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SFD (15499)Building Address 81-$75 Mountain Viet Development Co. Inc. P.O. BOX 1504 78-495 CALLE TAMPICO LA OUINTA, CALIFORNIA 92253 Mailin Address 75-594 Arista Del Red" City __]Zip Tel. Indian Wells, 9221D (619)773-3783 Contractor ,.Same Address Zip State Lic. City & Classif. g 579845 Lic. # r Arch., Engr., n Nobel Designer A� MS Box 16606 1110 559-4305 Crity [J Zip State Srvi , CA 92713 Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby firm that I am I' nsed under provisions of Chapter 9 (commencing with Section effec . D Isix 3 of the Bu�ess sedand Professions Code, and my license is in full force and ffect. r s OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Susines8 and Professions Code: Any city or county which requires a permit to construct, after, 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 rive 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 Inprove for the purpose or sale.) ❑ 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. & 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. :ER IFICATE OF EXEMPTION FROM WOR RS' COMPENSATION INSURANCE (This section need not be c eled N the permit is for one hundred dollars ($100) vatuation or less.) I certify that in the perfor ante of thg work for whjcb.th' permit is issued, I shall not mplo any erso n .y ma/(pin/er�°so as t me subjec the Workers' Compensation Ia ate wr�r ■ �_— NOTICE TO APPUCANT: 11, 4ifter 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. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. 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 No. 15499 BUILDING: TYPE CONST. OCC. GRP. A.P. Number 767--480-005 ,Legal Description Lot 5 Tract 26729 Project Description SFD Plan 1 The Estates at La Quinta R3 Sq. Ft. Size 3818 No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Permit does not include block mall or pool. Estimated Valuation $229 , 276.00 PERMIT AMOUNT Plan Chk. Dep. 250.00 Plan Chk, Bal. 666.95 Const. 1,094.50 Mech. 102.50 Electrical 220,53 Plumbing 214.50 S.M.I. 22.93 Grading 2000 Driveway Enc. .00 Infrastructure 4,982.16 Arts in Public Plaices 323.19 TOTAL 7.897.26 7.647.26 REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Ceyt er Line Side Setback from Property ine N //f G.-1 FINAL DATE Issued by: Date Validated by: Validation: INSPECTOR,, y f N 14 Permit �3 /1• V/ J CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINU FEES 1ST FL. SO. FT. ® 2ND FL. SO. FT. POR. SO. FT. ® GAR. SO. FT. ® CAR P. SO. FT. WALL SQ. FT. SQ. FT. ® ESTIMATED CONSTRUCTION VALUATION $ UNITS YARD SPKLR SYSTEM MOBILEHOME SVC. BAR SINK POWER OUTLET ROOF DRAINS DRAINAGE PIPING ' DRINKING FOUNTAIN URINAL ' $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 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 46 OUND PLUMBIN UNDERGROUND A.C. UNIT COLL. AREA WESLAB GRADE C11S ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS WER O SEP C TA ROUGH WIRING DUCT WORK ROCK STORAGE //��IG FOUND. REINF Z/ C S (ROUGH) / � � z 111444 METER LOOP HEATING (FINAL) OTHER APP.IEQUIP. REINF. STEEL S (FINAL) rJ�` TEMP. POLE GROUT WATER HEATER VICE-� INAL INSP. -_eUry G BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. INAL INSP. /� RAMING -/ S / FINAL INSP. - y� 7o, Gr ROOFING////yyyy��I5'-0/t r ,W�� ©/� I `� , KJ � �• KJ REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL ifATHING /Z MESH NSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESlINITIALS GARDEN WALL FINAL 1, I 1 a CITY OF LA QUINTA ; of,µF