04134 (SFD)4 4Q��
�4,j� r
P.O. BOX 1504
Building 51-800 Ramirez 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
Ferry Lucio
Mailing BUILDING: TYPE CONST. OCC. GRP.
Address 79-860 Boqueron way _ A.P. Number 773-171-003
CityZip Tel.
Bermuda rj nc a 9'2011 1 345--4236 Legal Description
Contractor Project Description Single Family t3wf3ll inn
Address
Zip I Tel.
State Lic. City
& Classif. 317390 Lic. #
Arch., Engr.,
Designer
Address Tel.
City( 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 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, 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 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. If, however, the building
or improvement is sold within oneyear 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 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. O 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 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, 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.
ZONE: BY:
Minimum Setback Distances- ?`31ai` A DYWVOA-V' ..s f ? .:: < •3
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
I hereby affirm that there is a construction lending agency for the performance of the
Sq. Ft. 15q®
Size
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Lender's Address
FINAL DATE
INSPECTOR
This is a building permit when properly filled out, signed and validated, and is subject to
$ +
9/89
expiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
Issued by:
Date Permit
I agree to comply with all city and county ordinances and state laws relating to building
Estimated Valuation
091,736
PERMIT
mentioned property for inspection purposes.
AMOUNT
Plan Chk. Dep.
$250.00
Plan Chk. Bal.
Mailing Address
$ �•�
Const.
r . U
Mech..
Jb. VIU
Electrical
in
.31 ,
Plumbing
1105. U
S.M.I.
5.7-1—
.yGrading
Grading
20 . Uu
Driveway Enc.
.0f�
Infrastructure
TOTAL
eta a f'�� • �'
? '
REMARKS
ZONE: BY:
Minimum Setback Distances- ?`31ai` A DYWVOA-V' ..s f ? .:: < •3
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
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.)
Side Setback from Property Line
Lender's Name
Lender's Address
FINAL DATE
INSPECTOR
This is a building permit when properly filled out, signed and validated, and is subject to
$ +
9/89
expiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
Issued by:
Date Permit
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives sof this city to enter the above-
mentioned property for inspection purposes.
Validated by:
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
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
COLL. AREA
SLAB GRADE 7t
ROUGH PLUMB
YARD SPKLR SYSTEM
2ND FL SO FT. 6
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR SO FTa
DUCT WORK
ROCK STORAGE
FOUND. REINF.
POWER OUTLET
ROOF DRAINS
GAR SO. FT. C1
HEATING (FINAL)
- OTHER APP.IEOUIP.
REINF. STEEL
GAS (FINAL)
DRAINAGE PIPING
CAR P. SO FT. 0
GROUT
WATER HEATER
DRINKING FOUNTAIN
WALL SO. FT. a
FINAL INSP.
BOND BEAM
WATER SYSTEM
URINAL
SO. FT. a
GRADING
cu. yd.
plus xE
=$
ESTIMATED CONSTRUCTION VALUATION S
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
CROOFING—
FLOOR DRAIN
MECHANICAL FEES
/E
�(�ll��
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOXDISHI
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, 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 a to c
SEWAGE DISPOSAL
SO.FT.GAR g 3/� c
HOUSE SEWER
GAS PIPING
PERMI7 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
M
GROUND PLUMBI
NDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 7t
ROUGH PLUMB
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
Z�SEWER OR SEPTI
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 xE
=$
LUMBER GR.
FINAL INSP.
j�tdRAMING < ����/
FINAL IN
CROOFING—
r/� I
�_�� -
/E
�(�ll��
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR*
GAR. FIREWALL
LATHING - (Y
MESH
261�-/iNSULATIONIS0UNDF- `�
FINISH GRADING -
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
• OF
,NOTICE: THIS DOCUME
.79 A!•WTUTY FEES
r
BE DU LaiCAT ED..
TO: City of La Quinta DATE:
-� Department of Community Development
78-105 Calle Estado
La Quinta, CA 92253
This is to rtify that ,f -
developer of �� O which is•
located at `— p //Y within
i` this District, has paid school facility es imposed pursuant to the'
~. "'authority generated
y Gover ment Code Sectiolt 53080 in t e amount
covering a total of 519-p square feet of ( re identi 1: or 'a • '
( .).industrial/commercial development and that building permits for:`.
I ;this footage in this development may now be issued by your jurisdiction'
for DESERT SANDS IFIED CHOOL DISTRICT J `
White , Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold -'Developer
y' . (10)-37 '
Z
O
P
U
W
U)
U)
Y
Q
W
(r
''glf,�w.;vr, V -r-% i7,plmt T,! +e
COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISIONf
SEWAGE DISPOSAL SYSTEM 773
PERMIT APPLICATION FOR A SUBSURFACE
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 $40 is required when the application is submitted. Check must be made payable to the County of Riverside.
