002750 (BLCK)CAU
Tity 4 sCP QamrA
Building
Address
Owner
Mailing
Address 7't fir:} . City Zip Zip Tel.
56
Contractor
Address
p I Tel -
State Lic. I City
& Classif. ., Lic. #
Arch:, Endr.,
Designer
Address I Tel.
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
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.
DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I 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).
❑ 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. 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 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.)
❑ I 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 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 completed if the permit is for one hundred dollars (3100) valuation
oriess.)
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
subject to the Workers' Compensation proviskins of the Labor Code, you must forthwith
comply with such provisions or fh[s parmil ahali 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 certlfy that I have read thls appHratlon and slate that the above information is -correct.
I agree to comply with all city and county ordlnances and state laws relating to bullding
construction, and hereby authorlxe representatives of this city to enter the above -
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zin
No. J r.. 0 7 `5 .
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number
Legal Description_
Project Description
Tot.
Sq. Ft. No. No. Dw.
Size Stories Units
New C Add ❑ Alter ❑ Repair ❑ Demolition ❑
(Estimated Valualion
I _1t',fl iril
PERMIT AMOUNT
Plan Chk. Dep.
Plan Qhk. Bal.
ConSt.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
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 "'_tr Permit
Validated by:
Validation:
A688Z
1Z 9 �D.CG Ch
HARD COPY
CONSTRUCTION ESTIMATE
NO.
ELECTRICAL FEES
NO.
PLUMBING FEES
1ST FL. SQ. FT. ®
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SO. FT. ®
CAR P. SQ. FT.
WALL SQ. FT.
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION
$
UNITS
YARD SPKLR SYSTEM
MOBILEHOME SVC.
BAR SINK
POWER OUTLET
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
UHINAL
$
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, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B. I.U.
SQ_ FT, ref c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID @ 11/i c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3Ac
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
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.IEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
24110 BEAM 2 r�
7�
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
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'$ SIGNATURESIINITIALS
GARDEN WALL FINAL
Buena Engineers, Inc.
AN EARTH SYSTEMS, INC. COMPANY I T } P` 1983
CITY OF LA QUINTA
3� �# ,�,,, y nFk1n �Ws��t+fT M..
79-811 COUNTRY CLUB DRIVE, SUITE #4 • BERMUDA DUNES, CALIFORPI %22t71 (619) 345-1588
December 31, 1987
Pinecreek Development
51-625 Eisenhower Drive
La Quinta, CA 92253
Project: Lot 16 and 18 /Avenida Diaz
La Quinta, California
Subject: Report of Field Densities
Single Family Residence
B7-0221-P1
87-12-824
On October 13, 1987, a representative of our firm performed density tests
in the fill for the proposed houses 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 were performed
as per authorization of Bob Cullen of Pomona Valley Equipment,
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 five (5) density tests were performed. Tests results indicate that
a minimum of ninety (90) percent relative compaction has been obtained
within the areas tested.
The maximum density -optimum moisture were determined in the laboratory
in accordance with ASTM D 1557-78, Method A or C.
Test results are as follows:
Soil Description USCS
Light brown slightly
silty fine to coarse
sand with gravel SP
VENTURA
(805) 642-6727
MaximumDensit -O timumMoisture
124.0 pcf 8,4 F
LANCASTER
(805) 948-7538
BAKERSFIELD SANTA BARBARA
(805) 327-5150 (805) 966-9912
BERMUDA DUNES SAN LUIS OBISPO
(619) 345-1588 (805) 544-6187
December 31, 1987 -2-
137-0221-P1
87-12-824
1. The projects are located at Lot 16 / 54-880 Avenida Diaz and Lot 18 /
54-430 Avenida Diaz in the City of La Quinta.
2. Prior to our arrival at the site, the grading on both sites had been
completed.
3. The purpose of testing was to observe compliance with the minimum
requirements of the City of La Quinta, California.
Limitations
This firm did not perform a soils investigation, did not conduct any tests to
determine the general condition, adequacy or stability of soils on the
property, nor did it observe the backfilling or compacting operations which
were already completed at the time our personnel were called to the site,
The only services performed were the specific moisture and density tests
summarized in this report, These test results provide only limited
information about the surface materials observed at the locations and
depths tested and cannot be relied upon for information about subsurface
conditions or compaction, or to determine the appropriateness of any design
or construction of improvements on the site. No inspection was made of the
contractor's work and no guarantee or warranty of that work in backfilling
or compaction of the soils on the site is made or implied.
If there are any questions, please do not hesitate to contact this office.
Respectfully submitted, Q�KOFESS1p�r
BUENA ENGINEERS, INC. Reviewed and
raft.. ? L
Phillip D. Clanton
Sr. Technician
PDC/JRV/mea
Copies: 2 - Pine Creek Development
2 - City of La Quinta
2 - P.S.f1le
2 - VTA file
C11 a
�r CO
Joseph R. b'en s
Civil Engineer
r,
No. C 012i0
P.
ii
.0r Criv\
BUENA ENGINEERS, INC.
Buena Engineers, Inc.
AN EARTH SYSTEMS. INC. COMPANY
REPORT OF RELATIVE COMPACTIONS
Job No. B7-0221-P 1
CONTRACTOR. DATE: December 3 1, 1987 Report No. 8 7-12-824
ADDRESS: JOB & LOCATION: La Quinta, CA
TEST NO. I DATE DESCRIPTION % MOISTURE DRY DENSITY RELATIVE MAXIMUM
TESTED IN PLACE IN PLACE COMPACTION DENSITY
54-430 Avenida Diaz/Lot 18
10-13-87 Per Plan 3.0 BSG
10-13-87 Per Plan 1.5 BSG
54-880 Avenida Diaz/Lot 16
10-13-87 Per Plan 3.0 BSG
10-13-87 Per Plan 1.5 BSG
10-13-87 Per Plan FSG
B5G = Below Subgrade
FSG = Finish Subgrade
WE CERTIFY THAT THESE TESTS WERE PERFORMED IN CONFORMANCE WITH
COPIES:
12.1 I 112.4 ` 91 J 124.0
13.0 112.0I 90 j 124.0
9.4
114.2
92
124.0
9.1
113.5
92
124.0
11.0
1 141
92
124.0
BUENA ENGINEERS, INC.
r
i
sy-{/3o 1
za-r -
zw.57' �zis y
C4u.5-1
76-1
tz t.I LA sy xtto
E-Cxuu- �
OL-7clsTrw��
f+zdc+f �
r
rle�rsE
t
E x•Jrrry�
/"-/Z- /B 551- 41 Fo
plc-yvr p � O/�
BUENA ENGINEERS, INC.
���z�/&� �70z�ip1
DATE: FILE N4.