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0301-134 (SFD)LICENSED CONTRACTOR DECLARATION .1 hereby affirm under penalty of perjury that I am licensed undeFprovi , sibos;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 Wate 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: ( ) . 1, 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, Busines$,A Prof ssionals Code). I ias` Owner of the,property, am exclusively contracting with licensed contractors to construct the pr?Ject (Sec. 7044, Business & Professionals Code). O I am:exempt unclei Section B&P.C. for this reason Date Signature of Owner WORKER'S COMPENSATION DECLARATION I hereby affirm Linder pegalty o )perjury one of the following declarations: I have and will maint.30-a cettificate of consent to self -insure for workers' 'compensat(pn, as provided for Ky 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 9 'ATr UND 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 subjd8t to the workers' compensation provisions of Section 3700 of the Labor C6de,,L spall fbrthwith comply with thovefp rov is ions Date: 4-474 Z i ApplicantWaening: Failure to secure Workers' Com�p2r&aton coverage is 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 ermit subjec , t tothe conditions and restrictions set forth, on his application. I ach person upon whose behalf this application is made & eachpersonat I. 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 tor... 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 tdr*th; building construction, and hereby authorize representatives of this City to, enter 'ente I Aupon the4itiove-mentioned property,for inspection purposes. VSignature (Owner/Agent) zM,/' Date 2, BUILDING PERMIT PERMIT DATE / VALUATION LOT 03()1_'134 TRACT 23/ JOB SITE APN ADDRESSNAVA AV7A-t«7 . , Tt) EMA M10 OWNER CONTRACTOR I DESIGNER EN (NEER AT "r. TORIMS A0. Tl ORM COMSTRUM"1014 $1-301 AVE, 50 8 1 .9 00 P".gmjr., 32, ;03 0 1 1RD10 CA. 9.2r201 "W'Dio CA 91201 611 -2v4s 145 y7,72 USE OF PERMIT I i BMW, FAMMY DWF.TYR4G 1.899.S.F. SPI). P9PLMIT P0,.F,3 'NOT INC*IU0X BWC!K WAL1, POtX C*1 TANWAY. APPROACRI, Irl"Cr CONMMUC-1 ]oil 1,99914D 3F P0Rr,1­YP.A,T1Q- 36.00 V 0ARAGWARPORX 491.9.4 OF 1!'1 :x' FEE WAMARY. CONSIAUCTION PEF, 104 -000A18.000 PLAN CHZCK FRE 101,400-439-318 $570.73 M? DEPOSIT 101-000-439-.318 4259100 A1FC1iAW1CA1, I'MR, 101-000-421-101 $39.00 h,',LZC'TR1CA1, 119C, 101-000-420-000 $124.709 PLUMBINO Fly?, -000-419,000 STRO) MOTION FE, F, 1=1 D 101-000-24.1-000 $11.32 ORADING FEEk 109 -0)Q-p,-f,-000 DEVEIP, PER IMPACr FU J�410S,00 PREME P1,A14 101-000-441-145. $160.00 Summovi- co.14my"'umlox AND PLA14 CIM.Ck $4,10434 5 PKIRMFE, IKIN DUE NOW FEB 0 41003 C17'Y OF LA MCIE 'PT A RECEIPT DATE s ABY DAT INALE INSPECT !�/ 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 Exhaust Fans 0. K. to Wrap — - p F.A.U. Framing Compressor Insulation =(_�� _ Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath 5;9 • o SZ Final 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 I Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines - 1 Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection - - Encapsulation Gas Piping Gas Test & Appliances Final COMMENTS: /00 y�,( �d / T,J 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) �� e* OUTu L4ND�— EOTECI—INIC4L = FOUNDATION ENGINEERS AND MATERIALS LABS February 24, 2003 _ Mr. Alex Torres 81900 Avenue 52 Indio, CA 92201 Subject:'C mpaction Test Report X53=630 AvenidaNavarro C54=444' Avenida Herrera La\Quin`ta, California SGI Project No. P03023 Dear Mr. Torres; Attached is a. summary report of compaction tests made of fill within the house pad on the subject project sites.' The building pads are comprised of iminor cut and fill. Placement and