9444 (SFD)r./4
Building 54-510 Diaz
Address
Mailing
Address
City
Indio.
Contractor
P.B.A.
Address .
S aLme
P.O. BOX 1504 .)) N o .
78-105 CALLE ESTADO // J
LA QUINTA, CALIFORNIA 92253 �f 10 ;�s
__71BUILDING: TYPE CONST. OCC: GRP.;
SA 45-250 Smurr #12
Zip Tel.
52201 1
347-2470
Zip
State Lic. City
&Classif. 547897 Lic.# 1469
Arch., Engr.,
Designer
Address Tel.
City IZipI State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7 ) of Division 3 of the Business and Professions Code, and my license is in full force and
ffect. i
_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
peirnif 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).
❑ 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.)
❑ 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. O Certified copy is hereby furnished. ly;
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not 'be completed i1 the permit is for one .hundred dollars ($100) valuation
or less.)
1 certify that in the performance of tha work for which this permit is issued, I shall not
employ anyperson 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
Ihereby 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
A.P. Number_
Legal Description
Project Description
Ste?
z
Sq. Ft. 1709
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑
Demolition ❑
Pe.%T1;iit includes block garden
gall
Permit does
not include pool
Estimated Valuation94,556.00
rX56 00
PERMIT
AMOUNT
Plan Chk. Dep.
275'0,00
Plan Chk. Bal.
279.14
Const.
617.00
Mech.
55.50
Electrical
Plumbing
165.00
S.M.I.
6.65
Grading
20.00
Driveway Enc.
20.00
Infrastructure
2030.09
TOTAL
3574.78
3:324. /'t3
REMARKS
08vii.0:7 #t) i567 04-91)_411 t.()
I V W4.M^1 I i t1 i Wt.. I .9.3,:-f , f o
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
x
1ST FL. $Q. FT. ® $
UNITS
SLAB GRADE /y �j G
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM '
2ND FL SQ. FT. ®
FORMS
S R
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. $Q. FT.
GAS (ROUGH)
METER LOOP
GAR. $Q. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT. ®
TEMP. POLE
DRAINAGE PIPING
WALL SO. FT. ®
GROUT
DRINKING FOUNTAIN
SQ FT ®
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
_$
FLOOR DRAIN
MECHANICAL FEES
FRAMING 6 �? f%/
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIRE ZONE ROOFING
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.
SQ. FT. ® c
BATH TUB
LATHING 3
SQ. FT. ® c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
SQ.FT.GAR ® V.c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE IPL.CK.FEE
CONST. FEE JELECT.FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK C/ �j�
✓
GROUND PLUMBINGtA D
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE /y �j G
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
S R
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. `� 9�
/
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
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. �D 9 ! f/
FRAMING 6 �? f%/
FINAL INSP.
ROOFIN
�/�
%,, `//
A/�%�" /
/ _�
IG'
71 711f7/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING 3
MESH
INSULATIONISOUND L8 9r
FINISH GRADING
FINAL INSPECTION 9�
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESJINITIALS
GARDEN WALL FINAL
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 4/22/91 Type of Permit I La Quinta
No. 10556 Permit #
Log #
Owner Name Pinson Brothers & Arroyo
No. Street See Below
City La Quinta zip 92253 Study Area 110
APN # I Tract # I Lot # Square Footage 13400
Type of Development Single Family Residence No. of units
Comments 54-510 and 530 Avenida Diaz
Each home is 1700 square feet
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 FT58 X ® or $ 5,372.00 have been paid to D.S.0 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 Pinson Bros. & Arrroyo Telephone
Name on the check
By Richard M. Beck
Director, Facilities Planning & Development
Fee collected /exempted by Shelley D. Bennett
n Payment Aeee;ved z � r
Signature 1' �i ( A ; ` a'
� �.��'"dck N6.,,2846
Collector: Attach a copy of county or city plan check application form to distriei copy for allwaivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting! '
' OFFICE OF .
