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09316 (SFD)T4 4 4Q" P.O. BOX 1504 Building 78-105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Owner Address 31 , City I Zip Tel. Contractor Add e State Lic. City & Classif. Lic. # I 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 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,Susiness 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 rive hundred dollars ($500). ❑ Ifas owner of the property, or my employees with wages as their sole compensation, will do)ihe 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.) ❑ 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 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 0 Copy is filed with the city. ❑ Certif`3-1P0AIrhe�reb?L,,,�r ed. CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATIONINSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation Of 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. Oate Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions or 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-. Ten 1 tioned property for inspection purposes. Signature of applicant -Date- Mailing ateMailing Address City, State, Zip No. 09316 ILDING: TYPE CONST. OCC: GRP. P. Number Legal Description -r 17, S ,.,ek,: 4_12 Project Description c;i "PrTox T11,*v%4 lrs riwa,l 1 4 no. -r Sq. Ft. No. Size 1676 Stories No. Dw Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Permit does not include black walls or pool if applicable n PERMIT Plan Chk. Dep. Plan Chk. Bal.. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS AMOUNT 281.23 621.50 55.50 1-11.40 iE►.?g 20 _ tits 20.00 2026.08 nn.it;•1 A� ttk- 4004 Ar,_A7«9't t4 .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 1ST FL. SO. FT. ® $ UNITS COLL. AREA 2ND FL. SO. FT. YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SO. FT. ® DUCT WORK DRAINAGE PIPING WALL SO. FT. DRINKING FOUNTAIN. SO FT ® HEATING (FINAL) URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GRADING cu. yd. $ plus x$ LAUNDRYTRAY AIR HANDLING UNIT CFM FINAL INSP.r�j�� q/ KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEMIPERM 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/. c SEWAGE DISPOSAL SPARK ARRESTOR SO.FT.GAR ® 3/ac HOUSE SEWER GAR. FIREWALL 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 PLUMBIN2�g UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE 6r`� 9 ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS S SEPTIC T N ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP.r�j�� q/ FRAMING FINAL INSP. ROOFING VENTILATION r REMARKS: FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL MNG ESH INSULATION/SOUND 9� 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) 347-8631 Date 4/12/91 1 Type of Permit I La Quints No. 110537 Permit # Owner Name James Lincoln Log # No. 52640 street Vallejo city La Quinta zip 92253 study Area 112 APN # I Tract # 1 Lot # 17 Square Footage 11676 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 1.58 X 11.676 or$ 2,648.08 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 J.J.'s Painting Telephone (714)969.5563 Name on the check 4 By Richard M. Beck •. �,,,�F Director, Facilities Planning &Development ,�,s.._,. r Fee collected /exempted by Shelley D. Bennett Payment' 1R,eceived Signature Check„) No. 633 : Collector: Attach a copy of county or city plan check application form to' district copy -for. -all waivers. cEmbossed Original- BuildingDept./Applicant Copy - Applicant/Receipt t CoPYAonntn6 '� RECORDING REQUESTED UY LA JOLLA BANK ORDER NO. ESCROW NO. _ WHEN nECORDEO MAIL TO Nsm# I ,La Jolla Bank - sl,.,l 888 Prospect, Suite 140 Addle$$ La Jolla, CA 92037 Cdr sul. L ATTN: NANCY PFEIFFER i.o nEcon DEns VSE ONLY FULL RECONVEYANCE LA JOLLA BANK, A CALIFORNIA CORPORATION MAY 7 as trustee under that certain Deed of Trust dated executed by- GREG BUSHELL, A SINGLE MAN AND JIM LINCOLN, A SINGLE MAN AS JOINT TENANTS and recorded as"Instrurnent No. 178877 on MAY 15 , 1990 as Trustor , 19 90 in Book ----------- .at Page --- of Official