SFD (003471)P.O. BOX 1504 No. 003471
Building 78-105 CALLE ESTADO
Address 51.6$5 Mendoza LA QUINTA, CALIFORNIA 92253
Owner _.
John FSA - gA ���� Atr� '�- Triet. BUILDING:. TYPE CONST. OCC: GRP. -
Mailing
Address 1248 Buena Vista A.P. Number 773-142-021 .
CityZip Tel.
Palm snri.nas 922£2 322-2653 Legal Description
Contractor Project Description : inefilp rami v [201A*11.#nC7
.littt�A .,
Address.
City Zip Tela
State Lic. City
& Classif. 475070 Lic. # 1076 Sq. Ft. 1374 No. No. Dw.
Arch., Engr:, Size. Stories -Units
Designer New 1D Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
AAA* 1iln*-A-*%
City Zip State 456" Ga raCte
Lic. #
LICENSED CONTRACTOR'S DECLARATION 600 f S s wa Ftnce
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.
SIGNATURE DATE
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.S,Business and Professions Code: Any city or county which requires a $75r830.00
permit to construct, alter, improve, demolish, or repair any structure, prior*to its issuance also AMOUNT
the
requires the applicant for such permit.to file a signed statement that he is licensed pursuant to PERMIT
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 Plan Chk. Dep.
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 Plan Chk. Bal.`
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. Lt
Professions Code: The Contractor's License Law does not apply to an owner of property who - 361. 00
builds or improves thereon and who does such work himself or through his own employees, Mech.
provided that such improvements are not intended or offered for sale. If, however, the building .36,. of)
or improvement is sold within one year of completion, the owner -builder will have the burden Electrical' a
,of proving that he did not build or Improve for the purpose of sale:)
O I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing ��f'�
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 - S.M•I, - C
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading on
❑ I am exempt under Sec. B. & P.C. for this reason
Driveway Enc. 20 . 00
Date Owner Infrastructure 1.667.92
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.
TOTAL -s • .✓
CERTIFICATE OF EXEMPTION FROM REMARKS
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, after making this Certificate or Exemption you should become ZONE: BY: '
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith .Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked. -
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
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.) Side Setback from Property Line
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed andvalidated, and is subject to FINAL DATE. INSPECTOR
expiration if work thereunder is suspended for 180 days. �� 2 �P
I certify that I have read this application and state that the above information is correct. Issued by: Date Permit
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. Validated by:
Signature of applicant Date
Mailing Address Validation:
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINP FEES
IST FL. SQ. FT. ® $
2ND FL. SO. 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
SLAB GRADE 1
FLOOR DRAIN
MECHANICAL FEES
Jr BONDING
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
OF I
SEWER OR S P� C T
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
DUCT WORK
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
BOND BEAM
SQ.FT.GAR ® 3/ac
HOUSE SEWER
$
GRADING
CU. yd.
plus x$
GAS PIPING
PERMIT FEE
/� ��
Y4161 -NAL INSP.
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 PLU I G
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 1
OUGH PLUMB.
Jr BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
OF I
SEWER OR S P� C T
O ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
NAL INSP.Cr�,G-a
BOND BEAM
WATER SYSTEM
$
GRADING
CU. yd.
plus x$
-$
LUMBER GR,
/� ��
Y4161 -NAL INSP.
FRAMING
�INAL INSP. G _ Y
vG
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND 2,L '
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS.
GARDEN WALL FINAL
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
OF
SCHOOL FACILITY FEES
TO: City of La Quinta
Department of Community Development
78-105 Calle Estado
La Quinta, CA 92253 ®®�� q ^
RO 0ICEa
DATE:
LA
904
THiS DOCUMENT CANNOT
This is to certify that
developer of 116i C K is
located at $/— ,3 within
this District, has paid school facility flees imposed purs ant to the
authority generated by Government Code S ti St 53080 in the mount of
covering a total of squ r feet of ('re'sidential or
( ) industrial/commercial development and that building permits for
this footage in this development may now be issued by your jurisdiction.
for DESERT SANDS UNIFIED SCHOOL DISTRICT
White - Building Department • Yellow - Facilities Plannin • Pink
/- Accounting • Gold - Developer
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'r 1_41EUUESIEU BY
+ •, '�`/.� 7/) 1 U/�7 IINENWISE SHOWN BELOW
�LS�� ing, Inc.
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r , a )0z
.•il;lic ��s�
f
same as -above address
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SPACE ABOVE THIS LINE FOR RECORDER'S USE
GRANT. DEED
7773 iyoz 00 i- 7
THE UNDERSIGNED GRANTOR(S) DECLARE(S)
DOCUMENTARY TRANSFER TAX is $ 7.70
computed on full value of property conveyed, or
O computed on full value less value of liens or encumbrances remaining at time of sale
D unincorporated area
)(J city of La Quinta , AND
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
DUntia M. Fowler, a widow
hereby GRANT(s) to
Irjhn Harrison Contracting, Inc.
the following described real property in the • City of La Quinta
County of Riverside • State of California:
-,of: 9, Block 113 of Santa Carmelita at Vale La Qui,nta, Unit No. 12, as
shown by [gap on file in Book 18 pages 79 and 80 of Maps, Records of
riverside County, California.