s BUILDING & SAFETY DEPARTMENT 777-7012 INSPECTION REQUEST LINE 777-7153 Owner NRB Development Contractor same as above Permit Number 15499 POST ON JOB IN CONSPI %APE INSPECTOR MUST SIGN ALL APPLICABLE SPACES I JOBADDRESS81-.875 Mountain View Lane SFD Permit does not include block wall or pool. TYPE OF INSPECTION DATE INSP. FOUNDATION & SETBACK - FOOTING STEEL MAIN GROUND SYSTEM GROUND PLUMBING '- PRE-GUNITE DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED CONCRETE SLAB _ JOISTS & GIRDERS ELECTRICAL GROUND WORK DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED ROUGH ELECTRIC ROUGH PLUMBING ROUGH GAS & GAS TEST HEATING & VENT - A/C FIREPLACE ROOF BOND BEAM O.K. TO WRAP 70 ' 5 GROUT ❑ 4' ❑ 8' FRAMING INSULATION Q PRE -ROOF COVER NO WORK UNTIL ABOVE HAS BEEN SIGNEn. DRYWALL INTERIOR ra EXTERIOR LATH POOL PRE PLASTER POOL FENCE & GATE S EWY;rSEPTOCTANK FINALS ELECTRICAL PLUMBING FINAL GAS TEST HEATING - A/C HOUSE NUMBERS JOB COMPLETED TEMP POWER ABOVE APPROVALS DO NOT INCLUDE RIGHT TO 1/95 TURN ON UTILITIES OR OCCUPY BUILDING Building fa< TWit 4 XA P.O. BOX 1504 APPLICATION ONLY 0 )►` r"1'0 ANC Mailing Address-TS -SA City Zip Iv U IArIN uJFa,IS I q 221 O Contractor ress 78-105 CALLE ESTADO OUINTA. CALIFORNIA 9=1 TYPE CONST._OCC. GRP. R • 2:2 I . I .P. Number agal Description: alT <-1 2 (e- VOc 1- Q T �S CS roject Description I C &rES A7- /i/ Z4 z/ I\kD" KMX 1 n) U \'rein l \L-# -'N F_ State Lic. cIry & Claasif. 7 Lic. N Sq. Ft. > 0 1 0 No. No. Dw. 1 J Stones Units l Arch., Engr.,13�Designer �� . 0 Add lJ Alter' Repair O Demolition Address e1• tD n .max r. 9_ 11'1, 1 Lic• " I her it"I 4hal l II rtdir nitres of Chapter wm (commc' 700q .,.� of O I{canes is effeet�� OMMEWWIID[lI DECLARATION I hereby affirm that I am exempt from the Contractors LkX"M Law for the following reason: (Sac. 7031.5.9rseess and Proheabn Code: Any key or county wMch regtaiM a peon to construct. agar, brprove, don *W. or repair airy atttreaae, prior to fa anuanee also requires tee dooft nt for such 011111n+ to ue a 10 1 saalamera tiler he Y —xied purwnt b Me provabrs of fits contractorb License Law. Chapter a (oonrrtenteenp weh Section 7000) of Division 3 of the Business and Pnofeealera COOL Of tier no is exeepr 01009001n, and One beat for the +a•o•d exarrplien. Any viOlrlon of Secllon 7031.E by any, rabOsaanf abr a PwvW su4mis the appecent to a civil penally of not more Man five hundred dollars (3600). i I, as owner of the property, or my employees with wages es their sole Mtbn cOmpen, will do the work, and the structure is not intended or offered for sue. (Sae. 7014, 8ulono s and Professions code: The Contrschir's Ucunse Law dose not a pry to an over of Property Who builds or reproves thereon and who does such wont normally Of through it% own 0r101010 arovded that such arprovwnenfs are not intended or offered for swi N. however. Me building or vrprovwno nt era sold wtilin are yewof Coo 10110 n. die oww-0ddw w1 here the burden of orownp that he did not build or improve far the Psapoee Of saes.) I - I, as owner of the property, am exclusively contracting with licensed contractors to coo struet the project. (Sec. 7044, Suaeness and Protseatm Cade: The Camactor's License Law does not apply to an owner of property who bid*or WIND a Maroon, and who contacts kr such orgects with a contractors) rcwnsso punauarf to Me Conbacrer's License Law.) I am exempt under Soc.—S. 8 P.C. for this reason Date Owner wOf1KOW COWENMTION DECLAMATION hereby affirm that. l here a certificate at eCllsent t0 lowlltalaR or a card "" d WorksCompensation Insurance, or a certified tropy f . 3000, Labor Cods.) Policy No. Company Copy is filed with thecity. ❑ Cartified copy Is hereby fwrMMMd. CEIMFICATE OF EXEi PTM PMON WOMKEOW COINBgATION INWMANCE (rhea SeCtlon need not be compared If Me Pweaa is for are hundred rasars (3100) mesnllm Or iess. ) I county that in the performance of the crook for vrhlalt this permit Is Issued, I stall not employ any person in any manner so as to become subject to Lie Workws' Compensation laws of California Date Owner NOriCE 7O APPLICAMr: If. after malting OW Certllcre of Eurrptlon you should became subrect to the Nbrlir"' Compensation piowele of the Labor Cods, you must brMwidr comply with such proinsione of flee 00 me sites be dawned revoked. COM MUCTION LEMING AGENCY hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 30e7, CAe Code.) Lender's Nail Lender's Address This is a building permit when property 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 an city and county ordinances and state law 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 {timatad Valuation PERMIT AMOUNT Plan Chill. Dep. 67 Plan Chk. Sal. Const. Mach. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Urle' Vrom Rear Prop.'Line� Rear Setback Side Street Setback from Center L ne' \ -� Side Setback,from Property Line FINAL DATE INSPECTOR "' Issued by: Date Permit// / Validated by: Validation: 011 111 r1likirl nfulQlnhl -0NSTRUC7I00d ES"MA'E _ No. elECTRICAL Ef.ES ''- r0 ) a LUM6iNG FEES " 00 2ND F'- P,Q yck0 GAP ZO CAR • WAL'- ES -MA -Er CCNS-PUCT!ON SO FT 4&p _rl ;:T SO FT SO. FT -n S0. FT 3 SO cT .a VALUATION I I'•APC Sp'('-o j/S—M MOBILEHOME SVC SAP ,INK POWER OUTLET' ROOF DRAINS DRAINAGE PIPING OWNKING FOUNTAIN URINAL S WATER PIPING NGTE. Ncl !o _e .sea as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER ',ENT SYSTEM �.%,N EYAP _JGL -OCD SIGN WASH ER(AUTOMDISH) APPL'ANCE DRYER GARBAGE DISPOSAL =URNAC.E UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR MANGLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM B.T U TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEMIPERM LAVATORY SEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. @' c BATH TUB SO. FT 4 c WATER HEATER MAX. HEATER OUTPUT. B.T U. SQ. FT. AMD O Ira c - SEWAGE DISPOSAL SO.FT.GAR C Nc HOUSE SEWER GA3'PIPING PERMIT FEE PERMIT FEE PERMIT FEE ' DBL TOTAL FEES MICRO FEE MECH.FEE PLCK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING i AIR COND. SOLAR' SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL AREA SLAB GRADE ROUGH PLUMB. BONGING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH METER LOOP HEATING IFINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVE FINAL INSP. BOND BEAM WATER SYSTEM ORAOMIO - _ - . __ LUMBER GR. Y FINAL INW FRAMING FINAL INSP. _ ROOFING -- REMAIN* VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIOWSOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL Imomloww a BRAN^ I YRtt wmTuwa GARDEN WALL FINAL COACHELLA VALLEY UNIFIED SCHOOL DISTRICT CERTIFICATE OF COMPLIANCE (Government Code 53080) Project Name: The Estates at la Qu.inta Project Address: Monroe Street and Avenue 54 Project Owner's Name: NRB Developoment Co. - Bob Gibbs Phone No.(619)773-3783 Project Description: 3Dwellings: 1 @ 3818 and 2 @ 3.833 SaFt Building Type (Check o esidential XX (Include No. of Dwellings) Commercial ustrial Tract No.: 25769 Lot No.: 4, 5,. 6 (If tract attach Schedule "A" of all lots by tract, square footage for each lot and total.) Assessor's Parcel No.:, 767-480-004-2, 3, 4 (If Schedule "A" is used show Assessor's Parcel No. for each lot if one exists or Assessor's Parcel No. for parcels before subdivided.) Total square feet of Building Area: 11,484 Sq.Ft. Certification of Applicant/Owners. The person signing certifies that the above information is correct and makes this statement under penalty of perjury and further represents that he/she is authorized to sign on behalf of the ov Dated: JUKE 16, 1995 to City/County Certification: (Signature) Optional (Title) SCHOOL DISTRICT REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE) ov. Code Gov. Code Agreement Existing Not subject to 53080/65995 65970 prior to 1/1/87 fee requirements AB 181, SB 1 ) (SB 201) Note: FEES WILL BE PAID UPON CLOSI OF ESCROW WITH COMMONWEALTH LAND TITLE COMPANY, PALM DESERT, CA 619-341-2229 Total Nuber of Sq./Ft. 11,484 Amount per Sq/Ft. $ 1.72 Amount Collected $ 19,752- 8 School District Officia . C f itle: Asst. Superintendent, Admin. Serv. Foch "T ' Pensis ate: JUNE 16.1995 Phone: (619) 399-5137 Ext. 235 Note: AB 2926 and SB 201 fees are capped at $1.72 per square foot for all residential Construction, and at $0.28 per square foot for commercial/industrial projects. JUN 21 '95 05:39PM COMMONWEALTH TITLE P.1/1 RECORDING REQUESTED BY: FIDELITY TITLE COMPANY 95.5089DT 252888 WHEN RECORDED MAIL THIS DEED AND, UNLESS OTHERWISE SHOWN BELOW, MAIL TAR STATEMENTS TO: NRB DEVELOPMENT CO., INC. 75594 VISTA DEL REY INDIAN WELLS, CA 92210 SPACE ABOVE -THIS LINE FOR RECORDER'S USE GRANT DEED APN: The undersigned grantor(s) declares): Documentary transfer tax is $343. 5 �XXX� Computed on full value of property conveyed, or Computed on full value less liens and encumbrances remaining at time of sale. Unincorporated area: ( ) City of , and FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, PALM SPRINGS SAVINGS BANK, F.S.B. hereby GRANT(S) to NRB DEVELOPMENT GO., INC., a California Corporation the real property in the City of LA QUINTA, County of RIVERSIDE, State of California, described as: Lot 4, 5 and 6, Tract 26769, as per map recorded in Book 235, Page(s) 40 and 41 inclusive of maps, in the office of the County Recorder of said County. Dated April 26, 1995 State of California County of Riverside ) S.S. On June _6,__19-9-5 before me, Tina M. =, Not ry public personally appeared Stephen G. Hoffmann .&__Sue BAtts personally known to me (-vr-grvvu+-tv--vn the to be the person(s) whose name(s) Ware subscribed to the within instrument and acknowledged to me that /they executed the same in 2si r/their authorized capacity(ies), and that by tad./their signature(s) on the instrument the person(s), or the entity upon 'behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. Signature •j7'Z (.% *SAIL TAR STATEMENTS TO: PALM SPRINGS SAVINGS BANK, F.S.B. BY / Nkee/T1 le Ste�h Ho fmann BY Pie enir /C . Ewa- / 7 Lc.r._- Cc Name/Title Sue Batts Senior Vice President 4mv TINA M. CRUZ comm. ♦ 986173Nototy Pubilc -- ColifotnioRIVERSIDE COUNTY Comm. Expae+ FED 28, 1997 W-W- j (This area for official notarial seal) ESI/FME, Inc. STRUCTURAL ENGINEERS & CONSULTANTS SINCE 1974 October 13th, 1995. Attn: Jim Dumas A & M Construction P. O. Box 366 . La Quinta,. CA. 92253 Ph. (619) 564-4832 Fax (619) 564-0406 RE: Field meeting of October 6th, 1995. Dear Jim As requested by The City Of La Quinta, enclosed are the comments on the various lots that encompassed our structural walk. The purpose of this visit was to observe the level of compliance to the approved set of construction documents. PLAN 1 : LOT 5. 1. ADD shear wall SW'12 at the rear "Pirewall" of the Garage and change opposite end of wall to SW 12 also ( see item 8 below) . 2. ADD A35's @ 8" o.c. at DR / Guest Bed per R-4 / D3 . 3. Master Bath ADD 2x shims at top with (8) 16d's . 4. ADD 2 x 4 short cripple over diagonal header at rear of MASTER SUITE. 5. At wall between NOOK and KITCHEN, ADD two bays of 1/2" plywood blocks with a 2 x 4 drag strut nailed to blocks and 6x10 LIV. RM. header. 6. REPLACE 4 x 10 header at rear of FAMILY ROOM. 7. ADD detail Q1 / D3 at rear of Family Room fireplace. 8. Due to the 32—inch " electrical panel " at BED 3, ADD six Simp. A35's at the top plates of the POWDER / Hall wall. 9. ADD shim over 4 x 12 header at rear of BED2 for full bearing. PLAN 2: LOT 4. 1. At garage girder truss ADD 2 x 6 ledger to support jack —hips. Nail with three 16d's / web . 2. ADD A35's @ 48" o.c. at Garage rear wall per provided detail Q / D2. 3. ADD SW12 over header at rear of Garage. 4. ADD horizontal diaphragm at WET BAR / GARAGE corner. 5. ADD A35's @ 8" o.c. per R-4 / D2 at DEN/GUEST Bed. 6. At rear of MASTER SUITE, shim bottom of header and ADD 3/8" plywood, 24" x 5.5' with 8d's @ 4" o.c. at edges and 12" o.c. @ field. 7. At rear of LIVING ROOM ADD NEW 2 x blocking per' detail 11 / D3 . 8. ADD A35's @ 8" o.c. at D.R./KITCHEN per detail R-4 / D2 . 9. Over the NOOK ADD 2x and plywood per detail R1 / D3 . 1921 EAST CARNEGIE AVENUE, SUITE 3J • SANTA ANA, CALIFORNIA 92705 • (714) 261-1811 FAX (714) 261-8506 ..r�,+"Y•.,�,r,.w`,+rG"�+r��+9'4�*4'1. .. -. "?y«���,�'K.�""'�"'s^" t°�.""""""'f-•++„' �1NfF •rry ASSESSOR'S PARCEL NUMBER COUNTY OF RIVERSIDE HEALTH SERVICES AGENCY DEPARTMENT OF ENVIRONMENTAL HEALTH 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 as indicated on the attached check list. A non-refundable filing fee is required when the application is submitted. Check must be made payable to the County of Riverside. Approval of this applica- tion shall remain valid for a period not to exceed ode yZar from date of payment. LOG # Agent,, Contractor, Contact Person Address "" City State Zip sr�� L,�y Telephone 6 /9 iL .d. ;uc� . :� y �•,a v�� 4 -J79 Owner Address City State Zip Telephone /! Z O� Job Property Address City Zip 0 W— lU Lot Slie Water AgencYlWell lise7of Permit, P/P, SUP, PUP, etc. Legal Description �7� "e - rs� • QO�• S Dwelling, H Site Prep., etc. ,� Signature o Appli nt' ` Date CHECItIbOX IF REQUIRED ❑ Holding Tank Agreements Completed ❑ Detailed Contour Plot Plans. Required (1 to 5 foot interval) ❑ Certification of Existing S.D. System Required ❑ Grading Handout Provided ` m ❑ WQCB Clearance Required ❑ Staff Specialist Lot Inspection Required Z 0 (Attach For DOH-SAN-007, Santa Ana Region Only ❑ Lot Inspection U❑ Soils Percolation Report Required W ❑ Date Lot Inspection Completed: Initials U ❑ Special Feasibility Boring Report Required Remarks: ❑ Maintenance Booklet Provided Initials Date ❑ Final Inspection by Department of Environmental Health is required. � (' n IIII rr by 7U 1 5 R pi?U / r�j'y C142 / Soils Percolation Boring Report t/ !