04424 (SFD)42.E
P.O. BOX 1504 ; x.
Building 78-105 CALLE ESTADO
Address 52-717 Obregon LA QUINTA, CALIFORNIA 92253
Owner
Coachella Valley Land Company BUILDING: TYPE CONST. OCC. GRP.'
Mailing
Address 247 B. '. ahgt% atz Way,, #Q .... A.P. Number. 773-284-024-
City Zip Tel.
P41m Spring$ 92262 322-100 Legal Description '
Contractor h i�f o ro.
Starr Construction Project Description
-
Address
City ZIp Tel.
State Lic. City City X8.95 aL .
& Classif. Lic. # _ 'Sq., Ft. .,146,3. No, - No: Dw.
Arch., Engr., Size Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel. 47.5 sed. ftp garage
City Zip State 170 • of 4 r VMod fence
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that Tram licensed under provisions of Chapter 9 (commencing with Section
70 OO) of Division 3 of the Business and Professions Code, and my license is in full force and
effect. i.. a ee fir-' r+ ' >!✓» c.y.cw -ar.1% Ll:.
SIGNATURE r - DATE
OWNER-BUILDER DECLARATION Estimated Valuation
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 PERMIT -AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of . ,a
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 Plan Chk..Dep. $250.00
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
O I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. a 39 v14
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const.- '364 .00Professions 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, Mech. sr�
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 Electrical'•
of proving that he did not build, or improve for the purpose of sale.) 9
17
OI, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing IDS.. 0-0
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.1. NO;
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading 20#00 .
O I am exempt under Sec. 8. 8 P.C. for this reason
Driveway Enc. 20.00
Date ' owner Infrastructure ). f 69c8.96
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 tfieieofA(Sec. 3800, Labor Code.)
Policy No. Company ✓ %, A - 4-11
O Copy is filed with the city. O Certified copy is hereby furnished.
TOTAL I $71t609-53
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit Is for one hundred dollars $100 valuation 4 "7s'Y t 1 •` s,T �Y"" �`4g a •. 1
or less.) _
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_
NOTICE: TO, APPLICANT: If, after making this Certificate of Exemption you should become ZONE: BY:
subject to the Workers' 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 $Iris Street Setback from Center Line
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.) 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 it work thereunder is suspended for 180 days. 9/9/88
I certify that I have read this application and state that the above information. is correct. Issued by: Date 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 applicant Date
Mailing Address Validation:
.City, -State, Zip'
WHITE FINANCE PINK APPLICANT GREEN BUILDING, GOLDENROD; . ASSESSORS OFFICE -HARD COPY ,FILE
w_.. e,.-.... i._ ..4.: ,. �,. _,..,. ... �,.... ......: i''__�..,, .T .-.k-..�.c _c.fl.'-, ._ .r .,y...t... _z+fi:.•'&:: •. $'. .... _.....H_- _.µms_ •-•_ .. :_,. .,.. •.. r.*.-�. .r,;F .., _:a::_.., .-Ca��,.;-t ...t1 r., :'1..: _�._ .. _....., tifi::Y
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO FT y $
UNITS
COLL. AREA
SLAB GRADE
ROUGH PLUMB
YARD SPKLR SYSTEM
2N0 FL SO FT. a
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR SO FTat
DUCT WORK
ROCK STORAGE
FOUND. REINF.
POWER OUTLET
ROOF DRAINS
GAR SO. FT.
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
-
DRAINAGE PIPING
CAR P. SO FT. @
GROUT
WATER HEATER
DRINKING FOUNTAIN
WALL SO. FT. @
FINAL INSP.
BOND BEAM
WATER SYSTEM
URINAL
SO. FT. rd
GRADING
cu. yd.
