003609 (SFD)P.O. BOX 1504
Building 78-105 54-845 ObregOTi LA QUINTACCCALIFORNIAALLE DO
Address 92253
Owner
Lott Kier
Mailing
Address 222 Madeline Dr i
City Zip ITel.
Contractor
Richard Glover
City
Palm Desert
State Lic.
& Classif.
Arch., Engr.,
Designer
Address
92261 1. 340-5584
No.. 003609
BUILDING: TYPE CONST: OCC: GRP.
A.P. Number 774-293-04LI
Legal, Description
Project Description S:Ln rle Family Dwelling
. idly
473053 Lic. # 784 Sq. Ft. 1825 No- No. Dw
Size - Stories Units
Tel.
City Zip State
I I Lic. #
_ LICENSED CONTRACTOR'S DECLARATION,
1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Proffessions Code, and my licelnse is in full force and
effect. . _ _I %- ,f r
SIGNATURE - / /.I F 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 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 of property who
builds or enproves 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
New ❑ Add ❑ Alter ❑ _ Repair ❑
Garage 4001
Fence 309'
Estimated Valuation
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
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
❑ 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 (5100) valuation
or less.)
I certify that in the performance of thg work for which this permit is issued, 1 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 inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
HARD COPY
_TOTAL
REMARKS
w
102a
b
Demolition ❑
AMOUNT
4 6 7. b V
Jy .UU
iV�wMV
20 . V V
�40..uu
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: Date214j80 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SO. FT. ®
SO. 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
ROUGH PLUMB.
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GAS (ROUGH)
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
BOND BEAM
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR ® 3/ac
HOUSE SEWER
FRAMING
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
1 UN'S WUNA 1 UKLWINl I BALs
GARDEN WALL FINAL
OUND PLUMBIN '-7—
UNDERGROUND
A.C. UNIT
COLL. AREA
e�SLAB GRADE-�e--�' (�
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
AteORMS
-c..
SEWER OR E TIC T
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
n U
///►
(/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING i`% (L4% rnl,i/
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
1 UN'S WUNA 1 UKLWINl I BALs
GARDEN WALL FINAL
Desert Sands Unified School District
.•CERTIFICATION OF -PAYMENT
OF
SCHOOL FACILITY FEES &A
. CEJ
TO: City of La Quinta DATE: Xf(�
Department of Community Development
78-105 Calle Estado I .�
La Quinta, CA 92253 C,�
COQ '
This is to certify that
developer of7,1
ich is
located at
this District, has paid school facility fees impos pu uan�Jwithin the
authoritX,genera ed b Government Code S ction 53080 'n the amo nt of
Aey o-0
covering a total of 3' }Ca2 *;quare feet of ( t4—'re'sielential or
( ) industrial/commercial develo merit and that building permits for
this footage in this development may now be issued by your jurisdiction.
C
for DESERT SANDS-UNIlIFIED SCHOOL DISTRICT
White - Building Department •. Yellow - Facilities Planning • Pink
- Accounting • Gold - Developer
(10)-37
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COUNTY'OF-Rt'VERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION -
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.
Building Department Application. Log #
Na e 0 ner. Agent. Contractor. Eic.) 1
Mailing Address ,
Cdy
State% fj :
ZipCode � /- ' t
Telephon/e
'Job Progeny tltlress���
'`�G1 - Cbmmundy, �
al'oescnpt onProperty.�(L M. T,.B)rp...+7�t2 4r
•Assessor ;s Parcel No C -
'Wate�r well -
`_ "` • '„
Llse� f Perma t • t -� PJennng.case #
Lot Size
_
`
SFD.•MH Site Preparation Etc: �"�
1 U
.Signature of Applicaril - Date '
• 'The above information mustbe verified from Building Application '
STAFF USE — DO NOT WRITE BELOW THIS LINE
" initial Date
lop
Certification of Existing S.D. System required. , ° ; ❑ Yes ,5 N
WOCB Clearance required. ❑ Yes 21 No��'
t�
Soils feasibility report required. ❑ ,Yes D o tf�
Special, feasibility boring report required. ❑'Yes ® N
Detailed contour plot plans required El Yes ,O No; t
Yes
Staff Speaahst approval required. ❑ No Lot Inspection Date
e -
eSoils/boring report byProject # Date
l
Soils Map Page 1 r / el Soil Type- C—' Approved by
Date
wrf . + j
Type of System: U
' ❑New ❑Additional ❑Replacement •
No. of Bedrooms
(1) Septic Tank
Soil Rate Required
i ❑ Existing
w�
(2) Leach line sq. ft.
trench area)
Sidewall allowance
ft. rock/ Sq. Ft.
