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04335 (SFD)Titvl 4 44P Q" 04-335 Building Address Owner 52 - 4; C li r„arzanza 11 Coacllell;m Val4ev Land Co. Mailing Address �4 7t Z City FzjP 102 2 6 2 Tel. 9 Lfiqs Contractor Address n y Zip P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 State Lic. City _ &Classif. 337934 Lic.# f,9-5 Arch., Engr., Designer Address Tel. City I Zip I State Lic. # . LICENSED CONTRACTOR'S DECLARATION 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 ifATE 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 roriwfes 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 penally 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 exclustyely 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 contractors) 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 therr)Df. {Sec. 3800. Labor Coda.) 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 ($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 Cerfilicals at Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permft 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 certlry that I have read this application and state that the above information Is cbrrecl. 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 BUILDING: TYPE CONST. OCC. GRP A.P. Number 773--3 �-a"t`� Legal Description Project Description' " Sq. Ft. 1410 No. Size Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ .1701 ol�' 'a 1 < silo',= fence Estimated Valuation t75 PERMIT AMOUNT Plan Chk. Dep. r'25Q a Plan Chk. Bal. , L Const. „f Mech. Electrical 7 - :. 17 Plumbing 1.05 . 0f; S.M.I. a. �6 Grading Driveway Enc. M O C Infrastructure 1, F D R. 9 6- TOTAL REMARKS ZONE: SY: Minimum Setback Distances: Front Setback from Center Liner Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR r Issued by: Date Permit Validated by: Validation: WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SO FT (a S UNITS A.C. UNIT �I COLL. AREA YARD SPKLR SYSTEM 2ND FL SO FT. a BONDING MOBILEHOME SVC, BAR SINK POR SO FT a( FORMS SEWER OR SEPTIC TANK GAR SO. FT. of POWER OUTLET ROOF DRAINS DUCT WORK ROCK STORAGE DRAINAGE PIPING CAR P. SO FT. 6 METER LOOP WALL SO FT. @ DRINKING FOUNTAIN OTHER APP.IEOUIP. REINF. STEEL URINAL SO FT id TEMP. POLE ESTIMATED CONSTRUCTION VALUATION $ 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(AUTOXOISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED $ LAUNDRYTRAY AIR HANDLING UNIT CFM LUMBER GR. 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 SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID 11/4 c SEWAGE DISPOSAL SO.FT.GAR 3/4c 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 FE= PLUMB FEE STRUCTURE PLUMBING ELECTRICAL HEATING 8 AIR COND. SOLAR SETBACK FF _,OoP GROUND PLUMBING UNDERGROUND A.C. UNIT �I COLL. AREA SLAB GRADE ROUGH PLUMB BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. 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 Mzx FINAL INSP. ROOFING �., I�JI / -/ i'C / O REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL q�rTHING/2 MESH ✓ INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL J/ QIrIf. E OF AGRICUL'I URAL COMMISSIONER AND WEIGI ITS b.. MEASURES 49-613 Ilwy 86, Suite 11-12 Coachel.ln, CA 92236 619-342-8291 E. LEON SPAUGY co.i•nsa�o�En JAMES O WALLACE ASS%S;Atif CI)MMISSJUNEP CLE}IENI BE`VE`NISIE SEALER DATE CASE N0. Q �� L.NG� OiaZCS I't DEVELOPER'S NAME: S f r� & &)s4(-64- C.4 z6oj ADDRESS: 17-A �4 u ��Z LJA•� ♦`� Z lIIx So^. TELEPI1ONE: ( (o(g) _3 ;Z2 — 10 M j) S'24(5 s%c eAr-r-AtJZA P(Am, ��• Dear Developers After rev iewing'your landscapi.Iiq plays, all plant material listed is not ill violation of quarantine laws governing the Coachella Valley. If substitutions do occur alld they differ fruit platlt Ilkaterial listed, this office must be notified himadiately. Thank you for protecting and preservilig the Coachella Valley's pest -Free environment. Agr6lultural Catimi.ssioner's off ice cc: Indio and Riverside office I 00 z O t— U W cn W Z O H U LU In U) V Q LLJ cr 114 