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001179 (SFD)PERMIT APPLICATION City of La Ouinta Department of Building and Safety �3. This permit becomes void if work not commenced within 180 days from date of issuance, OR, it work has been suspended or abandoned for a oeriod of 180 days. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9• (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my'license is in full force and effect. License Class Lic. Number Date – Contractor OWNER -BUILDER DECLARATION: tl'hereby affirm that I am exempt from the -Contractor's License 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 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 applicant tc a civil penally of not more than five hundred dollars ($500.): O 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 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 i mprovemnt is sold within one year of completion, the owner -builder will have the burd9p of proving that he did not build or improve for the purpose of sale.). , ❑ I, as owner of the property, am exculsively contracting with licensed contractors.to construct 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. Coniraclor's License Law.).— I7 1 am exempt under Sec. B.�-P..,:G1(Attached,C ctifica,)e). ✓err. - w �, v C Date Owner WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Workers' Compensation Insurance , or a'certified copy thereof (Sec: 3800.1ab. C.). Policy No. Company O Certified copy is hereby furnished. o Certified copy is filed with the City Building Inspection Department or City Date Applicant Department. APPLICANT NAME (L. F, MI) Brian montme- ADDRESS P.O. IM lU4U CITY/COMMUNITY/STATE/ZIP La taJ (A '92,453 JOB SITE ADDRESS/SPACE 53-300 Avenida CITY/COMMUNITY/STATE/ZIP La QLi r*a,, CA 9`2253 ��"�� 81: 74 PA,28'l' M3 C. SII Fee 6.65 TWN.. PING SE S TRACT LOT2 ir MOD I SB TRACT NAME None ' OWNER NAME (L. F. MI) ]�)•t - ' CONTRACTOR -FIRM NAME Wick John= ClDnst. ADDRESS P.O. B= 2288 CITY/COMMUNITY/STATE/ZIP Trglio, `A 92202 . �+��+ PHONE # 347-6191 L1.5gF?169 ARC/ENG FIRM NAME ' ADDRESS CITY/COMMUNITY/STATE/ZIP PHONE I LICNC 0 USE OF PERMIT s M e family V �17 i rare •�++� BL ZON FSB ssa SSBI RSB OFC ZONE ORD I LOT SZ - END SIDE 0 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed if the permit is for one hundred ($100) o, less. I certify that n 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 Applicant NOTICE TO APPLICANT: If, after making this Certificate o0 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. _ ' DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:, ❑ 1hereby certify that noexcavation five (5)ormore feet irdepth into • which aperson isrequired todescend, will be made in connection'with work authorized by this permit, a -Id that no building structure, scaffolding, falsework; or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap 3.2, Grp 2, Art 2, Sec34t• Title B. C.A.C.) •❑ As oWher-builder, I will not employ anyone to do wck which would require a permit from the Division of Industrial Safety, as noted above• unless such person hs a permit to do such work from that division. ❑ Division of Industrial Safety Permit No. Date Applicant CONSTRUCTION LENDING AGENCY: I hereby affirm th6uth• iwis a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, CN. C.). Lender's Name Lender's Address 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 builring construction• and hereby authorize representatives of this county to enter upon the above-mentioned proper y for inspection purposes. Signature of Applicant or Agent Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF Er TRY: I certify I have read this application and state that the information given is correct. I agree to comply withal state laws and county ordinances relating to buidling construction, authorize. a'representativ6 oVtpe City rf La Ouinta Department of Building and Safety to enter upon the property fo�which I,hayeappliefl,fo�fhivp Aor�the purpose of making inspections. ` .Signature of Applicant or'Ageni�f),r:,e—C Date Print Applicant/Agent Name APPL/PRMT n I f i l 7!"1 Pariah to =wtn=t 1592 sq. rt. of S.F.D. 91 sq. rt. of poral and 9130 sq. rc. Or image as per approved plans. meth. Fee 22.00 Plan Check Fee 3PR-W-i �O ��:7'•� Climst. Fee .Elect. Fee 43.13 SII Fee 6.65 Phanbino- __ 50.50 Prop, Dwel. Fee 450.00 1r.318,0& /c;)6Cn,CJa (250.00) PD 12/14 ir TOTAL FEE ±Ta18,U5, VALUATION -94y894w00'•. BLDG. DEPT. NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Ftgs & Frms 34 Plenums & Ducts 2A Slab Grade 35 Furnace Compart. 3 Steel 36 Inlets & Outlets 4 Grout Blocks 37 Combustion Air 5 Bond Beams. 38 Compressor 6 Roof Deck 3 39 Appl. Clearance 7 Framing ' 40 Fire Damper 8 Vents 41 Smoke Detection Device 9 Garage Fire Wall 42 Commercial Hood 10 Fireplace P.L. ❑ 43 Final 10A fireplace T.O. ❑ NO. NO. ADDITIONAL INFORMATION T _ SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath S 12 Internal Lath 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Walls (Batts) 12B Ceiling (Batts) 12C Ceiling (Blown) 14 Final PLUMBING APPROVALS 15 Ground Plumb 16 Water Piping 17 Rough Plumb 3 18 Vents 19 Sewage.Disposal 20 Sewer 21 Water Heater 22 Water Softener 23 Water Service 24 Gas Test 25 Final Tank - Pit L. Line ELECTRIC APPROVALS REAR OF PROPERTY LINE p/L PA STREET NAME 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring g' 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final ��''^� .