SFD (11034)I
,j
Building
Address 51-940 Navarro
Owner
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Torres
Mailing
Address 441371 W. Sundae Crest
City Zip Tel.
La Quinta 9253 360--3337
Contractor
A. 0. Torres 111,A,— i
Address
same
City Zip Tel.:
399 -S-K/
State Lic. City
& Classif. B 55{3498 Lic. # 1451
Arch., Engr.,
Designer
Address I Tel.
City I
Zip I
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 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. r+is L l' ••
1GNATURE 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,Businessand 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 rile 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).
O 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.)
O 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.)
O 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.).
PQlipy No. Company
jZ Copy is filed with the city. O 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 doila>,($1.00) valuation
or less.) -
1 certify that in the performance of lhp 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' Compensationprovisions 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
Lenders 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.
1 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. 11034
JILDING: TYPE CONST. OCC: GRP.
P. Number 773-184-010
Legal Description
Project Description
Lot 15 Block 121
$FD
Unit 12
Sq. Ft. 1474
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter40 Repair O
Demolition ❑
Permit does
not include block
walls
or pool
Estimated Valuation'
414 .80
PERMIT
AMOUNT
Plan Chk. Dep.
250.00
Plan Chk. Bal.
2 5 7. 8 5
Const.
590.00
Mech.
55.50
Electrical
125.01
Plumbing
163.50
S. M.I.
8.90
Grading
20.00 1
Driveway Enc.
—0—
Infrastructure -
1942.11
TOTAL
3412.337
3162.337
REMARKS
a
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
t Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SO. FT. ®
CAR P. 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
A
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
HEATING (FINAL)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GAS (ROUGH) ' MET LOOP
LAUNDRY TRAY
AIR HANDLING UNIT CFM
GROUT
IKITCHEN 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
FRAMING / (L
L vv
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
REMARKS:
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
fO
GROUND PLUMBING f J J/ UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
A
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
I
W SEW EPTIC TAN ROUGH WIRING
DUCT WORK
HEATING (FINAL)
ROCK STORAGE
OTHER APPJEOUIP.
FOUND. REINF.
GAS (ROUGH) ' MET LOOP
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. L / j L%,
FRAMING / (L
L vv
FINAL INSP.
ROOFING
/� 't ` L Z �WI[
D
/.1 J'' 1 /l�J� �/J,�� (►D
o
K
REMARKS:
VENTILATION
FIRE ZONE ROOFING -
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING (za �� Wl
MESH 14t -h Q/l
a
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION-
NSPECTION
CERT.
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 6/18/92 Type of Permit IResidenTl7al
No. 11458 Permit # 111034
Owner Name Robert. Hernandez Log #
No. 51940 street Navarro
City La Quinta zip 92253 study Area 115
APN # 773-184-010 Tract # Lot # E:= Square Footage 11474
Type of Development Single Family Residence No. of unite Q
Comments
At the present time, the Desert Sands Unified School District does not collect fees on
garages/carports, covered patios/walkways, residential additions under 500 square feet,
detached accessory structures or replacement mobilehomes. It has been determined
the above-named owner is exempt from paying school fees at this time due to the
following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to Government Code 53080
in the amount of 1.58 X 1474 Jor$2,328.92 have been paid to D.S.U.S.D. for
the property listed above and that building permits and/or Certificates of Occupancy for
this square footage in this proposed project may now be issued.
Fees Paid By Alex Torres/bank check Telephone 37
Name on the check
By James E. Lively
Assistant Superintendent, Business Services
Fee collected/egem ted by a e Arhtur
Signature
P;^ 4 fi
Payment Received,", 'T� Y
ChecktNo,n981008594
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
The undersigned grantor(s) declare(s):
Documentary transfer tax is $45.65
.(X)::computed on'•full value of property conveyed,- or
A ).::`computed lon'full ,value .lase value of liens 'and encumbrances .remaining at time of:'sale.,• `::.•
( )'Unincorporated area: (X) city of Anchorage
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged:
J.;!:'. Hack and Robert S. Tope, Successor.co-Trustees of the Wilkinson Family Trust,
dated Agusut 7, 1972
hereby GRANT(S) TO
Roberto R. Hernandez and Senaida Hernandez... husband and wife as joint tenants'.
that property in Riverside county, state of California, described.as:
Lots 14 and 15 -in Block 121 of Santa Carmelita at vale La Quinta, unit No. 12, as shown
by Hap on file in Book 18 Pages 80 of Haps, Records of Riverside county, California.
