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0104-243 (SFD)LICENSED CONTRACTOR DECLARATION I,hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License # Lic. Class Exp. Date Date Signature of Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: t/) 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 & Professionals Code). ( ') I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). () I am exempt under Section B&P.C. for this reason Date a• i r' Signature of Owner - WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ( ) I have and will maintain a certificate of *consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ( ) I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier & policy no. are: Carrier Policy No. (This section need not be completed if the permit valuation is for $100.00 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, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions! Date: 11 Applicant s' ..n / —•Waming: Failure to secure Workers' Compensation coverageris unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition.,to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety+ for a permit subject to the conditions and restrictions set forth on his''.` application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection purposes. I Signature_( Owner/Agent) Date BUILDING PERMIT PERMIT# DATE VALUATION LOT 01104-24.3 TRACT fI " 04=7=c t. S136,30040 83 DC5 . . JOB SITE APN 1 ` ADDRESS W-90 CALMWS-70 ��i.�•��-Q�.J� OWNER CONTRACTOR/DESIGNER/EN (NEER Ptd LAQL)' ,.rA CA 12233 { 013,u! USE OF PERMIT Y�JSV `XA:J./��`'M•..l J.!.ti.itii .. ♦ , _' V 1 SFT) - PE}Fl IT D0.&S NOT IN CL UDE BLOCK WeUJWYy, POOL, OR DRIVEWAY APPROACH. FLOOD PLAIN PERMIT 11,E.QUiI).. D TrIACT CONSTRUCT10N .%2".09 SIS 1.ORC HIPATIO 86,00 Sli' 0ARAGE 714.00 SF " t • r , EsT"r34"Tlm 0-0911' OF C0n,"TrTAVCITEON 236A90.10" CONST17U(MlION F9E 101-000-418-000 V69.00 PLAN CHECK FEE 101-000439-319 �643.iS�i, ME DEP0MT 101 KODO-4 9.31 R 41550/00 ME/,;MldICA1, F EZ, 101-000-421.000 $99.50 F1,19CTR,1C;Ai, YZA2 103-000-420-000 20-000 $140.94 PLIUMBINDPER $156.50 L 0'SRONO MOTION ?E�' - REBID 101-0004 i 1.000 S,i.4.CA Oi'RADINO IF.F? 101-000-423-€300 $ 30.80 , DWE3 OPF..R IMPACT FEE ffUB-TUrAL, CONST tZITC'I'IOA4.eAli(�,.1>>`��:(iq.�r�f]3'[��C(vv Tgl9rpC(:E, , S3,i 54.4 00 � L"S PRE - d' ID PEM 4250,t%0 .%�.�J...�N O F APR 2 7 2001 L f Y DATE FINALED INSPECTOR y INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs _ _ Underground Ducts Forms & Footings • Ducts Slab Grade Return Air Steel Combustion Air Roof Deck _ . .m L �,�' Exhaust Fans O.K. to Wrap �j�aiD=ol �-Z' F.A.U. . Framing ? O �T Compressor Insulation �O1 ? �I Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior LathITS Drywall - Int. Lath Drywall 3? Final 5� Final //�%��% POOLS - SPAS BLOCKWALL APPROVALS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines L 5��0 Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection• x•5.0 `J7 Encapsulation Gas Piping _ Gas Test lit/ b Appliances Final COMMENTS: Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) ....�.'F"rR-"^' v�+„-•- r_:. - -..--.-.•-:r - �-..; .... i-...�«.c ....,� �t �....�_ „r.7 .. � :� ,. _ Wit.. - _ ... ..y...>a..- ._ _ N_ ,�'.Y"s'."'� ,Y _ Building 1 � / � j i Address � Lam. L Owner Mailing ' Address City Zip Chaat Contractor P.O. BOX 1504 t 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Tel:7&-t 9 & 3-Q (7G f) s 61rl- st 117?\, ' ki 1=A J'J LJ'. .,U= Address 2AVAV —. • -:-- AEAt City lZip Tel. 0 APPLICATION ONLY BUILDING: TYPE'CONST. Y N OCC. GRP. " A " I A.P. Number ?7r-� LtIt # fes_ l rll Legal Description Project Description "�� i iL��r —� -I:::,_4--LA L r X -f -I ,atT7 f1, n I —I A)/).r F't "J4 , ALL v- HA -2 da;?0112 1 State Lic. I City & Classif. Lic. # (arch., Engr., Designer /'i�� a �} I er Address el. ' City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 71100) of Division 3 of the Business and Professions Code, and my license is in full force and effect. SIGNATURE DTE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the follo ing reason: (Sec. 7031.S,Business and Professions Code: Any city or county which regyfres a permit to construct, alter, improve, demolish, or repair any structure, pdor fo'its issu ce also requires the applicant for such permit to file a signed statement that he is licensetl p rsuanf to the provisions of the Contractor's License Law, Chapter 9 (commencing with Sectio 7000) of Division 3 0l the Business and Professions Code, or that. he is exempt fherelrom, nd the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a peril, subjects the applicant to a civil penalty of not more than five hundred dollars (SSOO). !: I, as owner of the property, or my employees with wages as their sole c9mpensation, will do the work, and the structure is not intended or offered for sale. (Sec. 044, Buisness and Professions Code: The Contractor's License Law does not apply to an oy'FFiier of property who builds or improves thereon and who does such work himself or fhrougy his own employees, provided that such improvements are not intended or offered for sale. however, the building or improvement is sold within one year of completion, the owner -build will have the burden of proving that he did not build or improve for the purpose of sale.) ;f? "I' I, as owner of the property, am exclusively contracting with 1 censed 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 improve /hereon, and who contracts for such projects with a contractors) licensed pursuant to the Contra or's License Law.) I-1 1 am exempt under Sec. B. & P.C. fort 0 reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a cedified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company 1-7 Copy is filed with the city. ❑rCertified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be compleled if the permit is for one hundred dollars (S100) valuation or less.) I certify that in the performance of lhp work for which this permit is issued, I shall not employ any person in any anner so as to become subject to the Workers' Compensation Laws of California. Date -Own er NOTICE TO APPLICANT I!, after making this Certificate of Exemption you should become subject to the Worked' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. If CONSTRUCTION LENDING AGENCY I hereby �ahj irm that there is a construction lending agency for the performance of the work for whi/ this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's,eddress This i abuilding permit when properly filled out, signed and validated, and is subject to expiratpn if work thereunder is suspended for 180 days. I ce (ify that I have read this application and state that the above information is correct. I agoe to comply with all city and county ordinances and state laws relating' to building construction, and hereby authorize representatives sof this city to enter the above. , m�eFtioned property for inspection purposes. Signature of applicant Date /{Mailing Address / City, State, Zip Sq. Ft.No. Size 22 �3 Stories NewA Add ❑ Alter ❑ Estimated Valuation PERMIT Plan Chk: `Dep. Plan Chk. Bal. Const. Mech. ,f Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTA6_ No. Dw. Units Repair ❑ Demolition ❑ 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: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Desert SandsTAified_School District 47-950:Dune