PIUs X$
=$
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
0/e -Td
L/7j
U/'
V
'
0
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTOXDISHI
APPLIANCE DRYER
VENTILATION
GARBAGE DISPOSAL
FURNACE UNIT . WALL FLOOR SUSPENDED
FIRE ZONE ROOFING
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FIREPLACE
lKITCHEN 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. @ c
BATH TUB
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 1 V: c
SEWAGE DISPOSAL
SO.FT.GAR @ Y c
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 8 AIR COND. SOLAR
SETBACK
GROUND PLUMBII-,?G
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.
PIUs X$
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
0/e -Td
L/7j
U/'
V
'
0
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR,
GAR. FIREWALL
(LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
Building
Address —tea
Owner
' u�l'jGrGu
P.O. BOX 1504 APPLICATION ONLY
78-105 CALLE ESTADO
,c- LA QUINTA, CALIFORNIA 92253
G1O C'f�EG L a 1�.�1LLE,/ 4iiY D
BUILDING: TYPE CONST. OCC. GRP.
Mailing -
Address a 1,/7 7' 14V L /r'z G!%.4 V ty.L
A.P. Number 7 7-3.,- _-2 2 "t
-
Legal Description //.�. �- / 7
City
Zip
9
Tel. ,
32 Z
�(J s
Z
- /o 2-
Project Description .9i iJ e„ r. /;aAt/G/! .7�ulEi Gi�J�
Contractor
ZONE:
TOTAL
Address
CERTIFICATE OF EXEMPTION FROM
-2,,117 05" T W u &V,4 v
City
IZIP
Tel.:
State Lic.
& Classif.
Arch., Engr.,
Designer
Address
City
Lic. #
el. el
r Sq. Ft.
Size
New 15�
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 th usiness and Professions Code, and my licens is in full fort and
effect._ /J 'i"', S�e Y
_SIGNATURE - / 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 rive 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
No. No. Dw.
/ylQ3 Stories / Units
Add ❑ Alter ❑ Repair ❑ - -Demolition ❑
stimated Valuation
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.1.
RIM
such projects with a contract0r(S) licensed pursuant to the Contractors License Law.)
❑ I am exempt under Sec. B. 8 P:C. for this reason
Grading
Driveway Enc.
'or less.)
I certify that in.the performance of the work./for which this permit is issued, I shall not
Date owner
Infrastructure ,
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
r
�r?r_�, sit A1.Ar.i
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a`certificate of consent) to self-insule, or a certificate of
Worker's Compensation Insurance, or a certified copy tq'reot. (S6c. 3800, Labor Code.)
Policy No. Company �( /
Date Owner
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
ZONE:
TOTAL
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS', COMPENSATION INSURANCE
Front Setbackffrom Center Line f
/ a0 -ca -37 FE,ycE
AMOUNT
O
L
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
A/5 :4 07 4 /1 4 041) APP A'?—QQ 47
'or less.)
I certify that in.the performance of the work./for which this permit is issued, I shall not
- - -
ill GASH i TOTAL 1 275, 00
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
r
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption youshould become
ZONE:
BY:.
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
'
Minimum Setback Distances: r '
Front Setbackffrom Center Line f
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCYSide
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, Civil Code.)
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 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 applicant Date
.Mailing Address
Validation:
City, State, Zip
BUILDING DIVISION
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
SLAB GRADE
21SID FL. SO. FT.
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. @
POWER OUTLET
ROOF DRAINS
CARP. SO. FT. ®
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT. ®
OTHER APP.IEOUIP.
DRINKING FOUNTAIN
SO FT (ria
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
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.T.U.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1114 c
SEWAGE DISPOSAL
GAR. FIREWALL
SO.FT.GAR ® 3/ac
HOUSE SEWER
LATHING
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE --JCONST.
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.IEOUIP.
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
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
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COUNTY OF RIVERSIDE, DEPARTMENT OF HEALTH
ENVIRONMENTAL HEALTH SERVICES DMSION J' OR
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 specifications required on the attached check list.
A non-refundable filing fee of $40 is required when the application is submitted. Check must be made payable to the County of Riverside. t
Building Department Application Log N
Name (Owner. Agent. Contractor. Etc.)
