11903 (SFD)Building
Address 52-040 Cortez
Owner
uAM
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Synercon. D velopment Corp, Inc.
Mailing
Address 94-940 Hwy 111, .Ste. 429
City lZip Tel.
Indian wells, i,.A 3221.0 564-6929
Contractor
S!ynefc'0171 Development
Address.
Same
City Zip Tela
State Lic. 65528 I City 24 15 . Y
& Classif. Lic. #
--Arch., Engr.,
Designer
Address Tel
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 ofathe Business and Professions Code, an my license is in full force and
effect. s
SIGNATURE - DATE
_ 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, j 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 ($500).
O 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 Coder 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
t,
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, ora certified copy thereof. (Sec. 3800, Labor Code.)`
Policy No/ Company
f ❑vpy 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 (5100) 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 it 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 sof this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
No. 11903
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
Legal Description
Project Description SF
Sq. Ft.37 No. No. Dw.
Size Stories Units
Add ❑ Alter ❑ Repair ❑ Demolition ❑
Permit does not include
aluauon ;�U l r 485. 00
PERMIT
Plan Chk. Dep. '. .
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
r
AMOUNT
480084
558.50
62.00
120.03
144.00
V.2®
20.00
1,793.88
REMARKS 3.187.37
!'w�K'„ fi�3.. 6 t% �.•:, t •a
11w7__^n_. 07
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
IST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE C7
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL. SO. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
DUCT WORK
ROCK STORAGE
GAR. SO, FT, ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
DRAINAGE PIPING
CAR P. I SO. FT. ®
GAS (FINAL)
TEMP. POLE 30
WALL SO. FT.
DRINKING FOUNTAIN
GROUT
WATER HEATER
URINAL
SO. FT. ®
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
GRADING
cu. yd.
$ plus x$
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP. 3
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
VENTILATION
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ®c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
INSULATIONISOUND
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 C7
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
IF
LVSEW EReQR SFPTI[ rnwc
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) �Z9 yr2�
✓
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE 30
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP. 3
FRAMING q. 2 a
FINAL INSP.
ROOFING 9r{ Lv
II J!
_ `/�Jq.3�
�/"�L!/ Zi/l `
REMARKS:
OL
VENTILATION
'Afc'
�tK
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LA ING
MESH
INSULATIONISOUND
FINISH GR
FINAL INSPECTION
CER .
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 3/5/93 1 Type of Permit JLa Quinta
No. 112060 1 Permit #
Owner Name Synercon Development Corp., Inc. Log
No. 52040 Street Avenida Cortez
city La Quinta Zip 92253 Study Area 113
APN # I Tract # I J Lot # 0 Square Footage 11375
Type of Development I Single Family Residence INo. 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 1 75 or $ 2,172.50 have been paid to D.S.U.S.D. for
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 General Escrow Telephone
Name on the check
By James E. Lively
Assistant Superintendent, Business Services 44=
"r
1
Fee collected /exempted by Vickie J. Durrett A.J
Payment Received
/���i`M' " IJV V
Signature bheck NA..119367
Collector. Attach a copy of county or city plan check application form to district copy fdx all, waivers.
Embossed Original- Building Dept./Applicant " Copy- Applicant/Receipt Copy - Accounting
RECORDING REQU95TED 8'.�
AND WHEN RECORDED MAIL THIS DEED AND. UNLESS
OTMERW16E 9MOWN BELOW, MAIL TAX STATEMENTS TOj
N.Mtr—SYNERCON DEVELOPMENT . 7
ST�ecr 74-940 HIGHWAY 111 #429
App�Laa
INDIAN WELLS, CA..;:.192210
CITY, ATTNr NARK ABRAMb
6YAIF J
Title Order No19710Z5........ Escrow No .... 10-16923
PER GENERAL ESCROW CO.
RECORDED FEBRUARY 19. 1993
INSTRUMENT i 63649
This apace for Recorder's use
PARTNERSHIP GRANT DEED
THE UNDERSIGNED GRANTOR(s) DECLARE(s)
DOCUMENTARY TRANSFER TAX is t 23.3 O
❑ unincorporated area ❑ City of
Parcel No. _—
Q computed on full value of property conveyed, or
❑ computed on full value leas value of liens or encumbrances remaining at time of sale, and
FOR A VALUABLE CONSIDERATION, receipt of which is hereuy acknowledged,
MAJETIC HOMES NORTH PARTNERSHIP, A CALIFORNIA GENERAL PARTNERSHIP
hereby GRANT(S) to
SYNERCON DEVELOPMENT CORPORATION, A CALIFORNIA CORPORATION
the following described real property in the CITY OF LA QUINTA
county of RIVERSIDE , state of California;
LOT 20 IN BLOCK 38 OF UNIT NO. 3 OF SANTA CAR ELITA AT VALE LA QUINTA, AS SHOWN
By MAP ON FILE IN BOOR 18 PASS 59 OF MAPS, RECORDS OF RIVERSIDE COUNTY, CALIFORNIA.
MAJESTIC HOMES
NORTH
GREPARTTN�ERSHIP,
'PHE ffff LTRUN ArO&T'DATED,
JANUARY 31, 1992
Dated FEBRUARY 17, 1993 41,
STATE OF CALIFORNIASS BYe J*H#Yl1>3VH8FAW 1I6.TR SMIFORNIA CORP.
