001675 (SFD)Building 53-644 ,� t3a ObTegCm
Address
Owner
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Art Andersm
Mailing
Address 4-5-7010 RMICho Fa"+S
A «
City Zip Tel.
iA-- M1161 92200 1
340-6935
Contractor
ty jZip _ Tela
swin
I
State Lic. y "
Arch.; Engr.,
Designer
Address
No. 001675
BUILDING: TYPE CONST. NT OCC: GRP. R 3
A.P. Number 774-1001
Legal Description lot 6
Project Description 44i > elp fxMiliv 1 .lifts
City = 1594
Lic. # Sq. Ft. No. No. Dw.
Size E�- Stories Units 1
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
(vision 3 ofthee BBhsiness-and•Prdfessions •Code, and my license is in full force and
effect.
SIGNATUREIC ..�" 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 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 doesnotapply 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 contractingwith 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.)
O 1 am exempt under Sec. . B: & P.C. for this reason
Date Owner
WORKERS' COMPENSATIONDECLARATION
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
WORKERS'COMPENSATIONINSURANCE
(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.
New d Add ❑ Alter ❑ Repair ❑ Demolition ❑
a
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 I Minimum Setback Distances:
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 it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
1 agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize.represeotatives of this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant ��_�. r te' Date---,,
Mailing Address 1
City, State, Zip °
HARD COPY
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 815-85Permit
Validated by:
Validation:
A2315 8 15 i42666. CC
60
24
Estimated Valuation
$ 81r422.00
PERMIT
AMOUNT
Plan Chk. Dep.:
250.00
Plan Chk. Bal.,.,
Const..
1
Mech.
31.00
Electrical
W.17
Plumbing
815.00
S.M.I.
�a
Grading
Driveway Enc.
20.00
Infrastructure
1.221.33.
r
2gl76.60
1,926.60
TOTAL
REMARKS
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 I Minimum Setback Distances:
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 it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
1 agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize.represeotatives of this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant ��_�. r te' Date---,,
Mailing Address 1
City, State, Zip °
HARD COPY
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 815-85Permit
Validated by:
Validation:
A2315 8 15 i42666. CC
60
24
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
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
r
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
BOND BEAM
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1Ya c
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FRAMING fr
FINAL INSP.
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 f%S
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTI K�-S
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.� '
r
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.
$ —Plus—x$—=$
LUMBER GR.
FINAL INSP.
FRAMING fr
FINAL INSP.
/}ROOFING d
r
�rC
/
0-10/
REMARKS:
fi
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
i INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
I NSYtIa UN'S WUNA 1 UKUWIN111ALS.
GARDEN WALL FINAL
Building
Address
Owner
T4&f
P.O. BOX 1504 APPLICATION ONLY
78-105 CALLS
LA QUINTA, CALIFORNIAORNIA 92253
(--) r A- \ A rl P r s b Y ---
Mailing 1 n (�
Address 1—f /,5O
City Zip Tel51�`0a is
Contractor
ress
Zip . Tel..
State Lic. - I City
& Classif. Lic. #
Arch., Engr.,
Designer
Address
City (Zip (State I
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that.l-am licensed under pfpvJsions of Chapter 9 (commencing with Section
7000) of Divii ' 3 of iiia Busi as��� Professions my license is in full force and
effect. ,/J
A
SIGNATURE L/•� 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, atter, improve, demolish, or repair any structure, prior to its Issuance also
requires the applicant for such permit to We 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
or proving that he did not build or improve for the purpose of sale.)
b 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.)
O 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, alter 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
Ihereby 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 inspec Joripu oses.
Signature of applicant Date�y
Mailing Address__
City, State, Zip
BUILDING DIVISION
BUILDING: TYPE CO-NyST.y'/ OC/C'. /GRP.
A.P. Number
Legal Description h lei �D
Project Description
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
d
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
h
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:
A2171. 8 2 25800
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE
2ND FL. SQ. FT. ®
BONDING
YARD SPKLR SYSTEM "
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO, FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT.
OTHER APP.IEQUIP.
DRINKING FOUNTAIN
SO. 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
WASH ER(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,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 ® 11/4 c
SEWAGE DISPOSAL
GAR. FIREWALL
SQ.FT.GAR ® lAc
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 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
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 SIGNATURES/INITIALS
GARDEN WALL FINAL d
. 1. .
M
'06%f If 0 S
2 10
Desert Sands Uni&ed School: District
N BERMu0A:DUNES r R
RANCHO MIRAGE 82-879 HIGHWAY 111 0 IND10. CALIFORNIA 92 201-56 78 (619) 347.8631
INDIAN WELLS . ti
PALM DESERT a
-P LA OUINTA
`'gyp IN0IO �?
a
- 1
Aug. 1, 1985
City of La Quinta '
Department -of Community Development
78-1O5`Cal le -Estado
La 'Quinta, CA '92253
Re: LairQuinta. CoVe'-...Lots 3, 411 s 6
Gentlemen.:
The developer of the above referenced La Quinta Cove Lots
3, '4, -,&"6
has-mitiq ted..fts impacts on.our overcroWde.d'schools-by payment
of the 'amount of $628 Per unit to'be applied to-th.e.cost-of
district ;:educational facial i:ties made necessary by such new
development.
sin'cerely,
}
John Brooks
r Asslstant Superintendent
-., Business Services''
.JDB/crm
4
•
1
Z
O
U
W
to
m
Z
O
H
U
W
N
U
Z
O
U
W
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
,4 7 e)
✓
City ' '
State
Zip Code
Phone
, -
'moo �y�?s,
'Property Address t
Coity oOCommunity
`x
Lee/gal Description of Property (Lot, Parcel Map, Tract)
.t, r • l;,i�i r
�C f, r ' ,
r1 /,pg - l ,Yee '-y'-
"Assessors Parcel No. /
Water Serving Prroopertyt 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
Soils feasibility report required Yes ElNo EDt
Detailed boring report required . Yes ❑ No Ij
i
Detailed contour plot required Yes ❑ No C
Comments:
Soils or boring report by Date
Approved byit C; e
Soils Map Page Soil Type c Tract File No. Q Other
Number of Bedrooms
Septic Tank Size (gallons)
Rate Required
j��� ����
Type of System
Ne❑w��. Addition Replacement
�� �C�
Leach line sq. ft. of bottom area trench
Leach bed (sqAt tof bottom area bed)
Seepage Pit Diameter
ASO 6r O -"-
Number of Pits
Seepage Pit Depth B.I.
Total Depth of Pit
Location of System, f
C�—'V A ,-/ q '-6- ,
Additional Requirements J'-0
j
!/ r .G ,rr' ,.�.�� ,�... /,� ',.•• . 1 1� � r'r-, �r -. Y � �✓y''> . / f j�it.ac�;
`x'� t r • „/ �a� r? . , -4- rl ✓ f;_ .f , f c c. Dom. R_�.�-t.-� l< r nti�, /8 / -a. ,
A permit is,a,ppro� ved/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.
A -j
Signature of Health Official / Date
Receipt No. 14 tf/ Issued By f yr
District: Riverside ❑ Indio ❑ " Hemet ❑ Date
DISTRIBUTION: WHITE - Office File YELLOW = Applicant PINK - Building Dept. GOLDENROD - Pending File
DOH SAN 122 (Rev 10/84)