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0188 (BLDG)PERMIT APPLICATION City of La Ouinta Department of Building and Safety This permit becomes void if work not commenced within 180 days from date of issuance. OR, if work has been suspended or abandoned for a period of 180 days. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division Sof the Business and Professions Code, and my license is in full force and effect. License Class Lic. Number Date Contractor 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 ($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, Business 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 improvemnt 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.). O I, as owner of the property, am exculsively contracting with licensed contractors to construct 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.). O 1 am exempt under Sec. . B. 8 P.C. (Attached Certificate) Date Owner WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Workers' Compensation Insurance , or a certified copy thereof (Sec. 3800. Lab. C.). Policy No. Company o,Ceitlfled copy is hereby furnished. O Certified copy is filed with the.City. Building Inspection Department or City :Department / Date !/ - % . � ./�! i Applicant � 4.�:...�->✓`,+C/'' APPLICANT NAME (121. F, MI) y� �,♦ J ADDRESSJ /; - A w /,V" CITY/COMMUNITY/STATE/ZIP SPACE JOB SI'1r "'4 -SS 42 1//A'.) CITY/COMMUNITY/STATE/ZIP BOK PAG PRC C TWN RNG SE S TRACT LOT MOD SB TRACT NAME OWNER jyNAME (L. F MI) /tet ,C. );4I �/, CONTRACTTjOR-_FIRM NAME ADDRESS CITY/COM%M UN IT/Y/�STATE/ZI P /_ / PHONE /N� � LICNC N ARC/ENG FIRM NAME ADDRESS CITY/COMMUNITY/STATE/ZIP PHONE M LICNC N USE OF PERMIT LL BL ZON FSB SSB SSB RSB OFC♦ v ZONE ORD N LOT SZ END SIDE CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed if the permit is for one hundred (5100) o, 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. Date Applicant 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. DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION% O 1 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap 3.2, Grp 2, Art 2, Sec341, Titfell. C.A.C.) O As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from that division. O Division of Industrial Safety Permit No. Date Applicant CONSTRUCTION LENDING AGENCY: 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. Q. Lender's Name Lender's Address 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 county to enter upon the above-mentioned property for inspection purposes. Signature of Applicant or Agent Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state that the information given is correct. I agree to comply with all state laws and county ordinances relating to buidling construction, and authorize a'representative of the City of La Ouinta Department of Building and Safety to enter upon the property for which I have applied for this permit for the purpose of making inspections. Signature of Applicant or Agent Print Applicant/Agent Name Date APPVPRMT Nti 0 1813 berm"f iso 1 ui/d .A 0,0 1�.��it,,� • .�'l�b�i�r.� ���� ,lJG%' �.�� a vera ,,4,�r1/� Cy��i'EEr 1241e_- lekA,0,174- -411 /l/G.r[.' "3U 1 33 City ofLa Uinta TOTAL FEE VALUATION Arrow Printing 250/1-83 White: Finance Canary: Assessor Pink: Applicant Tag: Bldg. Dept. / (/,► NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Ftgs & Frms 34 Plenums & Ducts 2A Slab Grade 35 Furnace Compart. 3 Steel 36 Inlets & Outlets 4 Grout Blocks 37 Combustion Air 5 Bond Beams 38 Compressor 6 Roof Deck 39 Appl. Clearance 7 Framing 40 Fire Damper 8 Vents 41 Smoke Detection Device 9 Garage Fire Wall 42 Commercial Hood 10 Fireplace P. L. ❑ 43 Final 10A fireplace T.O. ❑ NP'N ADDITIONAL INFORMATION J, 0,0 SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath 12 Internal Lath 12A Drywall 13 Finish Grade .INSULATION Thick R" Value 7A Walls (Batts) 12B Ceiling (Batts) 12C Ceiling (Blown) t 14 Final PLUMBING APPROVALS 15 Ground Plumb, 16 Water Piping 17 Rough Plumb 18 Vents 19 Sewage Disposal 20 Sewer ,� 3 T 21 Water Heater 22 Water Softener 23 Water Service 24 Gas Test 25 Final Tank Pit L. Line ELECTRIC APPROVALS REAR OF PROPERTY LINE PSL P/I STREET NAME 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 • Service 32 Final RIVERSIDE COUNTY DEPARTMENT OF HEALTH PERMIT APPLICATION FOR A SUBSURFACE DISPOSAL SYSTEM Applicant: Submit this form with three copies of a scaled plot plan drawn to county specifications required on the attached check list. A non refundable filing fee of $15 is required when the application is submitted. Check must be made payable to County of Riverside. Name '�/% /r C/"�%. Mailing Address �� �D G��✓.L�����i� .fes �i 7 �`'�.