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0312 (SFD)PERMIT APPLICATION City of La Ouinta Department of Building and Safety This permit becomes void if work not commenced within 180 days from date of issuance. OR, if -work has been suspended or abandoned for a period of 180 days. I1_ ` CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed if LICENSED CONTRACTORS DECLARATION:' I hereby affirm that I am. licensed under provisions of Chapter 9 the permit is for one hundred ($100) o. less. I certify-th t inAhe performance of the worVfor which this permit is (commencing with Section 7000) of Division of the Business and Professions Code, and my license is in full force issued. I shall not employ any person in any manner'so a; to become subject to the Workers'CompensationLaws of and effect. �Californi / s-? •' ..e..- +.-------'� License Class, ,Lic. Number ,Date. Contractor OWNER'9UILDER DECLARATION: I 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.g(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 to a civil penalty of not more than five hundred dollars ($500.): 1 ❑ 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 forsale. If; however, the building or i mprovemnt 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.). ❑ 1, 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 Contractor's License.Law.). ❑ 1 am exempt under Sec: B. 8 P.C. (Attached Certificate). 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. Lab. Q. Policy No. Company ❑ Certified copy is hereby furnished. O Certified_ copy is filed with the City Building Inspection Department or City .Date Applicant Department. APPLICANT ANTS�I�/ je_Nfl) 0� ! ✓/ �Q��IG� i ! v���/",7� ADDRESS 7 CITY/COUC,+rr:' .iC�i JOB SITE ADDRESS/SPACE 15"©~ � lie ( li/'© CITY/COMMUNITY/STATE/ZIP • • , yeo6 PAG�q � QRC C z3/ado TWN RNG SE S TRACT LOT 30.ss MOO SB - TRACT NAME OWNER NAME (L. F. MI) , CONTRACTOR -FIRM NAME ADDRESS CITY/COMMUNITY/STATE/ZIP " PHONE 0 LICNC / !,!S'/ j ARC/ENG FIRM NAME ADDRESS CITY/COMMUNITY/STATE/ZIP PHONE 0 LICNC USE OF PERMIT BL ZONFS8 SSB SSB R58 OFC ZONE ORD 11 LOT SZ END SIDE Date Applicant NOTICE TO APPLICANT: If, after making this Certificate if Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must`t3rthwith comply with such provisions or this permit shall be deemed revoked. DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: O 1 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work -authorized by this permit: and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thir-y-six (36) feet high. (Chap 3.2. Grp 2, Art 2, Sec341, Title8. C.A.C.) � O'As owner -builder, I will not employ anyone to.do mork which would requ' ire a permit from the Division of Industrial Safety, as noted above• unless such person ras a permit'to do such work from that division. O Division of Industrial Satety.Permit No. Date <; . ri '� ? Applicant fn': .= Z� CONSTRUCTION LENDING AGENCY: I hereby affirm that -here is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, ;iv. Q. Lender's Name Lender's Address I certify that I have read this application and state that ue above information is correct. I agree to comply with all city and county ordinances and state laws relating to bu Iding construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. Signature of Applicant or Agent Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF :NTRY: I certify I have read thisapplication and slate that the information given is correct. I agree to comply with all state laws and county ordinances relating to buidling construction, and authorize a' representative of the City of La Ouinta Department of Building and Safety.to enter upon the property for which I have applied for this permit for the purpose of making inspections. Signature of Applicant or Agent Date Print Applicant/Agent Name APPUPRMT nim 7. 01 01 a, U, ec z3/ado _,eht�r . Mec,�/ `eG 19- ata , E-1e�r-_e-, 30.ss neo, a© r SkP 2 61983 tY of La Quinta TOTAL FEE / !,!S'/ j BLDG.DEPT. VALUATION 4, � V7.01 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 /0 // j �: 35 Furnace Compart. 3 Steel 36 Inlets & Outlets •' 4 Grout Blocks 37 Combustion Air 5 BondBeams38 Compressor 6 Roof Deck 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. ❑ NON ADDITIONAL INFORMATION 1 1 I \ ..SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath b 12 Internal Lath_ 12A Drywall 13 Finish Grade INSULATION Thick Value 7A Walls (Batts) 128 Ceiling (Batts) .% 12C Ceiling (Blown) 14 Final PLUMBING APPROVALS 15 Ground Plumb �® % 16 Water Piping 17 Rough Plumb 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 " PSL P/1 STREET NAME 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 298 Bonding 30 Fixtures 31- Service 32 Final t , ,y TESTING INSPECTION 1731-A WALTER STREET VENTURA, CALIFORNI.A`930'03 PHOINE (805) 642-6727 November 3, 1983 B-13740-P1 83-11-7 Desert Affordable Homes 15494 Palmdale Road, Suite 135 Victorville, CA 92392 Project: .50-795 Calle Quinta, 52-555 Ave. Ramirez,'51-570 Ave. Rmbio La Quinta, CA Subject: Compaction.Report On September 26, 1983 a representative of our firm performed dens_ty tests on fill placed in the building area on the above referenced projects. Testing was performed in accordance with ASTM 2922-78 and ASTM 3017-78 Nuclear Density Test Procedure. Testing was performed as per authorization of Terrill Lavit.. The estimated locations of the tests and their results are presented on the attached test report sheet. A total of- six (6) density tests were performed. Test results indicate a minimum of ninety percent (90%) relative compaction has been obtained within the areas tested. The maximum density-optimum moisture was determined in the, larboratory in accordance with ASTM D 1557-78, Method A. Test. results are as. follows: Soil Description Maximum Density Optimum Moisture Medium brown silty. fine sand 106.2 pcf 12.19E VENTURA LANCASTER (805) 642.6727 (80 5) 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) 544-6187 BUENA ENGINEERS, INC. rf November 3, 1983 -B-13740-P1 83-11-7 Limitations: The backfilling and compaction operations were completed at the time our personnel were called to the site. The test results summarized in this report present the moisture and density only at the locations and depth tested on the specified date. The summarized field and laboratory tests were performed in accordance with engineering principles generally accepted at this time and location. No opinion is expressed as to the uniformity of the material, compaction nor adequacy of the material to perform its intended function. No guarantee or warranty of the contractor's work is made or implied. BUENA ENGINEERS, INC. Reviewedand approved Norman G.Jackson, Jr. Norman G. Hallin CE 7370 NGJ/NGH/nan Copies: 4 - Desert Affordable Homes 2 - City of La Quinta .2 - PS file 1 - VTA file - BUENA ENGINEERS, INC. ZU 8 Enginpers,inK. REPORT OF RELATIVE COMPACTIONS lob No. B -13740-P1 11-3-83 83-11-7 CONTRACTOR: DATE: Report No. Desert Affordable Homes ADDRESS: JOB & LOCATION: TEST NO. DATE TESTED DESCRIPTION % MOISTURE DRl DENSITY RELATIVE MAXIMUM , IN PLACE IP, PLACE COMPACTION DENSITY 1 9-26-83 Per Plan' 1.5 15.3 95.3 90 106.2 2 9-26-83 0.5 14.1 98.6 93 106.2 3 9-26-83 1.0 16.5 96.0 90 106.2 4 9-26-83 0.51, 14.2 95.7 90 106.2 5 9-26-83 1.5 12:7 98.5 93 106.2 6 9-26-83 0.5 10.9 99.1 93 106.2 VVC � CM I Ir T I MA I I ML51: TL5T5 WERE P-ERFORMED IN CONFORMANCE WITH COPIES: