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001674 (SFD)4 P.O. BOX 1504 No. 001674 Building 78-105 CALLE ESTADO Address 500 pts LA QUINTA, CALIFORNIA 92253 Owner Art Ande3"sM BUILDING: TYPE CONST. VN OCC: GRP. R 3 Mailing Address 45 � ��t �3 I.A.P. Number ia�a-�U5°~Q04 City Zip Tel. r1 3i xa mwl s �32a€1 340-6935 Legal Description Contractor Project Description Rilv=3_421 f'.t4a`�$ W t 3l-IL"t Sam Address City Zip Tela amp- State Lic. City DIM 1590 & Classif: Lic. # Sq. Ft. No. No. Dw. MR 430. Stories 'Arch., Engr., Size - � Units �. Designer New a Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECIMATION I hereby affirm that I am licensed under provisions of,.Chapter 9 (commencing with Section 7000) of D vision 3 of the Business and Professions�Code, and my license is in full force and effect. SIGNATUREf % DATE OWNER-BUILDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following t+��� reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a °hr� , perrnit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also ' requires the applicant for such permit to rile a signed statement-that he is licensed pursuant to PERMIT 1 AMOUNT the provisions of the Contractor's License Law, Chapter. 9 (commencing with Section 7000) of .c• Divisi6n-3 of the Business and Professions Code, -or the he is exempt therefrom, and the basis ' p�� for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit .Plan Chk: Dep. 20.00 subjects the applicant to a civil penalty of not more than rive hundred dollars ($500). . - .. ❑ I, as owner of the properly,.or my. employees with wages as their sole compensation, will Plan Chk. Bal... F0.04 do the -work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and COf1St. (S Professions Code:. The Contractor's License Law does not apply to an owner of property who 379.0 builds or improves thereon and who does such work himself or through his own employees, Mech. �_� provided that such improvements are not intended or offered for sale. If, however, .however, the building i 00 or improvement is sold within one year of completion, the owner-builderwill have the burden Electrical - 80.57 of proving that he did not build or improve for the purpose of sale.) e p ❑ •l, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing . 8540 struct the project.:(Sec. 7044, Business and Professions Coder 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. 5.74 such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - Grading ❑ 1 am exempt under Sec. B. & P.C. for this reason Driveway Enc. 20.00 Date owner Infrastructure 1,221.33 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 7.142 7-8 1. 42.28 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 thg work for which this permit is issued, l 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 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 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, Civil Code.) Side Setback from Property Line Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE INSPECTOR 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 Orr 8 Hermit I agree to comply with all city and county ordinances'and state'laws relating to building construction, and hereby authorize representatives ;r�of this" city to enter the above= mentioned property for inspection purrp,os4sF' —,­. ' �Valjd'ated by: Signature of applicant– = Wit' �'.• �_ Date Mailing Address �� ✓ ''T _ Validation: City, State, Zip A 2 3 1 7 8 15 185228 CK HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ 2ND FL. SQ. FT. ® POR. SQ. FT. ® GAR. SQ, FT. ® CAR P. SQ. FT. WALL SQ. FT. ® SQ. FT. ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET 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 APP.IEQUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE KITCHEN SINK ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. ®c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER REMARKS: GASPIPING PERMIT FEE PERMIT FEE PERMIT FEE DBLTOTAL 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 JJ v SEWER OR SEPTIC `iN' o ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REIN 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. PC (,FRAMING t'i' FINAL INSP. /L/ IA ROOFING ZI '/ Q%_ REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL 11 THING . MESH �J,'21NSULATION/SOUND G/ FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL. INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL. ,QLK- Y W hi�r�� � � t+GGlt�GtJ L V P.O. BOX 1504 APPLICATION ONLY Building ��O c, n � 78-105 CALLS CALIFORNIAESTAD9 Address J ,� o �-,.