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0111-027, 05171 (SFD)'•� S: ••+ .*LICENSED CONTRACTOR DECLARATION .� { I hepeby affirm under penalty of penury that.1 am'licensed.under.Fprovlslons of •• ' Chapter 9 (commencing with Section 7000) of Division 3 of the Business and DATE Professionals Code; and my License is in full force and'effect.' License # Lic. Class err Ezp. Date S ,• JOB SITE{, ADDRESS r ,j - r Date ILL ' ' " Signature of Contractor OWNER -BUILDER DECLARATION w• 4..� I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: i'� ( ) 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, Business & Professionals Code). ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). () I am exempt under Section B&P.C. for this reason Date _Signature of Owner WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ( .) I have and will maintain aIcertificate of consent to self -insure for workers' compensation, as provided, for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. �, 1 have and will maintain worker's' compensation insurance, as required by Seton 3700 of the Labor Code, for the performance of the work for which this p1rmit is issued. My workers' compensation insurance carrier & policy no. are: Carrier OTATE FUND Policy No. 7120"_99096'r (This section need not be completed if the permit valuation is for $100.00 or less). ( ) I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as/to become subject to the workers' compensation laws of California, and agree th tif I should become subject to the workers' compensation provisionsof Segtion 3,700 of the Labor Code, lshall•forthwith comply with those probisio,ns, yfr�„$e S•n r: ✓,4 ,'Dater r' ' ` �r Applicant— Warning: pplicant Warning. Failure to secure Workers' Compensation coverage Is unla�wful and shall subject an employer to criminal penalties and civil fines up tof$100,000, in addition to the cost of compensation„damages as provided for in Section 3706 of the;Labor Code, interest and attorney's fees. � u IMPORTANT Application is hereby made to the Director of Building and Safety ,.for a permit subject to the -"Conditions and restrictions set tforth on his application. 1. Each person upon whose behalf this application is made & each perjon t. whose request and for whose benefit work is performed under or purs t any permit issued as a result of this applicaton agrees to, & shall, ind i & hold harmless the City of La Quinta, its officers, agents and empl e . 2. Any permit issued as a result of this application becomes null and Did !f work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancel tion: I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating,tothe building construction, and hereby authorize representatives of this-CiWta enter•upon the above-mentioned prtoperty for inspection purposes I f 11 Signature (Owner/Agent) LL, Date' OWNER '� i •;; BUILDIN.G"P:ERMIT { ,A • ti VALUATION pp��.y T•ap�y spy t LOT •i&.'lMaY & [3i7J.,OMM BMTM-IN' P;0,13,+JCC 450 :i.fs.t 1'rjXimrPA CA 93253 USE OF PERMIT '311ouki, k.kk/Si?.. y i.?.W�i..,L:Ta1b eY-^R/-,.tkps A6. t•a:.,n,Ncn. "%04+e OR DRIV, MAY APP110MCH PERMIT#• { l TRACT P T33 -2834m, CONTRACTOR / DESIGNER / EN INEER r a: -78-120 CALLEE ME)O SATI L• 204 '.0 LA JD '1. CA. . 92253 (7,60)564..1866 E'ML0 £d5 ', r, TIAC z CONOT1tU=-ON . 