Records, in the office of the County Recorder of RIVERSIDE County, California, having been requested in writing, by the holder of the obligations secured by said deed of trust, to reconvey the estate granted to trustee under said deed of trust, DOES HEREBY RECONVEY to the person or persons legally entitled thereto, without warranty, all the estate, title, and interest acquired by trustee under said deed of trust. RECON. NO. Dated: 1�I0uELlf3EfL8,--1 (SEAL) .. J STATE OF CALIFORDIE&A S.S. COUNTY OF SAN On NOVEMBER 8 19 90 before me, 111 0 undersigned, a Notary Public In and fol said County and Slate, personally appeared NANCY I. PFEIFFER personally known to me (or proved to me on ilia basis of satisfactory, evidence) to be lhe_ASST. VICE Presldenl, and — ----------------- known to me to be the --------------- Secretary of ilia corporation that executed the within Instrument, and known to me to be the persons who executed the within In- strument on behalf of the corporation therein named, and acknowledged to me that such corporation executed the within Instrument pursuant to Its By -Laws or a Resolution of Its Board of Directors. W T ESS my hand and offlclal seal. Notary Public In and for said County an late OFFICIAL SEAL t (ARI -ANNE MARTINEZ Q s �~ NOTARY PUBLIC - CALIFORNIA • " SAN DIEGO COUNTY F a t My Comm. Expires Aug. 13, 1993 Nan y Pf if e A istant Vi President In Jolla Ran C C B STATE OF CALIFORNIA S.S. COUNTY OF On , 19 before me, ilio undorslgnod, a Notary Public In and for said County and Stale, personally appeared personally known to me (or proved to me on the basis of satisfactory evidence) lobe the person whose name subscribed to ilio within Instrument and acknowledged that executed the same. WITNESS my hand and official seal. Notary Public In and for said County and Slate Notary Seal — 4 M 04.1=13DED MAIL 10: La Jolla Bank P.�J..Box 8169 ."La Jolla, CA 92038-6169 Loan Number 27101074-7 SUBSTITUTION OF TRUSTEE Whereas, GREG BUSHELL, A SINGLE MAN AND JIM. LINCOLN, A SINGLE MAN AS JOINT TENANTS was the original Trustor,• T.D. SERVICE INC., A CALIFORNIA CORPORATION was the original 'Trustee; and " LA JOLLA BANK, A CALIFORNIA CORPORATION was the original 13eneficiary under that certain Deed of 'Trust dated MAY 7, 1990 and recoiled on MAY 15, 1990 as, instrumenl: no. 178877 Off::i.c:i.a.l.. Records of RIVERSIDE Coulity, Cal:i.Corilia, an(3. Whereas, the undersigned is the present- Beneficiary widcr said Deed of Trust, and Whereas, the undersigned desires to substitute a new Trustee under. said Deed of Trust in the' place and stead of said,original Trustee thereunder., in the manner in said Deed of'Tiust`provided, Now, therefore,' the undersigned hereby substitutes L,A J•nc,l.,n BAN)<..p CALIFORNIA CORPORA'I'ION,.whose address is P.O. Box 8169, La Jolla, CA 92038-8169, as Trustee under said Deed.of Trust. Whenever the context hereof so requires, the masculine gender includes .the feitin ux . and/ or neuter, and;the singular, number includes the plural. La Joll Bank ' A Cali rnia Corpor t' f Nanc Pfe•ff r * Assistant Vi President* ti- La Jo11a Bank,-S,S.B. State of California ) County of San Diego ) SS On NOVEMBER -8, 1990 before me, the undersigned, a Notary. Public in and for. said County and State, personally appeared NANCY I. PFEIFFER , proved to me on the basis of satisfactory evidence to be the person who executed the within instrument as ASSISTANT VICE PRESIDENT Of the Corporation therein'named,* and acknowledged to me that such Corporation executed the within instrument pursuan_t`to its By-laws or a Resolution of its Board of Directors' F- 0 OFFICIAL SEAL (ARI -ANNE MARTINEZ m 'NOTARY PUBUC . CALIFORNIA SAN DIEGO COUNTY F My Comm. Expires Aug. 13, 1993 ot-ary, Public • 'i e NOTE SECURED BY DEED OF TRUST LOAN. 27101074-7 f NOTICE TO BORROWER: THE TERMS OF THIS NOTE MAY CONTAIN PROVISIONS THAT ALLOW FOR A BALLOON PAYMENT AT MATURITY. Property Address: LOT 17, BLOCK 152, AVENIDA VILLEJO LA QUINTA, CA 92253 $ 9,000.00 LA JOLLA MAY 07 California 19 90 For value