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9607-093 (RPL)LICENSED CONTRACTOR DECLARATION - I hereby affirm under penalty. Of(perjurykat lam licensed under provisions of Chapter 9 (commencing with Section}7000) of Division 3 of the Business and Profeasionals Code, and my License is in full force and effect. License # Lic. Class Exp. Date ` 2U'!, 41 C-53 3/31/A)1Date-1/, Signature of Contractor, 4 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ( ) 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, Business & Professionals Code). ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). ( ) I am exempt under Section B&P.C. for this reason Date Signature of Owner WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ( ) I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ( ) I have and will maintain workers' compensation insurance,. as required by Section 3700 of the Labo Code, for the performance of the, work for which this permit isti9s0ed.-'IV f-Ar'iks' compensation insurance ca?ir)er&'1p''8hb4y n5. are: Cartier Policy No. (This section need not be completed if the permit valuation is for $100.00 or less). ( ) I certify that in the performance of the 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 Californi nd agree that if I should become subject to the workers' compensation pr vis)J'ons of Section 3700 of the Labor \Code, I s all fo hwith comply Wit h.those pro4isAi ns. bate: �J Applicant' + . a. Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct.] agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for' pection Qurposes. Signature (Owner/Agent)` Date411,'`- BUILDING PERMIT PERMITy6417-093 CONTROLk 7 GS DATE 7/21/96 VALUATION i11,4W,00 LOT TRACT JOB SITE 5 4-659 AVENIDA A�1()PiT ZUKIL ADDRESS APN 774-264-1103 OWNER CONTRACTOR/DESIGNER/ENGINEER MAhl:.WARITI' NIAS'nilt POOLS 54659 AVENiDA hf0N 1*E7AJ&4A 73555 EiWY I i i LA QUINTA CA 01251 PALM I F8F RT CA 02160 Ili)9)W.)-6115 CISL# 16 USE OF PERMIT ANI JOI MIA KX.)L ANI! 811A ONLY R►'tTUATED C*0SM OF CONSTRt1UKIN 11,600ma fi11i1 AHA' H`1T I01-(XX)-4:t9.3IK 59).90 :' il�I'utA_'1'lt1N ! lili !0i-cw-1!R-0(?C1 hil-C1IANWAl,1-15i . i )OL 101 -000 -421 -ow )il.P.Cl'RICAI. I.7:)? - NX 11, 101 VK) -42040) S45.00 )'1.tlf�iltltJt7 F1 i - pJ?CrL I01 -0(X) -4I9 -(til) $27 'X) r I ,f11Y)TAL CONSMUC-110N AND PLAN C!iRCK $30390 LESS PRE -RAID lTA7.S $0.00 L I UT FEE.8 DUE, NOW )D "03.90 -,�j 96. tw g Y I RECEIPT DATE'- BY DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final POOLS - SPAS BLOCKWALL APPROVALS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test 6 7V Final Gas Piping PLUMBING APPROVALS Gas Test 8' Electric Final Waste Lines Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation CAW Gas Piping Gas Test Appliances Final COMMENTS: Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) MASTER PHLS & SPAS JUL 2 5 1996 Td4t 4 4(v Oubt 0 RECERV ED 78-495. CALLE TAMPICO - LA QUINTA, CALIFORNIA 92253 - (619) 777-7600• FAX (619) 777-7101 July 23, 1996 Master Pools 73-547 Highway 111 Palm Desert, CA 92260 ATTN: Bill Haneseck SUBJECT: Setback Adjustment 96425 LOCATION: 54-659 Avenida Montezuma This letter is to report approval of the subject setback adjustment application pursuant to Chapter 9.188 of the City -of La --Quinta Planning and Zoning regulations, subjecf to Conditions and according to: the attached Exhibit A as approved. SETBACK ADJUSTMENT REQUEST: To reduce the rear yard pool setback from 5 feet to 3 feet for a private swimming pool/spa. This request also incorporates a reduction in the southerly side yard setback from 5 feet to 2 feet for the necessary pool equipment. CONDITIONS: 1. Obtain all necessary building permit(s) from the Building and Safety Department, and, 2. The pool equipment location as shown on Exhibit A shall maintain a minimum of three (3) feet from the property line of the subject property. If the 3 foot requirement cannot be met, then the equipment shall be relocated. After review it was determined that: _1. .. This adjustment is.. consistent with the intent and purpose of the Zoning Ordinance to allow development of single family house§ -aiid swimming pools/spas in the SR Zoning District. - sba96-425 MAILING ADDRESS - P.O. BOX 1504 -. LA QUINTA, CALIFORNIA 92253 w T--,dy 4 4a Q" July 23, 1996 78-495 CALLE TAMPICO — LA QU1NTA, CALIFORNIA 92253 - (619) 777-7000 -FAX (619) 777-7101 Master Pools 73-547 Highway 111 Palm Desert, CA 92260 ATTN: Bill Haneseck SUBJECT: Setback Adjustment 96425 LOCATION: 54-659Avenida`Montezuma This letter is to report approval of the subject setback adjustment application pursuant to Chapter 9.188 of the City of La Quinta Planning and Zoning regulations, subject