� , � � c� O City State 1 Zip Code Phone *Property Addr0117 /X *City r Community 'Legal Description of Property (Lot, Parcel Map, Tract) , 'Assessors Parcel No. Water Serving Property From 414 Lot size Signature;of ApplicantDate The above information must be verified from Building Application '✓ Staff Use — Do Not Write Below This Line initial Date + WQCB Clearance required Yes ❑ No O' 2 X-3 Soils feasibility report required Yes ❑ No (3 Detailed boring report required Yes ❑ No Detailed contour plot required Yes ❑ No Comments: Soils or boring -report by Date Approved by Date „ASoils.MapPage .: w, "-"- Soil Type r- Tract File No. Other Number=of-bedrobdi–' "r fr.A, To ILC -r 11f)o,v\ c,tc' /1� 1„ ,Na,t` (Septic Tank Size (gallons) 4}}7rO CAI. 51 �.7f� 1?4,e/% Rate Required � Type of System New Addition Replacement T44ty 1'1"A(F1 P'd L' b /1 941.,4. - ([ ,/ CU KAi -TA •,J -I f! F' Jr Ci- %ivr ! I �� ❑ ❑ Leach line sq. ft. of bottom area trench Leach bed (sq. ft. of bottom area bed) Seepage Pit DiameterNumber 6, : of Pits Seepage.Pit Depth B.I. Total Depth of Pit Location of Systemr/ 0 �„ j w ' � c• s. 6?r� Additional Requirements 1 ��i yy�L.<.�� �I'/•-F e.tw-(__.r. 7 SJ"0.�7� �_/Z*r (iilC� l�f: A permit,is approved/deniedaforthe design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements set forth in Section B above. A building permit is necessary for the installation of the above designed system. / Signature of Health Official Date Receipt No.�� Issued By District: Riverside ❑ Indio 2--' Hemet ❑ Date l L DISTRIBUTION: WHITE - Office File YELLOW - Applicant PINK - Building Dept. GOLDENROD - Pending File DOH SAN 122 (Rev 10/82) L1 3, . pioneer consultants 251 TENNESSEE STREETm REDLANDS, CALIFORNIA 92373 a (714) 793-2691 J. N. 3174-016 August 25, 1983 Landmark Land Company Post Office Box 1000 La Quinta, California ' 92253 Attention: Mr. Lloyd Watson Re: Lot 13, Desert Club 5 Golf Course Equipment Storage La Quinta Area Riverside County, California Subject: Pad Grading Inspection Gentlemen: At your request this firm has performed testing and inspection of the grading for the building pad for the referenced site. Our services ' consisted of compaction testing, visual inspection, and determination of moisture content. of the soil for optimum working conditions. Periodic tests and inspections were provided by a representative of Pioneer Consultants to check the contractor on compliance with the recommendations. The presence of our field representative at the site was to provide to the client a continuing source of professional advice, opinions and recommendations based on the field representa- tive's observations of the contractor's work, and did not include any superintending, supervising, or directing of the actual work of the contractor or the contractor's workmen. The opinions and recommendations presented hereafter are based on our tests and observations of the grading procedures used, and represent our engineering judgment as to the contractor's compliance with the job recommendations. The grading operation was observed to be performed in the following general manner: 1. The pad site was cleared of brush, vegetation and trash. All vegetation, refuse and rubble was removed from the pad area. 2. The surface of areas to be filled was subexcavated to a depth of 1.5 feet, watered to near optimum moisture and recompacted. 3. Approved on-site soils were placed in layers on the prepared surface, and each layer was compacted before the next layer was added. J.N. 3174-01.6 Landmark Land Company August 25, 1983 Page 2 4. The maximum depth of controlled compacted fill was 3 feet in the north end of -the pad area. 5. The minimum acceptable degree of compaction was 90 percent of the maximum, dry density obtained in accordance. with ASTM Standard D1557. 6.. It is our understanding that 'a ;concrete slab and parking lot '. grading will -be done at a later, date, i Field density tests were made -during, grading of --the pad to determine the degree of compaction and moisture content. .'All field density Jests are listed in the ".Summary of Field Density Testing", CI IAARA AM %/ Based on the field density test results, the observations of the grading procedures used in the field, and our experience, it is our opinion that the grading of the building pad was performed in accordance with the intent of the job recommendations. If you have any questions, please feel free to contact us at your convenience. Respectfully, PIONEER CONSULTANTS Jagdish N. Mathur, P.E. Principal Geotechnical Engineer JNM:JB:jls Addressee (2 ) Attachment pioneer consultants 251 TENNESSEE STREET • REDLANDS. CALIFORNIA 92373 • (714) 793-2691 J.N.. 5174 'O/I/ PROJECT Z1,0_ 164tdA/k bAjr, NO. LOCATION DATE DESIGN FILL DEPTH FEET FILL DEPTH FEET TEST DEPTH FEET TEST ELEV. FIELD DENS. PCF MOTS. CONT. % RELATIVE COMPACT. PERCENT Max.* Dry Dens.. AJ ff o 931 Z .� a o /% 2 * Maximum Dry ensity determined' by. field checkpoint PC Form 127 tXH11311 NO. 1