- .-mac t� , . - . • -. ., _ �� �� /�f! l / L �' �"� ` �• 2 C. t5 1 Z' t ' A ('i:' -e �..1 i t,,.l. 'fA,. l% U �� l Y•+ RIVERSIDE COUNTY DEPARTMENT OF HEALTH PERMIT APPLICATION FOR A SUBSURFACE DISPOSAL SYSTEM Applicant: Submit this form with three copies of a scaled plot plan drawn to county specifications required on the attached check list. A non refundable filing fee of $15 is required when the application iE submitted. Check must be made payable to County of Riverside. Name Mailing Address 1(-7,416) City State Zip Code Phone 'Property Address A ` 2-2Y- 'City or Community *Legal, Description of Property (Lot, 'arcel Map, Tract) �— 2 Z /1- e' /�'c/ �° / s7 .• s i �` i•� 'Assessors Parcel No. Water Serving Property From ',Lot size Signature of Applicant Date 'The above information must be verified from Building Application Staff Use — Do Not Write Below This Line Initia. Date WQCB Clearance required Yes ❑ No Soils feasibility report required Yes ❑ No Detailed boring report required Yes ❑ No 10 Detailed contour plot required Yes ❑ No ❑ t Comments: Soils or boring report by t n-\ Date Approved by Date Soils Map Page Soil Type Tract File No. Other Number of Bedrooms Septic Tank Size (gallons) Rate Required Type of System New Addition Replacement Leach line sq. ft. of bottom area trench Leach bed (sq. ff. of bottom area bed) Seepage Pit Diameter Number of Pits Seepage Pit Depth B.I. Total Depth of Pit 5' ❑ 6 r ©'— ©`^ N Location of System Additional Requirements \�•1t:e ► � � �� � •. � �r ��'�S\ � � �1�� — t �� t ..v � � v �"�- T�rv.,,,� G, lt.J'p � ( A permit is approved' denied for the design of a subsurface disposal system as indicated o -t the accompanied plot plan using the requirements set forth in Section B above. A building permit is necessary for :he installation of the above designed sy�stem. � Signature of Health Official Date Receipt No. I 1 ". %lam //9 Issued By r� District: Riverside ❑ Indio Q Hemet ❑ Date '� 1r DISTRIBUTION: WHITE - Office File YELLOW - Applicant PINK - Building Dept. GOLDENROD - Pending File DOH SAN 122 (Rev 10/82) y XCIVE® =111MEnginelers, Inc. �� 01 01 1905 clr� of LA COMMUNIT+ DEVELOPMINTA ENT DEPT w TESTING INSPECTION 1731-A WALTER"STREET • VENTURA, CALIFORNIA 93003 a PHONE .(805) 642-6727 January, 25, 1985 Job.No'.B-.1.4989-P1 85-1-223 Pomona Valley:Equipment P.O. Box 457 La Quinta, CA. 9225.3 Subject: 53-300, 53-320,-53-340 Ave. Ramirez La Quinta, CA Compaction Report Gentlemen:. On January.21, 1985 a representative of our.firm performed den_. sity tests on the fill placed in the building area on the above re ferenced project. Tests were performed at-random'locatdons.in ac- cordance with ASTM 2922-78 and ASTM 3017-78 Nuclear. Density Test " Procedure. Tests performed as per authorization of Bob-Mc Callum. The estimated.locations of.-the tests are presented on the attach— ed plan with their results being summarized on"the attached test.re- port sheet. A total of six (6) density tests were"performed. Test results indicate that a minimum of ninty.percent (900) of rela- tive compaction has been-:obtained within the areas test,ed..,The maximum density-optimum-moisture was determined in the laboratory in accordance with'.ASTM D 15.57-78, Method A, five-(5) layer curve. Classification Maximum Density-Opti:mWn Moisture Light brown silty fine sand 108.9 14.2 VENTURA LANCASTER (805) 842.6727 (805) 948.7538 THOUSAND OAKS BAKERSFIELD SANTA BARBARA PALM SPRINGS SAN LUIS OBISPO (805) 495-8484 _(805) 327.5150 (805) 966.9912 (714),328-9131 (805) 544b187 January 25, 1985 Job No. B -14989-P1 85-1-223 LIMITATIONS The backfilling and compacting operations _were completed. at the ti The. personnelwere called to the site. The test results summa-. rized in.this report represent the moisture and density -only at the location and depth tested on the specified date. The summarized.field and -laboratory tests were performed'in:accordance faith engineering principles generally accepted at this time and:'location. No opinion is expressed.as to the uniformity of the material, compaction nor the adequacy.of.,the material to perform its intended function. No quar- antee or warranty of the contractors wort: is made or, implied. Respectfully submitted, BUENA ENGINEERS, INC. Reviewed and Approved— Norman. G. Jac son, Jr. RaYod Brannen ` NGJ/REB/kls _ C.E. 28966 Copies: 4- Bob McCallum. 2- City of La.Quinta 1- P.S. file 1- Vta. file REPORT OF RELATIVE COMPACTIONS Job N013 -14989-P1 CONTRACTOR: DATE: January 25,_ 1985. Report N085-1-223 ADDRESS: JOB.& LOCATION: Ave. Rainirez La Ouinta. CA TEST NO. DATE .. DESCRIPTION - % MOISTURE DRY -DENSITY oRELATIVE MAXIMUM TESTED IN PLACE IN PLACE COMPACTION DENSITY . .1 1-21-85 2.5 from grade -53-300 12.0 105.2. 97 108.9 2 1-21-85 0.5 from grade -53-300 13.2 100.1 92. 108.9 3 1=�1-85 1.5 from grade -53-320 12.5 101.6 93. 108.9 4 1-21-85 0.5 .from grade -53-320 15.3. 102.6 94 108.9 5 1-21-85 2.0 from grade -53-340. 9.7 106.4 98 108.9 6 1=21-85 1.0. from grade -53-340 13..9 102.3 94 108.9 WE CERTIFY THAT THESE TESTS.WERE PERFORMED IN CONFORMANCE WITH COPIES:. BUENA ENGINEERS, INC. L y N 7