COUNTY,,OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION "-►73 v �% — 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 required on the attached check list. A non-refundable filing fee of •$37 is required when the application is submitted. Check must be made payable to the County of Riverside. /91 Building Department Application Log # Name (Owner, Agent, Contractor, Etc.) Mailing Address City PALM S PR,,,i;J e-5- s State L'A Zip Code Jz Z G z, Telephone el- -,q) .3zz -/o z e Job Property Address Commanity " Legal Description of Property. (Lot, PM, TR) mss` W Sz y ,'F -Z 94-4' 42,4QA,, A)Z-A •GAJ 4941 7 A Lal'// ,�[ �C /S4 L[.0 .1 r- / b 'Assessor's Parcel No. Water Agen or Well '%� ��/�%� ' " Permit r )It `�' "l'� Z4��lanning Lot Size 1v 773 — Z.� — ®� [�, Use of Case # �© X i co SFD, MH Site Preparation Etc. Signature of Applicant Date The above information must be verified from Building Application STAFF USE — DO NOT WRITE BELOW THIS LINE Initial Date ElYes FINc ��! L -7-2 0 Certification of Existing S.D. System required. / !t WQCB Clearance required. El Yes 21� i Soils feasibility report required. ❑ Yes 2 / Detailed boring report required. ElYes IN6 Detailed contour plot plans required. ❑ Yes MANO Staff Specialist approval required. ❑ Yes No Lot Inspection Date Soils/boring report by Project # Date r Soils Map Page �� �g Soil Type C Approved by A— Date % Z 19 J 1 Type of System:(/ E)2 ❑ ❑ No. of Bedrooms (1) Septic Tank . MvGals. 'S/oil Rate Required Existing New Additional Replacement (2) Leach line sq. ft. Sidewall allowance Install-_ �Line(s) Ft. Long, (✓ Leach bed Sq. m `" (Bottom -trench area) ft. rock/ - Sq. Ft. Ft. Mcfe• wi min. inches Ft. of bottom-- otto per running ft. per rock below drain lines area Leach lines/bed-special design for slope: (3) Pit Diameter ` No. Pits Pit BI Seepage Pit total depth Applicable /~ N/A �urden factor Max. allowable depth / v This application$ app ov dhdenied•for the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements set forth in Section B _8 . A building permit is necessary for the installation of the above -designed system. ' (1) Septic tank and sewer lines must be 50' from any wells�l7 f r- `y > 4" �`°i ' (2) Leach lines must be 100' min. from any wells including expansio —ZQ�j„/ 6'2)) Seepage pits must be 150' min from any wells including expansion area. •/ -),,,40 Signature of Health Official RECEIPT NO. -71' -3G Issued by eo, Dated "" o 7 T - District: El Riverside ®'Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File DOH -SAN -122 (Rev. 6/86) From the desk of ... City of La Quinta Finance Department 71y/LSC V\A O N r ng J /t u Pc Is cu�7 n 4 � USE CODE COUNTY OF RIVERSIDE 9 OFFICE OF ASSESSOR ASSESSOR'S PARCEL NUMBER 173-321-011-1 R1 PROPERTY OWNER'S STATEMENT ON NEW CONSTRUCTION Owner's Name and Mailing Address Property Situs REDEVELOPMENT AGENCY:CITY OF LA QUINTA 52.965 AVENIDA CARRANZA 78495 CALLS TAMPICO LA QUINTA CA 92253 LA QUINTA CA 92253 Date Sent: AUG 239 1996 Our records indicate a. building permit was issued for the above situs. Please complete this form and return it to the Office of the Assessor within 3 weeks of the date shown above. Also include any additional information you believe important in evaluating the new construction. Owners' Name Owner—builder ......... Yes ......... No Please complete below Permit Date 05/07/9 Permit Number 327 Contractor Permit InformationPUOL/SPA Contractor's Address Completion Date Estimated date if not complete City Zip Telephone Please Check Where Appropriate 1... STRUCTURAL CHANGES a) ..... Addition .............................. Square feet (complete items 3, 3a & 4) b) ..... Alteration ........................... Added Square feet (compete items 3, 3a & 4) c) ..... Patio ..................................... Square feet (complete items 3, 3a &4) d) ..... Pool or Spa ........................ (complete item 2 or 2a) e) ..... Other .................................... Square feet (complete items 3, 3a & 4) Please explaii}::::....:................................................ ...............................................................................:...................... TOTAL COST OF WORK (Labor and Material) $ ................................ 2... POOL/SPA 2a ... SELF-CONTAINED SPA ONLY.­,'- NLY.•:•Type) Type)...... Gunite ..... Fiberglass Type) ...... Gunite ...... Fiberglass ....:..Redwood ..... Plastic Lined Size) ............:...:...... In ground....... Above -ground'. Heater) ..... Gas : Solar .......... None Size.) ........:................:.: .. . Pool. Sweep) -.-..-..'Yes ..... No Heater).:.... Gas ..:..: Electric Decking) ............... Approximate square feet Spa) ..... Attached ..... Detached ..... None TOTAL COST OF WORK FOR ABOVE $ ...................... TOTAL COST OF WORK FOR ABOVE $......................... 3 ... INTERIOR DETAIL Floors)..... Tile ..... Carpet ..... Vinyl ..... Concrete ..... Wood ..... Other.....:.......:............::.............................................................. Walls) ..... Drywall....:. Paneling ..... Plaster ..... Other........................................................................................................................... Plumbing) :....1 /2 Bath ...... 3/4 Bath ....... Full Bath Remarks: ....................................................... : .......................................................................................................................................................... ................................................................................................................................................................................................................. 3a... EXTERIOR DETAIL Walls)..... Stucco ..... Siding ..... Brick ..... Other ..................................................... ............................................................................. Roof Covering)..... Clay Tile ..... Concrete Tile ..... Composition Shingle ..... Wood Shingle ..... Gravel or Rock ..... Composition Roll ..... Lattice ..... Other.................................................................................................1........... Remarks: ....... ............................................................ : ...................................................................................................................................... ......................... ................ ........... ........................................... ............ :............................... ................................................................... Please complete reverse side ASR - 749 - 20 (REV 10/93) 1052 4... SKETCH OF NE1\,' CONSTRUCTION Make a "K_•Idl oi, the "llov its dinlcfl�it.il� i,ld lo'!::,-i. ip! C0111PLIUltiOn ......... ... ...... .... . .. ........... . . . ......... ..... ... . .................. .......... : ....... .. ............. ........... .... . . ... ............. .. fetal SqUI-11-e lreC! - . ................... Sketch example 16' NOV R:10'11 A,rdiliiKl Palk) Existing Residence Existing Girave Street Street PLEASE COMPLETE BELOW' The. Assessor's Office may audit this statement for, completeness and accuracy and may contact.you for additional information as required. . Signature of owner or agent Date Title (agent) Address City. State & Zip Telephone Number (Sam — 5pm) DISTRICT OFFICES For any inquir'es, please contact the Disthet Office in your area. I.... RIVERSIDE 2.... PERRIS 3....TEi%,IECU-LA 4 ..... HEMET 4080 Lemon Street 227 North'"D" Street. 41002 County Center Dr. Suite 230 S.SO N. State Stree-t P.O.- Box 12004 Bldg. A Temectila–Ca. 92390 Hemet. Ca. 92343 Riverside. Ca. 92502-2204 Perris, Ca. 92570 (909) 694-5000 (909) 766-2500 (909) 275-6200 (909)-940-6775 (909) 679-S464 SLII1 City Toll Free 5.... PALM SPRINGS 6.... I N 010 7.... BLYTH E 3255 E. Tahquitz Canyon Way 46-209 Oasis 160 N. Broadway Room 1 14 Room-406 Blythe, Ca.'92225 Palm Springs, CA 92262 Indio. Ca. 91201 (619) 922-6189 (619) 778-2400 (619).342-8261 ASR-749-20(REV !0-331