10109 (SFD)'
Building
Address
Owner
78-610 Saguaro Dr.
Hank Czeranski
Ira,
4 -4 a .
P.O. BOX 1504 N o .
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
\ f
10109
BUILDING: TYPE CONST. OCC: GRP. --
mailing
Address 67-220 Rango Rd
City Zip Tel.
Cat. City 1 92234
Hank Czeranski
same
State Lic.I City
& Classif. 502905 Lic. #
Arch., Engr.,
Designer
Address
City (Zip (State I
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section
veff�ec)t f Division 3 of the Business and Professions Code, and my license is in full force and
_SIGNATURE DATE
OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,8usiness 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 rile 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 to 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-buider 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 contractors) licensed pursuant to the Contractor's License Law.)
O 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
❑ Copy is filed with the city. O 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 (8100) valuation
or less.)
I certify that in the performance of the work for which this permit is issued, I shall not
=any person in any manner so as to become subject to the Workers' Compensation
Laws of California
t!Date Owner��—
NOTICE TO APPLICANT. ff, after 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
1 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 if work thereunder is suspended for 180 days.
I certify that 1 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
A.P. Number
Legal Description Lot 90 Unit 1 of Desert Club
Project Description
SVD
Sq. Ft. 1648
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑
-Demolition ❑
Permit does
not include block
wails or
pool
Estimated Valuation
56,277.80 cc
9 V j2 07 7 e
PERMIT
AMOUNT
Plan Chk. Dep.
250.00
Plan Chk. Bal.
284.34
Const.
626.00
Mech.
55 5£11
Electrical
iii. fin
Plumbing
31-60.50
S.M.I.
9_711
Grading
20 . 00 ,
Driveway Enc.
20.00
Infrastructure
2111.79
CA
TOTAL
3693.$3
1t_ y 1 'T- �. y f=
4 lt' t '� � f� � iti�,l � �� i �,?
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 e
1ST FL. SQ. FT. ® $
UNITS
COLL. AREA
2ND FL. SO. FT. ®'
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT. ®
DUCT WORK
DRAINAGE PIPING
WALL SQ. FT.
DRINKING FOUNTAIN.
SQ FT ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
4 cu. yd.
$ plus x$
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FINAL INSP.
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR Hp
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SQ. FT. ® c
BATH TUB
FIRE ZONE ROOFING
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/. c
SEWAGE DISPOSAL
SPARK ARRESTOR
SO.FT.GAR ® 3/<c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEEPERMIT
FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE I PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR'
SETBACK
GROUND PLUMBING PlXrh,14VUNDERGROUND
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 APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE /O tr
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
4 cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
FRAMING /
FINAL INSP.
ROOFING a A / L
(
I re ��� /�/
ppp
w
! N
`�/ n /
Itlp � L
6
�2•
0
ha
LLL
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
THI G
MESH
INSULATIONISOUND C (t
FINISH GRADING
FINAL INSPECTION -
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
Building
Address
Owner
P.O. BOX 1504
W,/0 � amara Y
LA Q71105 CALLE ESTADO >
UINTA, CALIFORNIA 92253
.Z 1
Mailing
Address &/7=.ZZo
cityaica�va2 61
Contractor
_2Z0
ZZ3
+
CiY�I �`p%Lz 3 5,I I e3 Z2
State Lic. / City
& Classif..5-0 Z 151 ►- Lic. #
Arch., Engr.,
Designer
Address Tel.
City IZip I State I
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 am Iicensed•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.
�SIGNATl1RE �,1, - DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Buslness and .Professions Code: Any city or county which requires a
Permit to construct, atter, Improve, demolish, or repairany,structure, prior to its issuance also
requires the applicant for such permit to file a signed statement that he Is licensedpursuant 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 to a civil penalty of not more than five 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:. Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of .property who
builds or Inproves thereon and who does such work himself or through his own employees,
provided that such Improvements, ere not intended or offered for sale. If, however, the building
or Improvement Is sold within one year or completion, the owner -budder will have the burden
of proving that he did not build or Improve for thapurpose of sale.) -
0 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.)
0 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
Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy 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 performance of thg work.for which this permit.is issued, I shall not
employ any pperson In any manner so as to become subject to the Workers' Co pensation
Laws o Iiforni �i♦ / i
Date Owner x,
NOTlC TO P ICANT: It, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions or 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 if 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 inspec ion_pu`rpose
Signature of applican ��'`�✓ry� Date,9
-Mailing Address — O
city, state, Zip
APPLICATION ONLY
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number // L
Legal Description_ L O 90 //,1 /� O ,L 0G5e,'X C�kp Aq,
Project Description S.