_ COUNTY OF_ --
On s
before me, the undersigned, a Notary Public in and for said County y
and State, personally appeared
known to me
to be —of.the partners of the partnembip
that executed the within instrument,, and acknowledged to me that
such partnership executed the same.
Signature
I
Name (Typed or Printed)
Notary Public in and for said County and State (Space above for 011licial notarial oval)
MAIL TAX STATEMENTS TO PARTY SHOWN ON FOLLOWING LINE; IF NO PARTY 80 SHOWN, MAIL AS DIRECTED ABOVE
Name Street Address City lk state
I•AI00 6:75 (.P6
Z #;L9b9V996L9 +-96Z9LbE6L9 .�50:OL : £6—£Z -Z ILLOL .10td000lal X083X :,19 INH
Installation Certificate: Residential CF -613
Use of this form to satisfy the requirements of the Administrative Code Is optional, but the Information must be provided and posted.
Site Address Permit-
Number
An installation certificate is required to be posted at the building site prior to the issuance of the occupancy permit. This form
may be used to meet these requirements. All appliance categories listed below are the actual equipment installed. Note that
the efficiency and type of the appliance installed must be equivalent or better than the appliance specified on the Certificate of
Compliance (CF -1 R). This certificate (or its equivalent) shall be prepared and signed by the person(s) assuming overall
responsibility for the appliance installation.
I, the undersigned, verify that the equipment listed in the category above my signature is the actual equipment installed and
that the equipment meets or exceeds the requirements of the Appliance Efficiency Standards. In addition, I have verified that
the equipment is equivalent to or more efficient than the equipment specified on the Certificate of Compliance submitted to
demonstrate compliance with the Energy Efficiency Standards for residential buildings.
i
HVAC SYSTEMS
Note: Hydronic boiler information is entered here. Other hydronic or combined tlydronic equipment is listed under
Water Heating Systems.
Heating Equip. CEC Con ifled Actual Distribution Duct or Heating Load Heating
Type (furnace, Manuf. Make & Efficiency Type and Piping Before Over- Equipment
heat pump,etc.) Model Number AFUE etc. Location R -Value Sizing Btuh Capacity Btuh
Vy lKawl, jEr2gr l - 5 Jj ®C►
RPTlDo ia_s� 14€Pi'spymp
CEC Certff led '
Cooling Equip. Compressor Unit Actual Distribution Duct or
Type (air cond., Manuf. Make & Efflclency Type and Plping
heat pump, etc.) Model Number {SEER)2�2 Location R - Value
The building design heat loss and design heat gain rate have been determined using a method specified in Section 150(h) of
the Energy Ency Standards, and are two of the cntena used for equipment sizing and selection.
Signature
WATER HEATING SYSTEMS
Water Heating CEC Certified
System Type Manuf. Make &
(storaoe cas. etc.) Model Number
HVAC Subontractdr (Co. Name) or General Contractor or Owner
i
Energy' External
Rated' Tank Factor or Tank
Input (kW Capacity Recovery Standby' Insulation
or Btuh) (gallonsl Eff Iclency Loss % R- alue
,1k oitn
For small gas storage (rated inputs 75,000 Btu/hr), electric resistance and heat pump water heaters, list Energy Factor.
For large gas storage water heaters (rated input >75.000 Btu/hr), list Rated Input, Recovery Efficiency and Standby Loss.
For Instantaneous gas water heaters, list Rated Input and Recovery Efficiency. i
For Instantaneous electric water heaters, list Rated Input. ;
FAUCETS & SHOWER HEADS
All faucets and showerheads installed are listed in the Commission's Directory of'Cert'rfied Faucets and Showerheads,
pursuant to Title 24, Part 6, Subchapter 2, Section 111.
��$ G
' Signature V Date Plumbing Subcontractor (Co. Name) or General Contractor or Owner
Revised January -1992
r1 -
Client
Client
I- Client
I. $
EARTH SYSTEMS CONSULTANTS S.C.
BUENA ENGINEERS DIV.
79-811 B Country Club Drive
Bermuda Dunes, CA 92201 9 (619) 345-1588 w
DATE
TEST LOCATION
JOB NO.
3 // 2 -
FIELD TESTING
REFERENCE CURVE
PROJECT
DRY
DENSITY
lbs./Cu. ft.
52 &L/6
Co? r 7 -
LOCATION
Z A 'Al TAI
CONTRACTOR
'7-i
OWNER
WEATHER
TEMP. 0 at AM
0 at PM
PRESENT AT SITE
TEST
NUMBER
TEST LOCATION
f-11—
LOT
150.
ELEVATION
FIELD TESTING
REFERENCE CURVE
MOISTURE
CONTENT
%
DRY
DENSITY
lbs./Cu. ft.
MAXIMUM
DRY
DENSITY
%
MAXIMUM
DRY
DENSITY
lbsJcu. ft.
OPTIMUM
MOISTURE
CONTENT
%
412
'7-i
17 r7
U
5:) -0V6
J-8
VA ( n11'1 ILL11 5 1�
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.. ....
LJ A 6A t,-jT Lr,-# s -Y/S1/NG
Y se7/A/GREMARKS:
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REMARKS:
t A�,gAoz'z 0 19z) , 7f 5.75
4( 15� Ad //t/ ,11.51116 A A-11) V.r- 7, 0
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CLIENT REPRESENTATIVE Sl '_7RE
FIELD REPORT
1,/
TECHNICIANS SIGNATURE im? V79