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003063 (SFD)P.O. BOX 1504 Building 78-105 CALLE ESTADO Address 54-660 AveaicU Rubio LA.QUINTA, CALIFORNIA 92253 Owner betula E snd .A�rne`��e �r Mailing Address City lZip y%kii^ ' 97.711. � Contractor o wnerlsuilder Address City Zip Tela State Lic. City & Classif. Lic. # Arch., Engr., Designer Address Tel. City Zip 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 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 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 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 penalty 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, 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..lf, 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 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.) - ❑. 1 am exempt under Sec. B. & P.C. for this reason Date - • r Jr 7 Owner �/ f� r t.' (i.�% , _•r x�-a✓i 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 ($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 V J " `t.Owner 'r NOTICE 'TO APPLICANT: if, after making -,this -Certificate of Ezemptlon '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 Ihereby 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 Date Mailing Address City, State, Zip HARD COPY No. 003063 BUILDING: TYPE CONST: OCC. GRP. A.P. Number 774--272-009 Legal Description Project Description Sin4le amity Dwelling REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Sq. Ft. Size 1438 No. No. Dw. Stories Units New Q Add ❑ Alter ❑ Repair ❑ Demolition ❑ R a } i if 31 '-w---tainincr Wall ?nn: imf _ wrtna rence Issued by: A A6 1, Mf_ e,R 1 a"t? Validated by: Validation: Estimated Valuation X77_AU tit) PERMIT AMOUNT Plan Chk. Dep. 52510.00 . Plan Chk. Bal. $ 40.16 Colist. 367.00 Mech. .33.44 Electrical 75.05 Plumbing .103.00 S.M.I. 5.43 Grading 20.00 Driveway Eno. ,r* r>,r ; �. •,.. 120.00 :1_ Infrastructure W L -TI-ISti i ` iii AL: 1_113S,53( TOTAL 'A2n4g.17 $1799.17 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 4/21/8 Fe.rmit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO.PLUMBING FEES IST FL. SQ. FT. ® $ UNITS SLAB GRADE 2ND FL. SQ. FT. ® BONDING fYARDSPKLRSYSTEM POR. SQ. FT. ® MOBILEHOME SVC. INK GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. ® GAS (ROUGH) DRAINAGE PIPING WALL SO. FT. ® OTHER APPJEOUIP. DRINKING FOUNTAIN SO. FT. ® 4OEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER HEATER SERVICE FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation WATER SYSTEM GRADING cu. yd. $ —Plus—x$—=$ FLOOR DRAIN MECHANICAL FEES FINAL INSP. l Zi WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED VENTILATION 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. SQ. FT. ®c BATH TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR p 3/ac HOUSE SEWER DISULATION/SOUND/6-�2 0- 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 OUND PLUMBIN '� UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE / OUGH PLUMB. . �/T-j BONDING HEATING (ROUGH) STORAGE TANK FO MS t CEWER OR SEPTIC TPC (,J/ l �FtOUGH WIRING Gl _2 (/ ! 7 DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) 4OEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ —Plus—x$—=$ LUMBER GR. FINAL INSP. l Zi RAMING,.� FINAL INSP. f D d OOFING /Q / /f J L y� Irl (� �� J REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL 2 4. 6TH I NG MESH DISULATION/SOUND/6-�2 0- FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL Desert Sands Unified School District ' CERTIFICATION OF PAYMENT . OF SCHOOL FACILITY FEES T0: City of La Quinta ; DATE: Department of Community Development'' 78-105 Calle Estado La Quinta, CA .92253 This. is to ce-rtify t at, , developer, of _ 6 which is located at`'S - Q ' within this District, has paid school facility fees i_posed pursuant,to the authority generated b Government'Code SectioW 53 8 in the an:o nt f covering a total of.square feet „( ) resic.ential or ' ( ) industrial/commercial'development and that building permits.for this footage in this development may now be issued by"your jurisdiction. fU DESERT SAIN .S UNIFIED SCHOGL DISTRICT' White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Go?d - Developer J (10)-37 ,s ivy i1 0.'•y 4 i rt �, i i''1 A. i b i.- Recording;Rkuested By AND WHEN RECORDED MAIL THIS DEED TAX STATEMENT TO: 0 E— Del.y1e E. Brown O() Annette Brown • CDP C> 81=485 Ave 49 b C13 8 H Indio, Ca. 92201 ax W o IL ZF C-> CC ASSESSOR'S PARCEL NO. J ESCROW NO. 157 3 / TITLE ORDER NO. 3gR6.5 SPACE ABOVE THIS LINE FOR RECORDER'S USE GRANT ®EE® �--� The undersigned grantor(s) declare(s): Do entary transfer tax is $� ( ) computed on full value of property conveyed, or ( ) computed on full value Ilse value of liens and Hncurnbrances rernainin at time of sale. (' ) Uninwrporeled area: ( ) City' ofally and By this instrument dated March 9, 1987 , for a valuable consideration, -Ida Weiss, A Widow and.Louise Harvey, A Married Woman as Joint Tenants hereby GRANTS to Delyle E.