Date:. June. 1, 1992
STATE OF CALIFORNIA )
COUNTY OF R I V E f2, S 9 )
On SU �f E �-} , tc 9 before me. the
undersigned, a Notary Public in and for
said State, pg;sonally appearedeA7ARWAl T
per0onally known to me (or proved to me on
the rbasis of satisfactory evidence) to be
, the persons whose name 4k-4.. subscribed to
,the within instrument and acknowledged that
41 14 executed the same. witness my hand and
official seal.
signature_-��
PEwt)y H CALK%NS
Name (typed or printed)
Robert S. Tope, TruNtee
(This area for official• notarial• seal)
HAIL TAIL STATEMENTS AS DIRECTED ABOVE
,LYFrq•Tv-,�r.•l�v. .. ..M1=^Y�.�t'irl`u'Y'h'.1•"+t LP .'Fa w"'�I .' }�,-4�(�" Y; f•w,�9uy•-•ytl rlN�+.��,f'.•J^''t,y.,,�,. "'i %0r,>✓
COUNTY OF RIVERSIDE HEALTH SERVICES. AGENCY Assessors' Parcel No.
7'3— ���—O� D
DEPARTMENT OF ENVIRONMENTAL HEALTH
PERMIT APPLICATION FORA SUBSURFACE SEWAGE DISPOSAL SYSTEM r
Applicant: Submit this form with four copies of a SCALED=p of plan (1-20 SCALE) drawn to County speculations as indicated on the attached checklist.
A non-refundable filing fee (see below) is required when the application is submitted. Check must be made payable to the County of Riverside.
Approval of this application shall remain valid for a period not to exceed one year from date'of approvaL
1
LOG # VERIFY ITEMS IN SECTION A FROM A NON -FEE BUILDING '& SAFETY (goldenrod) .APPLICATION
Agent, Contractor, Contact Person
�'
Phone
Address City State Zip
� 5"c c i. 4b,;aA
0 s 3
0-33 37
/ Id. ww s -LA
Owner
Phone
Address City State Zip
9,zz s
Job Property Address
City
State
Zip
Legal Description Prop. (PM, Tract, Lot)
CA.
2253
1 D� (S �I- 1
Lot Size
Water Agency/W111 ..
Use of Permit P/P, CU, eta
Othee /,
v �TiQ,
G V W /� l�
Dwelling, MH Site Prep, etc.
C (/irk �
fa Q ��
Signature of Applicant
Date
CATEGORY REV CODE FEE
CATEGORY REV CODE FEE
M SUBSURFACE DISPOSAL (per system) 1238 $153.00
❑ SITE EVALUATION UPON REQUEST 7349 $120.00
(NO PLOT PLAN)
❑ MULTIPLE PARCELS WITHIN SAME LAND DIVISION
❑ SEWERISEPTIC VERIFICATION 7348 $ 58.00
a. 1st 4 Parcels (Each) 1238 $153.00
❑ PRELIMINARY ELECTIVE EVALUATION
b. Each Parcel after 4 7344 $ 55.00
(Attach DOH -SAN -53) 7352 $ 69.00
❑ REREVIEW (2nd review same parcel) 7344 $ 55.00
❑ HOLDING TANK 7351 $119.00
❑ SITE EVALUATION in Conjuction with Critical Area 7346 $197.00
0 ALTERNATIVE EXPERIMENTAL SYSTEM 7345 $656.00
❑ GRADING PLAN REVIEW DETAILED 1238 $104.00
❑ SITE EVALUATION Lot Less Phan 10,000 Sq. Ft. 7347 $172.00
❑GRADING PLAN REVIEW CURSORY 1238 $ 55.00
❑ SECOND FIELD VISIT (SITE EVALUATION) 7346 $ 85.00 J
� COPIES (LAND USE) 7786-81 $
.50
INITIAL DATE
Holding Tank Agreements Completed ❑ Yes No
Certification of Existing S.D. System Required ❑ Yes No
WQCB Clearance Required ❑ Yes E No
(Attach Form DOH SAN 007, Santa Ana Region Only)
Soils Percolation Report Required ❑ Yes E No '
Special Feasibility Boring Report Required ❑ Yes C No
Detailed Contour Plot Plans Required (1 to 5 ft. interval) ❑ Yes No
Grading Handout Provided. ❑ Yes No
Staff Specialist Lot Inspection Required ❑ Yes No.
Maintenance Booklet Provided ❑ Yes ❑ No Lot Inspection Date Initials
/F
C/42 / Soils Percolation Boring Report by i Lic/Project # Date '
Soils Map Page Soil Type Approved By Date
No. of Systems
Type of System(s)
❑ Holding Tank ❑ ReplacementBedroom
NA -Dwelling Units
Fixture Units
(1) Septic Tank
Soil Rate
Grease/Sand
Greaselntcp/Lint Trap
Et New ❑Addition
,
�p9U
Z
3 M•>'
Gal.
Gal.
❑ Existing
Sq. Ft.
Total Linear
Sidewall Allowance
Leach Bed sq. ft.
Bottom Area
Ft.
ft. rock/ sq. .per running ft.
Install Line(s) ft. long ft. wide with
of Bottom Area
/
/
Inlet Tested Depth ❑ NA
min. inches rock4elow drainlines or
/
Proposed Bottom Tested Depth
Leachlines/bed special design for slope:
(3) Pit Diameter
No. Pits
Pit Below
Seepage Pit Total Depth
i / 8 •
Other:
Inlet (BI)
(TD)
Applicable
5
Max. Allowable Depth
N/A Overburden Factor
y
Well Review Approved: Signature Date Well Drilling Permit #
Grading Plan Approved: Signature Date
REMARKS:
This applicatiois APPROVED/ ENIED for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated
on the accompanied plot plan, using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the above -designed
system. No construction is permitted in the required reserved 1000/a expansion area.
Septic tank must be 100' minimum from any wells
(2) Leach lines must be 100' minimum from any wells, including expansion area
<",p Seepage pits must be 150' minimum from any wells, inclu ing expansion area
Signature of Health Official Date
❑ CASH E!�'CHECK NO.�
RECEIPT NO. �'Issued By / "(� Date S a6 -��'
DISTRICT: ❑ Riverside, Q.-I-jov ❑ Hemet ❑ Perris ❑ - Rancho Calif. ❑ Blythe
DOH -SAN -122 (Rev 1/92) DISTRIBUTION: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Plans/Records '
(:e,itvz 4 W Quint
78-105 CALLE ESTADO — LA QUINTA: CALIFORNIA 92253 - (619) 564-2246
FAX (619) 564-5617
March 10, 1993
To Whom It May Concern:
While....:performing the required 'foundation inspection agt 51-940
y'
Navarro, I. observed (2) number four re -enforcement .bars in all
footing conditions, as well as 6 X.6 X 10`wire mesh, visqueen and
sand that are common requirements in other FHA homes.
Please feel free to contact this office if you have any questions.
Sincerely,
BUILDING & SAFETY DEPARTMENT
Lonnie Day
Building Inspector I
MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253
(i of En Ou.,inta
1utl to dub �dfi 3t 1*
This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building
Code certifying that at the time of issuance this structure was in compliance with the various
'ordinances of the City regulating building construction or use.. For the following:
BUILDING ADDRESS 51-940 Navarro
Use classification Single Family Dwelling Bldg. hermit No. 11034
Group R3• Type Construction VN Fre Zone Use Zone SR
Owner of Building Robert Hernandez address 51-940 Navarro
City La Quinta, CA 92253
By; Mark Harold
Dote: March 17, 1993
Building Official
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