Palm`s Road Notice: La uinta " CA' 92253 Document Cannot Be Duplicated 760=7 9= 5-15 CERTIFICATE:OF COMPLIANCE Date 4/25/01 APN # 770-104-009 No. 21940 °}Julcisdiction La Quinta Owner NameTracy & Veronica Rutledge Permit # No. 50-960 street Calle`Obisbo a City. La Quinta zip " 92253 Square Footage 2;233: "g# Study Area Tract # Type of Development Comments Lot # 83 Single Family Residence No. of Units 1 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 *acement;mobilehomes. It has been determined the above-named owner is exempt from paying school fees' at this,tiine'.due to, ihe following reason: EXEMPTION:NOT APPLICABLE This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 2.05 X 2,233 or $ 4,577.65. .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 CC/ Palm Desert National Bank - Tracy Rutledge Telephone ' 760 564-5607 Name on .the check By Dr. Doris Wilson Superintendent Fee collected /exempted by, Paula Ruiz Signature L JOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996),this will serve to notify you that the 90 -day approval period m which you -may, protest the fees or other payment identified tbove will begin to run from the date on which the building or instajlation permit for this project,is sssued of on whicti they are paid to the Districts) or to'another public'entity authorized to ;ollect them on the District('s)(s')'behalf, whichever is earlier. 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 REC"-JL_Q " EPUBLiC ULE•CO.. CIRDING.REQUESTED BY: AND WHEN RECORDED, MAIL TO: Tracy Rutledge 519,40 Ave. Navarro La Quinta, CA 92253 DOC i 20L,@0 -440>f33 l i /03/2000..08":00A . Fee': 6 : 00' Page _1 of ,1 rpoc T Tax Paid Recorded in.Off'icial Records County of.Riversida Gary L. Orso Assessor; County; Clerk_& Recorder .M, s U PAGE SIZE DA PCOR NOCOR SMF MISC. I (0_ _ & --� A '. R L COPY LONG REFUND NCHG EXAM THIS SPACE FOR RECORDER'S USE ONLY """` AssEssoRs PARCEL No.: 770-104-009-8 The undersigne&Grantor(s)-declare that the DOCUMENT TRANSFER TAkxIS: TITLE ORDER NO.: 508714-13 $'.6,6.00 'County $ City xx 'computed on the full- value, of the interest of property conveyed, or EscRow No.: 6540-CW_computed on. the: full,.value less th;e value of liens or encumbrances remaining thereon at the time of sale. GRANT DEED OR transfer'is EXEMPT from tax for the following reason: FOR A VALUABLE CONSIDERATION, receipt.of which is hereby acknowledged, Louis J. Carriere IV and Jacqueline Carriere, husband and wife as joint tenants hereby GRANT(S) to Tracy Rutledge and Veronica L. Rutledge, husband and wife as joint tenants all that real property situated in the City of La Quinta County of'Riverside; State of,California, described as: Lot 83 of Desert Club Tract, No. 5, as shown -by Map on file in Book 2.1, Pages 61 and 62 of Maps, Records of Riverside County, California . Dated October .24, 2000 STATE OF CALIFORNIA, COUNTY OF 7/1-� I,• `� ON �O' —%7j , before me /Z/ h LUDO Eis J r V — Notary Public, personally "appeared ar c� Tot CLC �•l/C? Q �i� l•r j �Zr 3 cqu , _me Carriere personally, known to me (or proved to me on the.basis of'satisfactory evidence) CHRIS7Y: L WOLCOTT to be the person(s) whose name(s) is/are subscribed to.the within instrument° and 1?104'�8 acknowledged to met he%she/they executed the same in his/her/theirNokwKtft _ C authorized capacity i , , an that by his/her/their signature(s) on the instrument _. the person(s), or a entity u "on behalf of which the pers n(s),acted, executed '� C� the instrument. ^M�es/wg7,2M WITNESS m han d ffICi• I al. i Signature MAIL TAX STATEMENT TO: (This area for official notary seal) Tracy Rutledge : 51940 Ave. Navarro,•.La Quinta, CA 92253 50-0160 C^tA - (:�FC3tseo. TA'y',v 7 .78=495:CALLE TAMPICO u LA QUINTA;.,CA 92253•,- ('760) 777=7075 APPLICATION FLOOD.. -PLAIN •DEVELOPM'EN;T PERMIT- _ ;.