compaction of fill soils were not observed by our firm. The compaction tests were made in conformance to In-place Density by Nuclear Menods (ASTM 2922 & D3017) on February 12 and February 18, 2003, and the test results are attached. Approximate locations of the tests are indicated by paced distances. from .physical features on the site. A legend is included with this report to identify abbreviations and maximum density determinations used in the report summary. The soils used in building pad construction varied from clean sands to sandy silt. LIMITATIONS The tests results summarized in this report present the moisture and density only at the locations and elevations tested on the specified dates. The density testing was performed according to the generally accepted, geotechnical 'engine Bring standards of practice that existed in the Coachella Valley of Riverside County at the time the report. was prepared. No opinion is expressed as. to the uniformity of the material, compaction, nor adequacy of the material to perform as intended. No guaranty or warranty of the contractor's work is made or implied. The tsst locations are approximate, determined by pacing and sighting from distinguisha:)le field features. In doing our work', we have relied on topographic and surveying information provided . by others.., 780 NORTH FOURTH STREET • EL CENTRO, CALIFORNIA 92243 • (760) 370-3000 • FAX (760) 337-8900 79-607 COUNTRY CLUB DRIVE, SUITE 5 • BERMUDA DUNES, CALIFORNIA 92201 • (760) 360-0665 • FAX (760) 360-0521 Mr. Alex Torres 53-630 Avenida Navarro/54-444 Avenida Herrera SGI Project No. P03016 Natural or imported soils (if any) at one foot or below existing pad grade, were not investigated or tested by ou; firm. No warranty is made.as to the stability/density of these soils. With any manufactured product, there are statistical variations in its uniformity and.in the accuracy of tests used to determine its quality. As 'compared to other manufactured products, field placement of materials usually presents large statistical variations in its, uniformity and in the accuracy of the test results. Thus, even with careful observation and testing, all parts of the constructed product may not comply with the job requirements. Therefore, our opinion means that there is only a statistically -based probability that the densities obtained comply with the job requirements. This report is issued with the understanding that the owner or his representative has the responsibility to insure that this report is submitted to the appropriate governing agencies. Please review the test results and contact our office with any questrons or comments. Sin rely yours, So /ands Geechnica/ Inc. lI W Greg M. Chan( Princi al Engin 0 C c E No. C 34432 r m Cf f iv i�F OF C r,V1�0`� , Southland Geotechnical Laboratory Test Results Summary -Client:. Mr. Alex Torres Project No.:. P03,023 Project: 53-630 Avenida Navarro/54-444 Avenida Herrera Maximum Density -Optimum Moisture (ASTM D1556): - Soil Type Max. Opt. Description USCS (Pcf) 1 . Brown Silty. Sand SM 129.5 6.5% 2. Brown Silty Sand SM 11'9.5 .13.0% 3. Brown Silty Sand SM 130.5 7.5% Legend for Summary Sheet Datum Below Note Test Type Column Column Colum FP' Finish Pad. P = Pass •N = Nuclear Gauge BG = Base Grade F = Fail (ASTM G2922 & D 3017) SG = Subgrade S = Sand Cone MT= Midtrench (ASTM D1556) PZ = Pipe Zone - TT = -Top of Trench BOF = .Bottom of Footing - BSG = Below Subgrade NS= Natural Surface t IV Southland Geotechnical Compaction Test Summary Client: Mr. Alex Torres Project: 53-630 Ave.Navarro/54-444 Avpnirin Hprri-r;k Project No.: P03023 .r--- 0 f OR R ®r, - �;-O A., A '1- 07 Q-a —Y 3e -.e JA��Ma I.Aetup VJ Relative l Ee —0 -1 "mo ar 1 OU 1 53-630 Ave.Navarro 02/12/03 