001569 (MISC)Tiht 4 s4'P Qu&m
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address I- t_'%ve icb velasm LA QUINTA, CALIFORNIA 92253
Mailing
Address
City zip Tel— 347-7171
Contractor
Address
al:x
City lZip Tel.
State Lie. City —
& Classif. Lie. # 202
Arch., Engr.,
Designer
Address Tel.
City Zip I State
Lie. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7t. 0ppj of,[vision 3 of the Business and Professions Code, and my license is in full force and
etfecr
5ICNATLIME _ DATE
OWNER -BUILDER DECLARATION
I hereby affirm that 1 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 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 ($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
ftiressions Code: The Contractor's License, Law does not apply to an owner of property who
tildtds or kWioves thereon and who does such work himself or through this own arnpbysas;
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.)
❑ 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 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 Comysgsation 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 (S100) valuation
or less.)
I certify that in the performance of thg work for which this permit is issued, I shall not
employ any pperson 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 thouid became
sublacl to the Workers' Compansa0on provisions of the Labor Code, you musf 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-
1 agree to comply with all city and County ordinances and state taws relating to building
construction, and hereby authorize representatives of this city to enter the above -
mentioned property for Inapecfion purposes.
Signature of applicant Date
Mailing Address _
City, State, Zip
No. 00 569
BUILDING: TYPE CONST.
A.P. Number
Legal Description
Project Description
OCC. GRP. P. 3
^ 'A
Sq. Ft. No. No. Dw.
Size t: Stories Units
New [k Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dea-
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
ry,��•
Grading
Driveway Enc.
Infrastructure
1
TOTAL
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
1> Side Setack from Property Line
FINAL DATE //e �.rG �/ -INSPECTOR J/ f/
Issued by: Date Perm
Validated by:
Validation:
A 1 9 1 0 7 16 L135,66 CPS
HARD COPY
CONSTRUCTION ESTIMATE
NO.
ELECTRICAL FEES
NO.
PLUMBING FEES
1ST FL. SQ. FT. ®
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. Ff.
WALL SQ. FT. ®
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION is
$
UNITS
YARD SPKLR SYSTEM
MOBILEHOME SVC.
BAR SINK
POWER OUTLET
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
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(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
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 ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
IL
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
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 APP./EQUIP.
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
INSULATION/SOUND
FINISH GRADING
f FINAL INSPECTION l'
r
CERT. OCC.
FENCE FINAL
I WWtU IUK b M UNA I UKLWIN I I IRLS
GARDEN WALL FINAL
r�FIED
BERMUDA DUNES r
RANCHO MIRAGE
}' INDIAN WELLS H
PALM DESERT
%P LA ❑UINTA
010 INDIO y
Desert Sands Unified School District
82-879 HIGHWAY 111 r INDIO, CALIFORNIA 92201-5678 0 (619) 347-8631
July 16, 1985
City of La Quinta
Department of Community Development
78-105 Calle Estado
La Quinta, CA 92253
Re: 51-065 Velasco
Gentlemen:
The developer of the above referenced lot
has mitigated its impacts on our overcrowded schools by payment
of the amount of $628 per unit to be applied to the cost of
district educational facilities made necessary by such new
development.
Sincerely,
J L �. ►1i -
1,
John D. Brooks
Assistant Superintendent
Business Services
JDB/crm
OU12110 Ennineers,inr,
1731-A WALTER STREET VENTURA, CALIFORNIA 93003 PHONE (805) 642-6727
August 16, 1985 Job No. B-15181-Pl
85-8-229
Rich Johnson
P.O. Box 2288
Indio, CA 92202
Project: 51-065 Ave. Velasco
La Quinta, Ca
Subject: House Pad
Report of Field Densities
On July 23, 1985 and July 25, 1985 a representative of our firm
performed density tests on the fill placed on the building area
on the above referenced project. Tests were performed at random
locations in accordance with ASTM D 2922-81 and ASTM D 3017-78
Nuclear Density Test Procedure. Tests performed as per author-
ization of Rick Johnson.
The estimated locations of the tests are presented on the attached
plan with their results being summarized on the attached test re-
port sheet. A total of five (5) density tests were performed. Test
results indicate a minimum of ninety percent (90%) of relative com-
paction has been obtained within the areas tested. In areas of low
density, the soils were reworked and retested so that the minimum
requirement have been obtained. The maximum density -optimum mois-
ture was determined in the laboratory in accordance with ASTM D
1557-78, Method A, five (5) layer curve.
Classification
Light brown slightly silty
very fine to fine sand
THOUSAND OAKS
(805) 495-8484
VENTURA
(805) 642-6727
BAKERSFIELD
(805) 327.5150
Maximum Density -Optimum Moisture
109.3 pcf 13.1%
LANCASTER
(805) 948.7538
SANTA BARBARA PALM SPRINGS SAN LUIS OBISPO
(805) 966.9912 (714) 328.9131 (805) 544.6187
07
August 16, 1985
LIMITATIONS
Job No. B-15181-Pl
85-"-229
The compaction operations were completed at the time our personnel were called
to the site. The test results summarized in this report present the moisture
and density only at the locations 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 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 ENGINEERS, TNC
Borman G. Jac son, J .
NGJ/REB/kls
Copies:
4- Rick Johnson
2- City of La Quinta
2- P.S. file
1- Vta. file
Reviewed and approved
Raymond E. Brannen
C.E. 28966
BUENA ENGINEERS, INC.
CONTRACTOR:
ADDRESS:
REPORT OF RELATIVE COMPACTIONS
Job No. B-15181-P 1
DATE: August 16, 1985 Report No.85-8-229
Ave. Velasco
JOB & LOCATION: La Quinta, CA
TEST NO.
DATE
TESTED
DESCRIPTION
% MOISTURE
DRY DENSITY
RELATIVE
MAXIMUM
IN PLACE
IN PLACE
COMPACTION
DENSITY
1
7-23-85
3.0 from grade Per Plan
10.5
92.3
84
109.3
2
7-23-85
3.0 from grade '1
10.7
93.9
86
109.3
3
7-25-85
Retest #1 11
17.9
98.9
90
109.3
4
-7-25-85
Retest #2 "
ll.$
99.9
91
109.3
5
7-25-85
3.0 from grade "
I
18.1
102.1
93
109.3
WE CERTIFY THAT THESE TESTS WERE PERFORMED IN CONFORMANCE WITH
COPIES: -
BUENA ENGINEERS, INC.
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