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001921 (SATT)t Building U_120A�fdA Address Vallejo Owner P&A ichmm 0mot. Mailing Address P.O. t 288 City I Zip Tel. Address _ ... . Sam City " SIMM pip - Tela saw P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 No. 00192 BUILDING: TYPE CONST: V ' OCC. GRP. -R--3 A.P. Number774- M-0024 y Legal Description Lot 24 4 of lot 19 Project Description State Lic. & Classif. City Lic. # 202 EM 1682 Sq. Ftp 492 Size No. 'No. Dw. -Stories Units Arch., Engr., Designer NeW;p Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. Side Setback from Property Line FINAL DATE City —7 . . . ip . ... State Lic. #- Validated by: LICENSED CONTRACTOR'S DECLARATION .. I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of;Division,3 tithe Business and Professions Code, and my license is in full force and effect.. r �f Validation: A.3475 _ SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Seo,, 7031.5,Business and Professions Code: Any city or county which. requires., a permit to construct: alter, improve, demolish, or repair any 'structure, pdor,to its issuance also requires the applicant for such permit to file a signed statement thahhe 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 Dy '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.) ❑ 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.) O .I am exempt under Sec: B. ti. P.C. for this reason Estimated Valuation :85 626X20 , ' PERMIT - AMOUNT Plan Chk. De p " Plan Ch.k. BBI,' 327.10 Const. 391.00 Mach. - - �,,� 00 ' Electrical - 7�. 12 Plumbing 819.00 S.M:I.' Grading Driveway Enc. 0 o4 Date owner Infrastructure -V 1-0284.40 WORKERS' COMPENSATION DECLARATION I hereby affirm that l 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. - TOTAL 2,228..61 CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATIONINSURANCE (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 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____L_____' Owner NOTICE TO APPLICANT: If, alter 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 !• J i '/'` r :' , X Date Mailing Address— City, State; Zip + HARD COPY 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 15�-85Permit Validated by: Validation: A.3475 1'2{ 5 221861 Ck CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ 2ND FL. SO. FT. POR. SO. FT. ® GAR. SQ, FT. ® CAR P. SQ. FT. WALL SQ. FT. SQ FT ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER'PIPING NOTE: Not to be used as property tax valuation PLUMB./ FLOOR DRAIN MECHANICAL FEES HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER DUCT WORK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GAS (ROUGH) LAUNDRYTRAY AIR HANDLING UNIT CFM HEATING (FINAL) 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. SQ. FT. ® c BATH TUB BOND BEAM SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL LUMBER GR. SQ.FT.GAR ® 3/4c HOUSE SEWER ✓-FRAMING !_ FINAL INSP. ' 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 GRADEOUGH PLUMB./ BONDING HEATING (ROUGH) STORAGE TANK FORMS I� SEWER OR SEPTIC TANK UGH WIRING G DUCT WORK ROCK STORAGE �t}FOUND. REINF. /1 11 GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP.lit o�c BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. ✓-FRAMING !_ FINAL INSP. ' LL�� ROOFING i/ l/ / VENTILATION REMARKS: FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH AeINSULATIONISOUND I FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL IVX'S WUNA I UXtS/INI T IALS GARDEN WALL FINAL ��FIEp o ° Desert Sands Unified School District N BERMUDA DUNES r RANCHO MIRAGE _� 82.879 HIGHWAY 11 1 ® INDIO. CALIFORNIA 92201-5678 • (619) 347-8631 d INDIAN WELLS a s PALM LA ODUE TART December 5, 1985 ` �O INDIO 1 City of La Quinta Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 Re: 54-120 Avenida Vallejo, La Quinta Ge-ntl emen The developer of the above referenced lot has mitigated its impacts on our overcrowded schools by payment of the amount of $628 per unit to be applied to the cost of district educational facilities made necessary by such new development. Sincerely, John D. Brooks Assistant Supe.rintendent 4 Business Services JDB/crm 1 li Su'lena En ineersenc. � �� o ��� g DEC 2 31985 CITY OF LApUINTA COMMUNITY DEVELOPMENT DEPT TESTING INSPECTION 1731-A WALTER STREET VENTURA, CALIFORNIA 93003 PHONE (805) 642-6727 December 16, 1985 B -15862 -PI 85-12-225 Rick Johnson P.O. Box 2288 Indio, CA 92202 Project: 54-120 Avenue Vallejo La Quinta, CA Subject: Report of Field Densities, Residence House Pad On December 2 and 6, 1985, a representative of our firm performed density tests on the fill placed on the building pad on the above referenced project. Tests were performed at random locations in accordance with ASTM D 2922-81 and.ASTM D 3017- 78 Nuclear Density Test Procedure. Tests were .performed as per authorization of Rick Johnson Construction. The estimated locations . of the tests are presented on. the attached . plan, with their . results being summarized on t,he, attached test report sheet. A total of three (3) density tests were performed. Test results indicate a minimum of ninety (90) percent of relative compaction has.been obtained within the areas tested. In the areas of low. ; density the soils .were reworked and retested to verify the required compaction. The maximum density -optimum moisture was determined in the laboratory -in' accordance with ASTM D 155748, Method A. Test results. are as follows: Soil Description Maximum Density Optimum Moisture Dark brown silty very fine to fine sand 109. l.pcf 14.9% 4 VENTURA LANCASTER (805),642-6727 (805) 948.7538 BAKERSFIELD SANTA BARBARA PALM SPRINGS SAN LUIS OBISPO .nnr. nn� r.�n ,nne, ncc nnan 1C.M Ino n.0. lonGl GAA C407 December 16, 1985 B -15862-P l 85-12-225 Limitations: The test results summarized in this report present the moisture and density only at the locations and depths tested on the specified date. The summarized field and laboratory tests were performed in accordance with engineering principles generally accepted'at this time and location. No opinion is expressed as to the uniformity of the - material nor .adequacy of the material to ,perform its intended function. No guarantee or warranty of the contractor's work is made or implied. If there are any, questions, please do not hesitate to contact this office. . Respectf ully. submitted, - BUENA ENGINEERS, INC. Rev'ewed and Approved C� Z¢SSv Norm Jackson, Jr. Raymond E. Brannen /``—CE 28966 NJ/PDC/ms (/ X-6 "COMP Copies: 4 -Rick Johnson �21City of La Quinta 2 - PS file 1 - VTA file BUENA ENGINEERS, INC. - REPORT OF RELATIVE COMPACTIONS Job No. B -15862-P N 12-16-85 CONTRACTOR: DATE: R2pOfL NO. 85-12-225 ADDRESS: JOB'& LOCATION: 54-120 Vallejo TEST NO. DATE DESCRIPTION % MOISTURE DRY.DENSITYRELATIVE MAXIM. -UM - IN PLACE IN PLACE COMPACTION DENSfrV 1 12/2/85 Per Plan 1.0 16.0 106.8 98 109.1 2 12/2/85 Per Plan Grade 2.7 96.5 88 109.1 3 12/6/85 'Per Plan Grade Retest #2 - 3.8 107.7 99 109.1 WE CERTIFY THAT THESE TESTS WERE PERFORMED IN CONFORMANCE WITH COPIES: BUENA ENGINEERS, INC. .n S1 ` O/ aell 3 m Al m BUENA. ENGINEERS, INC. m GATE: /.a -� - �S FILE N043-/•s��'P� y � p .n S1 ` O/ aell 3 m Al m BUENA. ENGINEERS, INC. m GATE: /.a -� - �S FILE N043-/•s��'P