SFD (08623)ce•
P.O. BOX 1504 No. 08623
Building 78-105 CALLE ESTADO
Addressr� ..lg nuc,,,,,.,. LA QUINTA, CALIFORNIA 92253 G
Owner
J01M L. Ha1rt
Mailing '
Address moo Hovk06
City Zip Tel.
Contractor
ress
City lZip
State Lic v' --`- "�-� I City
& Classif. 413 Lic. #
Arch., Engr.,
Designer��� �C8
Address Tel.
Clty ^� Zi State
Zip Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereb— 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. ,w r ✓
SIGNATURE .r f 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 rCode: Any city or county which requires a
permit •to construct, alter, improve, demolish; oc'repair any structure, prior to its issuance also
requires'the applicant for such permit to Iile.,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 or Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars (8500).
❑ 1; 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 or completion, the owner -builder will have the burden
or 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-
, yr struot 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
r`•"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.)
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 (8100) 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, alter 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 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 Dale
Mailing Address
City, State, Zip
i=
JILDING: TYPE CONST.4 OCC: GRP.
P. Number
,gal Description
oject Description 1y�11
Sq. Ft. No. No. Dw.
Size 1522 Stories Units •
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
112
Plumbing -3
Grading S
Driveway Enc. 20.00
Infrastructure
TOTAL
NtMAHKJ
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 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SO. FT. ®
Sp 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
-fit if frw
GAS (ROU H)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEQUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. 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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/a c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
VENTILATION
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 t/QA0
GROUND PLUMBING/0-3/0NDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE !� ��
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEW
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
-fit if frw
GAS (ROU H)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP ,�'--
GRADING
/g�--cu. yd.
$ plus x$
=$
LUMBER GR.
FRAMING �b /O
FINAL INSP.
ROOFING
�Kf�
�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING W/V
MESH
INSULATION/SOUND/g;j?/, M
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 10/1/90 Type of Permit JLa Quinta
No. 110176 Permit M
Owner Name William O. Wilkinson Log #
No. Street See Below
City La Quinta Zip 92253 Study Area
APN # I I Tract N 1 Lot # Square Footage 112,448
Type of Development I Single Family Residence INo. of unite
Comments J;1_A4.9; Ramir07 Kd_19..0 R1ihin _F;9_9SZ0 Mon.in.7,n r%2Qdn Nnx7n ^ ri_QQn
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 Fl. -5-8--1 X112.448 1 or $ 19,667.84 have been paid to D.&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 William O. Wilkinson Telephone 345 -OW
Name on the check
M
Richard M. Beck
Director, Facilities Planning & Development
Fee collected /exempted by Shelley D. Bennett
Signature /z/6 ivp'o", 0 - a4j�d
Payment -Rec ;iyed
Cbeck No. 019694
Collector: Attach a copy of County or City plan check application form tc, 01etict copy.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
C.D.
on
C1
RECORDING REQUESTED BY
UNION LAND TITLF COMPANY
AND WHEN RECORDED MAIL TO:
Name William 0. and Barbara L. Wilkinsol
Street 11716 Beverly Blvd.
Address
City 8 r Whittier CA 90601
State
L.
MAIL TAX STATEMENTS TO:
r
Name
__Street - SAME AS ABOVE
Address
City &
State
L
7
'�' `' 2 Q:
X ae 1
V c t f .
.. s: I. S
ui
t�.~.Gc'�� � W
etal 3 $
Grant
SPACE ABOVE THIS LINE FOR RECORDER'S USE
A.P.N. 773-335-011
The undersigned grantor(s) declare(s):
Documentary transfer tax' is $ 11 .00
( x ) computed on full value of property conveyed, or
( ) computed on full value less value of liens and encumbrances remaining at time of sale.