Mailing Address
City
State
Zip Code
Telephone
11 L
i z 4 2.
3 2 z —/o 4 l0
'Job Property Address
'City or Corn nity 'Legal Description of Progeny (Lot. PM. TR)
5 - CS 6 /2 G'a J
i{ ��.9 t'sz !-oT' / ,�',[� �. 3 Ll .cs . r' 1
'Assessor's Parcel No
Water Agency or Well
V w A•®�
Use of Permit Planning Case M
Lot Size
y73 -a&y- oz�
1,� twra
SFO. MH Site Preparation Etch
Signature of Applicant Date
'The above information must be verified from Building Application
f, STAFF USE = DO NOT WRITE BELOW THIS LINE
In tial Date
Certification of Existing S.D. System required. ❑ Yes El No��
WOCB Clearance required. �* ❑ Yes El No
Soils feasibility report required.•, ❑ Yes E bNo"'
Special feasibility boring report required. El Yes No
''Detailed contour plot plans required. ❑ Yes No
Staff Specialist approval required. ❑ Yes No Lot Inspection Date t
Soils/boring report by 01 rid/,01 Project N Date
Soils Map.Page Soil Type Approved by Date
Type of System:
No. of Bedrooms
(1) Septic Tank /
Soil Rate Required
❑ Existing New ❑Additional ❑Replacement .,
��
Gals.
"!Gals.
�t
(2) Leach line sq. ft.
Sidewall allowance Install +• Lines) � Ft. Long,
�_
Leach bed Sq.
(Bottom trench area)
ft. rock/ Sq. Ft. Ft. wide With min. inches
Ft. of bottom
per running ft. El 15 k below drain lines
area
Leach lines/bed-special design for slope:
(3) Pit Diameter
No. Pits
Pit BI'
Seepage Pit total depth_
Applicable
❑ 5' 6'
!
' f
l
Max. allowable depth
N/A Overburden factor
!
r f ' C &POYA1/C� PP
EUb �/ t3c t 7✓ -<
%V Wt i
IV
� 4
This application is approved/denied for the design of�a subsurface disposal system as indicated on the accompanied plot plan using the requirements
set forth in Section B above. A building permit is necessary for the installation of the above -designed system.
19 Septic tank and sewer lines must be 50' from any wells
-)E
lines must be 100' min. from any wells including expansion area
I,2 ge pits be 1,56' in. from any -wells including expansion area
Signa re Of eat Cral Date
r
R`ECEIPT NO. �� t
Issued by w\ 61
Date 51�s''�1ts
District: ❑ Riverside ❑ Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe
Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File
DOH -SAN -122 (Rev. 4/88)
�.7 .
Of
A v R ofFI:E OF' E. LEON.SPALGY
1 !` - COari05-�0`EA
Q AG(ZICU.L f U.IZ/1L Cti1Cv
O11SSIONER
)A ES O WALLACE
0 rI �, '. �'�i �U� •. � ,�ss�srr�r �nH•uc5iu•cP
' ^ ^' WEIGI TS & .ME-ASUI ES. }
CLEMENT BENVEIrISTE
� � 3 ) 4. 5yt SEALER
ire ,
49-613 `Hwy, .86, Bu1;W.I3-12
'Conchella,-.GA •`92236;: : f`.
gq) 619-342-8191
DATE
DEVELOPER'S NAME s ' � i"`/� ,� C' e-J �' ;'d u.; Fp. r-i o
ADDRESS:
TEL,EPi ONEt ( 4-1 f) 3.)
773.-
Dear Developer:
After reviewing your laruiscaping:plans, all plant material listed 1.is not in
violation of guarant-ine''`laws governing ;the Coachella Valley.If substitutions
do-occur and they.differ fran plant, mjterial listed,, tliis office'nnast be notified
imnediately.
Thank you for protecting and preservingthe::Coachella'.Valley's pest-free environment.
Agricultural Comaissi°' er's OEFice
ccc Indio and Riverside-Office
r^