received, the undersigned (herein "Borrower") promises) to pay to LA JOLLA SAVINGS BANK, A CALIPURNIA CORPORATION (herein "Note holder"), or order, at its principle office, or at such other offices holder may from time to time designate, in lawful money of the United States, the principal sum of NINE THOUSAND and NO/100 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX DOLLARS with interest on the unpaid balance from DATE OF FUNDING . Interest as earned shall be computed on the basis of 365 days in the year with THE ACTUAL NUMBER OF days in each month. The interest rate on this Note is 11.500 % Interest shall be charged on only those funds disbursed. All earned interest shall be due and payable In consecutive monthly Installments on the 1 ST day of each month beginning JULY 1990 and continuing until JUNE 01 , 1991 ("Maturity Date") on which day the unpaid principal balance and all unpaid interest due thereon shall become due and payable in full. As and when required by law, the Note holder shall give written notice to the undersigned, or successor in interest, of prescribed information about the balloon payment at least 60 days and not more than 150 days before the balloon payment in due. If any monthly installment under this note is not paid prior to the due date of the next monthly payment, the entire principal amount outstanding and accrued interest thereon shall at once become due and payable at the option of the Note holder. The Note holder may exercise this option to accelerate during any default by Borrower regardless of any prior forbearance. In the event of any breach or other default, the Note holder reserves the right to increase the interest rate by FIVE percentage points ( 5.000 %) above the interest rate in effect at the time of breach or default; however, if the Note holder does not elect ncrease the interest rate, the interest rate that will be charged on all amounts remaining unpaid will be determine ding to the terms controlling interest rate adjustments stated herein. Should interest not be paid, it shall therea era ' e i rest as the principal. If suit is brought to collect this Note, the Note holder shall be entitled to coll c a ason costs and expenses of suit, including, but not limited to, reasonable attorney's fees. Borrower shall pay the Note holder a late charge a 9 re y monthly installment not received by the Note holder within 15 days after the installmen Borrower may prepay the principal amount outstanding in w6(o r " -The Note holder may require that any partial prepayments be made on the date monthly installments are ue. Any partial prepayment shall be applied against the principal amount outstanding and shall otherwise agree in writing. Any exception to this prepayment privilege clause must be agreed to in writing by both the Note holder and the undersigned. Presentment, notice of dishonor, and protest are hereby waived by all makers, sureties, guarantors and endorsers, and shall be binding upon them and their successors and assigns. If more than one person signs this Note, each person is fully and personally obligated to keep all of the promises made in this Note, including the promise to pay the full amount owed. Any person who is guarantor, surety or endorser of this Note, is also obligated to do these things. Any person who takes over these obligations, including the obligation of guarantor, surety or endorser of this Note, is also obligated to keep all of the promises made in this Note. The Note Holder may enforce its right under this Note against each person individually or against all of us together. This means that any one of us may be required to pay all of the amounts owed under this Note. The indebtedness evidenced by this Note is secured by a Deed of Trust, dated MAY 07 ' ,1990 , and reference is made to the Deed of Trust for rights as to acceleration of the indebtedness evidenced by this Note, including paragraph 17 which provides as follows: Transfer ofthe-Property ora Beneficial Interest in Borrower. If all or any part of