_ AGRICULTURAL COMMISSIONER
V AND
WEIGHTS & MEASURES CALVIN C. KAMIIJSKAS
JAMES O. WALLACE 4080 LEMON S1REE1, ROOM 19 ft.WaN Corr'NiNolmm
AQrlcuOwol CommlfUonrrr RIVERSIDE. CALIFORNIA 92501 CLEMENT DFNVEPJISIE
Dlreclor of Welahli A Me01w09 (714) 787-2561 Soolor
83-612 Ave. 45, Suite 7.
Indio', CA 92201
(6191 342-8291
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 frafn plant material listed, this office nest be notified
immediately.
'Bank you for protecting and preserving the Coachella Valley's pest -free envirom ent.
Agricultural Camdssio er's Office
cct Indio and Riverside Office
CASE W.
PC
DEVELOPER'S NAMC;:
ADDRESS-
* I51—
` ELEP11ONE: Sq:j,_
" c947 O 3q7
— 3116-
l16--_7
-_7—7 d-
Dear Developer:
AT.
T-7 4
Z7 1 -. OZli-
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 frafn plant material listed, this office nest be notified
immediately.
'Bank you for protecting and preserving the Coachella Valley's pest -free envirom ent.
Agricultural Camdssio er's Office
cct Indio and Riverside Office
%N T ,rrllEICORDED;rTWl�t9 Aft Y.
STATEMENT TO:
PINSON_BROTHERS & ARROYO
.45-250 SMURR ST. #12
INDIO, CA 92201
ASSESSOR'S. PARCEL NO.
ESCROW NO. - 3685—
TITLE ORDER NO.
GRANT DEED
The undersigned grantors) declare(s):
Documentary transfer tax is.$ 146.30
( ) computed on full value of property conveyed, or
( )computed on full value less value of liens and enc umbr ces re Hing at time of sale.
( ) Unincorporated 'area: ( YCity of � QU1� and
By this instrument dated FEB. • 5th, 1991 for a valuable consideration,
JOSEPH VAN MULLEM AN UNMARRIED MAN
hereby GRANTS -to
PINSON.BROTHERS & ARROYO A CALIFORNIA PARTNERSl-l1P
the following described real property in the State of California, County of. RIVERSIDE
Lots..,21.;:' 22,�.•23 =,and,.24 -of Block 270 of Santa Carmelita At Vale La Quinta
Unit no..25:a•s' per 'map recorded in Book 19 pages 50-51 of maps in the office
of the County Recorder of Said County.
STATE OF CALIFORNIA
... ) SS.
C.OUNTY'=OF )
On before me, the
undersigned, a Notary Public in and for said County and State,
personally appeared
personally known to me (or proved to me on the basis.of satisfactory
evidence)'to be the persoh(s) whose name(s) subscribed
to the within instrument and acknowledged that
executed the same.
Signature
JOSEPH VAN
•Z.
r
Uj�8OW
aNcc
U_�-,Cr
'.
~
Cn
w
a
li
I<
SPACE ABOVE
THIS 1_112 FOR RECORDER'S
USQ
GRANT DEED
The undersigned grantors) declare(s):
Documentary transfer tax is.$ 146.30
( ) computed on full value of property conveyed, or
( )computed on full value less value of liens and enc umbr ces re Hing at time of sale.
( ) Unincorporated 'area: ( YCity of � QU1� and
By this instrument dated FEB. • 5th, 1991 for a valuable consideration,
JOSEPH VAN MULLEM AN UNMARRIED MAN
hereby GRANTS -to
PINSON.BROTHERS & ARROYO A CALIFORNIA PARTNERSl-l1P
the following described real property in the State of California, County of. RIVERSIDE
Lots..,21.;:' 22,�.•23 =,and,.24 -of Block 270 of Santa Carmelita At Vale La Quinta
Unit no..25:a•s' per 'map recorded in Book 19 pages 50-51 of maps in the office
of the County Recorder of Said County.
STATE OF CALIFORNIA
... ) SS.
C.OUNTY'=OF )
On before me, the
undersigned, a Notary Public in and for said County and State,
personally appeared
personally known to me (or proved to me on the basis.of satisfactory
evidence)'to be the persoh(s) whose name(s) subscribed
to the within instrument and acknowledged that
executed the same.
