001601 (BLCK)P.O. BOX 1504 No. 001601
Building 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253 µ
Owner
C. md"'al1 BUILDING: TYPE CONST. OCC: GRP.
Mailing
Address 53-399 Mbrdda Herrera A.P. Number
City Zip Tel.
TA (N-A1�71*a 012253 ' Legal Description
Contractor Project Description
3i
Address - • �' _ .._ .
a'bMe
City Zip Tel...
State Lic. City
& Classif. Lic. # Sq. Ft. No. No. Dw.
Arch.; Engr.,
Size•.. Stories Units
-
Designer New E* Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.ndwood ft
City Zip State
. 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
OWNERoBUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following1
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• ^r
requires the applicant for such permit to file a signed statement that. he is licensed pursuant to - PERMIT AMOUNT
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 Plan Chk. De
for the -alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit- p -
•' subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
0 I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal.
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and COnSt
Professions Code: The Contractor's License Law does. notapplyto an owner of property .
who '
builds or improves thereon and who does such work himself or through his own employees, Mech.
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 Electrical '
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- Plumbing'
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 S. M. 1. - `50
such projects with a contractor(s) licensed pursuant to the Contractor's License Law:)
Grading
O 1 am exempt under Sec. B. t P.C. for this reason
Driveway Enc.
Date Owner f - . �(x et i,!�- c:�` t Infrastructure
WORKERS' COMPENSATION DECLARATION
hereby affirm that I have a certificate ofconsent 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
CERTIFICATE OF EXEMPTION FROM REMARKS.
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 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 ZONE: BY:
subject to the Worke/s' Compensation provisions of the- Labor Code; you. must forthwith Minimum Setback Distances: '
comply with such provisions or this permit shall be deemed revoked.
Front Setback from Center Line
Rear Setback from.Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
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.) Side Setback from,Property Line
Lender's Name
Lender's Address FINAL DATE INSPECTOR
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 slate that the above information is correct. Issued by: Date / q
`'8-55 Permit
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. Validated by:
Signature"of applicant v d v+wA K. i` -...� �l Date
Mailing Address 4' Validation.
City, State, Zip
A1858 7 8 20.00 Sl
HARD COPY
T
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
DUCT WORK
ROCK STORAGE
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
METER LOOP
HEATING (FINAL)
DRAINAGE PIPING
CAR P. I SQ. FT.
GAS (FINAL)
WALL SQ. FT. @
DRINKING FOUNTAIN
SQ FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
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, TEM/PERM
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.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
MESH
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMITFEE
DBL'
TOTAL FEES
MICRO FEE
MECH.F£E 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 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
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ -Plus-X$-=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION51
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS,
GARDEN WALL FINAL
71
- 4/91-
04'JeMD
ALL PIPS
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Bum Enaineers,lnc.
1731-A WALTER STREET • VENTURA, -CALIFORNIA 93003 e PHONE (805) 642-6727
April 10, 1985
Rich Johnson
P.O. Box 2288
Indio, CA 92202
Project: 53-399 Avenida Herrera
54-325 Ave. Juarez
La Quinta, CA
Subject: Building Area
Compaction Report
Job No. B -15181-P1
85-4-156
On March 18, 1985 a representative of our firm performed density tests on the
fill placed in the building area on the above referenced project. Tests were
performed at random locations in accordance with ASTM 2922-78 and ASTM 3017-78
Nuclear Density Test Procedure. Tests performed as per authorization of Rich
Johnson.
The estimated locations of the tests are presented on the attached plan with
their results being summarized on the attached test report sheet. A total of
four (4) density test were performed. Test results indicate that a minimum of
ninety percent (90%) of relative compaction has been obtained within the areas
tested. The maximum density -optimum moisture was determined in the laboratory
in accordance with.ASTM D 1557-78, Method A, five (5) layer curve.
Classification
Maximum Density -Optimum Moisture
Tan silty medium to coarse.
sand 126.1 7.1%
THOUSAND OAKS
(805) 495-8484
VENTURA
(805) 642.6727
BAKERSFIELD
(805) 327.5150
LANCASTER
(805) 948.7538
SANTA BARBARA PALM SPRINGS
(805) 966.9912 (714) 328.9131
SAN LUIS OBISPO
(805) 544.6187
l
April 10, 1985
LIMITATIONS
Job No. B -15181-P1
85-4-156
The compaction operations.were completed at the time our personnel were called to
the site. The test results summarized in this report represent the moisture and
density only at the location and depth 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, compaction nor the adequacy of the material to perform
its intended function. No guarantee or warranty of the contractor's work is made
or implied.
Respectfully submitted,
BUENA ENGINEE INC.
I L
LZG7
Jack n, Jr.
NGJ/REB/ kl s
Copies:
4- Rich Johnson
2- City of La Quinta
1- P.S. file
1- Vta. file
Reviewed and Approved
?,,� 4"' -
Raymo d E. Brannen
C.E. 28966
1 41
(e
r,.
Engineers,inc.
REPORT OF RELATIVE COMPACTIONS
Job No. B -15181-P1
CONTRACTOR: DATE: April 10, 1985 Report No. 85-4-156
ADDRESS: JO8 & LOCATION: Avenida Herrera -Ave. Juarez
La Quinta, CA
TEST NO.
DATE
DESCRIPTION
% MOISTURE
DRY DENSITY
RELATIVEMAXIMUM
TESTED
53-399 Avenida Herrera
IN PLACE
IN PLACE
COMPACTION
DENSITY
1
3-18-85
0.5:. below finish grade Per Plan
6.4
113.1
90
126.1
2
3-18-85
1.0 below finish grade Per Plan
9.8
116.7
93
126.1
54-325 Ave. J.
3
3-18-85
0.5 below finish grade Per Plan
8.7
116.8
93
126.1
4
3-18-85
1.0 below finish grade Per Plan
4.2
113.9
90
126.1
WE CERTIFY THAT THESE TESTS WERE PERFORMED IN CONFORMANCE WITH
COPIES:
BUENA ENGINEERS, INC.
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