the Property or any interest in it is sold or transferred (or if a beneficial interest in Borrower is sold or transferred and Borrower is not a natural person) without Lender's prior written consent, Lender may, at its option, require immediate payment in full of all sums secured by this Security Instrument. However, this option shall not be exercised by Lender if exercise is prohibited by federal law as of the date of this Security Instrument. If Lender exercised this option, Lender shall give Borrower notice of acceleration. The notice shall provide a period of not less than 30 days from the date of the notice is delivered or mailed within which Borrower must pay all sums secured by this Security Instrument. If Borrower fails to pay these sums prior to the expiration of this period, Lender may invoke any remedies permitted by this Security Instrument without further notice or demand on Borrower. WITNESS THE HAND(S) AND SEAL(S) OF THE UNDERSIGNED. '*Z, ZJ9 GREG BU L ��I LML IN COL (Execute Original Only) CALIFORNIA - Interest Only - Fixed Rate LSSI-L21(03/90) wr• ti:fMs 1. -?y. `(: 7 ,,.,.s ^.s+r.,7. v,:sr,r—+_':"'•s"Tr.Sr=r*+y�-^+atM.-!. r-�'"�:w �:rrtf,..=`r.{RyK, ^rFr, , • .s y., w i . a''+ }^• .7' t. ��y Nr y •rr-y +art„^„ n RECEIPT NO. / Issued By `jr1 Date- DISTRICT: ate DISTRICT: ❑ Riverside, Indio ❑ Hemet 17 Perris ❑. Rancho Calif. ❑ Blythe DOH -SAN -122 (Rev. 3/90) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records F 1 COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH ENVIRONMENTAL SERVICES DIVISION PERMIT APPLICATION FOR A SUBSURFACE. SEWAGE DISPOSAL SYSTEM. Applicant: Submit this form with four copies of a scaled plot plan (1-20 scale) drawn to County speculations as indicated on the attached checklist . '� ��ll A non-refundable filing fee (see below) is required when the application is submitted. Check must be made payable to the County of ^�'et;'W A$ h h r- application pe. �G���Rlverside., Approval�of-this lication shall remain valid for period not to exceed one from. date of approval. year F, IS VERIFY ITEMS ffl' SECTION A FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG # r • Z6'� Ag ntContractor, ContactJRersoni Phone Address 8 Firm Tl rK L �. vc r I k( 1369-s'sv' '� 36- //15 W • in Owner '`^ L/ n- r�C �✓61 Phone Mailing Address city l�v� til fvr� r? eAc N State C/1 Zip 9Z rG Job Property Address !/r?I.GL �T J Legal Description Prop. (PM, Tract Lot) L� 7-\ i!, (k. /S"L Lot Size Water Agent l- Permit Use of Pet P/P, CU, etc. other 54,aq car,a � A ✓ �' Q- Vvlrf L' 1,6 50 x /G D Dwelling, H Site Prep, etc. Signature of Applicant pate CATEGORY: REV CODE CATEGORY: REV CODE FEE /15 SUBSURFACE DISPOSAL 1238 -f-59688 g9 ❑ SITE EVALUATION UPON REQUEST 7349 $-43-W- . m ❑ MULTIPLE PARCELS WITHIN SAME (NO PLOT PLAN) LAND DMSION , ❑ SEWER/SEPTIC VERIFICATION '7348 .$-1-7-M 0 a. 1 at 4 Parcels (Each) 1238. '$`57".00 (Less than 1 year) _;�7 b. Each Parcel after 4 7344 -4-24-00.37-1 ❑ PRELIMINARY ELECTIVE 7352 -$-24-00 . W ❑ Rereview (2nd review same parcel) 7344 $-2� Qq EVALUATION (Attach DOH SAN 53) ❑ Site Evaluation in Conjunction with ❑ HOLDING TANK 7351-$_4.7-tG9 Critical Area 7346 X00 1.73 ❑ ' ALTERNATIVE/EXPERIMENTAL 7345 e=270U- 0 Site Evaluation Lot Less than SYSTEM 3�!/ -w 13 / 10,000 Sq. Ft. 7347 S -87 J (' f/ ' INITIAL DATE Holding Tank Agreements Completed ❑ Yes No Certification of Existing S.D. System Required ❑ Yes I No WaCB Clearance required. (Attach Form ❑ Yes No DOH SAN 007, Santa Ana Region Only) Soils Percolation Report Required. ❑ Yes No Spedel Feed sibNHy Boring Report Required. ❑Yes No Detailed Contour Plot Plans Required (1 to 5 R interval) ❑ Yes No OCter ❑ Yes No Staff Specaital Lot Inspection Required ❑ Yes No Lot Inspection Date /P_/ Solis boring report by 7 Pry # per. Soils Map Page Sort Type Approved by _- Date U Z No. of Systems Type of Systems) ❑Holding Tank ❑Existing „.D elling Units Flxture Units �` (1) Septic TankFa5_ee oil Rate `' Grease GNew ❑ ReplaoerrrKit J �iaA6t M 6V, Qo-o Gel ^f� /(� Gal (2) Leach Line t