Signature
JOSEPH VAN
•Z.
r
GRANT DEED
GRANT DEED .
This form provided by
WESTERN MUTUAL ESCROW
SERVICES
STATE OF. CALIFORNIA
COUNTY OF RIVERSIDE SS.
31 ���
On this 5th day'of FEB, , in the scar 1991,
n
before me, the undersigned, a Notary Public in and for said Cour y and"
z
;j
State, personally appeared FRED BROUWERS
CL
personally known
oto
me (or proved to me on the basis of satisfactory evidence) to. be the
v F
LU v
person whose name 1S
'
Z U.
subscribed to the within instrument, as the Attorney -AS— in fact of
� Z
.J.O.SERH_._V.AN_MULLEM_ .
'`' `'"'
i !; ¢•
t i:��i i��lf . rl(!r!•li �'1' :iEAI-
i w
and acknowledged to me that su c I dic n:nr
{{ Ijr'i.:;,',
r '1 �
r„•.rl ; r•,; ;; .I tnt t
Idt;l;ll t'nl dr;. �.•dilVl ulp
w cc
O
THE. of JOSEPH VAN MU .F.M thereto as pr
HIS apd. own name as Attorney
1�: ;� :P'`
Uy Cornm. F_x,^,il�:-� .IUN 17,191;4
o
a
Signature
U
m
S
u
n
2
Name (Typed or Printed)
W
Notary Public in and for said County and State
1.121 1183 MAINIE
FOR NOTARY SEAL OR STAMP t
Client Name
Client Address
Client Phone
Buena Engineers,. Inc.
79-81 1 B Country Club Drive
Bermuda Dunes, CA 92201 • (619) 345-1588
DATE
,5-,3--911,97-
JOB NO.
_3 -10.2-
10.PROJECT
PROJECT
T Lo TS �/�i✓!�J/5
//9Z
LOCATION
Lf} . - a /'d T'q
FIELD TESTING
CONTRACTOR /p�
f0</✓,SdP/ &S
OWNER
WEATHER
TEMP.
o at AM
° at PM
PRESENT AT SITE
OPTIMUM
MOISTURE
CONTENT
%
5q -1/6 ��wA iAz
°
TEST
NUMBER
• TEST LOCATION
/
LOT
NO.
ELEVATION
FIELD TESTING
REFERENCE CURVE
MOISTURE
CONTENT
%
DRY
DENSITY
IbsJCu. ft.
MAXIMUM
DRY
DENSITY
%
MAXIMUM
DRY
DENSITY
IbsJcu. ft.
OPTIMUM
MOISTURE
CONTENT
%
5q -1/6 ��wA iAz
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96
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7,
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REMARKS: E2 9( C"eirfE%f�
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CLIENT REPRESENTATIVE SIGNATURE
FIELD REPORT
TECHNICIANS SIGNATURE 5924
! Buena Engineers, Inc.
79-8116 Country Club Drive
Bermuda Dunes, CA 92201 • (619) 345-1588
Client Name
Client Address
Client Phone
DATE
JOB NO.
3,20z -P/
PROJECT
T ZoTS
ELEVATION
LOCATION
44 a/"JTq
FIELD TESTING
CONTRACTOR pp
OWNER
WEATHER
U�- /e-
TEMP.
o at AM
° at PM
PRESENT AT SITE
OPTIMUM
MOISTURE
CONTENT
%
sq Ivo L1CW1j)A Az
i °
TEST
NUMBER
TEST LOCATION
LOTI
NO.
ELEVATION
FIELD TESTING
REFERENCE CURVE
MOISTURE
CONTENT
%
DRY
DENSITY
IbsJCu. it.
MAXIMUM
DRY
DENSITY
%
MAXIMUM
DRY
DENSITY
Ibslcu. R.
OPTIMUM
MOISTURE
CONTENT
%
sq Ivo L1CW1j)A Az
i °
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REMARKS: CAS f T£s-f-S int/ 7* ew, L)1W6 ,949 C,
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CLIENT REPRESENTATIVE SIGNATURE
FIELD REPORT
�
TECHNICIANS SIGNATURE 59_, 2 /.