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06212 (SFD)4 P.O. BOX 1504 N O . 12 Building 78-105 CALLE ESTADO Address 53-060 Wirer LA QUINTA, CALIFORNIA 92253 Owner Charjac Inc. Mailing BUILDING: TYPE CONST. OCC: GRP. -a -Address F. 0. BOX 59 A.P. Number 774.052-0114 City Zip Tel. La Qu nta 92253 564,-1400 Legal Description Contractor Project Description �+�•�+ Address General Contract HannamenC .. -. _ . - ... .... r_ City Zip Tel: State Lic. City & Classif. 524325 Lic. # 1235 Sq. Ft. 1531 No.. No. Dw. Arch., Engr., Size Stories Units Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ 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 effect- D'msion 3 of the Business and Professions Code, and my license is in full force and effec SIGNATURE GATE OWNER -BUILDER DECLARATION I hereby affirin that I am exempt from the Contractors License Law for the following Estimated Valuation, reason: (Sec. 7031.5,Bushess and Professions Code: Any city or county which requires a 903 Permit to construct, after, improve, deamush, or repair any structure, prior to its issuance also AMOUNT requires the �picant for such Permit to file a signed statement that he is icensed pursuant to PERMIT the provisions of the Cantractoes License taw, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professkms 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 Plan Chk. Dep. $250.00 subjects the applicant to a civil penalty of not more than five hundred dollars ($500). 2G�. 55 ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 672.00Professions Code. The ContracWs License Law does not apply to an owner of property who (a builds or improves thereon and who does such work himself or through his own employees, Mech. v+ provided that such improvements are not intended or offered for sale. If, however, the budding or improvement is said within one year of completion, the owner -budder will have the burden of proving that he did not bund or improve for the purpose of sale.) Electrical 111.69 ❑ 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 ,+50 does not apply to an ow5. owner of property who builds or inproves thereon, and who contracts for S.M.I. 8 such projects with a comtracrWs) icensed pursuant to the Contractor's License Law.) ❑ I am exempt under Sec B. & P.C. for this reason Grading 20.00. Driveway Enc. 20.00 Date owner Infrastructure 1,972.07 WORKERS' COMPENSATION DECLARATION hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of Workers Compensation Insurance, or a certified copy thereof. (Sec. 3900, Labor Code.) Policy No Company ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. I --N TOTAL 03,306..79 ` t CETE EXEMPTION FROM REMARKS Atte o t 4 ti WORKERS'COMPENSATION COMPEPE NSATION INSURANCE _ (This sedan need not be completed ff the permit is for one hundred dollars ($100) valuation '"t 'i' 01 Ht. i-`Ay;,*c'­ C V 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 aliforniaDateowner NOTICE TO APPLICANT: ff, after malmhg this Certificate of Exemption you should become ZONE: BY: sb#ect to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such Provision or tfus permit shall be deemed revoked. Minimum Setback Distances: 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 Lenders Name Lenders Address FINAL DATE INSPECTOR 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. 8/,2 /,24/89 I certity 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 y construction, and hereby authorize representatives .of this city to enter the above. mentioned property for inspection purposes. Validated by: Signature of applicant Date . Mailing Address Validation: City, State, zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS 2ND FL. SQ. FT. SLAB GRADE / YARD SPKLR SYSTEM POR. SQ. FT. ® MOB]LEHOME SVC. BAR SINK GAR. SO. FT. ® 1POWER OUTLET ROOF DRAINS CARP. SO. FT. R SEPTIC TA/kA,1/1 DRAINAGE PIPING WALL SQ. FT. DRINKING FOUNTAIN. SO FT ® URINAL ESTIMATED CONSTRUCTION VALUATION $ HEATING (FINAL) WATER PIPING NOTE: Not to be used as property tax valuation REINF. STEEL FLOOR DRAIN MECHANICAL FEES TEMP. POLE WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER WATER HEATER 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, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER. B.T.U. SQ. FT. ® c BATH TUB St - —q/ v a I SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. Fr. RESID ® 11/4 c SEWAGE DISPOSAL VENTILATION SQ.FT.GAR ® 3/ac HOUSE SEWER FIRE ZONE ROOFING 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. . . I SOLAR SETBACK 111131y7 GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE / ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS R SEPTIC TA/kA,1/1 ROUGH WIRING, DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. 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 2 / FINAL INSP. ROOFING L�� !� �' �t St - —q/ v a I REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING NSPECTION FINAL INSPECTION- CERT. CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL Desert Sands Unified School District CERTIFICATION OF PAYMENT OF ®r��,�^, �? SCHOOL FACILITY FEES �q (Loop T0: City ofT'tt��qA"'.q�" DATE: Department of Cot eve i T 78-105 Calle Estado La Quinta, CA 92253 This is tq pert', fy th t developer of hic is located at , wi hin this District, has paid 11schono f cility fees impos pursuant to the a t rit g n r(t by Gov nm n Cod ecti St 530 0 in t e oun fog covering a otal o square feet of ( esodehtial or / ( ) industrial/comme,-'Al—HJvdiopment and that building permits for this footage in this development may now be issued by your jurisdiction. 111 foiVbESERT S DS UNIFIED SCHOOL DISTRICT l�Bilcling V 1 �Wfii - Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer �ir I1 9— 1101-37 :•s.rve yr. ,�. .Cj�j'rl„�'{'�r`P"�Fs"K"T�:C, I � (4(1?h"A��`Y•'{+�y�hih"'u. ►ti'4,.�7 PS'3Ar;".".: s[ +..,�i.� .x".75. °:;'i�..w .p'.a �.J ...1` r • •tM''�, r --y _ COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH Assessors Parcel No. ENVIRONMENTAL HEALTH SERVICES %�� — 6ro5' 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 check list. 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 3 Agent, Contractor, C ntac Person Phoge/ Address &Phone �A Owner Phone Mailing Address City_ --. �L State Zip Job Property Address Legal Description Prep. (PM, Tract, Lot) (!Z1 ej, 7 A.,, e'/4 2- s 3 1S;?;G G ;P l'tr a 6, -T 7S e' 4 2 / CP . & A, T L + Lot Size Water Agenc wo Use of Permit P/P, CU, etc:afA U --;M Other ,. 1,:;,2 U j� Dwelling H Site Prep, etc. ��Si9pature of Applican'C" '^— �. �� Date , � CATEGORY: REV CODE FEE .. `^ -" ' ' CATEGORY: t REV CODE FEE ❑f SUBSURFACE DISPOSAL 1238 i$_5 0 (J O) 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 5&- 3❑ •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 ��� = -)49 Holding Tank Agreements Completed ❑Yes ©' N c Certification of Existing S.D. System Required ❑ Yes IDNo/ I WQCB Clearance required. (Attach Form ❑ Yes � No DOH SAN 007, Santa Ana Region Only) Soils Percolation Report Required. ❑ Yes 10-1 t Special Feasibility Boring Report Required. ❑ Yes ❑�'o• i Detailed Contour Plot Plans Required (1 to 5 ft. interval) 11 Yes 0' -Nd ' Other ❑ Yes 1710 Staff Specialist Lot Inspection` Required ❑ Yes ❑ No Lot Inspection Date ,s Soils boring report by # Date 1 v`/• /Project r Soils Map Page f I Soil Type �r� L– Approved by/ aZ! Date o ' =• Y ` No'of Systems Type of System(s) No. Dwelling Units 1 i (1) Septic Tank Soil Rate Grease/Sand `+ O Holding Tank ