04983 (SFD)i f 4 " .1 '
P.O. BOX 1504 "AN ADEQUATEL P DEB9498SR
Building IS REQUIRED ON HE JOB -SITE DURING
Owner
Address 5'� §8Q Villa LA QUINTA, CALIFORNIA 92253 ALL PHASES OF CONSTRUCTION1
Mailing
Address p. 0. $O?. 2.i ¢ 1
City Zip Tel.
La Quina 32253 346-4614
Contractor
Tela
State Lic.I City
„ >+
& Classif. � _ * * Lic. #
Arch., Engr.,
Designer
Address Tel.
City IZip I State I
Lic. #
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 DATE
OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Busirness and.Protessions Code: Any city or county which requires a
permit to construct, after, 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) or
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 appiicant to a civilpenally 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 or property who
builds or improves thereon mid 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 or property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
0 1 am exempt under Sec B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
1 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 r/
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed it the permit is for one hundred dollars (S 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 Owner
NOTICE TO APPLICANT." N, 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 -of' this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date -
Mailing Address
City, .State, Zip
11LDING: TYPE CONST. OCC: GRP.
P. Number 773-144-005
Legal Description
Project Description S J. D
Sq. Ft.���� No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal. g 9 q I R
Const. .
Mech. 0 . 00
Electrical
Plumbing 1.2 _ 0
S.M.I.
Grading qn. an
Driveway Enc. 0
Infrastructure
TOTAL $3,044.73
REMARKS ., ` r
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback fro -n Rear Prop. Line
Side Street Setback from Center Line
Side Setback froln Property Line
FINAL DATE -INSPECTOR
12/8%S8
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
'
Y
ARD SPKLR SYSTEM
2ND FL SQ. FT. (�
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
DRAINAGE PIPING
CAR P. SQ. FT. ®
WALL SQ. FT. ®
DRINKING FOUNTAIN
URINAL
SQ FT ®
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOXDISH)
APPLIANCE DRYER
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,TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1% c
SEWAGE DISPOSAL
SQ.FT.GAR ® 44c
HOUSE SEWER
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
JCI tlAlir� I � /J C
SLAB GRADE / l
FORMS
FOUND. REINF.
REINF. STEEL
GROUT
BOND BEAM
LUMBER GR. G
FRAMING/— p " 0 C
ROOFING -2--12-4
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING r!
MESH
INSULATION/SOUND �I' b ' X�
FINISH GRADING (l
FINAL INSPECTIONCf—,�L7—
CERT. OCC.
FENCE FINAL
GARDEN WALL FINAL
GROUND PLUMBING
ROUGH PLUMB.
SEWER OR SEPTI
GAS (ROUGH)
GAS (FINAL)
WATER HEATER
WATER SYSTEM
UNDERGROUND
BONDING
ROUGH WIRING
METER LOOP
TEMP. POLE
SERVICE
FINAL INSP.
FINAL INSP.
IL2 41
�� -L 2c<<
A.C. UNIT
HEATING (ROUGH)
DUCT WORK
HEATING (FINAL)
FINAL INSP.
GRADING
cu. yd.
$ —Plus -x$
REMARKS:
COLL. AREA
STORAGE TANK
ROCKSTORAGE
OTHER APPIEOUIP.
=S
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
OF
NOTICED SCHOOL FACILITY FEES
1 ��°� ')OC��ooUMENT CAS.
TO: City of QuiBE nt �9Q.sy��'�®� N®TDATE:
Department of Community Development
78-105 Calle Estado
La Quinta, CA 92253
This is to certify that
Lr 14
(WI
developer of lawhich is
located at _ 0.. — , within
this District, has paid school facility fees impose pursuart to the
authority genera d by �vernment C de'Section 53980 in the amount �pf.
UAX
covering a total of /,P-0 Nbh&&square feet of,' w iden al or
( ) industrial/commercial development and that building permits for
this footage in this development may now be,issued by your :urisdiction.