Sidewalf allowance Install Lines)ft long �t wide with Leach Bed sq. 1l^ Bottom area ft rock/' sq. R. min. inches below dnalol' 6r/ of bottom"area per running ft NA Leachlines/bed special design for slope: (3) Pit Diameter No. Pits Pit Below Seepage Pit Total Depth Other. Applicable Inlet (BI) (TD) Max. Allowable Depth C/0 N/A Overburden factor ❑ 5 fl 6 ' / U / 7 No. 2 System REMARKS: lhcz'f! u O PP 0 This application iAPPROVE /DENIED for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated on the accompan plan, using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the Z above -designed system. No construction is permitted in the required reserved 100% expansion area. 0 Septic tank and.sewer lines must be 50' minimum from any wells (2) Leach lines must be 100` minimum from any wells, including expansion area W © 'Seepage pits must be 155/0' minimum from any wells, including expansion area Signature of Health Official � �L�'.(/fltiMlal.(l./e .fiN��S !►! Date n RECEIPT NO. / Issued By `jr1 Date- DISTRICT: ate DISTRICT: ❑ Riverside, Indio ❑ Hemet 17 Perris ❑. Rancho Calif. ❑ Blythe DOH -SAN -122 (Rev. 3/90) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records F 1 40� Buena Engineers, Inc. 79-811 B Country Club Drive Bermuda Dunes, CA 92201 • (619) 345-1588 Client Name Client Address Client DATE F'j 4 JOB NO. j ?a1� 1 PROJECT ELEVATION LOCATION Q 0-t.) t REFERENCE CURVE CONTRACTOR OWNER WEATHER Cu— k(. TEMP. o at AM 0 a PM PRESENT AT SITE 1 TEST NUMBER TEST LOCATION LOT NO. ELEVATION FIELD TESTING REFERENCE CURVE MOISTURE CONTENT % DRY DENSITY lbs./Cu. ft. MAXIMUM DRY DENSITY % MAXIMUM DRY DENSITY lbs./cu. ft. OPTIMUM MOISTURE CONTENT % .) S I I 9 4,2 Yo � G1kt.�T" �t� rf�i` s '� "" L��• '�"l c9 S� t1G . l 07 + vT Qwcz R -,LF- REMARKS: X . 2W ELS (T E(LL 4AAS c J -r-- E-A<�r-- &Lr CF llkkE + NOSa. I t--)Fi �- l.�lid�w— 7A��f (J -• � t, F'F,.Pr A <T lJ 1" A A E l TL ' E 3 FIELD REPORT C I�c CLIENT REPRESENTATIVE SIGNATURE TECHNICIANS SIGNATURE 5528 El „. ri. . a . e .•� • .. ` • �'-tyy} Y,S:F?r':�:�"`+ej!-`.:'4'ie�'''Sr„�7P",r^G,."!R•'"u�” , 1 ,S� � • • � h• r,�•s' j 1�R - rte. r . :`a+.� ` •i' "y.'<: a (Quinta utttn anSPt11 ttil n This 'Certificate issued pursuant to the requirements of Section 306 of the Uniform Bulldirvg F Code certifying that of the time of issuance this structure was in compliance, with the various: ordinances of the City regulating building construction or. use. For the following: BUILDING ADDRESS 52-640 Vallejo Use Classification , SFD• Bldg. Permit No. 09316x':fi: M Group R3 Type Construction VN Fre Zone Use Zone SR James Lincoln 316 11th #F _ Owner of Building Address city Huntington Beach',' CA 92648 - _ �.` •' By'. Mark Harold 12/31/91 .-r' .�`'` _✓ -, �� Date: Building Official F c POST IN A CONN?ICUOU! PLACE • _ •yam YK..:�L^'ca ♦ � -e -*k Y" �:� - y •'r .� bra• __,:•'�n� - "-'.'" ,?F'S.z �YMY _ ' � •,-` h' r ,jy%•sL !-1�'C-r-I��Nr. �''it'.�.C�.�'•.4 � �'^•i•b. 4 • • � �..2 ' � � 'My'�- M ..y �W i ry. sk4y�� � r r ' i�� Zty ... r • . - • ; y 7'k. ..-S �7i#yam# •tiy �i,"•},.�.'.�1i. tev..]•; b1 . r }:�.'�� .- yam. .' �'Sri4`i•`•+, •' Certificate of Compliance: Residential (Page I of 2) UV •1K GREG BUsNELt_ .-7 ixal:cib pate project TUk QVCN�DA VF►I-LEJ0 LA QU t,, ► -A ( pirojectAddrew John B. Backer (619) 327-4565 Bw7diagPe�;`d Documentation Author Telephone Checked By / Date Point S stem L5 e mpUanee Method Nage, F=w Sygm or compaer) cumate Tone Edorcenmt Amory Use Only GENERAL INFORMATION I " /7v0 2 Total Conditioned Floor Area: fAFr-M ft Building Type: Single Family Hotel/Motel (check one or more) Multi -Family (less than 4 stories) Addition Multi -Family (4 or more stories) Existing -Plus -Addition Front Entry Orientation: North /East / South West Orientations (circle one or more) Number of Dwelling Units: Floor Construction Type: Sla Raised Floor (circle one or both) r .... Infiltration Control: Stand ight (circle one) RpEESS/p .. Q NA. BUELDING SHELL INSULATION y2� a Component Insulation Lotn cation/Coments (0"N(ddPtk9 TyR-Value (attic to garage typical, etc.) 3-3: R— II R- 3 0 Typical OF GLAZING Shading Devices - Glazing Area Glass Type Interior . Exterior Overhang Framing Type Orientation (sf) (single double) (roller blind, etc.) (shadescreen, etc.) (yesmo) (metal wood) Front.... Double Roller Blinds* None Yes Metal Front.... ( ) Single Left...... (r;) Double Roller Blinds* None Yes Metal Left...... ( ) Single Rear..... ( G) 50 Double Roller Blinds* None Yes Metal Rear..... ( ) Single Right.... (S) (c C, Double Roller Blinds* None Yes Metal Right.... ( ) Single Skylight....... 