05265 (SFD)ir, ; TWif 4 4 Q"
Buildin
Address 52-'405 Rubio
Mailing
Address
13 ra 1812— 366
City p Tel.
Address
City lZip Tela
State Lic. I City
& Classif. 487584 Lic. #
Arch., Engr.,
Designer
Address Tel.
City IZip I State
k Lic. #
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section
70pp) of Division 3 of the Business anii'Professions Code, and my license is in full force and
effecI.
14 f
OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractors License Law for the following
reason: (Sec. 7031-5,13ss and Professions Code: Any city or county which requires a
permit to construct alter, iWmve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such pemhd to lire a signed statement that he is licensed pursuant to
the provisions of the Contractors License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Processions Code, or that. he is exempt therefrom, and the basis
for
the alleged exemption. Any vioktion of Section 7031.5 by 'any applicant for a permit
sub%ecIs the applicant to a cvipenal y of not more than five hundred dollars (E500).
❑ 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, euisness and
Professions Code: The ConbacWs 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 sok/ within one year of completion, the owner -builder will have the burden
of proving that he did not buil or improve for the purpose of sale.)
❑ I, 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 contractorfs) foensed 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 1 have a certificate of consent to self -ins a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Secy 00, Labor Code.)
Policy No Cmpany
❑ Copy is filed with the city- ❑ Certified copy is hereby furor !7
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be conflated ff the permtt is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thg work for which this permit is issued, 1 shall not
employ any ppeerson in any manner so as to become subject to��t11t11te'NTorkers' Compensation
Laws of Califrnioa /�� jj1
Date Owner 'A
NOTICE TO APPLJCAM: D, after making this Certificate o11(,:emptuon you should become
sub%ect to the workers' Compensation provisions of the Labor—Code, you must forthwith
comply with such Provisions or Das Permit shag 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, Ciel Code.)
Lenders Name
Lenders 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 certity that 1 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
ateMailing Address
City, State, Zip
ILDING: TYPE CONST
No.
OCC: GRP.
05.265
P. Number y 7v r0./.0-01= A 024
gal Description
Project Description n ,�
Sq. Ft. 24€'35 No. No. Dw.
Size -Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT AMOUNT
Plan Chk. Dep. sn A
Plan Chk. Bal.
Const.
On
Mech.
Electrical
Plumbing
S.M.I. S
Grading
Driveway Enc.
Infrastructure i m _ nn
TOTAL $1,494.50
REMARKS
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 1/3/89 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
A.C. UNIT
COLL. AREA
YARD SPKLR SYSTEM `
2ND FL. SO. FT.
BONDING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
FORMS
7,TZ9WER OR SEPTI /6
GAR. SO. FT. Q
POWER OUTLET
ROOF DRAINS
DUCT WORK
ROCK STORAGE
DRAINAGE PIPING
CAR P. S0. FT. ®
METER LOOP
WALL SO. FT.
DRINKING FOUNTAIN.
SO FT ®
REINF. STEEL
URINAL
ESTIMATED CONSTRUCTION VALUATION $
TEMP. POLE
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER HEATER
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(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, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
REMARKS:
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/. c
SEWAGE DISPOSAL
SO.FT.GAR ® V4c
HOUSE SEWER
FIREPLACE
GAS 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 & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
7,TZ9WER OR SEPTI /6
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
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
FINAL INSP.
ROOFING �- a 2 '
/ ?� /�C
V >
ell
p
1I,
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING +,f Z'�
MESH
l NSULATION/SOUND —/6 Ov
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
CHICAGO TITLE COMPANY'
RECORDING REQUESTED BY
"AND WHEN RECORDED MAIL THIS DEED AND, UNLESS
OTHERWISE SHOWN BELOW, MAIL TAX STATEMENTS TO:
NAMEI— 71
A ✓i M CONSTRUCTION
STREET
ADDRESS P . 0. Box 366
La Quints, Ca. 92253
CITY.
STATE L
zip J
8809813-21
.Title Order No ............................. Escrow No!Q-814
;f
This space for -Recorder's use
L I Grant Deed I I
THE UNDERSIGNED GRANTOR(s) DECLARE(s)
DOCUMENTARY TRANSFER TAX is $ 27.50
unincorporated area— City-eo(G CKU0 p
Parcel No.O'computed on full value of property conveyed, or
O computed on full value less value of liens or encumbrances "remaining at time of sale, and
FOR A VALUABLE CONSIDERATION, receipt of which i.s hereby acknowledged,
PR EQUITIES, LTD., a California Limited Partnership
hereby GRANT(S) to A & M CONSTRUCTION, a Partnership
the following described real prol)erty in the
county of Riverside I , state of California:
Lots 11 and 12,. Block 48, Unit_No. 4 of;Santa Carmelita at Vale La Quinta,
as per map recorded in book 18, page 62 of Maps, Records of Riverside County,
STATE OF CALIFORNIA
0.