Building Department Application Log #
Name (Owner, Agent. Contractor. Etc.)
Mailing Address
It �(_; //F': -J
Jz i [X f""PrA , ,U i. • s y
City /
State
Zip Code
Telephone
'Job Property Address'Legal
Description of Properly. (lot. PM.
ivk
'Assessor's Parcel No
Wafer Agency orwell"
".et+
r
dux*doxiPlanning
Lot S,ie
Use of Perm,tr.�.�1PJr' Case M
•�� �.r �.°
�%
SFD. MH Site Preparation Etc.
r• V+1
Signature -of Applicant ' Date v -
A' p .. *The above information must be verified from Building Application
STAFF USE — DO NOT WHITE BELOW THIS LINE
Initial Date
/ [
Certification of Existing S.D. System required. ❑ Yes ❑"o
WOCB Clearance required. E) Yes Q No°�"
Soils feasibility report required. ❑ Yes ®No
Special feasibility boring report required. ❑ Yes ❑,No
t
Detailed contour plot plans required. ED Yes 0�,No
Staff Specialist approval required. ❑ Yes 0 No Lot Inspection Date
Soils/boring report by f Project # Date
Soils Map Page Soil Type"" Approved by a+/�— Date �a " �F
Type of System: V
No.. of Bedrooms
(1) Septic Tank
Soil Rate Required
❑ Existing ew ❑ Additional ❑ Replacement
A/W Gals.
p?.
(2) Leach line sq. ft.
Sidewall allowance
Install*. Lines) Ft. Long,
_ F inches
Leach bed Sq.
Ft o
(Bottom`tr c4 h area)
ft. rock/ Sq. Ft.
ft. (]'N/A
de with min.
below drain lines
bottom
per running
rock
area''"•
Leach lines/bed-special design for slope:
Applicable—
(3) Pit Diameter
1/
No. Pits
Pit BI
Seepage Pit total depth
`
6'
!
Max. allowable depth U
N/A � Overburden factor
r :�° � ' - �- i y�Y j. -- r'i. . ✓l.A' .'^%._' •i7 i O'lJi f C.''Y��•t ..,.tZC/'r� ��.•G"
�_ �i
�Y.' ��`
L.(' / % �. "-C..•�" /�'. •/ .I .,s/l - /�+`/.n .9 i �1 it"!�'7�''i".�. r.� .�.M�1 f�.I.�G �,. •r%� G a G Cri' . u:� ller
This application isproved/: ,ied-for the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements
se orth in Section B above. A building permit ist�necessary for the installation of the above -designed system.
SLY Septic tank and sewer lines must be 50' from any wells ^� 1 /sin/ata
?2)
Leach lines must be 100' min. from an wells includin ex a( Y 9 p C,i
(3) Seepage pits must be 150' min. from any wells including expansion area /lp/t 1
1pO x' 12 '�.
/ z► .C:*.� :'—,(�>f--c
Signalure'of Health Official �` Dater
RECEIPT NO._ 4 72^- Issued by � Date 04
District: ❑ Riverside �2* rh o ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe
Distribution: WHITE—Office file . YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File
DOH SAN 122 (Rev 8187)
Q--
rF-121111111
f , ,
A' • R` OFFIfE,OF. E. LEON SPAUGY
1. •o.
sAGfZGULl-URAL COti1N115SLONER
COMMISSIONER
�It�1 JAMES 0. WALLACE
i - AI V lJ, _ .. ASS:S.A.,t COMMISSIONER
AlxCLEMENT BENVENISTE
. WELGHT.S MEASUfZE°S SEALER
}• 49-613 Hwy. $'6, Suite B=12
\,.., Coachella., CA =92236
�1 3
q Y 4 619-342-8291 g,
CASE NO*. : 'K ,�C I'PuD o(_-:'CA /k
DEVELOPER'S NAME:
ADDRESS :. LC--Zr-A,_1 W. A..
TELEPHONE a ((o l Q ); : ` 3 4_ " L{
Sri u A,) ,x;01 �r�.K .�:z i1 �� �73� -car- 0�3
Dear Developer:
After. reviewing your land"scaping plans,, `all plant. material. listed is not in
violation of quarantine'" laws governing _the, Coachella Valley. If'-substitutions
do occur and ::tfiey differ from plant material listed, this; office must be notified
immediately: { ,,
Thank you for: protecting.-And preserving' the Coachella Valley's pest-free environment.
Ag ultural Cam issioner.'s: Office-
cc: Indio and Riverside O'f f ice.:
y, -