06155 (SFD);Building
Address
Owner
Mailing .
Address c
City
La N
Contractor
54-510 Herrera
Steve Pazrhadi
Tel.
4
P.O. BOX 1504 No.���
78-105 CALLE ESTADO
• LA QUINTA, CALIFORNIA 92253
Address-
42-405 Washington St -,-OC
*:City Zip Tela
Palm Desert 92260 345-7.307
State Lic. City
& Classif. 45377.5 Lic. # $11
Arch., Engr.,
Designer
Address Tel.
City I
Zip I 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. i 4 +" . -- -�
I . R : � •..�. ; i + +err f
SIGNATURE 2 / . DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License law for the following
reason: (Sec..7031.5,8ushess 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 permw to tie a signed statement that he is licensed pursuant to
the provisions of the Contractors License Law, Chapter 9 (commencing with Section 7000) o1
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 penally of not more than five hundred dollars ($500).
❑ 1, 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 Contractors 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 krprovements are not intended or offered for sale. If, however, the building
orimprovement is sold within one year of completion, the owner -budder will have the burden
of proving that hedid not build or improve for the purpose of sale.)
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project (Sac. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of properly who builds or improves thereon, and who contracts for
such projects with a contractor(s) iceraed 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 1 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 correlated B the pemnit isforone 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 -L, ±L -f ' owner - }u
NOTICE TO APPLICANT: 8, 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 of this permit shoo 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
Lenders 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
BUILDING: TYPE CONST.
A.P. Number
Legal Description
Project Description
OCC: GRP.,
774-283-001-2
SFD
Plan Chk. Dep. S250.00
Plan Chk. Bal.
S 233.62
Sq. Ft.1476No.
Size
No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Electrical
1f19.i%
Plumbing
is4�5
S.M.I.
Grading
2 0%001
n $82:377
PERMIT
AMOUNT
Plan Chk. Dep. S250.00
Plan Chk. Bal.
S 233.62
Const.
563,00
Mech.
6n.00
Electrical
1f19.i%
Plumbing
is4�5
S.M.I.
Grading
2 0%001
Driveway Enc.
20.00
Infrastructure
1.824.23
TOTAL3sZF{0•
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 II7S.PPETT�OR
Issued by- Date_Permit
II Permit
Validated by:
Validation:_
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING F€ES
IST FL SQ. FT. ® $
UNITS
COLL AREA
SLAB GRADE �� _�-
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL SQ. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
DUCT WORK
ROCK STORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING,(FINAL)
DRAINAGE PIPING
CAR P. I SQ. FT.
GAS (FINAL)
TEMP. POLE
WALL SQ. FT.
DRINKING FOUNTAIN
GROUT
WATER HEATER
URINAL
SQ FT ®
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
GRADING
cu. yd.
—Plus—x$—=$
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOXDISH)
APPLIANCE DRYER
� d " 2 1; /��
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GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
VENTILATION
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
GAR. FIREWALL
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1 Vi c
SEWAGE DISPOSAL
SQ.FT.GAR ® N4c
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
ETBACK /_— d
GROUND PLUMBIN �2 (fes
UNDERGROUND
A.C. UNIT
COLL AREA
SLAB GRADE �� _�-
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
1114* OR SEPTIC TAWI
• TAWI_
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 P. Gf,.L fv
FRAMING 12,127 /jam _
�� V7
FINAL INSP.
ROOFING
� d " 2 1; /��
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REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING toff/ / �D
MESH
INSULATION/SOUND
FINISH GRADING
1
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
Al OF
�7*1ne. SCHOOL FACILITY FEES
TO: City o f L Qu Quint o �` DATE : ' / 1
Q +c,v�J`` U ���
Department of CommG i,"�tAyD,eVe�Ylop�me.nt,
78-105 Calle Estado CV i��ll
La Quinta, CA 92253
Thisis to rtif that /laEA
developer of which is
located at — within
this District, has paid school facility fees imposed 'pulisrGant to the
autho't ge nratq,0 by a nment Co a ectiolt 3080 'n,t e amount oj
Ai
coveting a total of iLV7 square feet of ( ) residential or
( ) industrial/commercial development and that building permits for
this footage in this development may now be issued by your jurisdiction.
for DESERT SANDS UNIFIED SCHOOL DISTRICT
White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer
(10)-37
1)1 I IIA or
AGRIC:UL I UMI. CUMMISSIO"E"t
A -NO
WI:IGI 1 I S ✓J hi[INSURES
IIg-613 Ilay 116, Ilttlte II -12
'Cutiche l l" t CA 92276
619-342-a291
E. EEW SI'A"t-,v
co••ru�;nr.•tn
)A�If.S U WAUACE
�si�sta�t �:'1'+'•u5sro�tn
CEE�IEyI hF`VEMSIE
st.�un
t%ni mi's 1 NASI D C r.1 ► S
ADDRESS
ri1014r,
.� U,�, -4 a� � tock- 3�� (�C�.a.�• Nl.�
Dear wvelvperl
ted In mL
Mter reviewing your 10110sc"14119 111011"t Ittl Illalttlin ValleyJ.lsIE substi.tutivlls
violation o[ yuarantille lows tjuveEllllly 1111 tvac he
occur n11d they c1lEEer [tt_In Illant Il�alerlal lisledthls o[[ice most be notlEied
do
icm�diately.
tk L�tvtectLly and Ilteserviny the Coachella Valley's nest-[ree envirolnlent•
Tio you y i
l
' r
kyr uLtutel Caultissioiierl s vE
fire
CCl lndlo and Itiverside VEEice
Buena Engineers, Inc.
79-811 Country Club Drive, Suite 4 �: "r•
Bermuda Dunes, CA 92201 • (619) 345-1588 / 328-91:x;1
f
•4Y
Cii t Name
-Client Address
Client Phone
DATE
TEST LOCATION
JOB NO.
ELEVATION
FIELD TESTING
PROJECT
fji�'-x /cam.'/•r
AUT ,_/ -.5 5-16
A 53"a
LOCATION
MAXIMUM
DRY
DENSITY
Ibslcu.ft.
�
CONP TRACTOR
0
OWNER
r"
17
WEATHER
TEMP. 0 at AM
0 at PM
PRESENT AT SITE
c
/
I
6
TEST
NUMBER
TEST LOCATION
LOT
NO.
ELEVATION
FIELD TESTING
`.EFERENCE CURVE
MOISTURE
CONTENT
%
DRY
DENSITY
Ibsicu. ft.
MAXIMUM
DRY
DENSITY
%
MAXIMUM
DRY
DENSITY
Ibslcu.ft.
OPTIMUM
MOISTURE
CONTENT
%
i�7iST-r
c
/
'-' r-7-, J
J
Lof Z
r /`//P H.`
REMARKS:
CLIENT REPRESENTATIVE SIGNATURE
FIELD REPORT
T€OlINICIANS SIGNATURE U887/