>•M, LA QUINTA, ORNIA 92253 Owner Mailing / Address r City Zip Tel. Contractor Zip State Lic. I City & Classif. Lic. # Arch., Engr., Designer Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under prov,Isions of Chapter 9 (commencing with Section 7000) of Division 3•dN the Business a d Prof 6"sions Code, and my license is in full force and effectN / / SIGNATURE / -' DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors License Law for the following reason: (Sec. 7031;5,13usiness and Professions Code: Any city or county which requires a permit to•construct, after, 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 or 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.) ❑ 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 .O 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 ($100) valuation 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 - Owner NOTICE TO APPLICANT. If, 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 '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 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 ins�ection'pur ores. � /fes � Signature of applicant �i �— Date_x .Mailing Address City, State, Zip BUILDING DIVISION BUILDING: TYPE CONST. -OCC. GRP. L� A.P. Number Legal Description L- c,4 Project Description Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ stimated Valuation PERMIT ,l AMOUNT Plan Chk. Dep. Plan Chk. 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 Permit Validated by: Validation:_ A2172 8 2 25x00 CK CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ® $ UNITS SLAB GRADE 2ND FL. SQ. FT. BONDING YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. ® GAS (ROUGH) DRAINAGE PIPING WALL SQ. FT. OTHER APPJEOUIP. DRINKING FOUNTAIN SQ. FT. ® 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.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. 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, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/e c SEWAGE DISPOSAL GAR. FIREWALL SO.FT.GAR ® 3/.c HOUSE SEWER LATHING 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 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 MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL E''b s 2� _0 Desert Sands Unified School District H BERMUDA DUNES r RANCHO MIRAGE C 82-879' HIGHWAY 11 1 • INDIO..CALIFORNIA 92201-5678 • (619) 347.8631 r INDIAN WELLS H PALM,DESERT d` LA OUINTA INDIO 1� Aug. 1.,' 1985 City of La.;Quinta Departmenof.Community Development;- 78-:105 -Cal 11- _ Esta:do La ..Qui-nta;' -.CA 92253' Re: La -Quinta..Collve°:.:Lots 3, 4,; 6 Gentlemen: The developer of 'the above referenced,;. La, Qu i nta Cove Lots 3, 43, " & 6 has mitigated, is impacts on Our-overcr6wded schools by.payment of the amountlof $628 per unit to. 'be,appli.ed'to the cost of. district .educational favi-li.tie's -made necessary by such new development. Sincerely, John .:Brooks Assistant.Superintende.nt :Business .Serv.ices .JDB/crm all Z O 11— U U W N M Z O H U W rn 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 $15 is required when the application is submitted. Check must be made payable to County of Riverside. Name Mailing Address City ~ State Zip Code(% Phone / C 'Property Address �'`City�Communitya 'Legal Description of Property (Lot, Parcel Map, Tract) '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 [I Soils feasibility report required Yes ❑ No [ f Detailed boring report required Yes ❑ No ❑ Detailed contour plot required Yes ❑ No ❑ Comments: Soils or boring report by Date Approved by -tDate• i ' U, a G 4Other"`f� -, Soils Map Page Soil Type Tract File No. Number of Bedrooms Septic Tank Size (gallons) Rate Required Type of System Ne❑wReplacement Eli Leach line sq. ft. of bottom area trench ,/ Leach bed (sq. ft. of`bottom area bed) Seepage Pit Diameter Number of Pits Seepage Pit Depth B.I. Total Depth of Pit Location of System " ire+' W AdditionalG- Requirements � /> `!tet k'%C .c•.,Y ,i% �. ,-. s.,._ A permits°approved/den,iedaforthe design of a subsurface disposal system as indicated on the accompanied rplot 'plan� using the requirements set forth in Section B above. A building permit is necessary for the installation of the above designed system. Signature of Health Official Date Receipt No. �Q �l Issued By 1 District: Riverside ❑ Indio ❑ Hemet ❑ Date j DISTRIBUTION: WHITE - Office File YELLOW - Applicant PINK - Building Dept. GOLDENROD - Pending File DOH SAN 122 (Rev 10/84)