11747 (SFD)1 �
Y
4
P.O. BOX 1504
Building 5-452 tiantexurra 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Mr. & I irs . Daniel Aguayo
Mailing
Address 54-585 Rubio
CityZip
Tel.
La Quinta, CA
92253
1 564-2625
Contractor
q1eam Builders
Address
79-600 Cortes Lane
City
Zip
Tela
La Quinta
92253
347-3701
State Lic.
City
& Classif. B-580219
Lic. # 2859
Arch., Engr., 1.0. Roach
Designer
A. dress
t 419 Sawg.ras Circle
Tel.
360-1114
City Zip State
Palm Desert, A 92260 Lic. #
I 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 !' s' 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 file a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Lew, 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 mors than five hundred dollars (8500).
❑ 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 ourpose 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. ❑ 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 (8100) 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. 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 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 sof this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
No. 11747
BUILDING: TYPE CONST. OCC. GRP.;
A.P. Number 773`241-016--015--014
Legal Description
Project Description SFD
REMARKS
tees redact lot morger inceati a
program.
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:
Sq. Ft. 2051.No. 1
SizeStories
No. Dw.
Units
New O Add ❑ Alter ❑ Repair ❑ Demolition ❑
Permit includ--s
stucco gall. Pool permit
to be obtained
separately.
Estimated Valuation
$125,715.00
PERMIT
AMOUNT
Plan Chk. Dep.
250.00
w as
Plan Chk. Bal.
s
Const.
Mech.
Electrical
Plumbing
S.M.I.
12.60
Grading
Driveway Eno.
AI I
Infrastructure
tirci, in Fu -BET.,
Pucci;
b4.13
TOTAL
r`�•5`J�
1 �:).S5
REMARKS
tees redact lot morger inceati a
program.
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. PLUMBIN(: FEES
IST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SO, FT. ®
CAR P. SQ. FT.
WALL SQ. FT. ®
SQ FJ ®
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
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEQUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE G A g
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
FINAL INSP. '7 � 3 --%
SO. FT. ®c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1+A c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ic
HOUSE SEWER
VENTILATION
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 G Aq 0-
GPI51ND PLUMBING jj,4
ERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE G A g
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP. '7 � 3 --%
FRAMING 3 -f� .44 �
FINAL INSP., 1
ROOFING'j
GD
'awl�rNl
-1 }
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING Sim h L
MESH
INSULATIONISOUNDS/��&3 -V
FINISH GRADING
FINAL INSPECTION7-2-71/73
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS,
GARDEN WALL FINAL
Building
Address
Owner ,
4 47lu
P.O. BOX 1504
Tr -78-105 CALLE ESTADO
L It--t&LA GUINTA, CALIFORNIA 92253
Mailing
Address
City Zip Tel.
I- Q3I r��. clZZ l
Contractor
ty lZip I Tel.
State Lic. City
& Classif. Lic. #
Arcn., tngr.,
Designer
Address
4I 1 "G.IIZ T�'a 2(s, I
14
Cit i 1 ` Zip State �lL�
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I he 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
1 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 his 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 .•nore 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, Bulsness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
Wilds 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. ❑ 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) valuation
or less.)
I certify that in the performance of thg work for which this permit is issued, I shall not
employ any pparson in any manner so as to become subject to the Workers' Compensation
Laws of Callfornia.
Date Owner
NOTICE TO APPLICANT: ff, 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 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 1 have read this application and state that the above information Is correct.
1 agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to inter the above-
mentioned property for inspection purposes.
Signature of applicant Date
.Mailing Address
City, State, Zip
FINANCE
W
APPLICATION ONLY
.DING: TYPE CONST. yK OCC. GRP.
Number _ —1-115 -24 l np i :p - Ol e, - O t 4
dDescription-22'45Z AVE N104 M(AV MI—OM�
�r,t nperrintinn 2,051 S . F. `_=1 i INJ6=7 F FLMILY
Sq. Ft.^r l s iF' No. No. Dw. I
Size CTJ Stories Units
New Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
I rastructure
TOL-sc- 72 _5,73o
7S
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:
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 3/11/93 1 Type of Permit I La Quinta
No. 112070 Permit #
Log
Owner Name Mr. & Mrs. Daniel Aguayo
No. 42-452 Street Avenida Montezuma
city La Quinta Zip 92253 Study Area 112
APN # 773-241-016 Tract # Lot # 0 Square Footage 12051
Type of Development Single Family Residence No. of units 1Q
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 2 051 or $ 3,240.58 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 Daniel Aguayo Telephone 564-2625
Name on the check
. �• S
By Tames F. Lively
Assistant Superintendent, Business Services_r
s
r ` �
Fee collected /exempted by Vickie J. Durrett
Paymeri_r,-Received-.-'
Signature
Check No. 001
Collector. Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
Professional Service Industries, Inc.
American Engineering Division
REPORT OF FIELD COMPACTION TESTS
TESTED FOR: VVI //51 PROJECT: 5
DATE: �%G� Z OUR REPORT NO.: v-7,3
TEST
NO.
TEST LOCATION
ELEVATION
IN
FEET
COMP
CURVE
NO.
TEST
MOISTURE
%
TEST
DRY
DENSITY
LBS./CU. FT.
RELATIVE
COMP.
%
RETEST
NO.
NOTES
4
4. SUBBASE
C. TEST IS AFTER RECOMPACTION
soil ID number
5. SOIL CEMENT
no,q5Z
6. OTHER
1,
Professional Service Industries, Inc.
ILI
NOTES: DENSITIES SHOWN: Lbs. per cubic foot
1. FILL MATERIAL
A. TEST RESULTS COMPLY WITH SPECIFICATIONS
WATER CONTENT: Per Cent of dry weight
2. BACKFILL
B. TEST RESULTS DO NOT COMPLY
PERCENT COMPACTION: Based on maximum
3. BASE COURSE
WITH SPECIFICATIONS
dry density obtained on sample indicated by
4. SUBBASE
C. TEST IS AFTER RECOMPACTION
soil ID number
5. SOIL CEMENT
6. OTHER
Respectfully submitted,
Professional Service Industries, Inc.
42-240 Green Way, Suite C • Palm Desert, CA 92260 • Phone: 619/341-5790 • FAX: 619/341-5794
PSI A-100.2 (# 1)