05465 (SFD)1 I
r v
h ,
P.O. BOX 1504 No. 05465
Building 78-105 CALLE ESTADO
Address 51-605 Obraixost LA QUINTA, CALIFORNIA 92253
Owner I
- C. Eauf£atmn
Address
City Zip Tel.
1619/
Contractor
Alex G. Torres
Address
City Zip Tela
. quiuta 92253 619/774-0767
State Lic. City
& Classif. 550498 B-1 Lic. #
Arch., Engr.,
Designer
Address I Tel.
CityI Zip I State I
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.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5;Business, and ProfessionsrCode: Any city or county which requires, a
permit to construct, after, mprove; demolish, or repair any structure, prior to- Its' issuance also
requires the'appfx:anI 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 rive 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 Contractor's License Law does not apply to an owner of property who
builds or inproves thereon and who does such work himself or through his own employees,
provided that such improvements are not intended or offered for safe. h 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 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 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 y' f
WORKERS' COMP,ENSATION'INSUMNCk
(This section need not be completed it the pemmlt is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thg work for which this permit is issued, 1 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: 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 or this permit shaft 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, Civil Code.)
Lender's Name
Lender's 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
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number 773-123r-015
Legal Description Lot 5 Varth 112
Project Description 03
krl
Sq. Ft. 153£3
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
$82o960.00
PERMIT
AMOUNT
Plan Chk. Dep.
250.00
Plan Chk. Bal.
233.19
Const.
563.00
Mech.
53:50
Electrical
111.61
Plumbing
157,50
S.M.I.
5.31
Grading
20.00
Driveway Enc.
20,00
Infrastructure
1,828.35
TOTAL
REMARKS
;4
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 3/9/89 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
A.C. UNIT
COLL. AREA
SLAB GRADE
i
2ND FL. SQ. FT. ®
BONDING
YARD SPKLR SYSTEM •
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
POR.; SQ. FT. ®
SEWER OR SEPTIC TANK
ROUGH WIRING
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
GAS (ROUGH)
METER LOOP
DRAINAGE PIPING
CAR P. SQ. FT. ®
REINF. STEEL
WALL SO. FT.
TEMP. POLE
DRINKING FOUNTAIN.
URINAL
SO FT ®
WATER HEATER
SERVICE
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
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
F.AMING 4
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
ROOFI G /`
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 B.T.U.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1+/e c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
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
,ROUND PLUMBING7/d-X
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 APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM'
$
GRADING
cu. yd.
plug x$
_$
LUMBER GR.
FINAL INSP.
F.AMING 4
FINAL INSP.
ROOFI G /`
C �'O l� �/
G
67/e rb J
1
Jl CrPL
s
REMARKS
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWAL� 7,9
``
LATHING i F
MESH t
6 NSULATIONISOUND—Ic/
FINISH GRADING
/
/ FINAL INSPECTIO
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
I
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
OF
SCHOOL FACILITY FEES
N®TICE: THIS DOCUMENT CANNOT
TO: City RELDURUCATED, DATE:
Department of Community Development
78-105 Calle Estado
La Quinta, CA 92253
4r�
foil
406
-(9� ,C/
This is to certify t at J
developer of Q hich is
located at— it in
this District, has paid ahool facility fees imposed pursuant to the
at orit genera y O�vernment C de Secti S 3080 i ,(h amount of )
$
cov ring a total of squarU feet of (A) residential or
( ) industrial/commercial development and that building permits for
this footage in this development may now be issued by your jurisdiction.
([3
U -1
for DESERT ANDS UNIFIED SCHOOL DISTRICT
White - Building i1ftartment • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer
(10)-37
COUNTY OF'RIVERSIDEbEPARTMENT OF HEALTH Af°°'iO'° NO'
79_3 /c;? -3 — !�
ENVIRONMENTAL HEALTH SERVICES
r PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM
Applicant: Submit this form with four copies of a scaled plot plan (1-20 scale) drawn to County speculations as indicated on the attached check llsC
A non-refundable filing fee (see below) is required when the application is submitted. Check must be made payable to the County of
Riverside. Approval of this application shall remain valid for a period not to exceed one year from date of approval.
VERIFY fTEMS IN SECTION A FROM , BUILDING A SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG'*
`Agent. Contractor, Contact Person"
Phone
Address B.Phoire
Owner
Phone , .
Mailing Address
City State
'
Zip
Job Property Ad
Legal ption! (PM, Tract, Lot)
Lot Size
!
Water AgeMyl I•
Use of Ponnit P/P, CU etc 'Pt _
Other
V.A�f v
owelling, M Site Prep, etc.
lure of Applicant
bate'a ^ :+:w ; s. $v a.•t
CATEGORY: s�"~ ""� REV COD9� FEE C
CATEGORY:REV CODE .'i, FEE
M S� UBSURFACE DISPOSAL , 1238
_
❑ ` SITE EVALUATION UPON REQUEST 7349 $42.00
❑ MULTIPLE PARCELS WITHIN SAME ,
(NO PLOT`PLAN).�; •.
LAND DMSION
❑ SEWER/SEPTIC VERIFICATION 7348 $11.00
a. 1 st 4 Parcels (Each)' 1238 ; ' $45.00
(Less than 1 year)
b. Each Parcel after 4 7344 $16.00
❑ PRELIMINARY ELECTIVE 7352 $45.00
❑ RereviemiJ(2nd `review same parcel) -7344• $16.00
EVALUATION (Attach DOH SAN 53)
❑ Site Evaluation in Conjunction with
❑ HOLDING TANK 7351 ` $45.00
Critical Area 7346 ' $86.00:, i,
❑ ALTERNATIVE/EXPERIMENTAL 7345 $13200
❑ Site Evaluation Lot Less than
SYSTEM
10,000 Sq. Ft. 7347 $86.00
INRy►L DATE
Holding Tank Agreements Completed ❑ Yes GVNo l
Certificabon of Existing S.D. System. Required ❑ Yes ❑'I/Vor (��
Form ❑ Yes t7 -No
WOCB Clearanoe required. (Attach
/
DOH SAN 007, Santa Ana Region Only)
Sills Percolation Report Required. ❑ Yes EreNi X
Special Feasibility Boring Report Required. ❑ Yes ,
"
Detailed Contour Plot Plans Required (1 to 5 R interval) ❑ Yes❑/Nom
Other ❑ Yes t7(�
J
Staff Specialist Lot Inspection hequired ;' ❑Yes ❑ No -
- lot Inspection Date
Solis boring report by Project # Date
/ �y
'Map Page I r ' I Sall Type �u Approved by za r�3
Sills - Dffie
'
No. of Syslams
TyV6 of Syatem(s)
Hglding Tank O
/ No.Dwelling Unita 1 %
(1) Septic Tank
Soil Rate
kGr_eage/Sand
RepkKxwnerd
• }; ( ^ /L *red k
—(2—Leach�Line
Gal
Or
Sq. Ft
Sidewall allowance- ' a :�`
InstalG/ 1� *--, Line(s) R longft wide with
beach Bed s4 ft
trench area
R rock/ s R
min. UicFres io�k bedrainl'mes or
a a
�:�•;; per rurmiiig R /-
t NA
" Leachlines/bed special design for slope:
(3) Pit Diameter _
No. Pica
Pit Below
Seepage Pit Total
Applicable ;;
� /
Inlet (BI)
Max. Allowable
N/A {� Overburden factor
�q
�((+
9epth
No. 2 System ,,q
REMARKS:
This application i_ APPROVEb/D i71ED for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated
on the accompanie plo pla , using the `requirements set forth in SECTION C above. A building permit is necessary for the installation of ' the
apove-designed system. No construction is permitted.in the required reserved 100% expansion area.
1) Septic tank and sewer lines must be 50' minimum from any welist
Leach lines must be 100' minimum from any wells, including expansio ar
r 3 , Seepage pits must be 150' minimum from any wells, including expansion area /U
��� `
Si nature of Hearth Official Dat
Y
J
RECEIPT NO. _'�9/ 7 Issu/ 96 By �� Date 3 ' - '
DISTRICT: ❑ Riverside„ "C�rtd o ❑ Hemet `.{ q Perris ❑ Rancho Calif: 0 Blythe
DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHfTE - Office file 'YELLOW -Applicant -.PINK - Bldg. Dept GOLDENROD - Plans/Records
• � _ �.'�'„ a ,—) � ..L..
T4t�t 4 4a Q"
March 1, 1994
78-495 CALLE TAMPICO — LA QUINTA, CALIFORNIA 92253 - (619) 777-7000
FAX (619) 777-7101
To Whom It May Concern:
Please accept this letter in lieu of a copy of the California Energy commission required Title 24
Calculations for 5-1=G05=Avenida O reb gond La Quinta, California.
The house was inspected to meet all codes, including the Title 24 requirements during
construction.
Please feel free to contact us should you need further assistance or information.
Section 303(b) of the Uniform Building Code requires the Building Official to retain one set of
approved plans, specifications and computations, for a period not less than 90 days from the date
of completion of the work. The blueline drawings for this home were disposed of after the
above stated period of time.
Sincerely,
BUILDING AND SAFETY DEPARTMENT
Mark Harold
Building Inspector I1
kt
MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253