4 - Skylight....... Skylight ....... Double None * or vertical/mini blinds THERMALMASS off white. Type/Covering Area Thickness (Flab/exposed tile, etc.) (SO (inches) Location/Description (kitchen, bath, etc.) ( — Slab/Exposed a.5y M Kitchen/Bath/Entry I.CrNa/bsaaa. v. vv ur •�.....�.• s�w•� ---- l' ' �3I� X 9 0 IRVAC SYSTEMS Minimum Duct ' q�,pe a�cm, • Efficieacy LMDOU Duct Output /Model i ,Mffitiow.0 a ptt)) fSL 5EER.NSPF) otic, Mc.) IR -Value (Btuh) (or approved equal) FURNACE —r a DTIC 4_1 tcB,000 Ro p5 8 5 W J O4 9 0 8 0 AIR -CM. q s e_ . 4-i 44. nm Maximum Furnace Heating Output: 58.cte g Btuh SOT RATER SYSTEMS . Tank Manufacturet/Model it System T` (storage au cu) Capacity (or approved e4ual) Specs] feature(s).. . .� ,Lt—EG—r, .50 GAL. OR LESS APPROVED MODEL T GU,4-70l2 I�F10�J�=2 Y r4' SPECIAL FEATURES/REMARKS (Add extra sheets if necessary) COMPLIANCE STATEMENT This certificate of compliance lists the building features and performance specifications needed to comply with Title 24, Chapter 2-53 and Title 20, Chapter 2, Subchapter 4, Article l of the California Administrative code. This certificate has been signed by the individual with overall design responsibility and the building owner, who shall retain a copy of it and transmit the certificate to any subsequent purchaser of the building. When this certificate of compliance is submitted for a single building plan to be built in multiple orientations, all building conservation features which vary are indicated in the Special FeammsiRemarks section. Designer Name: TitlelFirm: Address: Telephone-. - Lic. #: (i�►a�) (dais) Documentation Author Name: Jobn 2. Backer Titk/FiTn: 300D H. Backer i Associates Add=s: 4501 H Sunni Dunes load, ID . . pals Springs, Ce 92264 Tckp1►ons 27-4565 Building O er Name: Title/Firm• Address: Ce ♦ / �` %� Telephone: (sig►atum) - ice) >Entoreement Agency Name: AImcy: Tekphone: 4itijr►.tws ar rhr�) 'Oak) JWJJa" dMW%Fi' &VA%0& BW %ow as f NOTE: Lowrise residential buildings subject io the Standards most contain these measures regardless of -the compliance approach used. Items marked with an asterisk (') may be superseded by more stringent compliance requirements listed on the Certificate of Compliance When this checi list is inowporated into the permit documents, the featut es Noted shall be considered by all parties as binding minimum component performance specifications forThe mandatory measures whether they are shown elsewhere in the documents or on this checklist only. DESCRIPTION Suilding Envelope Measures DESIGNER I ENPORCENIEW • 12-5352(a): Minimum cuing k%latiion R-19 wdgbted average. X 12-5352(b): loose fill insulation manufacturer's labeled R -Value. ' 12-5352(c): Minimum wall insulation in framed walls R-11 weighted average (does not apply to exterior mass walls). x 12-5352(k): Slab edge insulation - water absorption rate no greater than 03%. wager vapor Transmission rate no greater than 2.0 perm%nch. N A 12-5311: Insulation specified or installed meets California Energy Commission (GEC) quality standards. Indicate type and form. X 12-5352(f): Vapor barriers mandatory in Climate Zones 14 and 16 only. 12-5317: Infilaation/Eafiltration Controls a. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. b. Doors and windows certified. c. Doors and windows weatherstripped; all joints and penetrations caulked and sealed. x 12-5352(e): Special infiltration barrier installed to comply with §2-5351 meets CEC quality standards. )( 12-5352(d): Installation of Fireplaces 1. Masonry and factory -built fireplaces have: L Tight fitting, closeable metal or glass door b. Outside air intake with damper and control e. Flue damper and control 2. No continuous burning gas pilots allowed. HVAC and Plumbing System Measures 12-5352(8) and 2-5303: Space conditioning equipment sizing: attach calculations. 12-5352(h) and 2-5315: Setback thermostat on all applicable heating systems. ' 12-5316(a): Ducts constructed, installed and insulated per Chapter 10, 1976 UMC. 12-5316(b): Exhaust systems have damper controls. X 12-5314(c): Gas-fired space heating equipment has intermittent ignition devices. 12-5314: HVAC equipment, water beaters, showerbeads and faucets oe tified by the CEC. 12-5352(1): Water heater insulation blanket (R-12 or greater) or combined interior/exterior insulation (R-16 or greater); first 5 feet of pipes closest to tank insulated (R-3 or greater). X 12-5312(Exception 1): Pipe insulation on steam and steam condensate return & recirculating piping. N 12-5318(d): Swimming Pool Heating 1. System has: a. On/off switch on heater. b. Weatherproof instruction plate on heater. c. Plumbed to allow for solar. 2.75 percent thermal efficiency. 3. Pool cover. 4. Tune clock. 5. Directional water inlet. Lighting and Appliance Measures K 12-5352(1): Lighting - 25 lumens/wau or greater for general lighting in kitchens and bathrooms. ;2-5314(c): Gas fired appliances equipped with intermittent ignition devices. . §2-5314(a): Refrigerators, refrigeramr-faeearrt:, beemn and Buorescent lamp ballots oertiGed x by the CEC. Indicate make and model umber. tk®1Rewed Deoembc 1967 14- :I=-NI=-RGY SCALCULAT I=- P4 I=- R 13'I ON , ARI -E I E; JOHN H. HACKER,'CIVIC ENGINEER, PALM SPRINGS 327-4565 y NAME ------- JIM LINCOLN AND GREG BUSHELL ADDRESS --- - AVENIDA VALLEJO LA QUINTA DATE., -----7- 7/23/90 MANUAL J FOR HEATING"AND COOLING LOSSES AREA BLDG 1670 SQ. FT. ` T. PERIMETER 185.5556 LIN. FT.- INSULATION R VALUES..FLOOR 0 ..CEILING 38 .:WALL 11 ..DUCT 4.2 INSULATION AREA ..NORTH WINDOWS -73 SQ.FT.- PERCENT OF AREA 4.37.1258 AREA EAST WINDOWS 56 SQ.FT. PERCENT.OF AREA 3.353293 AREA SOUTH WINDOWS 60 SQ.FT. PERCENT OF AREA 3.592815 AREA WEST WINDOWS 20.5 SOFT. PERCENT.OF AREA 1.227545 AREA SKYLIGHTS 4 SQ.FT. PERCENT.OF AREA :239521 TOTAL WINDOW-AREA 209.5 SQ.FT. PERCENT OF AREA 12.78443 THE U VALUE OF THE',WINDOWS IS .65 DUAL PANE SOUTH OVERHANG LENGTH 2' INTERIOR THERMAL-MASS'AREA = 250 SQ FT. INFILTRATION (STD 0.018, MED -0.014, TIGHT -0.012) _ .018 HEATING LOSSES - FOOTING•LOSSES... 6442.489 BTU' CEILING LOSSES... 13i0.633 BTU » WINDOW LOSSES:. -4221.4225 BTU i WALL LOSSES.... 3161.962 BTU INFILTRATION LOSSES... 7454.88 BTU T TOTAL HEAT LOSSES BTU/HR.. 22591.29 GAS FURNANCE SIZE 53068.67 BTU OR 45,000 BTU COOLING LOSSES r t I FOOTING LOSSES... 2770.963 BTU. T CEILING LOSSES... '1691'.;139 BTU.' WINDOW LOSSES... 4 4130'BTU ' WALL LOSSES....- 4073.422 BTU• INFILTRATION LOSSES... 3206.4 BTU NO. OF PEOPLE... 5 COOLING LOSSES... 2000 ' KITCHEN... 1500. PTU ; DUCT LOSSES -INCLUDED IN=TOTAL - TOTAL COOLING LOSSES(SENS) 35784.72 BTU' r BUILDING'DATA 1700 CONDITIONED FLOOR AREA= lfr70 SLAB/RAISED FLOOR SLAB TOTAL GLASS AREA 213.5 SQ.FT CHECK ALL APPLICABLE UNIT TYPE CONDITION(S) (X) SINGLE FAMILY DETACHED (SFD) ( ) ADDITION ALONE ( ) SINGLE FAMILY ATTACHED (SFA) ( ) EXISTING BUILDING ( ) MULTI -FAMILY (MF) ( ) EXISTING -PLUS -ADDITION SCORE CARD MEASURES 1.CEILING,INSU. 2.WALL INSU. 3.RAISED FLOOR INSU 4.SLAB EDGE INSU 5.INFILTRATION 6.GLASS HEAT LOSS 38 11 0 0 STANDARD DUAL PANE U= .65 SUM 1-6= (-5 ) 7.SHADING (SHADE OPEN) = 2.961964 -1 73 SC= .6776 A. NORTH 4.371258 X B..EAST .0 3.353293 X D. SOUTH 3.592815 X E. WEST 1.227545 X H. SKYLIGHT .239521 X 8. SHADING (SHADE CLOSED) POINT SCORES 0 -8 0 0• 0 3 GLASS :AREA .6776 = 2.961964 -1 73 .6776 = 2.272191 -1 56 .6776 = 2.434491 .0 60 .6776 = .8317844 0 20.5 .77 = .1844311. 1 4 = .1. 115545 = .8557604 .9168862 .3132695 .1844311 9. INTERIOR THERMAL MASS 1..796407 10.EXTERIOR WALL MASS 0 SUM 7-10 =( 7 ) II.HEATING'SYSTEM .72 S.E. X.82= .5904001 12.000LING SYSTEM 9.5 SEER X.81= 7.695 13 WATER HEATING SrE-. 