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002681 (BLCK)T4'ht 4 4 Qum& Building Address Mailing Address 1Z�1R City Zip Tel. Contractor City _,_ ` lZip . Tel. P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 No. 002681 BUILDING: TYPE CONST. OCC: GRP.- A.P. Number Legal Description Project Description P.G.A. TRST State Lic. City & Classif.�� Lic. # Sq. Ft. 133 Size Arch., Engr., Designer New Address Tel. City Zip State Lic. # 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 fforce and effect:>,. f r t#. i. /, SIGNATURE X -1 " DATE r \ OWNER -BUILDER 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 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 (5500). ❑ 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 -builder 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 contractor(s) 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 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 ($100) valuation or less.) - I certify that in the performance of thg 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: If, 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 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 inspection purposes. r j Signature of applicant " ! Date Mailing Address t r i City, State, Zip t HARD COPY No. Stories Add ❑ Alter ❑ Estimated Valuation No. Dw. VI Repair ❑ Demolition ❑ FINAL DATE INSPECTOR Issued by: DatePermit _ Validated by: Validation: Ab 149 11 14 73.92 U ._ -PERMIT t AMOUNT Plan Chk. Dep. Plan Chk. Bal. 28.92 Const. ".50 Mech. Electrical Plumbing S.M.I. w50 Grading Driveway Enc. Infrastructure TOTAL 73.92 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: DatePermit _ Validated by: Validation: Ab 149 11 14 73.92 U CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ UNITS SLAB GRADE 2ND FL. SO. FT. BONDING YARD SPKLR SYSTEM STORAGE TANK MOBILEHOME SVC. BAR SINK POR. SO. FT. ® DUCT WORK ROCK STORAGE GAR. SO. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) OTHER APP.IEOUIP. DRAINAGE PIPING CAR P. SO. FT. ® TEMP. POLE WALL SO. FT. GROUT DRINKING FOUNTAIN SO. FT. ® FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER SYSTEM WATER PIPING NOTE: Not to be used as property tax valuation _$ FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER . GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM 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. SO. FT. ® c BATH TUB GAR. FIREWALL SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL, MESH SO.FT.GAR ® 3/ac 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 GROUND PLUMBING UNDERGROUND 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 APP.IEOUIP. 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 FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS_ GARDEN WALL FINAL 79-811 COUNTRY CLUB DRIVE, SUITE *4 • BERMUDA DUNES, CALIFORNIA 92201 • (619) 345-1588 November 19, 1987 Landmark Land Co. P.O. Box 1000 La Quinta, CA 92253 Project: PGA Maintenance Building Avenue 58 P.O. 28301 La Quinta, CA Subject: Report of Field Densities Parking Lot Entrance Subgrade B -14413-P12 87-11-763 On October 27, 1987, a representative of our firm performed density tests in the subgrade for the entrance to the parking lot at the above referenced project. Tests were performed at random locations in accordance with ASTM D 2922-81 and ASTM D 3017-78 Nuclear Density Test Procedure. Tests were performed as per authorization of Rueben of Landmark Land. The estimated locations of the tests are presented on the attached plan with their results being summarized on the attached test report sheet. A total of two (2) density tests were performed. Test results indicate that a minimum of ninety (90) percent of relative compaction has been obtained within the areas tested. The maximum density - optimum moisture were determined in the laboratory in accordance with ASTM D 1557-78, Method A or C. Test results are as follows: Soil Description USCS Maximum Density -Optimum Moisture Brown silty fine sand SM 119.2 pcf 10.8% VENTURA LANCASTER (805)642-6727 (805) 948-7538 BAKERSFIELD SANTA BARBARA BERMUDA DUNES SAN LUIS OBISPO (805) 327-5150 (805) 966-9912 (619) 345-1588 (805) 544-6187 November :19; 1987 . - B -14413-P12 _ 87-11=763 l.. The project is located north of Avenue 58 and west of Madison Street, in the City of La Quinta. 2. Prior to our arrival at the site subgrade. was cut and compacted. 3. The purpose of testing was to observe compliance with the minimum requirements of the City of La Quinta, California. The test results summarized in this report present the moisture and density only at the locations and depths 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 or compaction. No guarantee or warranty of the contractor's work is made or implied. If there are any questionsi please do not hesitate to contact this office. Respectfully submitted, BUENA ENGINEERS, INC. Phillip D. Clanton PDC/FR/ms X-22 COMP Copies: 4 Landmark Land Co. 2 - City of La Quinta 2 - PS file 1 - VTA file 41R,evied and ApprovedMWH,c WZ� `�C 6�` GE 128 Richard M. Beard Exp. 12/31/89 Geotechnical Engineer �'�` P� g 9� CH Vi OF CAV F�% BUENA ENGINEERS, INC. CONTRACTOR: ADDRESS REPORT OF RELATIVE COMPACTIONS DATE: 11/19/87 JOB & LOCATION: .lob No. g_14413 -P12 Report No. 87-11-763 PGA 58th Ave. Maint. Bldg. TEST NO. DATE DESCRIPTION % MOISTURE DRY DENSITY RELATIVE MAXIMUM TESTED IN PLACE IN PLACE COMPACTION DENSITY Subgrade 1 10/27/87 Per Plan 8.0 113.9 96 119.2 2 10/27/87_ Per Plan 9.9 112.5 94 119.2 WE CERTIFY THAT THESE TESTS WERE PERFORMED IN CONFORMANCE WITH COPIES: 1 NC. 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