1,620.00 OF RECEIPT DATE % /' / BY I' 97,$29.15®,.r POMI'i.R "£'75? IlUMMAR CUNS':i'RUCTIONF '101-M-4.18-000 $630.30 Pi&i CHECK WIVE 101-600.4.39'-1 18 W"o f i,E':D3,�X-08:1`i 101-000-439-318 4150100 tt1401 lfl("AL79Z 101--000-421-000 V".01t 101-000«420=1700 $114, 3 P).LW9kNO,MR 101-0 0-419-000 $12A.00 STRO4.40 MOTION ME, -MD 101.,000-741-000 0116 (1: ADING91r.;�.' 101 -Oa* -4.21.000 V0100 DEVELOPER IMPACT FES $1,907.00 P RWInez , . 101 000-441ya.�5 �1GU.S0 "I.CK - 1`Ai:: CflC)%&e,TW3't1 C:[nN" AND i'3..AN e."'Fl. C' TJ? PPM -PAID TI )V 16 2001 � _ A P.yI' MS DVD ]KO7 WEAL YOP LAQUINTA WANCE DEP' RECEIPT DATE % /' / BY I' 97,$29.15®,.r 4-250.00,- L INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs _ _ Underground Ducts Forms & Footings Ducts Slab Grade Steel I Return Air Combustion Air / Roof Deck _ Exhaust Fans 0. K. to Wrap=© of F.A.U. Framing �� U2� — Compressor — — Insulation _ lam% J Vents— Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath / Drywall - Int. Lath Final Final I POOLS -SPAS BLOCKWALL APPROVALS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Pibg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines �j� (�-� '�� Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans OX for Finish Plaster Sewer Lateral Pool Cover Sewer Connection ���/� f Encapsulation Gas Piping Gas Test Appliances Final COMMENTS: Final Utility Notice (Gas) ELECTRICAL A 2�_ROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels � - Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final - Utility Notice (Perm) i ' .w.­f"`til.''ry"'P71@`l"1�''kj+t':A'+''q'a""FY Building Address -5 d Address Address s (. ty/',,/ f QWW /f Contractor a� CQJ �IGGII'�Iii(,/t�111� P.O. BOX 1504 APPLICCAION ONLY 78-495 CALLE TAMPICO r I ? it LA QUINTA, CALIFORNIA 92253 \. BUILDING: TYPE'CONST. OCC. GARP. A.P. Number7 7" Q.01 Tel FEW - Project / - l Legal Description `�"�`� E' Project DescriptionN .__._TOA 6"r 45.Q - C, 't'V7* Z Tel .. q State Lic ,. & Classif. �, =855 City Lic. # 8" % Sq. Ft. l r, •- No. No. Dw. �'� Size Stories Units Arch., Engr.,/'����� Designerln/1} Newy❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Ad?J s Tel C' y Zi State 0 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 DATE OWNER -BUILDER DECLARATION Estimated Valuation 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 requires 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 PERMIT AMOUNT 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 Plan Chk. Dep. for the alleged exemption. Any violation of Section 7031.5 by any applicant a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). . 111. Plan Chk. Bal. I": 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 Cont. 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, - , Mech. ;r provided that such improvements are not intended or offered for sale. If, however, the building or improvement s .sold within one year of completion, the owner -builder will have the burden ' - Electrical of proving that he did not �uild or improve for the purpose of sale.) _ t .- r _t H I, as owner of the property, am exclusively contracting with licensed contractors to con- +. Plumbing . struct the project. (Sec. 7044; Business and Professions Code: The Contractor's License Law, builds improves thereon, :' S. M. 1. .does not apply to an owner or property who or and, who contracts'for licensed to the Contractor's License Law.) 4'• +-!'t i .� such projects with a contractor(s) pursuant to" , ,: ,u' n� #, .;,: - - - Grading '. I'! I am exempt under Sec. B. 8 P.C. for this reason .t ► nd-T 0 n ' �, LL. " r±3:"4, � r•u` ;�� r ...� Driveway Enc. ' �' �,• �. `°y t� ` ,:.1 k InfrastrUOtUre;' -- Date .. - Owner .t"tilr �..i:� .'-ft1 .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.) -Z!,. - Policy No Company ' n copy is filed with the city.. ❑ Certified copy is hereby luinmshed. .I TOTAL.' CERTIFICATE OF EXEMPTION FROM. - REMARKS 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 thF 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 ZONE: BY: subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances: ' comply with such provisions or this permit Shall be deemed revoked. Front Setback from Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY %I $Ide Stceet-Setback from Center Line hereby affirm that there is+a construction lending agency for the performance of tfie-� for this is issued. 3097, Civil Code.) ,n� —�Y Sid Setback ror�1 Property Line work which permit (Sec. ame Lender's Name- Lender's Address Lender's FINAL �PECTOR ' This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that 1 have read this application and state that the above information is correct. ISs� d y:MADat Permit I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above. mentioned property for inspection purposes. i Val dat d b Signature of applicant Date CIS Or L. F147A Mailing Address Vali ation: City, State, Zip :i WHITE = FINANCE YELLOW = APPLICANT PINK a BUILDING DIVISION RECORDING -RRQUESTtb BY. WF!Eilli'fikdORbED, MAIL :CO b 0t0AES"BEi TEIN LA CA. 9225"1 j_SFACE ABOVE R A. -.N, T D E THIS LINE FOR RECORDER'S USE x E -D The undePlIned declare(s,) ,Documentary transfer t � is,$ 46.75 ax, 77a;-,� 83-002(x) v Au.,46 tz ve /0 cok�ut'dd on' -f value of property conveyed, or TITLE ORDER NO.V.R.2:01622-:-1 OOMPUted,ton thW' fill value less liens or J ZSCROW NO.: 2107 7_2JE1. ng'at the time of sale e nces Temaini FOR A VALUABLE CONSIDERATION, receipt of wbich,.is hereby 'acknowledged: GERARD kURV`k' SCAB: &.,BROWNSON�an u=arried m8n hereby GRANT'(p) to AFFRTEY IRZAANSTP.INand.DOCOR'ES BERNSTEIN husband and wife an joint tenants The following real propE!rty irl" the La Quinta, Riverside couhty, St'ate of California,;_ describ#das I Lot 22 in ,i3fock 164, cif'san't'ai, tCA=elita-:at Vale La Quint& unit Na. 17. as. ,111.,�_ 1. ... I I - �i" . - ,;khown map on file, in.Hook 19 page S.i f 4cords of Riverside County y Aec6rder. ,Dates:':f:August .29, 20.01 GMALRD MURPHY r STATE,':of CAtj80j6jjA COUNTY, OF SCOTT A.''BROWNSON on — beicre me, the undersigned, r-ersonaIly- appeared_ _per6onall& knowh to ii4`-_`(orT' -proved, to nie-on'ttie basis of -- satisfactory to be the pc rson( I a) name(s), is./are subsCdibed to ihelyithi; in'strument and acknowledge -A that he/,ihe/,thej executed cutO,d the same in his/her/thei:_- aUt1ior'i2;_. C-apacit", Y(Ies') and That -by-his1h'er/t_,heii_-' signature (s';'on the instrument strument the person -,(-,a) ir,6� ' C -the entity upon ,behalf *of which the person(,s.) :acct6dl, exer.Cated the. instrur�ent. . Withdkis mk`li�and and,.offtclal seal. Signatli (This area for official notarial seal) MAIL TAK STATEHENTS TO; 515.20 Axiahida Obregqh,­.La-,Quinta, -CA. 92253 T001n :.![,Vi S Ur iM999 09L YVJ 91:60 (1a& TO..,ZT/ 0 D ECENE C OCT 1?(i�? RC bISTRfCT - °PLAN°NINE .REVIEW FORM CITY OF LAQUiNTA PLANNING DEPARTMENT This form is to be used byCDD staff for review of: sh' le family dwellings in the ove Residential) District per: Section 9.50.:090' of th-e,'1 obing. Code. Its purpose is' -to determine: 1) that the proposed house des* n does not:dbplicate�, he same architectural style of,any house within 2 -00 --feet 4-th � pp it cant,—and/or- 2) if -there is a need_ for=the applicant to file for Master Design Guidelines�If the applicant does need to'file a Master Design Guideline, please transmitted this inf"ormationto the Building :and>Safety Department as part of your correction list. Please attach additional explanatigns: as. necessary. �64"'S APPLICANT LENDEL VENTURES SITE ADDRESS 5}2-520 Avenida Rubio, . 2 63 Z / APN 773 _ .3�n ._ 002 CASE NO.: -2 91-rY 565 LEGAL: LOT 2'2, BLOCK 164 UNIT `� S.C.@V.L.Q. ' CHECK AND APPROVED BY: Wally Nesbit' DATE: /0 /2 Inform the assigned Building: plan checker- upon your ass tignment to,,this case. The CDD Executive Secretar.y, maintains a log bookAo track applications and assign case numbers. REQUIRED ITEM Y N COMMENT/CORRECTION Verify legal and APN. iri'formation Consistent with MDG on file .Cas applicable MDG filing required (5.fili' " since 9/3/98) Architectural v,ariet-y .within=200 feet of the surrounding area: Colors` ;u ',,Materials., Architectural design features - Other Requirements: APPROVED BY COMMUNITY DEVELOPMENT DEPT`' BY DATE _01 z. /0 I EXHIBITc CASE N0. P.O. BOX 1504 Building 78-105 CALLE ESTADO Address 52-52.0 Rubio LA,QUINTA, CALIFORNIA 92253 Owner Steve Gavin Mailing Address 47RI f4 ir City Zip ^7nS w n t Contractor Address W State Lic. & Classif. Arch., Engr., Designer . Address Tei. Tel. City Lic. # Tel. No. 05171 BUILDING: TYPE CONST. OCC: GRP. A.P. Number 7714-7S1I. Anil Legal Description Project Description , ! Y► a — e Sq. Ft. No. No. Dw. Size 1345 Stories Units m l New ❑ Add ❑ "' Alter ❑ Repair ❑ Demolition ❑ City (Zip ( State Lic. # i. 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` r f -.1 3 a' t DATE j� OWN EWBUILDER'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 requires a permit to construct, atter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to We 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 o/ the Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exemption. Any viofa0on o/ Section 7031.5 by 'any applicant for a permil subjects the applicant to a civil penalty o/ not more than five hundred dollars (8500). ❑ 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, Suisness and Professions Code: The Contractor's License Law does not apply to an owner of property who Lxdlds'. or bnproves thereon and who does such work himself or through his own employees, provided that'such improvements are not intended or offered for sale. ff, however, the building or improvement, is sold within one year of completion, the owner -builder will have the burden of proving that he did no: build or improve for the purpose o/ sale.) O 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 appy 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.) 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 tha 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: It, after 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.) 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 100 days. I certity 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 ateMailing Address city, State, Zip L i ti BY: Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. x+1Z Plan Chk. Bal.SCO P1 2U • A Const. 11 q . v n Mech. 714-77 Electrical 1 �, an Plumbing 9 9 S.M.I. 9fl 7y Grading +4 Driveway Enc. Infrastructure 1/00/1000 TOTAL et2 2 REMARKS W r IV ZONE: ti BY: Minimum Setback Distances: i 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 12 % 2 9 % 80ermit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE IC ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SO. FT. FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SO. FT. ® GAS (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR. SO. Fr. ® TEMP. POLE GROUT DRAINAGE PIPING CAR P. SO. FT. ® FINAL INSP. BOND BEAM WATER SYSTEM DRINKING FOUNTAIN. WALL SO. FT. =$ LUMBER GR. FINAL INSP. URINAL SO. FT. @ ROOFING 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 WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY 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 SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. Fr. RESID ® 11/4 c SEWAGE DISPOSAL FINAL INSPECTION SO.FT.GAR ® 3/ac HOUSE SEWER CERT. OCC. 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 ETBACK — 6OUND PLUMBIN UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE IC 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 APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus xi =$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING t i �/✓H REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESlINiT1ALS GARDEN WALL FINAL ) .�. Desert Sands Unified School District +' CERTIFICATION OF PAYMENT r OF ^ F PCO l HIS SCHOOL FACILITY FEES T0: Cit of La -U nLiCATFE� ,tlNOT _ ,(JQ ► - +� y DATE: D pa tment f Community Development 67k0 Ca a Estado Lu n CA 92253 e This 'is to certify that developer of which is, located at A;—,2 within - e' this District, has paid school facility fees imposed pursuant to the' n '.a horit genera d by G vernment ode�Sectiost 53080 i the.amouktt Of $ 6 ( a `..,,covering a total of square feet of ( ) r sidential or " industrial/commercial development and that building permits for this footage in this development may now be issued by your jurisdiction: joyLy for ESERT SANA UNIFIED SCHOOL DISTRICT =� White Building Department • Yellow - Facilities Planning • Pink - Accounting 0';G 0 ld - Developer a ` t' y SIP -08-1001 08x1 O PrwO 0 U.8 D FACILITIES T80pTTi�AS3Z Tm489 P.AOt/AO! P-101 .drool District IMMANVOILL8 ; a4 �9�960 Dlte79 [fid Plomd,o [:a r9 W1 I on "D gtstnca, C�1�fot�i9�j: 283 0 (980D 971-A618 o Z�A?at (9$0� 99i -ate$ TA - 10 A mss! somm`Op Bi3UMMON i0i n Droit 'I m,A. 09&cke PJM Kftdyka oasy:g^aza� , . M. DV mer z. Wit& EOO/Zoo `d 5, 2001 To Whom It ley Concern:. Thiel® cou p alai ool fears i,1'1ba &momt. of $2,341.24 vvmymid:on.J=e 27, 900by O;; r Murphy bn ®tfca fop. as sisig?e y�s�ea�d 'loo d.>�t SZ -3Z0 Ruldoo. La, Qui>art , >For °]X39 ss��; 44. �3 J. Murphy Co®stpu�don. ift`coii nmdon mor oO=enced Wd-th&paop", is now far awe. This s .ta irm you ffiat yew owxer (Ja:y & Dolores �er::ec®ia)sc tie amt as acedy ptid rasa ay>�Oat-m �ilt3s�hovld y baif6 r E' ctty 1G29'm = � Sh utd t > w owr' build ori above fer®noed prapsrt�r abt ea scd.s Garro ether Lila total sgsusrc;j to a vvtYl b� sixb��ct roo the netx► z cure M. 03 •par quarre•i a �a reed®dial, d f a rano a}gmid is 1990 wv®u�8 bs` yppli�I va ca Qii tovvc r, If s foaitc total aibould l:%Gas t the 1Z9 raq:'itt> tli� iaaw ovv would be t e itle�l> o r�'relmb tis i t be dfi&.—st the 1990 ante of $1.56gum fat. Should you hm any grea4®d at (760)771,852l. �9a�erarly, Anneft Barlow. 01tce TechuWm 6Z��89509Ls. NO1d,anals,,9011) dHdam P0. Wd IZ:Zj Now 100Z-01-dHS n Q Z 0 w m Z O U UJ A.] Z O U w n Z O U U.1 U) I COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH Assessors Panel No. 14-7 �1, �. `ENVIRONMENTAL HEALTH SERVICES - - o o 2, 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, Contact Person C� o .