to Conditions and according to the attached Exhibit A as approved SETBACK ADJUSTMENT REQUEST: To reduce the rear yard pool setback from 5 feet to 3 feet for a private swimming pool/spa. This request also incorporates a reduction in the southerly side yard setback from 5 feet to 2 feet for the necessary pool equipment. CONDITIONS: 1. Obtain all necessary building permit(s) from the Building and Safety Department, and, 2. The pool equipment location as shown on Exhibit A shallmaintain a minimum of three (3) feet from the property line of the subject property. If the 3 foot requirement cannot be met, then the equipment shall be relocated After review it was determined that: 1. This adjustment is consistent with the intent and purpose of the Zoning Ordinance to allow development of single family houses and swimming pools/spas in the SR Zoning District. sba96-425 MAILING ADDRESS P.O. BOX 1504 - LA OUINTA, CALIFORNIA 92253 ��Y' 2. There are special circumstances applicable to the property, including such factors as size, shape, topography, .location and/or surroundings that justify approval of the adjustment, in that the private rear yard area is smaller than required under existing zoning, and maximization of the area between the house, swimming pool/spa, rear and side property line necessitates the adjustment in order to acommodate necessary equipment and adequate walldng surfaces around the pool/spa for the occupants and/or guests. 3. This adjustment will not be detrimental to the health, safety, and general. welfare of the community because the yard improvements will be privately maintained and fenced to prohibit access to the improvements unless by the owner's permission, and will be situated in the rear yard area so as to be as unobtrusive as possible on the surrounding properties. If you have any question, please contact me at 619-777-7069. Very truly yours, JERRY HERMAN COMMUNITY DEVELOPMENT DIRECTOR Wallace Nesbit Associate Planner WN Attachment c: Building & Safety Department sba96-425 II J U L 1 y 1=0 U U CITY OF LAQUINTA PLANNING DEPARTMENT S(/-} CASE N0: 96� ZS CITY OF LA QUINTA FEE: $100.00 PLANNING & DEVELOPMENT DEPARTMENT APPLICATION FOR SETBACK ADJUSTMENT APPLICANT: Submit this form with two copies of a scaled site plan, drawn to adequately depict the nature of the request. A nonrefundable fee of $100 is required when the Application is submitted. Check must be make payable to the "City of La Quinta". If the Applicant is not the owner of the property, a letter must be submitted by the owner authorizing the Applicant to execute this document in his behalf. PLEASE PPjRIN//T OR TYPE APPLICANT/CONTRACTOR: M,9J1e/' I&ee DATE CONTACT PERSON ( IF DIFFERENT) .C111 /�GIl cs�cK MAILING ADDRESS 73 5y7 ss (city PHONE -7 eIV ? 4 State) (Zip) OWNER' S NAME: omr- G& cJ"G�7- PHONE %%/ - 38.3f MAILING ADDRESS: SYJ #ue17l1R 1oille,241ne � owt�7 bt_ f 1z,5�a (Address) (City) (State) .(Zip) STREET ADDRESS OF PROPERTY: Sa �e LEGAL DESCRIPTION OF PROPERTY: LOT ## -3 -rRAe` ^ P I O C/C a -] ASSESSOR'S PARCEL NUMBER: ADJUSTMENT REQUESTED: 2 �,ef��zn�... �N s��-K rz�t �Oc�(- s��✓J /0411 r�t�v�/�/lllih/%- /�. SEi 3�F.GK ����% Tic- T 70 X14s 41/G U�fT REASON FOR REQUEST: JUSTIFICATION: No request for a Setback Adjustment shallbe granted unless .it is determined that it is .consistent with the inten and purpose of. this Ordinance; that there are special circumstances applic cal to the property, including such factors as size, shape, topography, location or surroundings that justify the approval of the adjustment of the setback requirement, and that the adjustment will not be detrimental to the health, safety, and general welfare of the community or be -detrimental to property in the area of the parcel for which the adjustment is requested. FORM.013/CS 4 65q P.O. BOX 1504 Building,-,� 78-105 CALLE ESTADO Address 54 � AVMXi& Mootezilria LA QUINTA, CALIFORNIA 92253 Ir 14 sr r, - •.. ws • Mailing Address P.O. B= 2MB City I Zip ITel. Contractor Sam Address Sam City izip State Lic.I City & Classif. 397169 Lic. # 282 MFUM, Cflgr., Designer Address Tel. 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 the Business and Professions Code, and my license is in full .force and effect.. Jl _ i�� '. e / r ;�, _ 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 Busihess 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 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.) 0 1, 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. 