14190 (SFD)P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 78--685 AveE Ultimo LA QUINTA, CALIFORNIA 92253
Owner i oulple V Construction
Mailing 51-960 Ave. Herrera
Address
City Zip Tel.
',a Quinta: 92.253 771-1561
Contractor
Same
Address
Zip
State Lic. City
& Classif. R 681012 Lic. # 323
- -Arch:; Engr.,
Designer
Address Tel.
City( Zip I
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 of the Business and Professions Code, and my license is in full force and
effect.
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, prior to its issuance also
requires the applicant for such permit to rile 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 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.)
0 1, 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.)
O 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. ❑ 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.
Signature of applicant Date
Mailing Address
City, State, Zip
f
1
i
A
N o . 14190
BUILDING: TYPE CONST. OCC. GRP..
A.P. Number 7619-062-004
Legal Description Lot. 4 Desert Club Tract
Project Description SFd
ZONE: BY: "
Minimum Setback Distances: OC
Front Setback fro renter Line - 1 L`
Rear Setback from Rear Prop. Line / '
Side Street Setbac t
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date Permit
Validated by:
Validation: °
Sq. Ft.
Size 2290
No. No. Dw.
Stories Units
New ❑ Add ❑
_
Alter ❑ Repair ❑ Demolition ❑
Permit includes blobk garden walls.
Pool permit
to be obtained separately.
Estimated Valuation
$146t023.00
PERMIT
AMOUNT
Plan Chk. Dep.
250. 0U
Plan Chk. Bal.
- ' • 15
Const.
i.� dU4 . UU
Mech.
* • T3 t . Mill
Electrical
Plumbing
156 . U0
.S.M.I.
14 .6 111,10
Grading
0. ou
Driveway Enc.
. V)0
Infrastructure
J 0 U. -)d •
wetlse { }�
Abu
Arta in -
i I Flaces .I6 Ib . f✓ V
f
TOTAL
• 39 4 t • 9
REMARKS
ZONE: BY: "
Minimum Setback Distances: OC
Front Setback fro renter Line - 1 L`
Rear Setback from Rear Prop. Line / '
Side Street Setbac t
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date Permit
Validated by:
Validation: °
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING -
1ST FL. SO. FT. ® $
UNITS
_
F
YARD SPKLR SYSTEM Sir
2ND FL. S0. FT.
FORMS
SEWER ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. S0. FT. ®
GAS (ROUGH) METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
GROUT
DRAINAGE PIPING
CAR P. S0. FT. ®
FINAL INSP.
WALL S0. FT.
WATER SYSTEM
DRINKING FOUNTAIN,
GRADING
cu. yd.
plus x$
=$
URINAL
SD FT ®
FRAMING l✓
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
A�G4 �Q f�r3S
12A 1
/
1
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
VENTILATION
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
FIREPLACE
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, 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
FINAL INSPECTION
SO.FT.GAR ® 3/4c
HOUSE SEWER
CERT. OCC.
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 z DERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE J
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. /
GAS (ROUGH) METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL) -y TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
$
GRADING
cu. yd.
plus x$
=$
LUMBER GR.
FINAL INSP.
FRAMING l✓
FINAL INSP.
ROOFING 1��30/f%('
A�G4 �Q f�r3S
12A 1
/
1
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHIN
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
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 619-775-3500
Date 10/11/94
No. 13115
Type of Permit I La Quinta
Permit #
Owner Name Double D Construction
No. 78685 Street Avenida Ultimo
Log
City La Quinta Zip 92253 Study Area 125
APN # Tract # Lot # 0 Square Footage 12280
Type of Development Single Family Residence No. of units 0
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 1.65 x 2 280 or $ 3,762.00 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 Double D Construction Telephone 771-1561
Name on the check
By
Dolores A. Ballesteros
Superintendent
Fee collected /exempted by Vickie J. Durrett
/F����..� Payment Received
Signature Check No. 1326
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy.- Accounting
M
SEP 19 194 10:44AM FIDELITY TITLE
P.1/4
FIDELITY NATIONAL TITLE INSURANCE COMPANY
4344 LATHAM STREET
RIVERSIDE, CA 925.01
PHONE NO. (909) 682-8880 * (800) 439-8880
AMENDED NO. 1 YOUR
C®PY
PRELIMINARY REPORT
Date: SEPTEMBER 19, 1994
To: GENERAL ESCROW Your No.: 10-31138
44900 SAN PABLO Order No.: 248120-JDP
PALM DESERT, CA.