14 �v • %� , . TOTAL'POINTS -1 0 0 7 X GLASS 4.37.1258, 3.353293 3.592815 1.227545 .239521 0 SC= .2552 A. NORTH 4.371258 X .2552 B. EAST 3.353293 X .2552 C. SOUTH 3.592815 X .2552 D. WEST 1.227545 X .2552 E. SKYLIGHT .239521 X .77 = = .1. 115545 = .8557604 .9168862 .3132695 .1844311 9. INTERIOR THERMAL MASS 1..796407 10.EXTERIOR WALL MASS 0 SUM 7-10 =( 7 ) II.HEATING'SYSTEM .72 S.E. X.82= .5904001 12.000LING SYSTEM 9.5 SEER X.81= 7.695 13 WATER HEATING SrE-. 14 �v • %� , . TOTAL'POINTS -1 0 0 7 X GLASS 4.37.1258, 3.353293 3.592815 1.227545 .239521 0 o 4 ' . OFFICE OF AGRICULTURAL COMMISSIONER AND WEIGHTS' & MEASURES �,� ;.• CALVIN C. KAMINSKAS ,LAMES O. WALLACE 4080 LEMON STREET, ROOM 19 Assl:lonl Commissioner Aprlcutturot Commissioner RIVERSIDE, CALIFORNIA 92501 CLEMENT BENVENISTE Director o1 Weights a Measures (714) 787-2561 Sealer 83-612 Ave..45,,Suite 7 'Indio, CA 92201- (619) 342-8291 DATE o -Z I— 9 CASE NO. C i,✓ S 010/ q DEVELOPER'S NNS: LN ADDRESS: 3 ( (o Or TELEPHONE: ( / �() c1 J. S- 2 Dear Developer: After reviewing your landscaping plans, all plant material'listed is not in violation of quarantine laws governing the Coachella Valley. If substitutions do occur and they differ from plant material listed, this office must be notified immediately. Thank you.for protecting and preserving the Coachella Valley's pest -free environment. VV Agricultural Conmissi er's_Office. cc: Indio and Riverside Office Building �O� Po G Address BUILDING: TYPE CONST. Owner Mailing - 'j c&t 4 4 Qumz P.O. BOX 1504 APPLICATION ONLY 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Sectlon 7000) of Division 3 of the Business and Professlons 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, atter, 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 Me provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of D(vislon 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). ❑ 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.) CTT 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 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) valuafion or less.) I certify that in the performance of thF 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 perIt i i step. (S 097, Civil Code.) Lender's Namel�fA N 1C 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 -of this city to enter the above- mentioned property for inspection purposes. Signature of applicant Date .Mailing Address City, State, Zip Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructu TOTAL REMARKS 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: BUILDING: TYPE CONST. OCC. GRP. Mailing - 'j Address Address ((p A.P. Number Legal Description 20 T � it Project Descriptio e, U City i J Nj - i?x 1 t Zip C' Z (o Lt r�J Tel. p (LI I (�q "5�6� Contractor Address Cit Cit . 73,_j4 Zip C12-& Y v Tel. ISI (7&9 -s -s -U3 State Lic. City & Classif. Lic. # Sq. Ft.No. Size (c �'(o Stories No. Dw. Units Arch., Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Sectlon 7000) of Division 3 of the Business and Professlons 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, atter, 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 Me provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of D(vislon 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). ❑ 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.) CTT 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 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) valuafion or less.) I certify that in the performance of thF 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 perIt i i step. (S 097, Civil Code.) Lender's Namel�fA N 1C 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 -of this city to enter the above- mentioned property for inspection purposes. Signature of applicant Date .Mailing Address City, State, Zip Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructu TOTAL REMARKS 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: