002123 (SFD)P.O. BOX 1504 No. 002.234
Building 78-105 LA QUINTACCALIFORNIA92253
Address �3�°"S-.0 � tom'
Owner
BUILDING: TYPE CONST. VN OCC. GRP., R 3
Mailing
Address 1947
A.P. Number '771-21RIS-026
City B Zip Tel.
90032
Legal Description
IM ATMIeS
Contractor Project Description!ilttlt�%a
9
Address. .
CityZip Tela
Wim �r 92330 (714) 244--9--42
State Lic. City ifs 140
& Classif: 34-7740 Lic. # Sq. Ft. Cxr . 781 No. No. Dw.
Arch.;.Engr
Size Stories - Units
Designer New - Add ❑ Alter O Repair ❑ Demolition ❑
Address Tel.
City ].Zip State
I. Lica#
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
70 00) of. Division 3 of the Business and Professions Code, and my license is in full force and
ef act
SIGNATURES DATE -
J I OWNER -BUILDER DECLARATION' . .
I hereby affirm that I 'am exempt from the Contractor's License Law forthe following' Estimated V81UatlOn- �yc�
reason: (Sec. 7031:5,Business and Professions Code: Any city or county q .which requires, a � � I
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 Iicensed''pursuant to -PERMIT AMOUNT
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 'anyapplicant for a permit ; Plan -Chk. Dep. 2 -MI XID .
subjects the, applicant to a civil penalty'of not more than five hundred dollars ($500). . " " ' - • s
O I, as owner of the property, or my employees with wages as their sole compensation, will - Plan Chk. Bal. 6j3
do.the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and . .NA
Professions Code: The Contractor's License Law does not apply to an owner of property who COr1St.
builds or improves thereon and -who does such work himself or through his own employees, Mech. �►s6
. provided that' such improvements, are not intended or offered Jor sale. If, however,. the building : ?A- fit -
orimprovement is sold within one year of completion, the owner -builder will have the burden ' Electrical
of proving that he did not build or improve for the purpose of sale.)
O I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing '�
• 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 S.M•I•
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
O I am exempt under Seca- B. & P.C. for -this reason Grading M 01
14
Driveway Enc. ?�t�
Date Owner Infrastructure
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
O Copy is filed with the.city.. O Certified copy is hereby furnished.
TOTAL 7_flSl_5�.3a_
CERTIFICATE OF EXEMPTION FROM REMARKS
.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 of California
Date Owner
NOTICE TO APPLICANT: If, alter making this Certificate of Exemption -you should become ZONE: BY:
subject to the Workeis' Compensation provisions of the 'Labor Code, - you must forthwith Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked.
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, CivilCode.) Side Setback from Property Line
Lender's Name
Lender's Address FINAL DATE INSPECTOR
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.. Issued by: Date 1—A—RA Permit
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. Validated by:
Signature of applicantN Date
Mailing Address •A -V _ Validation:
City, State, Zip i
A4-699 3 11 � %95,59 �l
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. a $
2ND FL. SO. FT.
POR. SO. FT. a
GAR. SO, FT. a
CAR P. SO. FT.
WALL SO. FT. a
SO FT a
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
t'
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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.
SO. FT. a c
BATH TUB
SO. FT. a c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID a 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR a 3/4c
HOUSE SEWER
REMARKS:
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
CSEWER OR SEPI T /
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.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
'(LATHING 0(
ESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
rL, I UM "J JMM MAI UMr W IMI I IALJ,
GARDEN WALL FINAL
y;
D'esert S:ands U` ed`. St ool District
H BERMUDA DUNES
,
RANCHO MIRAGE 2"
82-87. HIGHWAY. .1.11 4) INDIO. CALIFORNIA 92201-5678 • (619) 347-8631
.r INDIAN, WELLS-
�. PALM DESERT..' -.
J` LA QUIN.TA-
�O
INDIO
Ma'rch.5 1986
City. of La Quinta
Department of`Communrty
Development:
78405 'Calle 'Estado
La Quinta, CA 92253
Ret Lot 1, Block 13
Santa Carmelita
Gentlemen:„
The de've1oper of the:
above•.•referenced Tot
has mitigated its i'mpdcts,
on.our,overcrowded schools by payment
of the amount of. $628= per uni t ;to be, applied to the. cost' of
district educationa=l
faci`lti.ti es . made necessary, by -such''new
development.
Sincerely,
`John D Brooks
-
Assistant°'.Supe:rinten.,04ht
•.
Business Services
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COUNTY OF RIVERSIDE, DEPARTMENT OF HEALTH
PERMIT APPLICATION FOR A SUBSURFACE DISPOSAL SYSTEM
Applicant: Submit this form with three copies of a scaled plot plan drawn to county specifications required on the
attached check list. A non refundable filing fee of $-T5`1s required when the application is submitted. Check must be
made payable to County of Riverside.
Name
Mailing Address
City
State
Zip Code
Phone
G�lot?k-E
0A
q7, o
'Property ��11ddr � � A
`Citt Cerxamm�ab
'Legal Description of Property (Lot, Parcel Map, Tract)
�r�--
/.9ff('V
'Assessors Parcel No.
Water Serving Property From
Lot size
Signature of Applicant Date
'The above information must be verified from Building Application
Staff Use — Do Not Write Below This Line
Initial Date
��.
WQCB Clearance required Yes ❑ No 4 71"
Soils feasibility report required Yes ❑ No 4
Detailed boring report required Yes ❑ No IV
T
Detailed contour plot required Yes ❑ No
Comments:
Soils or boring report by Date
Approved by Date
`1f 11 Soil T ��` - . —L!�'� / .,. - Other 2
Soils Map Page Type Tract File No
Number of BedroomsSeptic
Tank Size (gallons)
Rate Required
/`� `
Type of System
New Addition Replacement
Leach line sq. ft. of bottom area trench
Leach bed (sf"f. . of bottom area bed)
Seepage Pit Diameter
Number of Pits
Seepage Pit Depth B.I.
Total Depth of Pit
11541D, 6' E9e'
Location of S stem
Additional Requirements
A permit is a provedydeLn.ied for the design of a subsurface disposal system as indicated on the accompanied plot planbo
using the requirements set forth in Section B above. A building permit is necessary for the installation of the ave
designed system.
Signature of Health Official Date
Receipt No. �L Issued By
{
District: Riverside ❑ Indio.❑--- . Hemet ❑ Dated
DISTRIBUTION: WHITE - Office File YELLOW - Applicant PINK - Building Dept. GOLDENROD - Pending File
DOH SAN 122 (Rev 10/84)
THE ABOVE INFORMATION IS -SOURCED FROM PUBLIC DOCUMENTS AND IS NOT GUARANTEED
Copyright (C)1996 Dataquick Informatio
Page 1
APN
773-284-014.
Use: SINGLE RESIDENCE
Phone
Owners:
HUD
Pg-Grd: 224 -C1/879 -E1
Site
52525 AVENIDA
OBREGON*LA QUINTA CA
92253
Census: 0451.04.7
Mail
3 HUTTON
CENTRE DR
500*SANTA ANA CA
92707
Zoning: R1
F1oodP:
Legal
LOT 1 BLK
163 MB 019/019
SANTA
CARMELITA VALE LA Map: MB -019-019
Tr/Lot/B1:.00000-00/L-0001/163
Assd
$98,000
TRA
020078
SaleDt:
10/31/96
SaleAm: $147,554
Land
$24,500
Tax.":
$1,686.98
Doc # :
417048
1st Td:
PerImp:
750
Sta/Ex:
CUR
Lender:
Addl:
Ownshp:
TaxYr :95-96
Title :
FIRST SW
PrevDt: 10/18/96
Last Trans W/O $:
$/SgFt:
$94.34
PrevAm: $147,557T
Yr Blt:
1992
SgFeet:
1,564
OutImp:
GarSgF: 462
BedBth:
3/2.0
Addtnl:
StSurf:.Y
GarTyp: ATTACHED
#Story:
1
Roof :
SHAKE
MscBdg:
CarSgF:
#Units:
1
Electr:
DEVELOPED
Ht/C1 :
B
GarSF2:
LotSz :
6,098
Gas :
NO
FirePl:
Y
GarTy2:
Water :
DEVELOPED
Pool
Y
CarSF2:
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_Sewer�NO�View--_
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--------------------------------
THE ABOVE INFORMATION IS -SOURCED FROM PUBLIC DOCUMENTS AND IS NOT GUARANTEED
Copyright (C)1996 Dataquick Informatio