� BUILDISITE LOCATION r LooQ;zoNE"'AO" -DEPTH 1 COMMUNITY PANEL NUMBER 4 X060709 0005 B, Map Revised: 8/19/1991 APOuc NT•INFORMATION SECTION APPLICANT NAME APPLICANT ADDRESS 1 4s 4v (MAILING ADDRESS, NOT THE BUILDING SITE) -:51.)4• U� DAYTIME TELEPHONE NO. Y10 -6'y f(# . %C.:U 5 INSTRUCTIONS 1. A Flood Plain DevelopmentPermit Is required by LQMC Sect16n 8:1.1•°04.01A). The'Applicant should complete the Applicant Information portion'of this application and submit it'to.the- Engineering Department along with the required documentation`noted hereon -at the same time the `Precise 'Grading Plan is submitted to the Building and Safety Department for plan checking. 2. Documentation required for STEP 1 OF 2 -APPROVAL- prior to' receiving clearance" for Building Permit issuance • Copy of the proposed Precise Grading Plan for'review and approval 'containing 'all information required by the checklist shown on the back of this application. 3. Documentation required for STEP 2 OF 2 APPROVAL prior to receiving Flood Plain Development Permit approval. Note, this approval occurs after foams for the lowest "habitable floor are,set and` before the Building & Safety s: Department authorizes foundation• construction.:'' • Submit a completed FEMA "E/evation Certificate" form to the Engineering Department. • Submit 95% relative density soils compaction certification to the Engineering Department. STEP 1 OF 2 APPROVAL STEP`2 OF 2 APPROVAL' The Precise Grading Plan submitted for this:.application has been All requirements have -been satisfied. -This Flood Plain reviewed and found to contain. all data requiredcto. satisfy the Development Permit is approved. requirements of LQMC 8.11 The proposed.dwelling is eligible to {: receive a building permit upon satisfying all other Building & Safety Department requirements. ` PAUTHORIZED SIGNATURE ATE" AUTHORIZED SIGNATURE DATE La Quinta Engineering Department La Quinta Engineering Department FILE: Upon Step 2 approval, original goes in "Flood Plain Development Permit" file;.copy.goes to Applicant F090 HEV -2 7/00.-• CHECKLIST FOR PRECISE GRADING PLANS IN "AO" FLOOD ZONE 1. Prepare Precise Grading Plan in accordance with Checklist for Precise Plans and the following additional. items. 2. All elevations shall employ the NGVD-29 convention. 3. Show and label elevation of "Highest.Adjacent Grade" next to the building footprint. This refers to the highest existing natural grade next to the proposed building prior to constructing the elevated the building pad. . 4. Show and label the "Highest Existing Elevation on Lot" 5. Show and label the "Lowest Habitable Finished Floor Elevation". Note,this elevation shall be at least ONE FOOT higher than the "Highest Adjacent Grade" elevation. . 6. The following grading note shall appear on the .plan: All fill material placed under the structure shall be compacted to ninety-five percent (95%) relative density. F090A 10/99 � � - _.-------------- - ----- - --.- - _- ----- --... ----- - - _--- --, i _ ..._-- -- ,OWNER/BUILDER, INFORMATION' Dear Property Owner: An application for a building permit has been submitted in your, name lisring'yourseIf as the builder of the property improvements specified. For your protection you,should be aware "that as "Owner/Builder" you are.the.iesponsible party of record on such a permit. Building. permits are not,required to be signed by property owners unless they are -personally performing their own work. If your work is being performed by. someone other than yourself; you may. protect yourself from possible liability if that person applies for,the'proper permit in :his or her name. Contractors are required by law to be. licensed and bonded by.the State otCalifornia and to have a business -license from the City or County. They are also required by, law co put their license number on all 'permits for which they apply. If you plan to do your own work; with the exception of various trades that you .plan to subcontract, you should be aware of the following information for your benefit and protection: If you employ or otherwise.engage any,persons other,than your immediate family, and the work (including materials and other costs) is $200.00 or more for the entire ,project, and such persons <are not licensed as contractors or subcontractors, then you -may be an employer. If you are an employer, you must register with the State and Federal'Government as an employer�and you are subject to several obligations including State. and Federal 'income-. tax withholding,, federal social: security taxes, worker's compensation insurance, disability' insurance costs and unemployment compensation contributions. There,may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. For more specific information about your obligations under Federallaw, contact the, Internal. Revenue Service (and, if you wish, the U.S. Small Business Adminstration). For, rnore'specif'c information about, your obligations under State Law, contact the Department of Benefit Payments"and the Division of Industrial,Accidents. If the structure is intended for sale; property owners who are 'not:licensed contractors are allowed to perform their work personally or through their own employees, without 'a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing.to be contractors is to.secure an "Owner [Builder" building permit, erroneously implying, that ,the property owner is providing his or her own'>Iaborand material personally. Building permits are not required to be' signed` by;gtoperty "owners unless, they. are performing their own work personally. Information about licensed contractors may be obtained by contacting.the Contractors' State License Board in your community or at 1020 N. Street, Saciamento,•Califoinia 95814. Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Very truly yours, CITY OF LA QUINTA DEPT. OF BUILDING AND SAFETY 78-495 Calle Tampico La. Quinta, CA 92253 (760)777-7012 FAX (760) 7'77-7011 OWNER'S SIG TURE/DATE so��oo Q b c5 60 PROPERTY ADDRESS „ . oto PERMIT NUMBER(s) Si ST veto / CITY OF LA QUINTA SUB-CONTRACTOR/� �I 4!v JOB ADDRESS S(%U �uS7 PERMIT NUMBER n/D�{�licl 3 OWNER ,; �ecY �' BUILDER Oce v�e� This form shall be posted on the job -with the Building Inspection Card at all times in a conspicuous place. Only persons appea ' g on this list or their employees are authorized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" isnot an acceptable response. ..... Trade / Classification ............ Contractor .. . ................._. r State Contracto t s License Workers Com p ensation Iransun: - I Crt :`eusinessaicense;:::::a Y if'cationL B C-81 cense Number 1xxxxxx1 Exp. 1xxIxx xx1 Carrier Name 1e.9 S ate Fund Ca1ComP Policy N umber FormatVari s1 E 1xx/xx/xx11e9A License e Nu mbe r xxxx1 te Ex . Da 1xx/xx/xx 1 EARTHWORK ( 1 t /L�e �b��c C �Lw�e-'� tv (Z M'� �- - 0� d 'a "C U w 1 3 6 0 I 0 I _, 1 0 C- 3 y FRAM,.N:..::�C:.��1..:......:.:::::,:;::;> lJv✓ e- <-' J:' STRUC.T'STEEL>> MASONRY.:1::::..:.::1::.;:<::.;;;. owr, eC R✓ �. q, ? PLUMBING (C 36) ... Ca U 1625 - gsin - 'LATH.:>.'.PLASTER>(C,:;::,: r . ;.:::. Qw:�cC bJ �r(cl'c�i /nJ 1 I _ %lvl 3 HVAC n�ti. Co d , ��(?�-�C C.-aG 7 Y X3(1 c s oa S°f, �� `u 6 0 / bS .,. . /f/f 'C� �CAL1„„ELECT� O-3 a d0 y Q Y ROOF.::.:G.;:::.::.::.1..