Install'*.._ Lines) Ft. Long, V
' 1 Ft_ ' d'e?wilp.� inches
Leaach bed Sq.
Ft. of bottom,,,,
(Bottom
„
ft. E&N/A
am�in.
per running - 1{
rock below drain lines
area
Leach lines/bed-special design for slope:
�{t
licable
(3) Pit Diameter.
`Qr ®
No., Pits
Pit Bl i
Seepage Pit total depth
-
Max. allowable depth �` f
N/A Overburden factor
t
"--
��•// �'KIL'�Cf..-'r..�y-.. /' (/GG '�1. .- /'A aV � �1 Vv' V f.!/7�DG(/i :/�^'�..
w 1
This application is app oved' deniedafor the design of a subsurface disposal system as indicated on the.accotnpanied plot plan using the requirements
set forth in Section B above: A building permit is necessary for the installation of the above -designed system.
Septic tank and sewer lines must bei50' from any wells, -440
P(22
Leach lines must be 100' min. from any wells including expansion area ..-�
wells including expansion area,i /p .! �V litre e4r,
(3))Seepage pits must be/1500'' min. from any wells
Signature Health Official /' /" '"
of
y'
RECEIPT NO.— Issued Issued byDate
District: ❑ Riverside 2In' ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe
Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File
DOH SAN 122 (Rev 8187)
LEIGHTON and ASSOCIATES
n INCORPORATED
GEOTECHNICAL and ENVIRONMENTAL ENGINEERING CONSULTANTS
February 22, 1988
Project No. 5870152-03
TO: Mr. Dick Glover
PO Box 1702
Palm Desert, California 92260
SUBJECT: Report of Compaction Test Results, Single Family Residence,
Avenida Obrego.n_, La Quinta, California
5'44 -w8'4 -'50W
At your request, we have performed four compaction tests on the near surface soils
.at the subject site. The test results and approximate test locations are detailed
in the attached sheets (Plates 1 and 2). The maximum density and optimum moisture
w ere determined as per ASTM Test Method D1557-78. The field density tests were
performed with a nuclear densometer in accordance with ASTM Test Method D2922-78.
The scope of our work was to perform compaction tests only and not to provide soil
or foundation engineering recommendations. Our services were performed after the
building pad was completed. The scope of our work did not include observing the
grading operation during placement of fills to check for uniformity of materials
used, construction methods, etc. Therefore, we cannot make any statement about
conditions below or beyond our test locations.
Should you have any questions regarding this report, please contact us.
Respectfully submitted,
LEIGHTON AND ASSOCIATES, INC.
Paul Hoerstin
Supervi Tech ici n
PH/BJI/mu
Distribution: (3) Addressee
Brent J. Inghram, RCE 40264
Chief Engineer
Enclosures: Plate 1, Compaction Test Summary
Plate 2, Sketch
Telex 2HIGHW49208 AGEO UR DESERT, CALIFORNIA 92260
BREN'T J.
INGHRAM
W No. 40264
oc Exp.
s CIVIL (6 ,
f F 1f
�lF
OF C A`��®
DAILY FIELD REPORT
No
Job Name p �� �� • C, LouE R
Project No.:
58�o %.5 Q13
Date: Z_ZZ_ as
. Loeat.iori: Sq _ $4 5 ^v�N�Oc� o8ii Gott
Weather:
Day: %4N ,
Contractor:
Foreman.
Field Technician: my,
Miles :
Hours
Equipment Working:
Inspection/ Testing of
A��LO�NG (�np
Test
No.
Test
Location
Elevation
or Depth
Soil
Type
Optimum
Moisture
Field
Moisture
Maximum
Density
Field
Density
Rel.
Comp.
I
seI
F-G•t
13.8
'1.9
108
143.4
95
z
to •8
X02 .9
95
3
8 .�
1'o a .i
00
4
'r G - 1'±
94 -
Summary of
Operations: F, G- F N 5 H G R o\OF
5� �L 1y P E tom'. F SNE GRa,\NaEt3
S\LlSNviV 1Z K-1 L K1%V.a`(o0.�
MlN-A tMsV\ an 10Z S\1 Bo
c.F
.a'
1
Supervisor:
Engineer:
Geologist:
Todays Yardage:
Yardage to Date:
LEIGHTON and ASSOCIATES
17975 Sky Park Circle, Suite E, Irvine, California 92714
Tel: (714) 556-1421 556-1422
100 (4.7T)
WHITE — File Copy YELLOW — Client Copy PINK - Field Copy GOLD — Office Copy
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