�U �u Lic�Project # Date Soils Map Page Soil Type Approved By T Date No of Systems Type of System(s) No. Dwelling Units (1) Septic Tank Soil Rate Grease/Sand ' ❑ Holding Tank ❑ Replacement 1NBW El Addition ❑ Existing Bedrooms, Fixture Units �" "I'l LF/-bAS 15 Vf V �f �y Z/ f- / Grease Intcp/Un ap Gal. Sq. Ft. Total Linear Sidewall Allowance Leach Bed sq. ft. of Bottom Area Ft. �7 Bottom Area ft. rock/ sq. ft. running ft. Install L Une(s) ft. long ft. wide with �� 1, Z V I �� �� Inlet Tested Depth �NA min. 1Z inches rock below drainlines or U Proposed Bottom Tested Depth Z Leach lines/bed speclal design for slope: (3) Pit Diameter No. Pi Pit Below Inlet (BI) Seepage P, Maximum Other: O Total.0 p h Allowable F- Applicable Depth __�-►J U W N/A_�< Overburden Factor ❑ ❑ 6' TO Well Review Approved: Date: Well Drilling Permit # SIGNATURE Grading Plan Approved: Date: SIGNATURE Sewer Verification Approved:: Date: % I-eac��PS A,-u6f ��e 1#1,5 , 11e .ncffl /N REMARKS: /� I1IMQ�ei���ll ' /ve / �l%lrUypi !)� /fac4s �jP/f flit/AS� M!/� �iP /h G ('CP. This application is APPROVED/ ENIED for the category checked in SECTION B FOR OFFICE USE ONLY above, regarding th esign of/a subsurface disposal system as Indicated on the acompanied plot plan, using the requirements set forth in SECTION C above. A build- 2 �yi '' 6.2.00 Ing permit is necessary for the installation of the above -designed system. No construc- Revenue code D Fee $ r tion is permitted in the required reserved 100% expansion area. S ptic Tank must be 100' minimum from any wells. Check # �Lgach lines be 100' from oq 5- (2f must minimum any wells, including expansion area. Date U Initial�� z Z ' (3) Sewer lines must be 50minimum from any wells. ' CRT 611 _O (4) Seepage pits must be 150' minimum from any wells, including expansion area. H U - W U) Signal a of Health Official %c �jc ) / 1 _J 1 r" Date. 4, DOWSAN 122 (Rev 9193) UistrlDution: WMI I h--- Utfice file; YLLLOW—Applicant; PINK —Bldg. Dept.; GOLDEN ROL—Plans/Records Earth Systems Consultants 1 Southern Califomia 1 October 6, 1995 NRB Development Company 75-594 Vista Del Rey Indian Wells, California 92210 Project:. Tract 26769 - Lots 4, 5 & 6 La Quinta, California Subject: Report of Field Densities Building Pad Grading Buena Engineers Dhdslon 79-811 B Country Club Drive Bermuda Dunes, CA 92201 (619) 345-1588 (619) 328-9131 FAX (619) 345-7315 B7-2960-P3 95-10-707 From July 19 through July 25, 1995, a representative of our firm performed density tests at the above referenced project. Tests were performed at random locations, in accordance with ASTM D 2922-81 Method A or B and ASTM D 3017-88 Nuclear Density Test Procedure. Tests were performed as per authorization of Bob Gibbs with NRB Development Company. The estimated locations of the tests are presented on the attached plan with their results being summarized on the attached test report sheet. A total of fourteen (14) density tests were performed. Test results indicate that a minimum of ninety (90) percent relative compaction has been obtained within the areas tested. The maximum density -optimum moisture were determined in the laboratory in accordance with ASTM D 1557-78, Method A or C. Test results are as follows: Soil Description USCS Gray. brown slightly clayey slightly silty fine grained sand SM Gray brown slightly clayey silty fine grained sand SM Maximum Density -Optimum Moisture 106.1 pcf 14.2% 109.0 pcf 13.9% October 6, 1995 -2- B7-2960-P3 95-10-707 DISCUSSION: 1. The project is located on the west side of Monroe Street between Avenue 54 and 56 in the City of La Quinta, California. 2. Pads were overexcavated to a depth of three (3) feet below pad grade. The exposed surface was processed by scarification, moisture conditioning and recompaction. The previously removed soils were replaced in thin lifts and compacted into place. 