Sq. Ft. No. No. Dw.
Size 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
TOTAL,
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:
Validation:
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619)347-8631
Date 10/10/91 Type of Permit La Uinta
No. 10923 Permit # 110109
Owner Name Hank Czeranski Log #
No. 78-610 ' street Saguaro Drive
city La Quinta zip 92253 study Area
APN # Tract Lot`# Square Footage 11648
Type of Development Single 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
This certifies that school facility fees imposed pursuant to Government Code. 53080
in the amount of 1.58 X 1648 or $ 2,603.84 _ have been paid to D.S.0 S.D. for
the property listed above and that building permits and/or Certificates of Occupancy for
this square footage in this proposed prroject may now be issued.
Fees Paid By Hank Czeranski Telephone
Name on the check
By James E. Lively
Assistant Superintendent, Business Services
Fee collected /exempted by Vickie J. Durrett
Payment Received
Signature1/lk Check No. 1360
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
COUNTY= OF'RIVERSIDE DEPARTMENT OF HEALTHAssessors Parcel No.
ENVIRONMENTAL SERVICES DIVISION 1617-3?'2,— G+U
PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM
Applicant: Submit this form with four copies of a SCALED plot plan (1-20 SCALE) drawn to County speculations as indicated on the attached check list.
A non-refundable filing fee (see below) is required when the application is submitted. Check must be made payable to the County of Riverside.
Approval of this application shall remain valid for a period not to exceed one year from date of approval.
MI13SE:$(] 9-81—TOrERIFY
G # ITEMS IN SECTION A FROM A NON -FEE BUILDING & SAFETY (goldenrod) APPLICATION
Agent, Cont ractjo , vital Person/
hone
2Z'�4�
Address City State Zip ,
vo- '� 2 erl.
Rancho Calif.
❑ Blythe
c��� 1f4n
Owner
Phone
Address City S ate Zip
�Job Property Address
6A9
City ,�
Z- �LC!!tel/�
St s
�R,
Zip
Legal Description Prop. (PM, Tract, Lot) [;
C�°Se•-� ��4�/s'A/LQj- �
,1E� LtQY�
/6
Lot Size _
Water Agency/Well
Use of Permit P/P, CU, etc.
Other
0 '� %0�
✓
Dwelling, MH Site Prep, etc.
gid'. 9/
Signature of Applicant
Date
CATEGORY REV CODE FEE
CATEGORY REV CODE FEE
X�SUBSURFACE DISPOSAL (per system) 1238 $153.00
❑ SITE EVALUATION UPON REQUEST 7349 $120.00
❑MULTIPLE PARCELS WITHIN SAME LAND DIVISION
(NO PLOT PLAN)
,L
$153.00
❑ SEWER/SEPTIC VERIFICATION 7348 $ 58.00
a. 1st 4 Parcels (Each) 1238
❑ PRELIMINARY ELECTIVE EVALUATION
b. Each Parcel after 4 7344 $ 55.00
(Attach DOH -SAN -53) 7352 $ 69.00
❑ REREVIEW (2nd review same parcel) 7344 $ 55.00
❑ HOLDING TANK 7351 $119.00
❑ SITE EVALUATION in Conjuction with Critical Area 7346 $197.00
❑ ALTERNATIVE EXPERIMENTAL SYSTEM 7345 $656.00
❑ GRADING PLAN REVIEW DETAILED 1238 $104.00
❑ SITE EVALUATION Lot Less than 10,000 Sq. Ft. 7347 $172.00
❑ GRADING PLAN REVIEW CURSORY 1238 $ 55.00
❑ SECOND FIELD VISIT (SITE EVALUATION) 7346 $ 85.00
❑ COPIES (LAND USE) 7786-81 $ .50
a INITIAL DATE
Holding Tank Agreements Completed ❑ Yes No `- -
Certification of Existing S.D. System Required ❑ Yes No
WOCB Clearance Required ❑ Yes No
(Attact(Fdfrp:99 SAN 007, Santa Ana Region Only)
Soils Percolation Report Required ❑ Yes No
Special Feasibility Boring Report Required ❑ Yes No
Detailed Contour Plot Plans Required (1 to 5 ft. interval) ❑ Yes No
Grading Handout Provided ❑ Yes No
Staff Specialist Lot Inspection Required ❑ Yes No
Maintenance Booklet Provided ❑ Yes No Lot Inspection Date Initials
% /
C/42 / Soils Percolation Boring Report by r f e Lic/Project # Date
s 'r
Soils Map Page Soil Type Approved By, �Q Date
No. of Systems
Type of System(s)
No. Dwelling Units
(1) Septic Tank
Soil Rate
Grease/Sand
Cl Holding Tank ❑ Replacement
�leW ❑ Addition
Bedroom §, Fixture Units
3 bllY•,� ;4,7U5
/00 U
ASF f2
7
�%
Grease lntcp/Unt Trap
❑ Existing
7
Gal.