( ) Unincorporated area: ( City of 4!01W % , and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
CHARLES BIGMAN AND DORIS MAE BIGMAN, Husband and Wife
hereby CRANT(S) to
WILLIAM 0. WILKINSON AND BARBARA L. WILKINSON, Husband and Wife as Joint Tenants,
as to an undivided k interest and.JOHN L. HART, an Unmarried Man, as to an
undivided h interest, all as TENANTS IN COMMON.
the following -described -real property in the C ay'- o�'Za guinea "-' --
County of Riverside , State of California:
Lot 16, Block.149 of SANTA CARMELITA TRACT, Unit No. 15, as per map
recorded in Book 18 Page 92 of Maps in -the Office of the County Recorder
of Riverside County, California.
Dated: December 9, 1988
CFWLES OGMAN
STATE OF CALiFORN!A
COUNTY OF SS DORIS MAE BIGMAN
G 1 ra r+ K
On I Ic� �$
before me, e �� L r a t y l� c�. a Notary Public
in and for said State, personally appeared
g_ni Ar e • Sy % Pr a is .. 601
, (known to me) (or
proved to me on the basis of satisfactory evidence) to be the person
whose name' S _ subscribed to the
within instrument and acknowledged that i ke
executed the same.
WITNESS my hand
(and
�.o..ff fi/c' I seal.
Signature
1, a A -
Name (Typed or Primed)
OFFZAL SEAL
NOTARY PUBLIC -NEVADA
CLARK COUNTY
My AVDolntment El IN$ July 30, 1991
17bis area for official notarial seal)
I Title Order No. 200570 Escrow or Loan No. 10-7779
UL -4 MAIL TAX STATEMENTS AS DIRECTED ABOVE.
f,
✓x
4.
` � .•62r
@IFS
'COUNTY OF RIVERSIDE ENVIRONMENTAL
HEALTHSERVICES DIVISION
PERMIT APPLICATION -FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM
Applicant: Submit this form with four copies of a scaled plot plan (1-20 "e) drawn to County speculations as indicated on the attached check list
A non-refundable filing fee (see below) is required when the application is submitted. Check must be made payable to the County of
Riverside. l Approval of this application shall remain valid for a period not to exceed one year from date of approval.
VERIFY ITEMS IN, SECTIO,NzA FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG #
.44
Agent reit Contact Person = (;. r Phone
o e
-Owner
Addre s & Firm
a0 C ero a T_,W, 2Z 10
�500o Iia *6
L. Har 25geos
„Y
_State
C
Zip3 a o Property Ad
a ^ O
a
Legal Description (PM, Tract, Ljpt
5
Lot Size f
~e nc ell
Use of Permit P/P, CU, etc ,q
Other
—If—
Dwelling, �� a ►rep, etc If—
V//
' nature of Applicant
Date
CATEGORY: REV CODE FEE
01" SUBSURFACE DISPOSAL 1238
CATEGORY: REV CODE FEE
{0 .42
Q SITE EVALUATION UPON REQUEST 7349 $ 43.00
❑ MULTIPLE PARCELS WITHIN SAME
(N,0 P136OT PLAN)
LAND DIVISION
C1 VERIFICATION 7348 $ 17.00
a. 1 at 4 Panels (Each) 1238 $ 57.00
(Less than 1 year)
P. Each Parcel after 4 7344 $ 24.00
❑ PRELIMINARY ELECTIVE 7352 $ 23.00
❑ Rereview (2nd review same parcel) 7344 $ 24.00
EVALUATION (Attach DOH SAN 53)
❑f etvaluation in Conjunction with
❑ HOLDING TANK 7351 $ 47.00
Cittk�l Area; r '"7346 $111.00
•-z� » r
❑ ALTERNATIVE/EXPERIMENTAL 7345 $222.40
❑ Site Evaluation Lot Less than
SYSTEM
10,000 Sq. Ft. 7347 $ 87.00
i INR/�DATE
Holding Tank Agreements Completed ❑Yes —19
®yo`'
Certification of Existing S.D. System Required ❑ Yes O N�
WOCB Clearance required. (Attach Form ❑ Yes
DOH SAN 007, Santa Ana Region Only)
Solla Percolation Report Required:... ❑ Yes 1
Special Feasibility Boring Report Requk-ed. ❑ Yes ~
Detailed Contour Plot Plans Required (1 to 5 It. interval) ❑ Yes d
Otfler ❑ Yes
Staff Specialist Lol,lnspection Required ❑'Yes
Lot Inspection Date
Sills boring report byDate
10 16
ArAF
Soils Map Page Sol Type C./ Approved by W D.
