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06247 (SFD)P.O. BOX 1504 No. 062147 Building Address 54-530 Herrera LA QUINTA, CALIFORNIA 92253 Owner Mailing Stere Parhadi BUILDING: TYPE CONST. OCC. GRP. Address Sam A.P. Number 774-M—n!12 City lZip ITel. Contractor I Del=is Uckenberg 42-405 Washington St., fC Zip I Tel. State Lic. _- ICity & Classif. __. Lic. # Designer Address Tel. CityI Zip I State Lic. # UCENS90 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 SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirim that I am exempt from the Contractors License Law for the following reason: (Sec. 7031.5,8usiress and Professions Lode: Any city or county which requires a permit to construct, after, improve, demolish. or repair any structure, prior to its issuance also repines the applicant for such permit to fie 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 more than five hundred dollars (5500). ❑ 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. M, however, the building of 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.) ❑ 1, 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 birds or irproves 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 Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No r ompany ❑ 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 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 o =.forma Date • t ' r Owner I' NOTICE TO APPIJCANT: ff, after making thisCertificate 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 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civi Code.) Lenders Name Lenders Address This is a building permit when property 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 ateMailing Address_ City, State, Zip Description Project Description S.F.D. Sq. Ft. Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ .. Repair ❑ Demolition ❑ Estimated Valuation %86 ,021 PERMIT AMOUNT Plan Chk. Dep. $250.00 Plan Chk. Bal. 246.13 Const. 583 .UO Mech. 53.50 Electrical 111.8383 Plumbing 157.50 S.M.I. 5.09 Grading 20.00 Driveway Enc. 20.00 Infrastructure 1,897.24 .1 TOTAL $3,343.04 c. 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: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS A.C. UNIT COLL AREA �� //''SETBACK 6SLAB GRADE(� YARD SPKLR SYSTEM 2ND FL. SO. FT. HEATING (ROUGH) STORAGE TANK MOBILEHOME SVC. BAR SINK POR. SO. FT. ® ROUGH WIRING GAR. Sp. FT. ® POWER OUTLET ROOF DRAINS GAS (ROUGH) DRAINAGE PIPING CAR P. I SO. FT. HEATING (FINAL) OTHER APPJEQUIP. WALL SO. FT. DRINKING FOUNTAIN. TEMP. POLE URINAL SO FT ® GROUT ESTIMATED CONSTRUCTION VALUATION $ SERVICE WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTONDISH) APPLIANCE DRYER ' GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FINAL INSP. LAUNDRY TRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEMg,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 SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1+/a c SEWAGE DISPOSAL SQ.FT.GAR ® V4c HOUSE SEWER LATHING n/WA 42-A MESH GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PLCK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR �/� ROUND PLUMBlq UNDERGROUND A.C. UNIT COLL AREA �� //''SETBACK 6SLAB GRADE(� RO`UGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS �� SEPTIC TAN 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. Z>� f(7 FRAMING FINAL INSP. ROOFING / !/ L� �. i ( O (` REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING n/WA 42-A MESH INSULATIONISOUND f) FINISH GRADING !� FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL 1 Cu i. Desert Sands Unified School District CERTIFICATION OF PAYMENT OF ®7icp.SCHOOL FACILITY FEES Ills DOC. l TO: City of La Quit,,Qb������` Department of Commu�tFi} Devellipmeif+t�� 78-105 Calle Estado a La Quinta, CA 92253 DATE: S.y.t This is to certify th developer of , which is located at - within this District, has paid school facility fees imposed pursuant to the $uYjIo it�ge er�ted by vernment C de Secti tt 53080 in h amo nt a�i covering a total of M square feet of (X s dential or ( ) industrial/commercial development and that build�iktg permits for this footage in this development may now be issued by your jurisdiction. for DESERT SANDS UNIFIED SCHOOL DISTRICT White - Building Department • Y How - Facilities Planning • Pink - Accounting • Gold - Developer j N W & (10)-37 1)1111,E OF AGIUCUL I MAI. COMMIS5101"LIt AND. WI:IC;I 1 IS b. MEASURES 49 -fill Ilwy 116, 11ul.te 11-12 C0110le1In, CA 92216 619-742-0291 E. 1.E011 SPnt;t-,v co•a.n�,ur..tn )n�lES U v:nllnCE MSISIA\I 1'; )td'•IISSII)\Ln CLEMENT ItE,,VEhl51 E Suan U11'1'C 1 °7 CASE I IU. tai L��a a 1 I)EVCLAI'[;It' 5 1 W 1Et �J�►J N S t`1� t)ea1: IJeveloper t After reviewing your landscttl)llt. I11an.1, 1111 1)lica,� ellOtvalley�.lslEJsubsliluttivlts Violative v[ yuarallthle 11)+'s e�oveE111ny ll1_ toy do occur Etna they diE[er Icon 1110"tn►•aleriul listed, this o[[ice ulusl be notified itul�dlately . '1'Ita11k you Tor pcvtectLly bltd 1rEeservilty lite Coachella Valley's hest-[ree eevirotnteet. nyi icul lural Itt�ss oiler s UL [ ice cet Indio al)d Riverside Mice Buena Engineers, Inc. 79-811 Country Club Drive, Suite 4 Bermuda Dunes, CA 92201 • (619) 345-1588 / 328-913) 1 Client Name Client Address )—'Ot-*Z, v 4,530 &;eW6�,4 Client Phone DATE TEST LOCATION JOB NO. ELEVATION FIELD TESTING PROJECT ` .EFERENCE CURVE MAXIMUM OPTIMUM DRY MOISTURE DENSITY CONTENT IbsJcu.h. % MOISTURE CONTENT % DRY DENSITY IbsJCu. h. LOCATION !' • 0I CONTRACTOR OWNER WEATHER TEMP. ° at AM ,1 at f*PM PRESENT AT SITE l 7 i TEST NUMBER TEST LOCATION LOT NO. ELEVATION FIELD TESTING ` .EFERENCE CURVE MAXIMUM OPTIMUM DRY MOISTURE DENSITY CONTENT IbsJcu.h. % MOISTURE CONTENT % DRY DENSITY IbsJCu. h. MAXIMUM DRY DENSITY % 7 7 rw J t a fZ 0 REMARKS: M �.i FIELD REPORT CLIENT REPRESENTATIVE SIGNATURE TgOHNICIANS SIGNATURE Ubb ' 3t.:..=a+.:�,.s....v:v;:_—:.........�..—.a.u.m:.�.�.'-..:a.� � �o...,. ... ... J.t.._:' ... ...�.. < .... ... _ _...... _. ... ....v........... .. .. i. ....._..�.� i.-._..... ...... .. F.