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0007-206 (SFD)\,' LICENSED CONTRACTOR DECLARATION ,,I hereby affirm :under penalty of perjury that I am licensed under provisions of Chapter 9 (cofnme`ncing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License # ?t 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: fi,C) 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). ( F) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). O I am exempt. under Section B&P.C. •for this reasom•i. Date _`' I i '" ! t^ ! Signature of Owner ! a .I ,A . 4n'. 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, 11 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. j Date: r f''• + 0 .f ADDlicant ll. ? ^ Warning: Failure to secure Workers' Compensation 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 subject to the conditions and restrictions set forth on his application. I 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 1$0 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// ,rr J� - > h Signature (Owner/Agent) d t ' ' f `-" ;Date .. ... ... .. - PERMIT# .... .._ ..i - f BUILDING PERMIT I DATE,r, VALUATIONy TRACTr �y %aei0+ •+LOT '35.50 tty y }°'-°�i �`�{,. 7'e7u JOB SITE/ ADDRESS r� APN -q��' , .. AVINED4 TO? �:,�r `i 0 -x.72 -Ow OWNER. CONTRACTOR/DESIGNER/EN (NEER WTIM AA ROSA EPERALES OWNER BILAT..:R:)ER 4 661 RMX0 CA* 922.01 USE OF PERMIT SFD- ,P1EFx.. IT 1100, �NOT IAfC1dUO2 BLOCK WAi.l:.a`,f}i OI,SPA CF. DRIVEWAY 'F€&..fsCT MN3iTRi6CTION 2353.04 OF POidMP.P TIO .2".00 ST? 0ARMEXARTAOla.T SP (NXIM'l Ri CTION Fft 101-0001,418-000 X5,:0 PLA114 CHZCX .VEEP 101.-4AtI"39- 318 $673.90 M. DEPOSIT 101.000-439-318-Sx90100 �gg+iE;kkl"KK:Feg�yANICAAAbb L FEE 1,01-000421-000 R�:�rG!•.l��'. & Ctv'yr.1'3 S` W`Wt 8 F.�� i z�k3i� F4�V•:°Fi!?iN � �� �f;i4a S€'RONG MOTION" M - RON 710'1-000-241X000 $14.14 STRONG t, IR.!1,DYNO PUP, *11..000. 23-000 $20.00 (d}ftikf xWe' R IMPACT FEE 61.907.0 _ O D $3,801.16 O 1105 1IRL-FAM) F".iW -x#2 50, (v G 15,'l ':?FPM" Ft'• .� DUR POW RECEIPT DATE f BY DATE FINALED PECTO INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings _ �Q Ducts Slab Grade _ Return Air Steel - Combustion Air Roof Deck_ D Exhaust Fans O.K. to Wrap Framing _ v,3 �� F.A.U. Compressor Insulation LO Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath 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 Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines 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: , Final Utility Notice (Gas) ELECTRICAL APP _R� V! LS 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) j /G/� QUMw Tar 78-495 CALLE TAMPICO . LA QUINTA, CA 92253 (760).777-7075 APPLICATION 0 It FLOOD PLAIN DEVELOPMENT PERMIT FLOOD ZONE "AO" - DEPTH 1 BUILDING SITE LOCATION. /-� COMMUNITY- PANEL NUMBER << -]6c1—)4L4 .— O ©5. 060709 0005 B Map Revised: 8/19/1991 APPLICANT INFORMATION SECTION ` APPLICANT NAME 71\,05 APPLICANT �j —,o 1 S V� u 6i < 4 ADDRESS -2 7S (MAILING ADDRESS, NOT THE BURRING SITE) Ca - 9 2-2- 0 DAYTIME TELEPHONE NO. '395?— o ► q 3 �X y �'�'� "' � ``'`'� C04* ?.e INSTRUCTIONS 1. A Flood Plain Development Permit is required by LQMC Section 8.11.040(A). 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 ands 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 pfoposed 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 forms for the lowest habitable floor are set and before the Building & Safety Department authorizes foundation construction. • Submit a completed FEMA 'Elevation Cerfificate° 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 Rood Plain reviewed and found to contain all data required to 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. C 0/ AUTHORIZED SI TU D ORSIGNATURE DATQ La Quinta Engine ng Depa ent a Quinta Engineering Department file; copy goes to Applicant FILE: Upon Step 2 approval, original goes in 'Rood Plain Development Permit " DERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Read the instructions on pages 1 - 7. SECTION A - PROPERTY OWNER INFORMATION Mr. and Mrs. Miguel A. Perales BUILDING STREET ADDRESS (Including Apt.. Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. nta BUILDING USE seE (e.g., Residential, Non-residential, Addition, Accessory, etc. Ua Comments area, if necessary.) ., .-_, ( ##0 - ##• - ##.##" or NFIP 8 HORIZONTAL DATUM: L-1 NAD 1927 1-1 NAD 1983 O.M.B. No. 3067-0077 Expires July 31, 2002 9 LJ USGS Quad Map 1_1 Other: SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION —2 2& r KIARAC B3. STATE 7B4. MAP AND PANEL B5. SUFFD( B6. FIRM INDEX nr • nrcnn rw.ry __ (Zone AO, use depth of flooding) NUMBER DATE EFFECTIVE/REVISED DATE AO S) ( 1 060709 000 B 8/19/91 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. 