(JC, fl6r DESERT SA S•UNIFIED SCFOOL DISTRICT
White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer
(10)-37
%'*o
ly
c RECEIPT NO.—,`Issued BY S Dat a -
DISTRICT: ❑ RiJerside Indio ❑ ,Hemet ❑ 'Perris 0 ~ Rancho Calif.. ❑: Blythe
DOH SAN 122 (Rev.. 5/88). DISTRIBUTION:-. WHITE - ;Office file -..YELLOW - Applicant PINK - Bldg. Dept ` GOLC ENROD. Plans/Records :'
�mt
FA
COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH Assessors Parcel No.
—
ENVIRONMENTAL HEALTH SERVICES
PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM
Applicant: Submit this form. with four copies of a scaled plot plan (1-20 scale) drawn to County speculations asiindicated on the attached checklist.
A non-refundable filing fee (see below) is required when the application is submitted. Check must be made payable to the County of
Riverside. Approval of this application shall remain valid for a period not to exceed one year from date of approval.
Q
VERIFY ITEMS IN SECTION A FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATICN LOG'
Z
"
Q
gent Co r, Contact Person
F
_73 _ ! -yAddress & ne�.3C1 •OL Q ` C/�
W
Ow r ^
.1 nmEwa
Phone
ingA�qddresa
P/State
UA
/ �r,C �O
o` X ICJ bProperty A f 1
ll esc riptio Prop. (PM `n
E(b'fj
Lot Size
Water A nc _�:
Use of Permit P/P, CU, etc. «Y (
Other WIT
Dwell'"
MH it� p, etc.
v
re of Applicant
pars
CATE, REV CODE FEE
O� SUBSURFACE'HISPOSAL 1238 $45.00
CATEGORY: REV CODE FEE
❑ SITE EVALUATION UPON REQUEST 7349$42.00
m
❑ MULTIPLE PARCELS WITHIN SAME
(NO PLOT PLAN)
Z
LAND DIVISION
❑ SEWER/SEPTIC VERIFICA ION 7348 $11.00
0
a. 1 at 4 Parcels (Each) 1238 $45.00
(Less than 1 year)
i5=-,
b. Each Parcel after 4" 7344 $16.00
❑ PRELIMINARY ELECTIVE 7352 $45.00
❑ Rereview (2nd review same parcel) 7344 $16.00
EVALUATION (Attach DOH SAN 53)
W
❑ Site Evaluation in Conjunction with
❑ HOLDING TANK 7351 $45.00
Critical Area 7346 $t36.00
❑ ALTERNATIVE/EXPERIMENTAL 7345 $132.00
❑ Sfte_Evalua*m Lot Less than
SYSTEM
10,000 Sq. Ft. 7347 $86.00
DATE
� ��
Holding Tank Agreements Completed ❑ Yes . / '� 0 X
Certification of Existing S.D. System Required ❑ Yes :72o
WQCB Clearance required. (Attach Form Yes m 0
DOH SAN 007, Santa Ana Region Only)
Soils Percolation Report Required. ❑ Yes �
Special Feasibility Boring Report Required. ❑ Yes j3'No
Detailed Contour Plot Plans Required (1 to 5 ft interval) ❑ Yes OwNro!
Other ❑ Yes 0 o�
Ro
Staff Specialist Lot Inspection Required ❑ Yes
Lot Inspecion Date
Soils boring report by' tt
Projec�# Date
Q
SolAl Page Soil Type � r r y Approved by 4 /L Date
U
No. of Systeme
TypWof Systema)
No. Dwelling Units (1 J
(1) Septic Tank
Soil Rate
IkOmase/Sand
0
13Ing Tank ❑ Existing
Replacement
BedroomFixt
s, ure lanit .„
_
Gftse I�nicp
�t�� M
ft
/J
H
JiV
—Gal
W
�
(2) Leach Line Sq. Ft
trench Hree
Sidewali allowance
Install Lines) ft long ft wide with
Leach Bed sq: It.
