04713 (SFD)04713
Building >a —0
960 :fp1CT"8l>r1'm
Address
Owner
tdco Developmant Corp
mailing
Address
City Zip Tel.
@anc'• o 'firage 2.270
Contractor
,riIIna
Address
WE
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
State Lic. I City �4
& Classif. Lic. #
Arch„ Engr.,
Designer
Address Tel.
City I Zip I State I
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I heraby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section
aMof i}ivision 3 of the Btltilneas and Professions Code, and my license is in full force and
effect.
StGNAT1IRE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the tollowing
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requ,res a
permit to construct, attar, 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 (S500).
❑ 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, Bussness 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-buNder 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 contractors) 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 consanl 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 nor be completed if fhe permit Is for ono hundred dokars (3100) valuation
or less.)
I Certify that in the performance of the work for which this permit is issued, I shall not
employ sny person in any manner so as to become subject to the Workers' Compensation
Laws of Californla.
Date -Owner
NOTICE TO APPLICANT: It, 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 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 Nama
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 correcL
i agree to comply witti 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. '
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number 174-295--006 _
Legal Description
Project Description
Sq. Ft. 18J4 No. No. Dw.
Size Stories units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
o1e7-94.
PERMIT
AMOUNT
Plan Chk. Dep.
$250.00
Plan Chk. Bal.
Const.
Mech.
Electrical
7: • .
Plumbing
105.
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
Issued by:
Validated by:
INSPECTOR
Date Permit
Signature of applicant
Melling Address
City, State, Zip
Validation:
WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE
CONSTRUCTION ESTIMATE
NO.
ELECTRICAL FEES
NO
PLUMBING FEES
1ST FL SO FT rp
2ND FL SO FT �
POR SO FT Qr
GAR SO FT Cr
CAR P SO FT a
WALL SO FT (d
SO FT ra
ESTIMATED CONSTRUCTION VALUATION
$
UNITS
YARD SPKLR SYSTEM
MOBILEHOME SVC
BAR SINK
POWER OUTLET
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
S
WATER PIPING
NOTE' Not to be used as property lax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTONDISH)
APPLIANCE DRYER
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, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER BTU
SO. FT c
BATH TUB
SO. FT. g c
WATER HEATER
MAX HEATER OUTPUT, B T U
SO. FT. RESID g 1 V. c
SEWAGE DISPOSAL
SO FT.GAR Cu 3/4c
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 t1 AIR COND SOLAR
SETBACK �
[�ROUND PLUMBING-�
/
UNDERGROUND
A.C. UNIT
COLL. AREA
AB GRADE ��
ROUGH PLUMB
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEFTiC ALI
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
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
-$
LUMBER GR
FINAL INSP
FRAMING
r
FINAL INSP
ROOFING
[gyp
t
/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR FIREWALL
LATHING
MESH
} SULATIONISOUND —
FINISH GRADING
FINAL INSPECTION-12.-
CERT OCC
FENCE FINAL
INSPECTOWS SIGNATURESIINITIALS
GARDEN WALL FINAL
OI I ICE OF
AGRICUL'I URAL COMMISSIONER
AND
Wt:IGI I IS & NILI\SUIZLS
49-613 Ilwy 06, Suite 11-12
'Concl+el in, CA 92236
619-342-0291
WFE - 1 �
DEVEWPER' S ME,
ADDRESS 6. I — 7 3 Q
E. (EON SP U;GY
co•.+�n5;ur..En
)AMES O WALLACE
ASSESiAM 1:1)MMISSn)\EP.
CEE}LENT CENVENISIE
SLALEn
CASE 11J.
TELEL'11014Et
s y
Dear Developers
e
Utter (reviewing your lmidscapi.l►g plans, all plant waterial listed i_s "at 111
violatioll of yuaxal)tine laws govemi.11y the Coachella Valley. if substitutians
do occur alld they differ ErUn plant m--Aerial lister], tills u[Eice must be liotified
burdiately.
Thank you Eor pmLectittg and preserving the Coachella Valley's pest -free envirotnnent.
1lgricultwcaJ Ca+t+ii s r ner' s UL E ice
cct Indio and Riverside UEEice
. ,,
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Buena Engineers, Inc.
- - 79-811 Country Club Drive, Suite 4
Bermuda Dunes, CA 92201 • (619) 345-1588 / 328-9131
Client Name
Client
Client Phone
DATE
3 -�T
JOB NO.
/-7q --
PROJECT
Jr.�_ x�� �' Wiz- Ynv
/,�..-�/✓/��i (�'�/�IfI�I'
LOCATION
CONTRACTOR
OWNER
WEATHER
TEMP.
o at AM
° at PM
PRESENT AT SITE
�JIl1�
TEST
NUMBER
TEST LOCATION
LOT
NO.
ELEVATION
FIELD TESTING
REFERENCE CURVE
MOISTURE
CONTENT
%
DRY
DENSITY
IbsJCu. ft.
MAXIMUM
DRY
DENSITY
%
MAXIMUM
DRY
DENSITY
lbs./cu. ft.
OPTIMUM
MOISTURE
CONTENT
%
�7
/ ' 0
cl/
✓
2 J1-5
52--S'94
�—SSaS
i
°50 — E60
�J
N, V
wv�
llll
REMARKS: LUI-K-4
l
`; ICl/% /I ✓ ; i.%)�- -� �jCr �1 "r G' f1/' Lr. j'f rS r� ,iLOE- /2-vG6':�'-
Cr 7
FIELD REPORT
m
C `, `CLIENT REPRESENTATIVE SIGNATURE
48
TECHNICIANS SIGNATURE