1--1 FIS Profile LK -1 FIRM 1--1 Community Determined Other (Describe): B11. Indicate the elevation datum used for the BFE in B9: 1_1 NGVD 1929 j_j NAVD 1988 k.j Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)7 (_j Yes 1_1No Designation Date: SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: 1X_1Construction Drawings' j_jBuilding Under Construction' (_jFinished Construction 'A new Elevation Certificate will be required when construction of the building is complete.. C2. Building Diagram Number _L- (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) C3. Elevations - Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, ARAE, AR/A1-A30, AR/AH, AR/AO Complete Items C3.a4 below according to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum used for the BFE in Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use the space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion. Datum _ Conversion/Comments Elevation reference mark used Does the elevation reference mark used appear on the s I_XI No IA a) Top of bottom floor (including basement or enclosure) 3f • L ft -(m) Q ,t% ❑ by Top of next higher floor ��.0 ft.m) m �Q.R /EY — ( m ❑ c) Bottom of lowest horizontal structural member (V zones only) _ ft(m) o � d Attached garage (top of slab) 3 5 - ft'(m) W �•C/� g . co ❑ e) Lowest elevation of machinery and/or equipment m N0. 12571 servicing the building (Describe in a Comments area.) — fL(m) AXP 3/3i/o�� ❑ f) Lowest adjacent (finished) grade (LAG) — fL(m) z Or g) Highest adjacent (finished) grade (HAG) 33.29Aft•(m) m `� ❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade ❑ i) Total area of all permanent openings (flood vents) in C3.h sq. in. (sq. cm) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available. 1 understand that an false statement ma be unishable b fine or imprisonment under 18 U.S. Code, Section 1001. I!`FNRF NUMBER FFMA Fnrrn R1 -A1 it 11 nn FITCH ENGINEERS INC 760 345 76 CFF RFVFRCF :CIr1F Fr1R rf)NTINI IATWIN RFPI Ar:FC At I PRFVIr1I I.0 FnITIr1NC oM® Information ®To Build On Engineering •Consulting • Tesffng REPORT OF FIELD COMPACTION TESTS TESTED FOR: ROSA PERALES PROJECT: 78-691 .LA TORRES 43-681 SMURR LA QUINTA, CA INDIO, CA 92201 DATE: September 24, 2001 OUR REPORT NO.: 073-10297-2 TEST DATA: (1) Medium to coarse grained sand'. OPT. MOIST. = 12.0$ TEST NO. TEST DEPTH ELEVATION SOIL ID NUMBER MAXIMUM LAB DRY it DENSITY WATER . CONTENT WET DENSITY DENSITY PERCENT COMPACTION COMMENTS' Spec. 95% Min .1 B11 FG 1 118.0 10.3 124.5 112.9 95.7 1 - A 2 811 FG 1 118.0 9.8 125.4 114.2 96.8 1 - A 3 811 FG 1 118.0 10.6 124.2 112.3 95.2 1 - A. 4 811 FG 1 118.0 10.3 125.0 113.3 96.0 1 - A TEST LOCATION: House pad. 1 NW corner. 2 SW corner. 3 SE corner. 4 NE corner. NOTES: TESTS PERFORMED PER ASTM D2922-96 8 ASTM D3017-96 *COMMENTS: 1. FILL MATERIAL A. 11=51 KtsUL 1 a L:UMFLT VVI I n artt.IrIW%I IUna DENSITIES SHOWN: Lbs. per cubic foot 2. BACKFILL B. PERCENT COMPACTION DOES NOT COMPLY WATER CONTENT: Percent of dry weight 3. BASE COURSE WITH SPECIFICATIONS PERCENT COMPACTION: Based on maximum dry 4. SUBBASE C. RETEST OF PREVIOUS TEST density obtained on sample indicated by 5. SOIL CEMENT D. MOISTURE IN EXCESS OF SPECIFICATIONS soil ID number. 6. OTHER E MOISTURE BELOW SPECIFICATIONS * (1) ASTM D-1557, Procedure A TEST INSTRUMENT: STANDARD COUNT' M: D:. REMARKS: ADJUSTMENT DATA M: D: Respectfully submitted, TECHNICIAN. Juan Nunez Professional Service Industries, Inc. 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. . CARLOS ELIAS Civil Engineer 38325 Charlesworth Dr.. Cathedral City,,;CA 92234 (619) 328-7271 December.30,22002 City of La Quinta Department, of Building & Safety 78.495 Calle.Tampico La Quinta, Calif. _92253 Gentlemen: Th-is--letter-c•o-n-c-e-r-n-s the Perales residence located at 78691 Avenida La Torres, La Quints, California. Roof sheathing of 15/32" plywood (O.S.B.) is structurally adequate for this building. Very truly yours, MP o c „u F E SS Lzgotow �`.os Carlos .Elias CE: je 0.16839 yj CML FOF CALIF�Q�\P CARLOS ELIAS REGISTERED CIVIL ENGINEER 38825 Charlesworth Drive Cathedral City, California 92234 Telephone (760) 328-7271 March 28, 2003 City .of La. Quinta Department of Building & Safety 78495 Calle Tampico La Quinta, Calif. 92253 Gentlemen: This letter concerns th.e residence being. constructed -at 78691` Av.enida.La-Torres, La Quinta, California. I have conducted a framing inspection on the residence. The building.const.ruc.tion. is in accordance with my structural design as shown on the architectural pl.a.ns. Very .truly yours,. ?r,0FE3, Carlos Elias C E : j e No. 1g8g Of CAU� 0. '