R rock/ sq.R
per running ft j
NA
min. inches dreinlinea or
om area
��►
<
_
Leachlines/bed special design for slope:
(3) Pit Diameter
No. Pits
Pit Below
a See pegs Pit Tgtal Depth
Applicabley��``/_
Into 481).
O
N/A Overburden factorQi—Ws
qQ
Max. FJIo Ike Depth
No. 2 SystemN/A
REMARKS:
s
This application is PPROVE ` ENIED for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated
on the accompanied pot plan, using the requirements set forth in SECTION C above. A building permit Is necessary for the .installation of the
Z`
above -designed system. No construction is permitted in the required reserved, 100% ex anion•area.
W
JJ Septic: tank and sewer. lines must be "50' minimum from. any wells 0 f . ,� �✓ S
"Leach lines must be 100' minimum from any wells, including expansio area
•
63,:..Seepage pits must be 50'_ minimum from any wells, including expansion area��0
inature of. Health_op . Date
ly
c RECEIPT NO.—,`Issued BY S Dat a -
DISTRICT: ❑ RiJerside Indio ❑ ,Hemet ❑ 'Perris 0 ~ Rancho Calif.. ❑: Blythe
DOH SAN 122 (Rev.. 5/88). DISTRIBUTION:-. WHITE - ;Office file -..YELLOW - Applicant PINK - Bldg. Dept ` GOLC ENROD. Plans/Records :'
�mt
FA
`^^rL"vvL�,;ar'l-i•('r•p—,i-^'�'y.titirc•��1'' :r.,-Ua. �.�-v4'K".. ,:r.r,�^.rwp , .,J ,.
-Suene' Engineers, Inc.
r <.►
AN EARTH SYSTEMS, INC: COMPANY
79-811 COUNTRY CLUB DRIVE, SUITE *4 • BERMUDA DUNES, CALIFORNIA 922.01 • (619) 345-1588
0
Work Order
BUENA ENGINEERS, INC., a California Corporation, (Geotechnical Consultant) and'Client agree to a work assignment
for Geotechnical Consultant as follows: �4
/u%/ W
Date: December 27. 198 iJ0a No. 67-1071-P1 Phone No.. 34-4614
Name of Project......... 51-580 Avd. vibba r•
J
Client Name ............... Now Generation BAa¢ers
.e.
Client Address............ 73-127 Sonora, Pala Desert, CA. 92260
Location of Job../..I.., %. La ouinta, CA-
Description
ADescri tion of Work... Nuclear Density Test
r
Authorized By............ Bob V a r tl
TERMS:
The Generat4onditions (attached) are incorporated in full as part of this agreement. Invoiees will be`submi'tted upon
;completion of work'or at two-week intervals and are due and payable upon presentation. A Late Payment Finance Charge
R;y-'computed at the periodic rate of 1 1/2 percent per month (an Annual Percentage Rate of 18 per,ent) will be applied to any
unpaid` balance commencing thirty days after 'the date of invoice. Submittals to governmental agencies are the
responsibility of the Client.
-Ga66ellation'of this contract by Clie must be in writing with'.seven days notice. Client agrees to pay for all services and
materials provided up to the time of termination.•
BUENA ENGINEERS. INC.
6L,lil2w 1 w�
Gate
PLEASE RETURN A SIGNED COPY TO
BUENA ENGINEERS, INC.
AGREED TO AND ACCEPTE-D:
1z'-wo
Client Name (in print)-
. �
Signature and Title
S.
Date
BAKERSFIELD
BERMUDA DUNES
LANCASTER
SAN LUIS OBISPO
SANTA, EARBARA
(805) 327-5150
(619) 345-1588
(805) 948-7538
(805) 544,6187 ..
'..(805),`966-9912
VENTURA..