Gal.
Sq. Ft.
Total Linear
Sidewall Allowance
Leach B d
Bottom Area
Ft.
tt. rocl sq. ft. per running ft.
Install Lina(s) ft. long ft. wide with
o om Area
sated Depth CNA
min. inches rock below dr 'aka_
Proposed Bottom Tested Depth
—
Leachlines/bad special design for slope:
(3) Pit Diameter
No. Pits
Pit Below
Seepage Pit Tojal Depth
(TD) If- 3
Other:
Applicably
N/A Overburden Factor
❑ 5 6
t/
!1
Inlet (BI)
Ifo
Max. Allowable Depth
Well Review Approved: Signature Date Well Drilling Permit #
Grading Plan Ap roved: Signature Date
REMARKS: �e A e G( f 4e U(/ —lam(/
H (lU e t7V 42",- l'0 ' / vl C
Aec" 12 ?
This application is PPROVE /DENIED for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated
on the accompanie t la , using the requirements set forth in SECTION C above. A building permit is necessary for the installign of the above -designed
syst�e No construction is permitted in the required reserved 1000% expansinn area- Vt
V-
Septic tank must be 100' minimum from any wells
Leachh lines must be 100' inimum from any wells, including expansion area
'
U(3 Seepage pits must-be�S0' imum from any wells, including expansion area
Signature of Health Official Date ` (v
1 41 1. 4 -?4k
DOH -SAN -1 22 (Rev 6/91) DISTRIBUTION: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Plans/Records
V
❑ CASH CHECK NO.��
RECEIPT NO. E 15 Z
Issued By '1'4
v (a r
Date �'/Z
DISTRICT ❑ Riverside ❑ Indio
❑ Hemet ❑ Perris 0
Rancho Calif.
❑ Blythe
DOH -SAN -1 22 (Rev 6/91) DISTRIBUTION: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Plans/Records
- - RIVERSIDE COON ENVIWRO�N111 NT OF UBLITH HEALTH
Food Estsbiisttrttent
Lod Gal. septic Tank
Trager Park Sq. R. of Lem Lina
-motel, Apt. x �Segf� Pit
✓ Dwelling P-0^1 vK 40C Connution to Smw
Commercial Building
Swine: mi Poole disposal
_� No on-site regongratigg inter Softening devices tray be disraear� a� 1t�3 ir:d{viduatwag
Board.
system herewith approved without cle =°gnco front t�hu W QWh c
!l Water supply re-vinz this instal'ati�in vt be f;,C-q on app mm.
Uniform Plumbing Code.
Ail sewage dish' i0stal6<Rti�^. irst.sa r or :� vsitl� requir�ra� of currscctt I rove
-r Any cutting s ar ;'r'.'i„ss ;I a CF:35 a! f:3ur (4) to � �;I nos{lift' ",�; d approval.
Approvalcult h�.5 n o�tair�:o! from t sd Regional Wator Quality Control Board for installation of the sewage
disposal syst". . fpr aocupency, construction it
This is to certify that the Riverside County Department of Pubd�-
nstallation the item(s) checked above. L
-lit l By
THIS APPROVAHUMD BY T
Septic tank and sever lines must be 50 ft. DEPARTMENT OF PUBLIC HEAL
from any wells, including expansion areas. IS VALID FOR ONE (1) YEAR
Leach lines must -be 100 ft. minimum and FROM DATE OF APPROVAL.
Seepage pits must be 150 ft. minimum from
any sells.
/�,� i
MAINTAIIIN 100% EXPANSION AREA. MIN. � FROM ANY WELL
MIN. 10' FROM ANY LARGE TREE OR WATER MAIN.
