PLBG (13899) + SFD (002442)54255 Avenida Martinez
13899
002442
T 0 0
.0 . lit t 4 4 a"
Building' 54-255 Ave. Martinez
Owner Coachella Valley Land
Mailing
Address 78-150 Calle Tampico
CityZip Tel.
La Quint#, CA 92253
Contractor
R.Y.S. Plumbing
Add ess
Y 110 Vtii.ardo, Ar.
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
i?al.m Desert, - r 92260 1341-9224
State Ljc.C_36 502396 City 3830
& Classif. Lic. #
Arch., Engr.,
Designer
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I ereby affirm -that I am licensed under provisions of Chapter 9 (commencing with Section
7 0) of Division 3 of the Business and Professions Code, and my license is in full force and
fect. e .
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 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 (8500).
❑ 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.)
❑ 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
❑ 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 (S 100 valuation
or less.)
I certify that in the performance of lhg work;forwhich' this permit islissued, I shall not
employ any person in any -manner so as3to become subject to'the Workers' Compensation
Laws of California..^„. Z ✓ { ,i
Date ' f Owner s► ! t L + a#
NOTICE TO APPLICANT.,,_If, -after making this Certificate of Exemption you should become
7 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 sof this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
No. 13999
BUILDING: TYPE CONST. OCC. GRP.
IA.P. Number
,Legal Description
sewer connect
Project Description
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
or
Estimated Valuation $1,080.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
30.00
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
30.00
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from CentdrRLlne
Side Setback from Prope rtyjLi
J
FINAL DATE INSPECTOR 1 I SI
Issued by: Date / A*N pe it /.
Validated by:
Validation:
\i
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
2ND FL. SO. FT.
BONDING
YARD SPKLR SYSTEM
STORAGE TANK
MOBILEHOME SVC.
BAR SINK
POR. SO. FT.
DUCT WORK
ROCK STORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT. ®
OTHER APPJEQUIP.
DRAINAGE PIPING
WALL SQ. FT.
TEMP. POLE
DRINKING FOUNTAIN
SO. FT. ®
GROUT
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER SYSTEM
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
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
SPARK ARRESTOR
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LATHING
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 PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER o@Rrgi FkMfrL
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
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
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION&�
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
COACHELLA VALLEY WATER DISTRICT
CASH RECEIPT DETAIL K20 A��ft6
Received Fmim:
Address: •
Account No. / LoI(a)
Service Address
❑ Meter(s)
❑ Service($)
❑ Backflow(s)
❑ House Lateral(s)
❑ DetectorCheck(s)
❑ Meter Surcharge
Sanitation Capacity Charge -SS—
❑ WS.B.F.C.
❑ Temporary Construction Meter
❑ Tum on Charge
❑ Uncollected Account - Name
❑ Inspection Fee -Tract -
Fee -
❑ Plan Check Fees Water I Sewer -
Tract -
❑ Bond Payment - A.D. -_Bond.
Assmt
❑ Customer Deposit
❑ Other
G.A. Code
TOTAL S --J L25 //t1
Remarks:
❑COPY to:
Cash Water Service ! 6.
Check
Money - Cashier
0
rder ,_ LV WD-aie tre9)
4
P.O. BOX 1504
Bujldjng54-255 A0 M xm 78 105 CALLE
A7lriracc LA QUINTA, CALIFORNIAORNIA 92253
Owner I
mailing I
Address fis5 Palm Cir. Y;(m Dr. suitim 10()
City I Zip ITel.
Contractor
ftv, ,mss cwstructim Co.
Address
saw
Zip -Tel:
State Lic. City
& Classif. 472924 Lic. #
Arch., Engr.,
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
70 OO) of Division 3 of the Business and Professions Code, and my license is'in full force and
effect.
SIGNATURE -i+ DATE
r - 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, Bussness 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.) •
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
.strucl 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. 0 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 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 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 allcity 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.
• r
Signature of applicant Date
Mailing Address
City, State, Zip
HARD COPY
No. 002442
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number 774 -253 --OM
Legal Description i•
Project Description Simlot t f.yti1y C 1VW_q
ZONE:
BY:
Minimum Setback Distances:
Front Setback from Center Line
1%913 1430
Sq. Ft. an
Size
No. No. Dw.
Stories Units
New pr Add ❑
Alter ❑ Repair ❑
Demolition ❑
FINAL DATE
INSPECTOR
7-1-36
Issued by:
Date Permit
Validated by:
Validation:
A5905
7 2 8Z48. Ck
Estimated Valuation
74t2M.00
PERMIT
AMOUNT
Plan Chk. Dep.
250.00
Plan Chk. Bal.
57 .94
Const.
358.00
Mech.
33.00
Electrical
75.87
Plumbing
".00
S.M.I.
5.22
Grading
20.00
Driveway Enc.