- Brown and Annette Brown, Husband and Wife.as Joint Tenants i , the following described real property in the State of California, Countyof Riverside Let 17.of Block 269.nf-1;anta.Carmelita pit Vale La.Quinta.Unit No. 25 as'per map recorded in Book 19 Page 51of maps in the office of the County Recorder of Said County. STATE OF CA ) SS.. �/� ! % COUNTY ) -� -�£_% /-G'✓.!_sii On _ before me, the Ida i s s undersig d, a Notary b In and, for said Pounty and State, `_personally.. appeared —__ O` Loud se Harvey personally known to me (e"reved4e-a ark ry auidence) to be the person(e) whose name(sj-cribed. to the within instrument and acknowledged that - executed the same. � �.�-w oso.►r-oo-oe-Dass-sssv�-a rrs-sss LORRr^-,i^)E rECHTMf1N Signature �-z Notary , ublic-Calitornia PrinCil,al Oilrce in .� Los Angeles County My Comm. Exp. Mar, 27, 1987 21.9050 8/83 i Z O F- U W cn 72 Z O U LU U) Y Q W rr X Z O F_ U LL) U) Ah lqw 1W COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION 177 PERMIT APPLICATION FOR A SUBSURFACE Y SEWAGE DISPOSAL SYSTEM Applicant: Submit this form with four copies of a scaled plot plan (1-20 scale) drawn to County specifications r-equired 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. IBuilding Department Application Log # Name (Owner, Agent, Contractor, Etc.) De le Mailing Address YS 11) 4 /9 City //V 0 to State C Zip Code v i Telephone �_, Job Property Address�r r A(� 11 �-/ fr.Com(17unity % �i Legal Description of Prcperty. (Lot, PM, TR) ort j r3� o� i� �� of G lJ' ��� 1.� )A, f, -# 'Assessor's Parcel No. Water Agen y �er all Lot Size t�C of Permit Planning Casa b ���`�S�� ase 0 SFO &W 51 7 SFD, MH Site Preparation Etc. Signature �ApphcantDate The above information must be verified from Building Application STAFF USE — DO NOT WRITE BELOW THIS LINE // Initial Date Certification of Existing S.D. System required. ❑ Yes © No WOCB Clearance required. f❑ Yes 21 o- Soils feasibility report required. ❑ Yes ❑11 No"e, Detailed boring report required.- ❑ Yes DO" Detailed contour plot plans required. ❑ Yes 1 No r � Staff Specialist approval required. El Yes D No Lot Irprection Date Soils/boring report by Project # Date Soils Map Pageldiffy Soil Type �' L Approved by • ��- �� Date Type of System: ❑ Existinge ❑ Additional ❑ Replacement No. of Bedrooms (1) Septic Tank MOP Gal.-.. Soil Rate Required (2) Leach line sq. ft. (Bottom trench area) Sidewall allowance ft. Sq. Ft. Install #_ Line(s) Ft. _ong, Leach bed Sq. of rock/ ' Ft. wl ith,MjQ,: inches Ft. bottom. per running ft. ®'N/A rock below drain lines area Leach lines/bed-special design for slope: Applicable (3) Pit Diameter No. Pits Pit BI1 Seepage Pit total depth ^'/� 7 N/A Overburden factor ~ 6� 2 / Max. allowable depth r( / / lei! �.�/' /'L-�,r * • .G -s-` �-i•.•� /!�7/J (% �-�'�-P�..-- � This application is app d1.diented-for the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements set forth in Section B above. A building permit is necessary for the installation of the above -designed system. ( Septic tank and sewer lines must ber50' from any wells it U IV- (2) Leach lines be 100' must min. from any wells including expansion area e/.� \3) Seepage pits must be 150' min. from any wells including expansion area Signature of Health Official •� /�/j' � Dam —,/�— RECEIPT NO. f .'� X Issued by � K District: ❑ Riverside ©-Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. DOH -SAN -122 (Rev. 6/86) Date 4/ 9 ❑ Blythe GOLDENROD—Pending Fle Yr!r OF • 0 OFFICE V -.- J-.1 I I 'I M AGRICULTURAL C0MM1qQr)KfrD E. LEON SPAUGY 4080 LEMON STREET, Roo," 19 CO-H-MISSIONFR VIVERSIDE, CALIFORNIA 92501 - JAMES O. WALLACE (714) 787.2561 ASSISTANT COMMISSIONER 46-209 Oasis Street, Room 14 Indio, CA .92201 (619) 342-8291 Dear Developer/Landscaper: Thank you for inquiring with the Agricultural Commissioner's local.quarantine laws. Office regarding Any diseases or insects associated with the plants/landscaping material presented on your landscaping plans do not pose a threat to the Coachella Valley Citrus, Date, Grape, Vegetable, or Field Crop industry.. Wethereforeapp-.-ove� y landscaping plans. our If however, any substitutions of plants/landscaping materials within your plans occurs between now and the actual planting date, You must contact this office within 48 hours before delivery into the Coachella Valley. Also, the substituted plants/landscaping material must be held for inspectiod upon arri-al. Any sub - be immediately treated or shipped out of the Coachella Valley at Stituted landscaping material found infected/infested with quarantine pests will of the Agricultural Co=issioner's Office• the discretion under penalty of perjury, I -the undersigned will Comply with the Ebove. Authorized Agent: gro a/ Name 19ra a/ Date_ y / �%. f Signature Permit Numbers) Developer _Oe 1411e 13 VV ( IZ--) _'-Address r/'-07 ef-45 IN AGRICULTURAL CMMISSIO'NER'S APPROVAL �����Date Authority cited: Agricultural Code; Sections 6301, 6461, 6462, 61-54, 6501, 6521- 6524 cc: 2 Plan Checl-, Indio Office, Riverside Office Yoi*rl A -