(805)642-6727
GENERAL CONDITIONS BETWEEN THE GEOTECHNICAL CONSULTANT AND THE CLIENT
SECTION 1: ENTRY AND PROPERTY CARE
1.1 The client will provide for right of entry of the Geotechnical Consultant and
all necessary equipment, in order to complete the work.
1.2 While the Geotechnical Consultant will take all reasonable precautions
to minimize any damage to the property, it is understood by the Client that
in the normal course of work some damage may occur, the correction of
which is not part of this agreement.
SECTION 2: UTILITIES
2.1 In the prosecution of his work, the Geotechnical Consultant will take all
reasonable precautions to avoid damage or injury to subterranean struc-
tures or utilities.
2.2 The Client agrees to hold the Geotechnical Consultant harmless for any
damages to subterranean structures and utilities which are not called to the
Geotechnical Consultant's attention and correctly shown on the plans
furnished.
SECTION 3: SAMPLES
3.1 The Geotechnical Consultant will retain all soil and rock samples for thirty
(30) days. Further storage or transfer of samples can be made at the
Owner's expense upon written request.
SECTION 4: INVOICES
4.1 The Geotechnical Consultant will submit invoices to the Client upon
completion of services or at two week intervals, which are due and payable
upon presentation. A Late Payment Finance Charge computed at the
periodic rate of 1.5 percent per month (an Annual Percentage Rate of 18
percent) will be applied to any unpaid balance commentiog thiriy days after
the date of the invoice.
4.2 Fee Schedules are periodically revised. Unless otherwise agreed, new
rates apply to on-going work as the rates are issued.
SECTION 5: OWNERSHIP OF DOCUMENTS'
5.1 All reports, boring logs, field data, field notes, laboratory test data, calcula-
tions, estimates, and other documents prepared by the Geotechnical Con-
sultant, as instruments of service, shall remain the property of the Geotech-
nical Consultant.
5.2 The Client agrees that all reports and other work furnished to the Client or
his agents, which is not paid for, will be returned upon demand and will not
be used by the Client for any purpose whatever.
5.3 The Geotechnical Consultant will retain all pertinent records relating to the
services performed for a period of five years following submission of the
report, during which period the records will be made available to the Client
at all reasonable times.
SECTION 6: CLIENT CHANGES
6.1 In the event any changes are made in the plans and specifications by the
Client or persons other than the Geotechnical Consultant, client agrees to
hold the Geotechnical Consultant harmless from any liability arising out of
such changes and the Client assumes full responsibiliy unless the Client
has given Consultant prior notice and has received the Consultant's
written consent for such changes.
SECTION 7: STANDARD OF CARE
7.1 Services performed by the Geotechnical Consultant under this agreement
will be conducted in a manner consistent with the level of care and skill
ordinarily exercised by members of the profession currently practicing
under similar conditions and in the same locality. ,No otherwaranty,
expressed or implied, is made.
7.2 The Client recognizes that subsurface conditions may vary from those
encountered at the location where borings, surveys, or explorations are
made by the Geotechnical Consultant and that the data', interpretations and
recommentdations of the Geotechnical Consultant are based solely on the
information available to him. The Geotechnical Consultant will be respon-
sible for those data, interpretations, and recommendations, but shall not be
responsible for the interpretation by others of the information developed.
SECTION 8: LIMITATION OF LIABILITY
8.1 The Owner agrees to limit the Geotechnical Consultant's liability to the
owner and all construction contractors and subcontractors on the project
arising from the Geotechnical Consultants professional acts, errors or
omissions, such that the total aggregate liability of the GeotechnicalConsul-
tant to all those named shall not exceed $50,000.00 or the Geotechnical
Consultant's total fee for the services rendered on this project whichever
is greater. The Owner further agrees to require of the contractors and his
subcontractors an identical limitation of the Geotechnical Consultant's
liability for damages suffered by the contractor or the subcontractor
arising from the Geotechnical Consultant's professional acts, errors or
omissions. Neither the contractor nor any of his subcontractors assumes
any liability for damages to others which may arise on account of the
Geotechnical Consultant's professional acts, errors or omissions.
