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05463 (SFD)Building Address 54-645 Owner T161f iCii ria Bieix wim Address 74-106 Vel.ard© M. City lZip Address 4 40 Qub& P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Dessert I -. 92264 1 613/346--8676 53-980 Avenida Ob><estoa City IZip I Tel. State Lic.I City & Classif. 550498 B-1 Lic. # Designer AddressTel. City Zip State I i Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section 7001)) of Division 3 of the Business and Professions Code, and my license is in full force and effect. i SIGNATURE - .+' l: '?,!-+� .r i 4 DATE G` OWNEWbUILDER DECLARATION r 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 rile 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). ❑ 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 appy 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 wither one year of completion, the owner -builder wig 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 appy 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 - r ❑ Copy is filed with the city. ❑ Certifiecopy,._ jereby fu nished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed i1 the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of tho 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 alifornia- DateOwner NOTICE TO APPLICANT: h, 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 shag 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 Lenders 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 certity 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 Address City, State, Zip No. 45 6 BUILDING: TYPE CONST. OCC: GRP. A.P. Number 774-273-'419 Legal Description Lot 7 Project Description SIS t Sq. Ft. 153 No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $82,960.043 PERMIT AMOUNT Plan Chk. Dep. 250.00 Plan Chk. Bal. 237.19 Const. 563.00 Mech. 53.50 Electrical Z I. Plumbing 357.50 S.M.I. 5.81 Grading 20.00 Driveway Enc. 20.00 Infrastructure TOTAL REMARKS .py 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 1ST FL. SO. FT. ® $ UNITS COLL. AREA y� 2N0 FL. � SQ. FT. YARD SPKLR SYSTEM BONDING MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® S TA GAR. SQ. FT. @ POWER OUTLET ROOF DRAINS FOUND. REINF. DRAINAGE PIPING CAR P. I Sp. FT. HEATING (FINAL) OTHER APPJEOUIP. WALL SO. FT. ® DRINKING FOUNTAIN FT ® URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FINAL INSP. 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 FIREPLACE SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1 Vi 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 GROUND PLUMBII UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS S TA 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 ///.2 FINAL INSP. Kt/(ROOFING �` �— (� /] `^� �/ %� Q /) REMARKS:- EMARKS:VENTILATION VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND/ FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIAIS GARDEN WALL FINAL Desert Sands Unified School District CERTIFICATION OF PAYMENT NOTICE: OF NOTICE: THIS DOCU� 5Qj9 C LITY FEES � THIS V �i9Y 6 -% BE DUPLICATED, TO: City of La Quinta DATE: Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 This is to certify that developer of ich is located at�Q ithin this District, has paid school facility feee imposed pursuant to the aut o ity genera a by Go ernment o S d o 53080 in the mount o co eying a total of square feet of ( )' esidential or ( ) industrial/commerc'al development nd that building permits for this footage in this development may w be issued by your jurisdiction. Ck *_ V -Vo// /////^/ or ESERT SANDS•UNIFIED SCHOOL DISTRICT White Building Department • Yellow - Facilit s Planning • Pink - Accounting • Gold - Developer (10)-37 „� ori r . ...<+. .•� r �• 4 �' '�' F :� � .r • COUNTY OF RIVERSIDE: DEPARTMENT OF HEALTH A°°°`aO'" Parcel NO• JENVIRONMENTAL HEALTH SERVICES 17N z'73 — D 1 �1 PERMIT APPCATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM Applicant:. Submf this form with four copies of a scaled plot plan (140 scale) drawn.to County speculations as indicated on the attached check IIsL A nonrefundable filing fee (see below) is required when the application is submitted. Check must be made payable to the County of Riveride. Approval of this application shall remain valid for a period not to exceed one year from date of approval. Q VERIFY ITEMS IN fCTION A FROM BUILDING 3 SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG 1r Z O Agent, Contractor,fact Pe ne Address 8 Phone l a�ef�-'sA li WOwner `� phone . Mailing Address City State Zip Jb Property d Legal Description Prop. (PM, Tract, Lip %�C �n IJIAG Z� SRS yrl CAt f1. Lot SizeWate/Well Use of PermitP/P, CU etc. 4 (2%4 i a Other a Qu c/�'i� 2_21r X) Q Q 6' V' ) JA. � elling Site Prep; etc. Sirnidure of Applicant Date >- CA ORY: REV CODE FEE CATEGORY: REV CODE FEE Q SUBSUREAC ISPOSAL! 1236.$45.00.• t ❑ SITE. EVALUATION UPON REQUEST 7349 $42.00 ❑ MULTIPLE P ELS WITHIN SAME J T i (NO PLOT PLAN) 1n LAND DMSI / ❑ SEWER/SEPTIC VERIFICATION 7348 $11.00 pa. 1st 4 Pa s (Each) 1238 $45.00 (Less than 1 year) i b. Each k after 4 7344 •+•316.00 D °❑ PRELIMINARY ELECTIVE 7352 $45.00 W ❑ Rereview (2n same parcel) 7344 $16.00 .~'EVALUATION (Attach DOH SAN 53) U) ❑ Slte Evalua Conjunction with. t„�` ❑ HOLDING TANK 7351 $45.00 r Crttkal Area 7346 $86.00 ❑ ALTERNATIVE/EXPERIMENTAL 7345 $13200 ; ❑ Site Evalu Less than SYSTEM 10,000 Sq, F � 7347 $86.00 IIN'fT`I�A-� DATE p 'N!, t; Holding Tank Ag Completed ❑ Yes N Imo”' �- '' ' %- 0 Certification of ng S.D. System Required ❑ Yes 200/, f +WQCB ulred. (Attach Form ❑ Yes DOH SAN 007 Ana Region Only) Y. Sella Percolatkxl'.' Required. ❑Yes No/ `L Special FeaslbN r ng Report Required. . __ ❑ _Yes.. _ 010 Detailed Contour PI s'Required (1 to 5,it interval) ❑Yes N Other 11 Yes ETlb c3,"/ ' ".. Staff Specialist I! nspection Required ✓ ❑ Yes ❑' No Lot Inspection bate yr Soils boring repofby�/ A f Projec Data Sella 'Map Page -f .. / Sol Type Vim — Approved by 1�-G.t� Date C.) No. of Systems 1 Tyne of Systems)No. Dwelling Unita / (1) Septic Tank Soil Rate Grease/Sand 2 f VO Holding Tank ❑ Existing Bedrooms, F.irdnrethft '40rease Intcp A Q I O�IQevv O Replacement3 ,6%2'h'}C: fGal U UJ \ ) Lesch Line Sq.Ft Sidewall allowance IrrsIDf . Line(s) R long H wide with Bed sq. ft trench ¢rCa fL rook/ sq. R min. below dratnlines or etea� . per running ft - t=rt�n Leachlines/bed spsciel design for slope: (3) Pit Diameter No. Pits Pit Below Seepage Pit Totel Depth 'Other: ' Applicable r i _L Inlet (BI) �k 7 N/A Overburden factor !, Max. Allow" Depth No. 2 System �� 1 REMARKS:' This application ' APPRO�pk, ENIf DMforthe category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated ' 0 on the accompan plo using the requirements set forth in SECTION C above. A:? -building permit .is necessary for the installation of the Oabove -designed 'system. No construction is permitted in the required reserved 100% expansion area.. r� 1 f Sep tic ta`nk and sewer lines must be 50' minimum from any wells /U. % (2 Leach lines must be..100' minimum from any wells, including expansio ar CQ/ �W Seepage,,pits,must be 150'• minimum fro any wells, including expansion area �- rt.,iu�, �'4 3— 7 gy �l ioc.4 'Si ature of Health Official Dat RECEIPT NO. ` ! 7 Issued By- e J i DISTRICT: ❑ Riverside, Indio ❑ Hemet q' Perris ❑ Rancho Calif. ❑ . Blythe DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records F �� �lII is111�� , . 'III E s —4 UF Ti�9wS This Certificate issued pursuant. to the requirements of Section 306 of the. Uniform Building Code •certifying that at the time of issuance,this structure was in compliance,-with'the various ordinances of -the City regulating building construction or use.. For the following: BUILDING ADDRESS .54-645 V Obregon Use Classification.'. SFD Bldg: Permit No. 054 6 3" ` Group - •.R3 Type Construction VN Fre Zone Use Zone SR Owner of Building ' . Wolfgang Bierman' Address., -74-106 Velardo .Rd City Palm Desert', CA. 92260 . By, Mark Harold J.. - ^. N ~�A.Dote: 7/26/90 , Building Official a POST IN A CONSPICUOUS PLAC9 x