COUNTY OF Orange SS
On May 5,` 19RR beforeme,-�,
Marsha -T-
CO)
T CO) (here insert the name & quality of the officer)
q-�q personally appeared Steven R P ar•nrk' Prac;�o,,t C
i'- & JO -Ann L. Kina; Secre rv�TrPa rr�r -- -
O personally known to me (or proved to me on the basis of.satisfactory
evidence) to be the person that executed this instrument, on behalf of
the partnership and acknowledged to me that the partnership executed - OFFICIAL SEAL t
it. , A^ AR'SHA J 'LATH'ROP
Signature
d
a
No
Public in and for said Countv and State
Dated_ April 251988
STATE OF CALIFORNIA
COUNTY OF SS.
On this day -.of. in the -year -
before me; the undersigned, a Notary Public in
and for said County and State, personally appeared
personally known to me (or proved to me on the basis of satisfactory -
evidence) to be the person whose name
subscribed to the within instrument and
acknowledged that executed the
same.
Signature
Name (Typed or Printed)
Notary Public in and for said County and State
o NOTARY PUBLIC - CALIFORNIA
a
My comm. expires JUN 24, 1991
FOR NOTARY SE
PR EQUITIES, LTD., a California
Limited tnership
FOR NOTARY SEAL OR STAMP
OR STAMP
MAIL TAX STATEMENTS TO PARTY SHOWN ON FOLLOWING LINE; IF NO PARTY SO SHOWN, MAIL AS DIRECTED ABOVE
Name Street Address -
1.1Q1 .
City& State
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This space for -Recorder's use
L I Grant Deed I I
THE UNDERSIGNED GRANTOR(s) DECLARE(s)
DOCUMENTARY TRANSFER TAX is $ 27.50
unincorporated area— City-eo(G CKU0 p
Parcel No.O'computed on full value of property conveyed, or
O computed on full value less value of liens or encumbrances "remaining at time of sale, and
FOR A VALUABLE CONSIDERATION, receipt of which i.s hereby acknowledged,
PR EQUITIES, LTD., a California Limited Partnership
hereby GRANT(S) to A & M CONSTRUCTION, a Partnership
the following described real prol)erty in the
county of Riverside I , state of California:
Lots 11 and 12,. Block 48, Unit_No. 4 of;Santa Carmelita at Vale La Quinta,
as per map recorded in book 18, page 62 of Maps, Records of Riverside County,
STATE OF CALIFORNIA
0.
COUNTY OF Orange SS
On May 5,` 19RR beforeme,-�,
Marsha -T-
CO)
T CO) (here insert the name & quality of the officer)
q-�q personally appeared Steven R P ar•nrk' Prac;�o,,t C
i'- & JO -Ann L. Kina; Secre rv�TrPa rr�r -- -
O personally known to me (or proved to me on the basis of.satisfactory
evidence) to be the person that executed this instrument, on behalf of
the partnership and acknowledged to me that the partnership executed - OFFICIAL SEAL t
it. , A^ AR'SHA J 'LATH'ROP
Signature
d
a
No
Public in and for said Countv and State
Dated_ April 251988
STATE OF CALIFORNIA
COUNTY OF SS.
On this day -.of. in the -year -
before me; the undersigned, a Notary Public in
and for said County and State, personally appeared
personally known to me (or proved to me on the basis of satisfactory -
evidence) to be the person whose name
subscribed to the within instrument and
acknowledged that executed the
same.
Signature
Name (Typed or Printed)
Notary Public in and for said County and State
o NOTARY PUBLIC - CALIFORNIA
a
My comm. expires JUN 24, 1991
FOR NOTARY SE
PR EQUITIES, LTD., a California
Limited tnership
FOR NOTARY SEAL OR STAMP
OR STAMP
MAIL TAX STATEMENTS TO PARTY SHOWN ON FOLLOWING LINE; IF NO PARTY SO SHOWN, MAIL AS DIRECTED ABOVE
Name Street Address -
1.1Q1 .
City& State
f
2
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T'! . N .st +�.';''� �, ' • �, r '� Q. T
COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH Assessors Parcel No.
ENVIRONMENTAL HEALTH SERVICES
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 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.
VERIFY ITEMS IN SECTION A FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG'*
Agent, Contractor, te rson we •
lCeSI-57
Lop'1 t ��; L
Address & Phone
.B7
5 ,� v �-
Owner
Phone Q
Mailing Add
rb 3 & 1P ,Q
City II
kA-- Qv i >�'6�
tate
sate
Zip
Jo Property Address v�'D
!ft S 1( 11
Legal Description Pro . (PM, Tract, Lot)
% -to X bZ -o
-773
Lot Size
Water Agency/well
Use of Permit P/P, CU, etc.