CC:Landmark Real Estate
Rancho Mirage
Todd Jackson
Y&ce President/Manager
JAC/cah
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COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION
PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM /77.3
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 637 is required when the application is submitted. Check must be made payable to the County of Riverside.
ley
Building Department Application Log #
Name (Owner, Agent! Contractor, Etc.)
-3,C)H� so& -lard f -f n rJ
Mailing Address
I Z Y. 8 63 a �,tl A
city
P,-��;L� s?�� t�&s
State
h
C
Zip Code
`j _, a 6 2 -
Telephone
Job Property Address AtVtc�Vf d A
'Cit ;rcCornrnunity
[�U(Ni
Legal Description of Property. (Lot, PM, TR)
t1i`j'�gLlc. f/3or sAv-7A Cr)!{,P1GL1-7A
✓ti c LH 4tr! Fr . Ll/V 17 -
i'Assessor's
'Assessor's Parcel No.
'Water Agenc�or-wellm
"" +� (J
Use of Permit/ >/�t'lAW6u�./A ��pl2nning Case #
Lot Size
`
das �
SFD, MH Preparation E/�c. 5/54
%� X,,00'
✓ /
� fN
Site
-Signatdre-6f Applicant
'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 ❑
required. Yes 12Nor�`'`� r
WQCB Clearance required. ED Yes Do 0iS
Soils feasibility report required. ❑ Yes ❑� No
Detailed boring report required. ❑ Yes NO--*"
%
T)
Detailed contour plot plans required. ❑ Yes o' 1 %
P
Staff Specialist approval required. ❑ Yes -'N o Lot Inspection Date
Soils/boring report by ,# Project # Date
Soils Map Page Soil Type A914 Approved by %/'f e./r <tI - -4 i 2
Date -,P
Type of System:
❑ P'New
No. of Bedrooms
s'
(1) Septic Tank
l
Soil Rate Required
Existing ❑ Additional ❑ Replacement
% Gals.
(2),Leach line sq. ft.
(B o : trench area)
Sidewall allowance
ft. rock/Sq. Ft.
Instalh-- Lines) Ft. Long,
iie,.wit
Leach bed Sq.
o
—Sq.
' A
F min. inches
Ft bottom
per running ft. ®rN
rock below drain lines
area
Leach lines/bed-special design for slope:
(3) Pit Diameter /
No. Pits
Pit BI
Seepage Pit total depth% r
Applicable
N/A__'"_Overburden factor
� ® 6'
Max. allowable depth D
17
i%
This application isQp rove d/1denied 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.
M,lm
O Septic tank and sewer lines must bir„50' from any wells -Y 10 ,t y, (
Leach lines
(2� must be 100' min. from any wells including expa/nsior, rea ,,
(3) Seepage pits must be 150' min. from any wells including expansion area
Sign"ature Of Health Official"' j - r < Date� /
_�-^Z'
Ar
RECEIPT N0.
District: ❑ Riverside .DI d ❑ Hemet
Distribution: WHITE—Office file YELLOW—App
DOH -SAN -122 (Rev. 6/86)
Issued by Date
❑ Perris ❑ Rancho Calif. ❑ Blythe
;ant PINK—Bldg. Dept. GOLDENROD—Pending File
2 Crj
-L
of it,
? u 4
V
AI �NtoM M1 b
4r9� 164
.Dear Developer/Landscaper:
OFFICE OF
AGRICULTURAL COMMISSIONER
4080 LEMON STREET, ROOM 19
RIVERSIDE, CALIFORNIA 92501
(714) 787.2561
49-613 Hwy 86, Suite B-12
Coachella, CA 92236
(619) 342-8291
E. LEON SPAUGY
COMMISSIONER
JAMES 0. WALLACE
ASSISTANT COMMISSIONER
Thank you for inquiring with the Agricultural Commissioners Office regarding
local quarantine laws.
Any diseases or insects associated with the plants/landscaping material presented
on your landscaping plans do not pose a threat to the Coachella Valley Citrus,
Date, Grape, Vegetable, or Field Crop industry. We therefore approve your
landscaping plans.
If however, any substitutions of plants/landscaping materials within your plans
-occurs between now and the actual planting date, you must contact this office
within 48 hours before delivery into the Coachella Valley. Also, the substituted
plants/landscaping material must be held for inspection upon arrival. Any sub-
stituted landscaping material found infected/infested with quarantine pests will
be.immediately treated or shipped out of the Coachella Valley at the discretion
of the Agricultural Commissioner's Office.
Under penalty of perjury, I the undersigned will comply with the above.
Authorized Agent:
Name 5hW-a A 6Z,,9 -Z 2 .9 CS'ti1 Date /o y f 8"7
Signature
.Permit Number(s) /Q f 7 RS 16 '2- 1 8
47
32-65-3.
Developer Q.Address 12 q;5;,(J �� /-
AGRICULTURAL COMMISSIONER'S APPROVAL Date l0 -2 /- 87
Authority cited: Agricultural Code; Sections 6301, 6461, 6462, 6464, 6501, 6521-
6524
cc: 2 Plan Check, Indio Office, Riverside Office