SECTION 9: INSURANCE
9.1 The Geotechnical Consultant represents and warrants that it and its
agents, staff and consultants employed by it, is and are protected by
workers' compensation insurance and that the Geotechnical Consultant
has such coverage under public liability and property damage insurance
policies which the Geotechnical Consultant deems to be adequate. Certifi-
cates for all such policies of insurance shall be provided to the Client upon
request in writing. Within the Ilimits and conditions of such insurance, the
Geotechnical Consultant agrees to idemnify and save the Client harmless
from and against any loss, damage, or liability arising from any negligent
acts by the Geotechnical Consultants, its agents, staff, and consultants
employed by it. The Geotechnical Consultant shall not be responsible for
any loss, damage or liability beyond the amounts, limits, and conditions of
such insurance. The Geotechnical Consultant shall not be responsible for
any loss, damage, or liability arising from any negligent acts by the Client,
its agents, staff, or other consultants employed by it.
SECTION 10: TERMINATION
10.1 This Agreement may be terminated by either party upon seven (7) days
written notice in the event of substantial failure by the other parry to perform
in accordance with the terms hereof. Such termination shall not be effective
if that substantial failure has been remedied before expiration of the period
specified in the written notice. In the event of termination, the Geotechnical
Consultant shall be paid for service performed to the termination notice date
plus reasonable termination expenses.
10.2 In the event of termination, or suspension for more than three (3) months,
prior to completion of all reports contemplated by this Agreement, the
Geotechnical Consultant may complete such analyses and records as are
necessary to complete his files and may also complete a report on the
services performed to the date of notice of termination or suspension. The
expenses of termination or suspension shall include all direct costs of the
Geotechnical Consultant in completing such analyses, records and re-
ports.
SECTION 11: OTHER CONTACTUAL REQUIREMENTS
11.1 Neither the Client nor the Geotechnical Consultant may delegate, assign,
sublet or transfer his duties or interest in this Agreement without the written
consent of the other parry.
11.2 If the Client is a corporation or public entity, the individual or individuals who
sign this Agreement on behalf of the Client warrant that they are duly
authorized agents of the Client. The Client binds himself, his partners,
successors, executors, administrators and assigns to this agrreement in
respect to all its terms and conditions.
Buena Engineers, Inc.
79-811 Country Club Drive, Suite 4
Bermuda Dunes,:,,CA 92201 - (619) 345-1588 328-9131
f
Client Name
Client Address
Client Phone
DATE
JOB NO.,
'REFERENCE CURVE
TEST
TEST LOCATION
LOT
1*3 7 7
PROJECT
DRY
MAXIMUM
MAXIMUM
OPTIMUM
NUMBER
'NO.
ELEVATION..._,DRY
'C&TENT
DENSITY
LOCATION
DRY
MOISTURE
%
.CONTRACTOR
DENSITY
DENSITY
CONTENT
OWNER
WEATHER
Ibs./cu. ft.
TEMP, t,10at AM
0 at ."IPM
PRESENT AT SITE
yk
' 37:9 8 CLIENT REPRESENTATIVE SIGNATURE
FIELD REPORT
TECHNICIANS SIGNATURE
J;"Z%111
FIELD TESTING
'REFERENCE CURVE
TEST
TEST LOCATION
LOT
MOISTURE
DRY
MAXIMUM
MAXIMUM
OPTIMUM
NUMBER
'NO.
ELEVATION..._,DRY
'C&TENT
DENSITY
DRY
MOISTURE
%
IbsjCu. ft.
DENSITY
DENSITY
CONTENT
%
Ibs./cu. ft.
%
yk
7p
ter.
s
A 'k
REMARKS:
7-d
/V
' 37:9 8 CLIENT REPRESENTATIVE SIGNATURE
FIELD REPORT
TECHNICIANS SIGNATURE
J;"Z%111