� -T IN 0it Ph Address & Phone � Owner Phone Mailing Address City •��'� L1c ` Stt IIAU Ziip� �J�22 J 3 Job Property,Address 0 22,. 6 Legal Description Prop. (PM,/Tract Lot) Of," IA C Uri Lc0t CSI 10, 17 - l_ad to f o4- K Q f :-, !21 oc�( Jul+ Lot Size Water Agency/Well Use of Permit P/P, CU, etc. f Other Dwelling, H Site Prep, etc. r r)e C 1 1 I r] Signature of Applicant Date CATEGORY: REV CODE FEE CATEGORY: f REV CODE FEE SUBSURFACE'DISPOSAL 1238 ,$45.00 ❑ SITE EVALUATION UPON REQUEST 7349 $42.00 ❑ MULTIPLE PARCELS WITHIN SAME ` (NO PLOT PLAN) LAND DIVISION /' 0 SEWER/SEPTIC VERIFICATION ( 7348 $11.00 a 1 at 4 Parcels (Each) 1238 $_45.00 (Less than 1 year) fi b. Each Parcel after 4 7344 $16.00 <' ❑ PRELIMINARY ELECTIVE 7352; $45.00 ❑ Rereview (2nd review same parcel) 7344 $16.00 r EVALUATION'(Attach DOH SAN 53) ❑ Site valuation in Conjunction with�! ❑ HOLDING TANK 7351 $45.00 Fritical Area 7346 $86. ❑ ALTERNATIVE/EXPERIMENTAL 7345 $13200 ❑ Site Evaluation lot Less than ° SYSTEM 10,000 Sq. Ft. ~ 7347 $86.00 "' .4. INITIAL DATE Holding Tank Agreements Completed ❑ Yes No ! • T Certification of Existing S.D. System Required ❑ Yes No WOCB Clearance required. (Attach Form ❑ Yes No DOH SAN 007, Santa Ana Region Only) <' Soils Percolation Report Required. ❑ Yes No Special fusibility Boring Report Required. ❑ Yes No Detailed Contour Plot Plans Required (1 to 5 ft. interval) ❑ Yes No Other ` ❑ Yes No Staff Specialist Lot Inspection Required < ' ❑ Yes No Lot Inspection Date Soils boring report by' - -- -- — —_ -project #--+--- —r` —� Date Soils Map"Page San Type Approved by Date No. of Systems Type of System(s) ❑ Holding Tank ❑ Existing �Dw, ailing Units *e,.^:;.� Fxture Units (1) Septic Tank Soil Rate i� Grease G ntcp New ❑ Repraoement /"1 i 4 ' Srf �U Q� / / U( 9, "e (2) Leach Line Sglw Sidewall allowance `'�" Install Line(s) R long wide with Leach Bed sq.4t Bottom trerridarea ft. rock/ sq. It. --r,,,perrunning It. ❑ NA min. inches rock. or of bottda" y Leachlines/bed special design for slope?. (3) Pit Diameter No. Pits Pit Below Seepage P JT."pth Other. Applicable , ❑ 56 Inlet (BI) Max. Allowable Depth � w N/A Overburden factor No. 2 System I. REMARKS: f This application is APPROVEP ENIED for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated on the accompanied'p�of'"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 iri.the required reserved 100% expansion area. 0 Septic tank and sewer lines must be 50' minimum from any wells (2) Leach lines must be 100',minimum from any wells, including expansion area 3) Seepage pits must be 150' minimum .from any wells, including expansion area Signature of Health Official2zt4-&-Date 12-1z1 A r,,- RECEIPT NO.' DISTRICT: ❑ Riverside, Indio DOH SAN 122 (Re"v. 5/88) DISTRIBUTION: Issued By ` " Date ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe WHITE - Office file YELLOW Applicant PINK - Bldg. Dept. GOLDENROD - Plans/Records ' . - = Or ,�{ ��, �� • �,;� OF-FICE OF E. LEON SPAUGY AGR[ UU71 UfZAI �:COtiIMISSIONER C0""15:,o`ER 0 �� -AND JAMES O-WALLACE D AWSTAM C7MMISS10%EW �'prl • 1VE'IGf I I s'':Fi.MEASUREs. CLEN1E`iT BE`VErISiE 1 7lSEALERt 49-61,3,.IIw.y. 86; -S .13 I3.-.1,2 ��,, ,,.