06731 (SFD)_J
Building 54--700 gig
Address
Owner
Mailing
Address P. 0. Bax 804
City Zip
2.a Quinea 192253
Contractor
Owner/Builder
Address
State Lic.
& Classif.
='Arch., Engr.,
Designer
Address
4 4aab&
P.O. BOX 1504 N o . 06 731
78-105 CALLE ESTADO
LA QUINTA,,CALIFORNIA 92253
BUILDING:- TYPE CONST. OCC: GRP.
A.P. Number 774.273--014
!64-49771 Legal Description
Project Description $FD
Lic. # Sq. Ft.. No. No. Dw.
Size . Stories Units
Tel.
City IZip I State I
Lic. #
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7(10(1) of Division 3 of the Business and Professions Code, and my license is in full force and
effect. ,(,tit* �✓' .ra C (t`� E'w
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 Me a signed statement that he is licensed pursuant to
the provisions of the Contractor's License taw, 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).
❑ 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 end 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 or safe.)
❑ 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 or property who bulfds or Improves thereon, and who contracts for
such projects with a contractors) 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 ff 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: ff, atter making this Cer ffcrcate 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 abuilding permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days:
1 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
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
IEstimated Valuation $85,963
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const. �.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
//yyam� AMOUNT
. W
$ 274.73
575.50
209.89
359.50
156.00
5.02
20.00
20.00
3.852.05
REMARKS
'6-, 034 P T-ir.?fr
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 12/8/89 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
UNDERGROUND
A.C. UNIT
1ST FL. SQ. FT. ® $
UNITS
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL SQ. FT. @
FORMS
SEW R �
MOSILEHOME SVC.
BAR SINK
POR. $Q, FT. ®
ROCK STORAGE
FOUND. REINF,
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
DRAINAGE PIPING
CAR P. SQ. FT.
GAS (FINAL)
WALL SQ. FT.
DRINKING FOUNTAIN.
GROUT
URINAL
SQ FT. ®
SERVICE
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER SYSTEM
FLOOR DRAIN
MECHANICAL FEES
GRADING
cu. yd.
$ plus x$
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
GAR. FIREWALL
SO.FT.GAR ® 3Ac
HOUSE SEWER
LATHING
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 I
� �
� /%//
, - Vs
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE !`
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEW R �
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF,
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. A �a Xv,
N
FRAMING 0 ® /1
FINAL INSP.
ROOFING
J
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND U
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
OF LA
SCHOOL FACILITY FEES
� ` �' n
�Rp e113
U-
TO: City o f Lia �aS®�� DATE:
J
Department of ommu�y�Dev l �rt�e�ntp�
78-105 Calle Estado )V® P
La Quinta, CA 92253 I
This is to c rt' f hat LJvvr I ULVL tq LJ—
developer
J—developer of which is
located at /L*, I within
this Distric , has paid school acility fees imposed pursuant to the
au o f ge a at by G v rnment Cod S ctio 53080 in t e a o nt of
$(n ���o �tU
���
covering a total of square feet of ( ) res'd nti 1 or
( ) industrial/commercial development and that buil ing permits for 6
this footage in this development may now be issued by your jurisdiction.
�Ic - 5'7
for DESERT SAND -UNIFIED SCHOOL DISTRICT
White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer
(10)-37
Ul1't'C L L./ y, q
01 I p.E or
E. LEW SPAUGY
AGRICUL I MAL COMMISSIONER
co'-wminvAn
!AMS v WAUACE
AN 0
As5151ANr r••� a •msn��t.n
WING) I IS b. 1ACASU11L•S
CLUNIE:11 aFwEnISIE
SOM
49-613 Itwy 116, Ilulte 11-12
'Cunelrelln, CA 92236
619-742-029!
CASC 11). 1-6,7— / S ZiA 7 -
UEVELIOPE•'R's tIN1Er ,S'�/it/G°/1�9w�J Wit' ave
ADDHES5 i 3e X ' ACY Z,4,�2Ji 41T%7
'i-ril • l M. C t (6 l Q) - 4:5-; z/- '/ 9 7 7
Dear Developed
AEter reviewltlg your latidsctgrhig Illans, till Itlttnt mlerlal listed is trot In
vloltatiull of quarantltte M-45 qov' et.nlny lite Coachella Valley. If substltutlotis
do occur told they diller [tun Irlattt iinLerital listed, this office must be notified
itm�dlately . .