' CIT F LA OUINTA
a � �
>
_MEMORANDA
' M
005182 10 5708 11-21-91 i0
MISC. 1 75.78
00ih 74000000
10 CASH i TOTAL 1 75.78 COM HARTUNG; BUILDING AND SAFETY DIRECTOR
J. AMOUNT TENDERED 75.78
CHANGE .00 ;LENDA LAINIS; PLANNING DEPARTMENT jj,tL,-
THANK YOU
fOVEMBER 19, 1991
'RINGE TOED LIZARD FEE FOR HOUSE UNDER
.ONSTRUCTION AT 78-610 SAGUARO DRIVE
Please note there is no evidence of payment of the Fringe Toed
Lizard Fe for the above unit. Fin ection shou n e
con ucted until proof of payment of $75.7 `is made.
POP,,
-G'c v -
MEMOGL.041/CS _1_
NO �j J. L... 1
0051,8, f0 y�r,8 11-2i-91 .
it
FROM:
APPLICATION
DATE:
COACHELLA VALLEY FRINGE -TOED LIZARD
SECTION 10k MITIGATION FORM
CITY OF.LA QUINTA
10.
APPLICATION.FOR
GRADING OR BUILDING
PERMIT NUMBER
6 SSgg i
10518�SAO, I �AP00-9 75_.78 14
ASSESSOR'S PARCEL NO(S) . GC I —7 3g 4 O.
ADDRESS -7 — Ll p
(Name of Developer). has applied for a
building/grading permit affecting acres.
This proposal will require the payment of $ S•7 8
($600.00 X acres)*.
By:
Title
We have received mitigation in the amount of $
($600.00 X acres) in the.form of cash on
from
Name of Developer
BJ/FORM.006
By:
Title
4
"P.O: sox 1504
•76105 CALLE ESTADO
LA OUINTA. CALIFORNIA 92253
Contractor Grsz/� r�G✓6L62S61'�� Owneryla.4— , Gi41.s•`��`
Address 7:2Zli X4,?. ..If 64atcZ Job Address %��-//d
La
,SQ"t`rtctro
La
Quinta City Licensi,No.: Expires: Bldg. Permit No.:
This form shall' be. posted on the job•with the,Buildinq"Inspection Card'.and it
shall be'the duty, 'of the General Contractor or if Owner -Builder Permit, the owner
to see that all sub=contractors._sign this card, giving his City ,of La Quints
Business License•Number,' Contractors, License.Number'and a current certificate
0'f Workman's Compensation.Insurance Certificate when he starts'the job. Failure
to comply.may•cause Building, Inspectors`to stop work, or complaints to be filed
against,. such, contractors or owners.'
CITY CONT.
SUB -CONTRACTORS NAME LIC..NO. EXPIRES LIC. NO.
EXPIRES
Grade i Excavate ,' AQy �'?Ah ey ���5•
2•
Pipelines
CD3 -
Cement -Foundations
4.
Cement Walks i Drives w
5.
Asphalt Paving
Framing CZev�in Ski,sl� 50 L2 0.57/z
34 5�
7-
Steel Structural
8.
Masonry '
Plumbing j�� ����z,s%: �OL9OS
/L. 3 9.Z„
L0.'
Lathing
L1.
Drywall
L2.
Plastering G2e✓4.4-Slt: Loses sTY- 50 Z9 U S
�L• / yZ.
L3
HVAC
1
Electrical �aVC �7'�`Z�LtvJrS G1E
L5.
Roofing
L6.
Sheet, Metal'
L7.
Floors -All Types
18:
Glass - Glazing
19.
Insulation/weatherstrip
20.
Sewage Diiposal
r
21.
Painting ./Decorating
22.
Tile
23.
Cabinets -Installations
24•
Ornamental -Metal
25.
Fences/Blockwalls
26.
Landscaping
27.,
Others
28.
,
DO ,NOT REMOVE THIS: rim
Before Final Building.Inspection:Will be 'Made
This'Form Must Be Completed and Filed With Title 24 Calcs and Plans
"T'
-� J4
Ila (Quinta
This Certificate issued pursuant to the requirements df Section 306 of the Uhiform SuIldhig:,
Code certifying that at the -,time of issuance this structure was in oompilonce with the various
ordinances of the City redUlatirig building construction or use. For the following.
MOM ADDRESS 78-610 Saguaro Drive `
Use Clossitication SFn Bldg. Permit No. _ 10109
Group R3 Type Construction VN firs Zone - Wit Zone R1
3.- 67220 Rango
Ownbt of Building Hank CzekanskAddress '
City Cathedra .City, CA 92234
By; . Mark Hard1d
3/12/92
Building 'Official om lil 'R 6oN904Cuouo PLAN l_
KEITH A. JOHNSON
Market Services
SOUTHERN CALIFORNIANCOMPANY
211 NORTH SUNRISE WAY • PALM SPRINGS, CALIFORNIA 92262
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