•' 'C6ddie1la; (,A 92236 Mq r v, l,ag7 619-342-8291' S .Z _SZ a DATE j Z - 2:/ - Fl Sf CASE VO: }2. FS 5 2 Z / C )A DEVELOPER'S NAME - ADDRESS: TELEPHONE: Dear Developer: - After reviewing your ,landscjping plans.,° all plant material 'listed is not in violation of quaran,Eine laws governing ttie :Coachella Valley. ' If. substitutions do occur. avid they differ frcin plafit-'`iMteri.al..listed, .this office must be notified irm>tidiately• Thank you -for and''preserving _;the Coactiella.Val-ley's pest -free environment. Agricultural Com.iss, per's Office cc: Indio and Riverside Office Fitch Engineers Inc. May .27, 1989 Mr.. Steve. Gavin 4783 Mt. Almagosa. - San Diego, Ca. 92211 SUBJECT: Report of In -Place Tests- 5252O Avenida Rubio La Quinta, Ca. Gentlemen: In accordance with -your request, this report has been prepared to present the results of the in-p1ace. tests performed on the, fill material at .'the subject site. by Fitch Engineers, Inc. These tests were performed on May 27., 1989. AVAILABLE PLANS To assist indetermining the:locations and elevations of our field density tests and:. -to 1defi-ne the general ..ext:ent of -the site grading for this phase,of.wor:k2 we.were.provided with .a grading plan by Fitch Engineer's., Inca FIELD-TESTING Field density testswere..performed by a: representative of Fitch Engineers, Inc. upon completion of.site-grading. The density tests- were taken according to' A'.S..T`M. Test 1556-74 'and the location and resuflts of :those. tests are shown on the attached plates. The locations:.And elevaaions;;of the in-situ tests were determined- in accordance with their importance and the accuracy and proximity of Mie survey control provided by Fitch Engineers Inc. representatives. Unless otl erw.ise noted,_.:their locations and elevatlQns Were.det.ermined by pacing And hand level methods and should be considered.accurate only to the degree implied by the CIVIL_ENGINEERING — PLANNING .- SURVEYING — DESIGN P.O. BOX 4551 PALM' DESERT, CA 92261. (619) 345-7667 -2 - method used. LABORATORY TESTS A maximum dry density determination was performed on a representa- tive sample of the soils used in the compacted fills, according to A.S.T.M. Test 1557-78,.Method A. --This method specifies that a four (4) inch diameter cylindrical mold of 1/30 cubic foot volume be used and that the soil tested,be placed in five (5) equal layers with each layer compacted by twenty-five (25) blows of a 10 pound hammer with a 18 inch drop. The results of these tests as pre- sented on Plate No. 1 were used in conjunction with the field density tests to determine the percent of relative compaction of the compacted fill. =This report covers only the work performed on May 27, 1989. Our opinions presented -herein are based on our observations and the relative compaction tests results. Due to possible variations in the uniformity of compacted fills, we only warrant that our work was performed in accordance with the currently accepted standards of practice and in such a manner as to have reasonable certainty that the mass grading complies with the job requirements. No other warranty, express or implied- is given or intended. If you should have any questions after reviewing this report, please do not hesitate to contact this office. This opportunity to be of professional service is sincerely appreciated. Respectfully submitted, FITCH.ENGINEERS INC. WM. H. FITCH R.C.E. 12571 _JOB NAME 52 520 Avenida" Rubio• La Quinta• Ca. TEST NO. DATE_ LOC/1TIO.N: OR ELEVATION •: DEP:7F1 OF- MOISTURE `ORY'.UEN. SOIL Ft EI 5/27/89.. See Sketch TYPE j; 111.4 121.6 91,;6 . �•S� 6..4 111 121:6 92:0' 3 F.: 11 G. 1.0 113.6 121.6 ----------------- SOIL TP 1.s cu .,/ Mo'Y#1- " ture I Ids ----------------- �t