'1hmik you for protecting and Itt.eserviny the Coachella Valley's lest*-[ree envirom ent.
nyticrota L Cau�Ltss atier s Ut t is
cc, Indio and Riverside U[Ilce
Buena Encineers. Inc.-
70-6118
nc.
70-6118 Country Club Drive, Bermuda Dunes, CA 92201 (619) 345-1588
Invoice
_ Involce Nt,Rrber: 893209
Sun Crown Corporation File Number: B7 -1846-P1
Bill Shields Invoice Date: 11113189
P.O. Box 804
La Quina, CA 92253 _ Please return payment to:
1731A Water Street
Yentura, CA 93003
For professional services rendered on La Cuinta Properties"ober through 11101
Date 92go&n Classfication
01111 Max Denis Curve (A)
10125 Zoned-Milea�
10127 Densly Teme t
Zone d - Mileage
11101 Denstr TeMest
Max Dens Curve (A)
Zone A - Mileage
Units ate C"
1.00 110.00 $110.00
1.00 40.00 40.00
1.00
7.00
7.00
2.00
40.00
80.00
1.00
7.00
7.00
2.00
40.00
80.00
1.00
110.00
110.00
1.00
7.00
7.00
Total Current Charges 1 $441.00
This b113 due upon presentation..
Buena Enaineers. Inc.
I
7. 811 B Country Club Drive, Bermuda Dunes, CA 92201 (619) 345-1588
lmoke
Invoice Nurnber: 893186
Sun Crown Corporation File Number: 87-1879-P1
Bill Shields Invoice Date: 11113189
PA. Box 804 Please return payment to:
La Quint&, CA 92253
1731A 11a14er Street
Yentura, CA 93003
0
For professional services rendered on 54700 Avenida Diaz through 11103
CMassiticatlon
Sjp�
�„t
�j
11101 Ste Recon Supervising Tech
2.00
65.00
$130.00
Zone A - Mileage
1.00
7.00
7.00
11103 Dons Testba
4.00
40.00
160.00
Zone d - Mileage
1.00
7.00
7.00.
Total Current Charges 1$304.070
This bM is due upon pmentekion.
%�- - .^.�. L i`.•��. ..--�" �.� §�"�^ yi"Y14 `�1r"i'"-1. - w�; yrjrfi..'miry.(�'1k��,��'�""'7i',+"7.V�:i��..t�..'4:^ �N"+..:.-!'r .. .,'='. -. -.• , _ ... . -' _ " - 'y lq.
s
+ i
Buena Engineers, Inc.
79-811 B Country Club Drive
Bermuda Dunes, CA 92201 • (619) 345-1588
Client
Client Add
Client Phone
DATEJOB
1-I-
NO.
-l�/
SP1 D��G,
PROJE T
0
OC TION
CONT CTO
WNER
WEA HER
TEMP. ° at
° at
AM
PM
PRESENT AT SITE
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THE FOLLOWING WAS NOTED:.
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CLIENT REPRESENTATIVE SIGNATURE
FIELD REPORT
2) .
TECHNICIANS SIGNATURE
Buena Engineers, Inc.
~� 79-811 Country Club Drive, Suite 4
Bermuda Dunes, CA 92201 • (619) 345-1588 / 328-9131
Client
Client Addres
Client Phone
DATE
ow. 3
(ct
JOB NO.
t87q - P
PROJECT
Ste-{ .• 7CG
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'LOCAATION
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CONTRACTOROWNER
FL
utJC?<5-j tJ
WEATHERTEMP,
MAXIMUM
DRY
DENSITY
%
o at AM
° at PM
PRESENT AT SITE
X"SP
7. S
TEST
NUMBER
TEST LOCATION
HODS E PA C�)
LOT
NO.
ELEVATION
FIELD TESTING
REFERENCE CURVE
MOISTURE
CONTENT
DRY
DENSITY
IbslCu. ft.
MAXIMUM
DRY
DENSITY
%
MAXIMUM
DRY
DENSITY
lbs✓cu. ft.
OPTIMUM
MOISTURE
CONTENT
X"SP
7. S
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REMARKS:
REMARKS: - •p LL ,
cv l0 G- 6jG-L Cl'P (tD Ac(_ E F
— S LT -L-1 c _ tvt TS - SC -31(_ SArML C .
e�ZCLIENT REPREdNTATIVE SIGNATURE
FIELD REPORT
TECHNICIANS SIGNATURE • 091 18