hundred dollars (8500).
❑ 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
bu*ft or improves thereon and who does such work himself or through his own employees,
provided that such rmprovemm ants 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 provf g 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 contractors) 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 1 have a certificate of consent to self -insure, or a certificate of
Work
efs Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Polity No company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(this section need not be completed If the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the perforinance 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: ff. after making this Certificate of Exemption you should become
subject to the Wofkers' Compensation provisions of the Labor Code, you must forthwith
coney w1M such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
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.)
Lenders Name
Lenders Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that 1 have read this application and state that the above information is correct.
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 Addrass
City, State, Zip
egal Description
roject Description V
Sze t - 1466 No.
ories
SFV
No. Dw.
Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
IEstimated Valuation $85.963
s
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
AMOUNT
242.42
6 576.50
53.50
109.89
137.50
5.02
20.00
20.00
1,852.05
REMARKS . ,.., rr- A.
i ;Fr. �3` i. 1lLi1Ar i 3t).1i.t.ii
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
10/17%89
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL SO. FT. ® $
UNITS
COLL AREA
SLAB GRADE
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL SO. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO, FT. ®
DUCT WORK
ROCK STORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
METER LOOP
HEATING (FINAL)
DRAINAGE PIPING
CAR P. SO. FT. ®
GAS (FINAL)
WALL SO. FT.
DRINKING FOUNTAIN.
SO FT ®
WATER HEATER
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE Not to be used as property tax valuation
WATER SYSTEM
FLOOR DRAIN
MECHANICAL FEES
GRADING
cu. yd.
$ —Plus—X$—=$
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL' FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
REMARKS:
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 ® 11/. c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ic
HOUSE SEWER
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 & AIR COND. SOLAR
SETBACK
OUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
R SEPTIC TAN
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPlEOUIP.
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 '��/�9/��
FINAL INSP.
ROOFING 'w
�' & -/r
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING f oWAI f/
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
\
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
OF
��/�
%%��
` `f or,ce'. SCHOOL FACILITY FEES
TO: City o fkQ°Wt�`�a,��'' DATE:
Department of N% n11 Deve` te� i'
78-105 Calle .Estado c
La Quinta, CA 92253
Uo
This is to certify that l� + [,(,✓]]
developer of'�' which is
located at I C 2ffll 6, 11p within
this District, has paid school facility fees imposea pursuant to the
auor at d by overnmen CodeA AT n ecti tt 0 'th `amohn
Vf g r
coveting a total of square feet of or
( ) industrial/commerci 1 development and that build�)Jlr-esfdentia
g permits for
this footage in this development may now be issued by your jurisdiction.
!!2 A gi k L , a
for DESERt SA S UNI IED SCHOOL DISTRICT
White - Building Department • Yellow - Facilities Planning • Pink - Accounting 0 Gold - Developer
(10)-37
' of 4,OFFICE OF
`
\; AGRICULTURAL COMMISSIONER
)� AND
;•;114, WEIGHTS & MEASURES CALVIN C. KAMwsw4S
JAMES 0. WALLACE 4080 LEMON STREET, ROOM 19' Assistant Commissioner
Agricultural Commissioner RIVERSIDE, CALIFORNIA 92501 CLEMENT BENVENISTE
Director of Weights d Measures (714) 787.2561 Sealer
49613 Highway 86, Suite B12
Coachella, Ca. 92236
r (619) 342-8291
DATE Q .{off,- 1(� �4'�, Y CASE NO.�4lylL� Q
DEVELOPER'S NAME: A)
ADDRESS: ��(� �y 7o L
TELEPHONE:
Dear Developer:
After reviewing your landscaping plans, all plant material listed is not in
violation of quarantine laws governing the Coachella Valley. If substitutions
do occur and they differ from plant material listed, this office must be notified
immediately. '
Thank you for protecting and preserving the Coachella Valley's pest -free environment.
Agri tural ommissiorier's Office
cc: Indio and Riverside Office
4
78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 - (619) 564-2246
FAX (619) 564-5617
July 5, 1991
To Whom It May Concern:
The structure located at 54-180 Avenida Rubio will be
located in a "B" flood zone per the revised F.I.R.M.,.(panels
060709 005 A and 0010 A) for La Quinta. This change will be
effective August 13, 1991. The property is currently
designated as zone AO (depth two (2) feet).
If you,have any questions, feel free to,contact me.
Sincerely,
BUILDING AND SAFETY
Tom Hartung
Director of Building and Safety
TH/lc
MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253
s
Buena Engineers, Inc.
~� 79-811 Country Club Drive, Suite 4
Bermuda Dunes, CA 92201 • (619) 345-1588 / 328-9131
Client Name
Client
Client Phone
DATE
JOB NO.
PROJECT
mac( - 10. O p,' cQ
ELEVATION
LOCATION
REFERENCE CURVE
CONTRACTOR
OWNER
WEATHER
� (ev / l +aod
TEMP.
oat AM
° at PM
PRESENT AT SITE
t
TEST
NUMBER
TEST LOCATION
�
LOT
NO.
ELEVATION
FIELD'TESTING
REFERENCE CURVE
MOISTURE
CONTENT
'%
DRYMAXIMUM
DENSITY
Ibs✓Cu. ft.
DRY
DENSITY
/.
MAXIMUM
DRY
DENSITY
Ibslcu.ft.
OPTIMUM
MOISTURE
CONTENT
0.1
1
s
of
12
.
I
I
r
, I
REMARKS:
(U I P J k. J x V'>1 a_ k- t1 pC(-- -'e Gt o UZ,
FIELD REPORT
CLIEN7-11 T 9.� (j p
RE PRESENTATIVESIGNATURE :V A .TECHNICIANS SIGNATURE r
ON