3. The purpose of testing was to observe compliance with the minimum requirements of the City of La Quinta, California. The test results summarized in this report present the moisture and density only at the locations and depths tested on the specified dates. The summarized field and laboratory tests were performed in accordance with engineering principles generally accepted at this time and location. No opinion is expressed as to the uniformity of the material or compaction. No guaranty or warranty of the contractor's work is made or implied. The test locations are approximate and were determined by pacing and sighting from prominent field features. In our work, we have relied on topographic and surveying information provided by others. With any manufactured product there are statistical variations in its uniformity and in the accuracy of tests used to measure its quality. As compared with other manufactured products, field construction usually presents large statistical variations in its uniformity and accuracy of test results used to measure its quality. Thus, even with very careful observation and testing, it cannot be said that all parts of the product comply with the job requirements although the degree of certainty is greater with full-time observation and testing than it is with testing only. Therefore, our opinion, based on testing the work means that there is only a statistically -based probability that the densities obtained comply with the job requirements. This report is issued with . the understanding that it is the responsibility of the owner, or of lris representative to insure that this report is submitted to the appropriate governing agencies. If there are any questions, please do not hesitate to contact this 'office. Respectfully submitted, EARTH SYSTEMS CONSULTANTS ?Gdk " i'lahlD. Clanton Field Technician pc/Compaction Copies: 4/NRB Development Company 1/VTA File Reviewed and Approved, EARTH SYSTEMS CONSULTANTS REPORT'OF RELATIVE COMPACTIONS JOB NAME: Tract 26769 Lots 4, 5 & 6 LOCATION: La Quinta, California JOB NO: B7-2960-P3 REPORT NO:95-10-707 Test No. Date Tested Description Elevation %Moisture Dry Densit5 Relative Maximum In Place In Place Compaction Density Building Pad Grading 1 07-19-95 Per Plan 3.0 BPG 10.9 10.9 93 106.1 2 07-19-95 . Per Plan 3.0 BPG 14.0 96.9 91 106.1 3 07-20-95 Per Plan 2.0 BPG 14.8 102.7 94 109.0 4 07-20-95 Per Plan 1.5 BPG 15.1 99.9 92 109.0 5 07-20-95 Per Plan 2.0 BPG 16.1 100.8 93 109.0 6 07-20-95 Per Plan 1.5 BPG 16.6 103.0 95 109.0 7 07-21-95 Per Plan PG 5.8 103.3 95 109.0 8 07-21-95 Per Plan PG 10.0 99.8 92 109.0 9 07-24-95 'Per Plan PG 9.0 101.1 93 109.0 10 07-24-95 Per Plan PG 11.4 102.3 94 109.0. 11 07-24-95 Per Plan 3.5 BPG 12.7 104.1 96 109.0 12 07-24-95 Per Plan 3.5 BPG 13.1 103.0 95 109.0 13 07-25-95 Per Plan PG 13.7 100.2 92 109.0 14 07-25-95 Per Plan PG 12.5 101.4 93 109.0 PG = Pad Grade BPG = Below Pad Grade DATE: October 6, 1995 EARTH SYSTEMS CONSULTANTS I I ins 'i a n O 8 0 �e lip 1.31 AC. 17•_ 177 .' 17S 179. , $ fP c.srL ­W.,LOT g _1.06 AC. e.reL u1 - - - — - --((PRIVATE STREET)' y • w 1n .7: 17•. 1n 1.25 ACc_- ' -"1.25 AC_ P.N.. 767-320-007 -- •-- I - I 71 11 12 13 I- 14 -_ I ri�� a 3 _,- O . 1.25 AC. 1.25 AC 1.25 AC. 1.2 AC: Z M i t1 na.� G `••- � 1 Y4 iii --- I '-------------- ,; � (4�; ; �; ; ram. 12 � -1-.- •�u �J `--`�I I✓I j -- I 1 j i 10 I t11 4 n14 1.31 AC, j 1.25'AC�I 3,?.5_A1�-_-.-t ---Z- ;---- �, 1.25 AC 1.25 AC. 1.25 AC. •I � I I LIMIT, IMIT OF OVER -EXCAVATION _ .. //1 75 '' yam::. _ _ �7S• J� - 1p0x I - - • TRACT BbFDIUARY �• I r' A.P.N. 767-330-011 ` .,