Other
'
Dwe H Site Prep; etc.
Date
Signature of Applicant
CATEGORY: REV CODE FEE
CATEGORY: REV CODE FEE
❑ SUBSURFACE DISPOSAL 1238 $4500
❑ SITE EVALUATION UPON REQUEST 7349 $42.00
❑ MULTIPLE PARCELS WITHIN SAME
(NO PLOT PLAN)
LAND DIVISION
❑ SEWER/SEPTIC VERIFICATION 7348 $11.00
a. 1st 4 Parcels (Each) 1238 $45.00
(Less than 1 year)
b. Each Parcel after 4 7344 $16.00
❑ PRELIMINARY ELECTIVE 7352 $45.00
❑ Rereview (2nd review same parcel) 7344 $16.00
EVALUATION (Attach DOH SAN 53)
❑ Site Evaluation in Conjunction with
❑ HOLDING TANK 7351 $45.00
Critical Area 7346 $86.00
❑ ALTERNATIVE/EXPERIMENTAL 7345 $132.00
❑ Site Evaluation Lot Less than
SYSTEM
10,000 Sq. Ft. 7347 $86.00
INITIAL DATE
`
(✓( �� ��
Holding Tank Agreements Completed ❑ Yes ❑ lNo
Certification of Existing S.D. System Required ❑ Yes ❑ No
WQCB Clearance required. (Attach Form ❑ Yes ❑ No
DOH SAN 007, Santa Ana Region Only) 1
Solis Percolation Report Required. ❑ Yes ❑ No I
y
Special Feasibility Boring Report Required. ❑ Yes ❑ No `
Detailed Contour Plot Plans Required (1 to 5 iL interval) ❑ Yes ❑ No i
Other ❑ Yes No
Staff Specialist Lot Inspection Required ❑ Yes No
Lot Inspection Date
Soils boring report.by L' `�' Project # Date
Soils Map Page Sal Type Approved by Date
No. of Systema
Type of System(s)
No. Dwelling Units
(1) Septic Tank
Soil Rate
Grease/Sand
1
❑ Holding Tank ❑ Existing
New ❑ Replacement
Bedrooms, Fixture Units
�
Grease Intcp
(2) Leach Line Sq. FL
r
Sidewall allowance
Install Line(s) ft long ` ft wide with
Leach Bed sq, tL
Bottom trench
R rock/ sq. R
per Winning fL
min. inches rock below drainlines or%: ""
of'bottom area
❑ NA
Leachlines/bed special design for slope:
(3) Pit Diameter
No. Pits
Pit Below
Seepage:Fit Total Depth
Other.,/
Applicable J
Inlet (BI)�
Max.jAllowable'bepth
❑ 5 <❑ 6
(
L
N/A Overburden factor
a.
No. 2 System
REMARKS: 1�l�( ��! tr 1 U U : Y PC' , 5 ri Cl
a
This application is APPRO,V.E ° /DENIED 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 100% expansion area.
�(1•)? Septic tank and sewer lines must be 50' minimum from any wells
3.
Leach lines be 100' from including '
(2) must minimum any wells, expansion area r'
`t
(3) Seepage pits must bei 50' , i�limum from any wells, including expansion area
�;
Y `,'L. �`ca Date t 1
f�
Signature of HealthOfficial v`°�!\ t
RECEIPT NO. Issued By Date
a°
DISTRICT: ❑ Riverside, O\Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe
DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept. GOLDENROD - Plans/Records
Of /1f.E Of
AGRICUL'I URAL COMMISSIONER
AND
WEIGHTS & MEASURES
49-613 Ilwy 86, Suite 8-12
'Coachella, CA 92236
619-342-8291 ...
E. LEON SPAUGY
CONwS itO�EA
JAMES Q WALLACE
AiSWAM 1:r)WM1SS1o%ER
CLEMENT BE`VENISTE
SEALER
DATE "f�-.-29-��. CASE M. R88RS 1229-I
n
DEVELOPER' S. NAME: AM
ADDRESS: 9dx 3 6
�. 9 2 2 S'3
/V/k/
Dean Developer:
After reviewing your landscapuig-plat is, all plant.material listed is -not in
violatioEi of quarantine laws governing the Coachella Valley. If substitutions
do occur and they differ fron plant material listed, this office must be notified
immediately.
Thank you'for protecting and preserving the Coachella Valley's Fest-free environment.
Agricultural Calmissio: 's Office
cc:. Indio and Riverside Office