18' N. X 12' E. from S.W. Corner fo Pad 1 1 8"BSG 116.8 8.3 90. P N 2 53-630 Ave.Navarro 02/12/03 18' W. from S.E. Corner fo Pad 1 18"BSG 116.6 10.3 90 P N 3 53-630 Ave.Navarro 02/12/03 30' E. X 3' S. from N.W. Corner fo Pad 2 FG 110.7 10.7 93 P N 4 53-630.Ave. Navarro 02/12/03 21' W. X 4' N. from S.E. Corner fo Pad 2 FG 108.4 12.4 91 P N 5 54-444 Ave. Herrera 02/18/03 30' S. X 42' W from N.E. Corner fo Pad 5 FG 113.6 12.3 96 P N 6 54-444 Ave. Herrera 02/18/03 30' S. X 28' W from N.E. Corner fo Pad 3 18"BSG 117.1 7.5 90 P N 7 54-444 Ave. Herrera 02/18/03 4' S. X 4' W. from N.E. Corner of Pad 3 18"BSG 117.6 1 r 1.51 90 P N 8 54-444 Ave. Herrera 02/18/03 42' S. X 6' W. from N.E. Corner of Pad 5 FG 112.1 11.4 64 P N . ."�.�`. �:� Y-� � .fi �� .e "'iTi Yri ,.,...q ,.y y,;'.:. T.�,'�il"fi:iC;x 'C s• � i _�-^� "'"d � W•i+ �.,, v Y c r OUTPL4ND EOTECUNIC L77 FOUNDATIoh ENGINEERS AND MATERIALS LABS , DSA Crile No.: Phone No. �� Di!�� COMPACTION �-�- TING DSA.1pp. No.: .� Fax No. �/�,17 0521 Nuclear Method ASTM• D-2922 & D-2950)Branch Office: Test No. Station: Elevation: QP,1 MaYI: Location: Alb/1Sf Density Count �I�� �03 �D 7,3 fD 3 Test No.:/ Z Moisture Count Elevation: MaYI: Location: Moisture Correction /V IAS Kam '^fie CO;i tAIf2 .,!:,F` li , Test No.: Station: Mode & Depth N f MaYI: Location: +� �� Wet Density, PCF �5. Al Al J. CWZ,4/eA 0,4 1.40 Test No.: `t Station: Dry Density, PCF Elevation: �< Mat'I: Location: +I i.J % Moisture r:Xt244 S 60A.,VIC12. Test No.: Station: Elevation: Standard Dens. (MAX.) ++�1.� 5 i� '�, rj +► Optimum Moisture Test No.: Station: Elevation: % Compaction 10 Specified Density ,_ I WO .F 1 q0 .¢ Test No. Station: Elevation: QP,1 MaYI: Location: Alb/1Sf 100 /S A/ Z 'E . FZDM 4� Cp�2� �' /•4 a� ,„ Test No.:/ Z Station: Elevation: MaYI: Location: /V IAS Kam '^fie CO;i tAIf2 .,!:,F` li , Test No.: Station: Elevation: f MaYI: Location: +� �� a0 �5. Al Al J. CWZ,4/eA 0,4 1.40 Test No.: `t Station: Elevation: �< Mat'I: Location: +I i.J /ii� X 'q 'Al r:Xt244 S 60A.,VIC12. Test No.: Station: Elevation: 'Mat'I: Location: Test No.: Station: Elevation: Mat'I: Location: I Test. No.: Station: Elevation: I Mat"l: Location: PROJECT NAME: 53 '&-?o AYE. 41 dwrre (A 641r f'rA PROJECT NO.: D3n�,�. / CLIENT: 4 • rat -1 CONST DATE: �� ®3 TECHNICIAN: L 0�1 VZ4ojA. Gauge Serial No.: ���� Density Std.: 116 7 Moisture Std.: �O Form No. 160 • Pioneer Printing 353-5401 EEOTECHNIDCAL = FOUNDATION ENGINEERS AND MATERIALS LABS EL CENTRO: 760 370 3000 BERMUDA DUNES: 760-360-0665 SAN DIEGO: 858-467-4900 TECHNICIAN DAILY REPORT PAGE OF Project Name: -53 6,1n 4)19W1a4 404 Project Number: � � , Client Name: tey Cton 7-axe� rST Owner's Rep Onsite: OSHPD/Building Permit No.: Plan File No.: DSA File No.: Scheduled Arrival Time: DSA App. No. Time In: Time Out: Lunch/Break: Mileage: Total Hours: 2?r General Contractor (Name & Company): Specialty Contractor (Name & Company): WEATHER CONDITIONS: C -1—o ulA /!/jpR/► 16, EQUIPMENT USED: Al A AREAS WORKED: Location of work observed, tests/samples taken, progress, remarks, job problems/issues 'T-X-Arr,l ?r 7'fS r a"C- M/46^1 A ,oUse A ✓e.✓,04 A/.4 VA X.9 1.4 ©L..-A/YtA 1, �1,4710'9 N 1A21-meirIF J_ '261 -fl -r kiffe- 7 exl A, al S m QZ 2, A P N c-/eVIno A!AWD 211 ,AJ P Ate .P ./r -s Aft 6 �o �u 447- Anv„r ✓o A Al De wl ra ,9,d -na- so;l A e Pu -r -ed A . es z) kPrf +4eeld -rde IA6 m ✓P MAx,(013”) Vowg R3 IeAl, 7f.8 C~Ac- PA/ 70 '° o DID YOU OBSERVE EVERYTHING YOU EXPECTED?: 0>ES 0 NO DID YOU OBSERVE ANYTHING UNEXPECTED?: 0 YES •0'NO IN PARTICULAR, WHAT SHOULD BE OBSERVED/CHECKED/RETESTED DURING NEXT VISIT: NON-CONFORMANCE: NOTICE: Our firm's technician's are represented onsite solely to observe operations of the contractor identified, to form opinions about the adequacy of those operations, and to report those opinions to our client. The presence and activities of our field representative do not relieve any contractor from its obligations to meet contractual requirements. The contractor retains sole responsibility for site safety and the methods, operations, and sequences of construction. 