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.
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