>.>.:.::.::.::.:.:.::<:.;. iQv S Guo c ;SHEETMETAL, 111d .4. 31..,;,,., e , S of FLD:ORING1:..:1 .� 3 GLAZING 1 1 c �(�. G (us5 �` �%rcroG�+- j� 03 6 ° INSULATION>;IG:'21>;>:::::<:>::::>: ac c� ns� lc �cn C ��^� �7 3 DQ < J� Q S �hC G Ce 6 / 3 � '7' VL 0. �/ .SEWAGE D SP ( 1 l C�1Sac.�C �✓�c� (.., 36 L � Qo� . . 0x 0 PA, -1 rs3-' o o q= - a NTI.:. G.:lC::.::.: �.;.:;:.;:::::.;:;: CERAMIC.;T:.: ;�:::;;.:.:::.>1::: (JC'nCG � Gv CABIN...:..::1:.::::.::�:.;:<.:::::.::.:::::::,:: FEN;CINS" .......::...:(:..;.;;::::�:: ! /V LANDSCAPING. (C,27f. OW tg"d (�c°' l CITY OF LA QUINTA SUB -CONTRACTOR LIST JOB ADDRESS PERMIT NUMBER OWNER BUILDER This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response. SE1 SUBJECT: 50 9-'-0' '-Calle Obispo, La Quinta, Ca. Genta''emen -, hereby `certify this day ':that -the,, finished:.f.loor elevation ;on:..the,; above: teferred .to lot is set at'r42e0. The approved grading 'p;lan. e.stablsh'ed`the elevation at '42.0. R e s il e c; t f ua`'1`'y:; W.M. -.H. ,.FIT -CH......... : C ...E;. ,:41:2;5:7::;1.....,:.. F 4C� T t. NA:...;1�y�:ll CIVIL°EN,GINEERING PLANNING SURVEYING — DESIGN P.O. BOX 4551 PALM -DESERT, CA 92261 c Information ® ®ToBuild:On Engineering • Consulting Testing REPORT OF FIELD COMPACTION TESTS TESTED FOR: TRACY.RUTLEDGE PROJECT: 50-960 CALLE OBISPO PO BOX 531 LA QUINTA, CA LA QUINTA, CA 92253 DATE: May 08, 2001 OUR REPORT NO.: 073.710132-2 TEST DATA: (1) Fine silty.sand. OPT. MOIST. 7 12.50 I MAXIMUM I I COMMENTS - TEST TEST SOIL ID LAB DRY * i WATER WET I PERCENT Spec. 90% Min NO. DEPTH I ELEVATION NUMBER DENSITY CONTENT I DENSITY -I DENSITY !.COMPACTION 1 8" FG 1 112.0 I 7.1 108.4 101.2 90.4 I1 - A 2 811 FG 1 112.0. 8 . 6 i 113 . 5� 104.5 93.3 11 - A 3 811 FG 1 112.0 �.. 4,7 _ 'I. •111.1 i 106.1 ! 94.7 i 1 - A 4 811 FG 1 112.0 4.9 .106.7 101.7 90.8 ! 1 - A - ----- .... _. ._ ._..... -- --- 1 ' ...__--- - -- ----...------- TEST LOCATION: Building pad. 1 NW corner. 2 SW corner. 3 NE corner. 4 NW corner. NOTES: TESTS PERFORMED PER ASTM D2922-96 & ASTM D3017-96 *COMMENTS: 1. FILL MATERIAL BACKFILL A. TEST RESULTS COMPLY WITH SPECIFICATIONS B. PERCENT COMPACTION DOES NOT COMPLY DENSITIES SHOWN: Lbs. per cubic foot2. WATER CONTENT: Percent of dry weight COMPACTION: Based maximum dry •- •3. BASE COURSE A. SUBBASE C. WITH SPECIFICATIONS RETEST OF PREVIOUS TEST PERCENT on density obtained on sample indicated by soil ID number 5. SOIL CEMENT 6. OTHER D. E. MOISTURE IN EXCESS OF SPECIFICATIONS MOISTURE BELOW SPECIFICATIONS * (1).ASTM D-1557, Procedure A TEST INSTRUMENT: REMARKS: PSI did not monitor the material placement TECHNICIAN: Vinnie De Souza r THESE TEST RESULTS APPLY ONLY TO THE SPECIFIC LOCATIONS NOTED AND MAY NOT REPRESENT ANY OTHER LOCATIONS OR ELEVATIONS REPORTS MAY NOT BE REPRODUCED. EXCEPT IN FULL. WITHOUT WRITTEN PERMISSION BY PROFESSIONAL SERVICE INDUSTRIES, INC. STANDARD COUNT M: D: ADJUSTMENT DATA M: D: Respectfully submitted, Professional Service Industries, Inc. PSI A-100.2 (4)F Professional Service Industries, Inc. • 42-240 Green Way, Suite C ! Palm Desert, CA 92211 • Phone 760/341-5790 • Fax 760/341-5794 - Certificate -of Occupancy City 0-f*La Quints Building and Safety Department This Certificate issued "pursuant .to the* regcurernents of Section 109 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: BUILDING ADDRESS: .50-9.60 CALLE OBISP.O. Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0104-243 Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL Owner of Building: TRACY & VERONICA RUTLEDGE Address: PO .BOX 531. City: LA QUINTA, CA., 92253 -&4-X By:. STEVE TRAXEL Date:. 11/14/01 Building Official POST IN A CONSPICUOUS PLACE