8 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 ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed it 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., It, 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 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 it 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' l r ' Date Mailing Address City, State, Zip HARD COPY No. 002377 BUILDING: TYPE CONST. OCC. GRP. A.P. Number 774-264-a3 Legal Description Lot 3 Project Description SIMIn fm3.1y dwailjm Dm. 1592 Sq. Ft. 430 No. No. DIN. Size Stories Units New EJ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $ 81,447.60 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 318.512 Const. 3719.00 Mech. 31.00 Electrical 70.12 Plumbing 69.00 S.M.I. 5.71 Grading Driveway Enc. 20.00 Infrastructure 7 , 1,2�2t1,.1 ,La`Jt.* 1 T K ::E!;I JsU TOTALI3X 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 ermit Validated by: Validation: A 5 7 6 0 6 10 't7 .4,18 U CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ 2ND FL. SQ. FT. POR. SO. FT. ® GAR.SO. FT. ® CAR P. I SQ. FT. WALL SO. 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 WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APP./EQUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM P. 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. SO. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL f7 7 0 `_, 7 SQ.FT.GAR ® 3/ac HOUSE SEWER REMARKS: VENTILATION GAS PIPING PERMIT FEE 11PERMIT 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 GRADEROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS / SEWER OR SEPTIC)f / ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. Z�'v GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. REINF. STEEL GAS (FINAL) P. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. 14FRAMING f{ F FINAL INSP. OOFING /,�0,t`v 7 f7 7 0 `_, 7 / p!J REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL ry LATHING 7 MESH CATION/SOUND FINISH GRADING / �J&FINAL INSPECTION v CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL 4 H U w s4 -1,65q �. T COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM / < 4 L T pplicant: Submit this form with four copies of a scaled plot plan (1-20 scale) drawn to) Runty specifications required on the attached check list. A non-refundable filing fee of 30 is required when the application is submitted. Check must be made payable to the Runty of Riverside Building Department Application Log # Name (Owner, Agent, Contractor, Etc.) ,rt' 1i < i X r, s e- <1 lr'/+S Mailing Address /1/, X 2 P 3 f City_ State r'/ ^/ Zip Code_ �� C' f Z Telephone I - ' 2 r' j *Job Property Address *City or - *Legal Description of Prpty. (Lot, PM, TR) Mt, n7fP<E. ,d : �:��;�ir /7� - !C *Assessor's Parcel No. 'Water Agency Use of Permit lIJA ! Iry `` `Lot `Size - l,C vr. 1-1. 1 6 SFD, MH Site Pre Planning Case # Py 1-.279 J_? X 1,-(] ./�.r � � • • it / �7..t ��' % -i - B/� Signature of Applicant Date *The above information must be verified from Building Application STAFF USE - DO NOT WRITE BELOW THIS LINE Initial Date / Certification of Existing S.D. System reqd. Yes[ ] No 1-1 WQCB Clearance reqd. Yes[ ] No[ -J Soils feasibility report reqd. Yes[ ] No ['] i Detailed boring report reqd. Yes[ 7 No f'] PA Detailed contour plot plans reqd. Yes C 7 No r-1 1 - 0 H Staff Specialist approval regd. Yes[ ] NoC -] Lot Inspection Date U W _ Soils/boring report by _ Proj . # Date / Soils Map Page 11 +A / Soil Type (ir Approved by I &I Date u / �F rj Type of System: No. of Bedrooms (1) Septic Tank Soil Rate Required Existing New Addition Replacement /L�U'f/ Gals. (2) Leach line sq. ft. Sidewall allowance Install Line(s) Leach bed (Bottom trench area) ft.._rock/ Sq. Ft. Ft. Long,._, Ft. wide Sq..Ft�. of per rerunning ft. with Min. "inches rock bottom-,__ N/A C J below drain lines area Leach lines/bed-special design (3) Pit Diameter, No. Pit Seepage Pit total depth It? for slope: Applicable ,ie[+.i- 6' C w--- Pits BI N/A Overburden factor /(� Max. allowable depth C,� x v� W 7, This application i$-approved`/#a%nAo&d for the design of a subsurface disposal s: -stem as indicated on the accompanied plot plan using the requirements set forth in Section B above. U A building permit is necessary for the installation of the above -designed system. z o Septic tank. and sewer lines must be _50' from any wells_ ' •'./A� / .1C'_ - H (2) Leach lines must be 100' min. from any wells including expansion -area Pq((3)•Seepage pits must be-15-0,1-min._from-any-wellsj.ncluding expansion area /� --~ -�. Sig,attire;oftHga,th,,Officia1 Date 7_ 6! , tVX RECEIPT NO. `f / Issued by r C Date . / k District: Riverside C ] Indio C T Hemet [ ] Perris[ ] Rancho Calif.[ ] Blythe[ ] / Distribution: WHITE -Office file YELLOW -Applicant PINK -Bldg. Dept. GOLDENROD -Pending File DOH SAN 122 (Rev. 2/86) '