No. of Systeme
TA of Systems)
❑ F�cildtng Tank ❑ Existing
No. Dwelling Units /
(1) Septic Tenk
Soil Rate reaae/Send
New ❑ Replaoenwnt
/B�edrpoma
3igMM . / ,!
L
/�
([
Gal
T Ga,
Leach Line Sq. FL
area
° ` Sidewall allowance
Iri �
Una(s) It. long _--ft wide with
1vt Bed e% ft.trench
fr
ft.rock/ - aq• fl•
min. wictse�godc below draMlines or
of battomarea
Leachlines/bed special design for slope:
(3) Pit Diameter
No. Pits
Pit Below
Seepage Pit Tote) Depth
(TD) /
Other
Applicable -�
f
Inlet (BI)
Max. M le/Depth
N/A Overburden factor
COW& L�1 6
I
I r
No. 2 System All I
REMARKS:
This application syd ;&PROVE EN IED for the category checked in SECTION B above, regarding the design of arsubsurface 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 100% expans n area.
1) Septic tank and sewer lines must be 50' minimum from any wells Q x C�%v.rr �cf
Leach lines must be -,100' minimum from any wells, including expansion rea /O � � �C^G /'J^
3) Seepage pits must be 50' minimum from a y wells, including expansion area
Signature of Health Official pie
RECEIPT NO. Issued;By Date
DISTRICT: ❑ Riverside, MOW ❑ Hemet q Perris ❑ Rancho Calif. ❑ Blythe
DOH -SAN -122 (Rev. 7/89) DISTRIBUTION: WHITE - Office.fila. ' YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records
d
a
COACHELLA VALLEY WATER DISTRICT
P n12-
� / CASH RECEIPT DETAIL
UR
Received From: �i/2-C/in/j .?SVG e . N/,41G e •' ►�
�7 Date.
Address: 3 J ,,�^��
Account No. 6061A �. �� Lot(s) % Tracts G�%S +°L)C. h
Service Address .-7 0 ,4,1ALIArL.2.0 G.A. Code
❑ Meter(s)
❑ Service(s)
❑ Backflow(s)
❑ House Lateral(s)
❑ DetectorCheck(s)
❑Me/ter Surcharge
15 ,Sanitation Capacity Charge ®� �
❑ W.S.B.F.C.
❑ Temporary Construction Meter
❑ Turn 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
Remarks: & / .r / zza
❑Copy to:
Cash
Check Q ��
Money
Order
TOTAL $ / 5 75. --
Water Service
Cashier -:E
C D-438 (11189)
a
OFFICE OF
AGRICULTURAL COMMISSIONER
AND
;;;•�.;; WEIGHTS & MEASURES CALVIN C. KAMINSKAS
mflf
JAMES O. WALLACE 4000 LEMON SIRE11. ROOM 19 +MEN BENV t NIS
•� CLEMENT BENVENISIE
ArkiAMof Comm4+10""I RIVERSIDE, CALIFORNIA 92501, Eeole+
the am of WNphU f><Mw1ue1 (714) 787.2561
49613 Ilighway 86, . Suite B12
Coachella, Ca. 92236
(619) 342-8291
DATE l� r CUSS NO.
DEVELOPER' 5 NN9E>I 7)eo-e-
ADDRESSt: 7?7;;2D
Dear Developert
After reviewing your landscaping plans, all plant material listed is not in
violation of quarantine. laws governing the Coachella Valley. If substitutions
do occur and they differ fran plant material listed, this office Tnust be notified.
immediately.
'Thank you for protecting and preserving the Coachella Valley's pest-free.envirorment.
! Agr cultural Can ss one s OFf e
i
cci Indio and Riverside Office
+
�it