20.00
Infrastructure
1,11.45
TOTAL
2. t2.+f.f3
1,782.48
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
7-1-36
Issued by:
Date Permit
Validated by:
Validation:
A5905
7 2 8Z48. Ck
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINGrFEES
IST FL. SO. FT. ® $
2ND FL. SO. FT. ®
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SO. 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
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
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.
SO. FT. ® c
BATH TUB
BOND BEAM
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR ® 3/ac
HOUSE SEWER
FINAL INSP.
FING ��/i
J�
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE LIPLUMB.FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
OUND PLUMBING % /
UNDERGROUND
A.C. UNIT
COLL. AREA
A/ SLAB GRADE
'
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
�G.FORMS Y
ER R SEPT ANY
ROUGH WIRING
DUCT WORK
ROCK STORAGE
L4fOUND. REINF.
/
&AS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL
GAS (FINAL)
WTEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
FING ��/i
J�
DEC 17 !v��
C�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE~
SPARK ARRESTOR
GAR. FIREWALL
OCK,LATHING 1
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
0,%FIE0
_
'0
H BERMUDA DUNES r
RANCHO MIRAGE
INDIAN WELLS H
PALM DESERT a
%1 LA OUINTA
''p INDIO y
Desert Sands Unified School District
82.879 HIGHWAY 111 0 INDIO, CALIFORNIA 92201-6678 • 1619) 347.8631
June 30, 1986
City of La Quinta
Department of Community Development
78-105 Calle Estado
La Qui'nta, CA 92253
Re: 54-255 Martinez
Gentlemen:
The developer of the above referenced lot
has mitigated i.ts impacts on our overcrowded schools by payment
of the amount of $628 per unit to be applied to the cost of
district educational faci'li.ties made necessary by such new
development.
Sincerely,
'- L - . n J.-4
John D. Brooks
Assistant Superintendent
Business Services
JDB/crm
F
AL HEALTH SERVICES DIVISION
COUNTY
PERMITOAPPLICATION,FOR ARSUBSURT ACES SEWAGE DISPOSAL SYSTEM 7 % p
33- }---
pplicant: 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
e is required when the application is submitted. Check must be made payable to the
ounty of Riverside
Building Department Application Log N
Name (Owner, Agent, Contractor, Etc.
Mailing Address
b L 1 6V
citymj6l
State
Zip Code Te ephone-I
2
*Job Property Address
_
,*City or C.Q' tl}
*Legal Description of Prpty. Lot, PM, TR)
ill/ s.' tio n rs-i1.
G A A
*Assessor's Parcel No.
/Water Agency
Use of Permit /)-.,.r40 19,4/ 4^
Lot Size'
Os e1a,,
A
SFD, MH Site Prep Etc. <,rp
Planning CaseNi 2 /
5'e Qv
/
,tea 71., . ►
hen► 1, r,A
Signature of Applicant Date
*The above information must be verified from Building Application
STAFF USE - DO NOT WRITE BELOW THIS LINE
Initiaal Date
Certification of Existing S.D. System reqd. Yes[ 7 No IT" / !! )
WQCB Clearance reqd. Yes[ ] No
Soils feasibility report reqd. Yes[ ] Ido[
Detailed boring report. reqd. Yes[ ] No. (/ ]/
PQ
Detailed contour plot plans reqd. Yes[ ] No f. 7 4
0
Staff Specialist approval reqd. Yes[ ] IIoV-3 Lot Inspection Date
w -
En Soils/boring report by Proj. N Date
Soils Map Page// /I Soil Type Approved by e/ #j/1 Date
r
Type of System: No. of Bedrooms (1) Septic Tank Soil Rate Required
Existing New Addition Replacement!J Gals.
(2ft. Sidewall allowance Install Lines Leach bed
(Boti0m trench area) --ft. rock/ Sq. Ft. Ft -:_Long, ' Ft. wide Sq. Ft _ of
per -running ft. with Mi"ir ,.- inches rock botto
N/A [ ] . _ below drain lines- area
Leach lines/bed-special design(3) Pit Diameter No. Pit Seepage Pit total depth/
for slope --Applicable caM 6' [Lgi Pits BI
N/A Overburden factor I / Max. allowable depth
I
✓ /.._ tiiJ }7;., /A70v
U
M
0
H
E
U
W
This application i a'pr ove Ld 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.
A building permit is necessary for the installation of the above -designed systea}olyyLi-ti's
/(l) ,Septic tank and sewer lines must be 50' from any wellsy/p. } t-✓ 'r
`(2) Leach lines must be 100' min. from any wells including expan ion area
eepage pits must be!150' min. from any wells including expansion area•//6I6
Signature of Health Official ' Date
RECEIPT N0.03-)on>s7( i`(17222 n ;1 i Issued by ; Date
District: Rive TS1( E,[°]j' I dio [40"emet [ 7 Perris [ ] Rancho Calif. [ ] Blythe [ ]
Distribution: WHITE -Office file YELLOW -Applicant PINK -Bldg. Dept. GOLDENROD -Pending File
DOH SAN 122 (Rev. 2/86)
G