Attn: BETTY COMAN Title Officer:
JOHN D. PEREZ
FAX NO. (9o9) 682-8812
Effective Date:
SEPTEMBER 8, 1994 at 7:30.am
The form of Policy or Policies of Title Insurance contemplated by this
Report is:
x California Land Title Association (Standard Coverage Policy -
1990)
W thA.L.T.A
American
Land
EndorsementAssociation
Form 1Loan
CoveragePolicy
(10-17-92)
American Land Title Association Residential Owners Policy
SCHEDULE A
The estate or interest in the land hereinafter described or referred
to covered by this report .
A Fee
Title'to said estate or interest at the date hereof is vested in:
WILLIAM R. BARNETT; JR., AN UNMARRIED MAN
The land referred tLAinreport
Stat4 of Californias, the and is described as
of
RIVERSIDE, City of QUINTA,
follows:
LOT 4 OF DESERT CLUB TRACT UNIT N0. 5, AS SHOWN BY MAP ON FILE IN
BOOK 21, PAGES 61 AND 62 OF MAPS, RECORDS OF RIVERSIDE COUNTY,
CALIFORNIA
a
Qum&
78-495 CALLE TAMPICO — LA QUINTA, CALIFORNIA 92253 - (619) . 777-7000
FAX (619) 777-7101
April 3, 1995
Michael Dietrick
51-960 Ave. Herrera
La Quinta, CA., 92253
Dear Mr. Dietrick,
March 31, 1995 the foundation for the guest house at 78-685
Ave Ultimo, permit 14952, was poured without a foundation
inspection. The Building Official has required the following to__
confirm foundation structural compliance.
1. Expose foundation footing four locations, one location each
side of foundation with a pothole to confirm footing depth.
2. Expose two of the above named footings to confirm footing
width.
3. Core foundation floor one location for confirmation of
minimum 3.5 inch slab thickness.
Stop all construction on guest house until foundation is
inspected for structural integrity. Please schedule an inspection
when above is completed.
Sincerely,
Depar ent of uuildin & Safety
aniel P. rawfo d J
Building Inspector I
cc file
0
MAILING ADDRESS - P.O. BOX t4.1504 - LA QUINTA, CALIFORNIA 92253
0
EARTH SYSTEMS CONSULTANTS S.C.
79-811 B Country Club Drive
�� Bermuda Dunes, CA 92201 • (619) 345-1588
CLIENT NAME
CUENTADDRESS
CLIENT PHONE
DATE JOB
NO.
PROJECT
7a-1,55 tt /Tmm
LOCATION
REFERENCECURVE
CONTRACTOR OVOER
WEATHER
C'(/(A 2
TEMP
TIME
PRESENT AT SITE
MAXIMUM
MAXIMUM
OPTIMUM
N- BER
kX1..,1 r d ic.
CLIENT REPRESENTATIVE SIGNATURE
FIELD REPORT
TECHNICIANS SIGNATURE �29
FIELD TESTING
REFERENCECURVE
TEST
LOT
MOISTURE
DRY
MAXIMUM
MAXIMUM
OPTIMUM
N- BER
ND.
ELEVATION
CONTENT
DENSITY
DRY
DRY
MOISTURE
%
Ibs/cu. ft.
DENSITY
DENSITY
CONTENT
QUS� /a
%
lbs/cu. it.
%
t
7-11p pul
13•3
/ov.L/
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ell
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REMARKS: i` !
rf/7f�c1/��//AL1 7006 bf i L 7e , 7f. S%S C)/v � fin isf�fi.7 <i��t�f
1-4641.5, . ��/ /`>/(i;H/�//tif i 7 i •V f"l (f T�..�s �o$ ,� C, j/</1./JC //U
/,0A X. Gf //S -o 'cl %SS7!� G,l.//!L
kX1..,1 r d ic.
CLIENT REPRESENTATIVE SIGNATURE
FIELD REPORT
TECHNICIANS SIGNATURE �29
OF
(t ofutt
This Certificate issued pursuant to the requirements of Section306 of the Uniform Building
Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating building construction -or use. For- the, following:
78-685 2�ve'bltimo
BUILDING ADDRESS
Single -Family Dwelling' 14190
Use Clossificotion Bldg. Permit No.
Group 'R3 Type Construction VN. --Fire Zone Use Zone SR. -
Owner of Building Double D Construction Address 51-960 Ave Herrera
City La buinta, CA-- 92253--
By: Daniel P, Crawford Jr
Date; May 18 -1995
Building OfficiYT
POST IN A CONSPICUOUS PLACE