780N 4th Street, EI Centro, CA 92243 0 79-607 Country Club Dr #5, Bermuda Dunes, CA 92201 0 5725 Kearny V,Ila Rd #L, San Diego, CA 92123 TECHNICIAN'S SIGNATURE d, n L/ DATE/DAY: -AlkowerM -- PERSON NOTIFIED:SIGNATURE: NOTICE: Our firm's technician's are represented onsite solely to observe operations of the contractor identified, to form opinions about the adequacy of those operations, and to report those opinions to our client. The presence and activities of our field representative do not relieve any contractor from its obligations to meet contractual requirements. The contractor retains sole responsibility for site safety and the methods, operations, and sequences of construction. 780N 4th Street, EI Centro, CA 92243 0 79-607 Country Club Dr #5, Bermuda Dunes, CA 92201 0 5725 Kearny V,Ila Rd #L, San Diego, CA 92123 Certfi6f a a ofcy- oecupan Building & aety Department This Certificate is issued pursuant to the" requirements of Section 109 ,of the California Building Code,'-•certifying 'that,' at the ;time of issuance,. ;this, structure was in compliance with the , `provisions of the Building 'Code and the various ordinances. of the City .regulating;. building construction and/or use:. - t ; - BUILDING ADDRESS: 53-630 AVENIDA NAVARRO ' Use, classification:'SINGLE FAMILY_DWELLING- .`-Building Permit No.: 0301-134 4 Occupancy Group: R-3 Type,of'Constructlon: VN �.Land`Use -RC _ Zone: Owner of Building:>ALEX TORRES _ -``° r�, �� `=Address: 81-301 AVENUE''50 -City, STZIP: INDIO.-CA 92f 0•1 r J ' By KKIRK:KIRKLAND �. ; ; Date: AUGUST, 13.2003 4 , y„ Building Official f ti 1 �. ,;• POST IN A CONSPICUOUS PLACE' , CERTIFICATE OF COMPLIANCE J xFIED Desert Sands Unified School District �o-i,4 47950 Dune Palms Road Q BERMUDA DUNES r 'Date 2/3/03 La Quinta, CA 92253 V!) RANCHO MIRAGEd INDIAN WELLSDESERT No. 24107 (760) 771-8515 * d,}> P LMLA QUINTA �y O ,- Owner Alex Torres APN # 774--.35-007 Address 81301 Ave 50 - Jurisdiction La Quinta City Indio Zip,92201 Permit # 0301-134 Tract # BLK 241 U-23 . Study Area Type Single Family Residence No. of Units 1 Lot # 'No. Street S.F. Lot # No. Street S.F. Unit 1 18 53630 Avenida Navarro 1899 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 ' Comments At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patio:/walkways, residential additions under 500 square feet,, detached accessory structures (spaces that do, not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile homes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the fallowing reason: EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Education Code Section 17620 and Government Code 65995 Et Seq.,. in the amount of $2.14 X 1,899 S.F. or $4,063.86 have been paid for the property listed ab:)ve and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued. Fees Paid'By Cash - Sue Cook Check No. - Name on the check Telephone 760-772-2848 ` Funding Residential By Dr. Doris Wilson Superintendent y Fee collected /exempted by. Sharon McG.ilvrey $4,063.86 $o�oo Payment Recd Over/Under Signature C NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified above will begin to'run"from the date on which the building or installation permit for this project is issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, wtichever is earlier. y NOTICE: This Document NOT VALID if Duplicated` Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy- Accounting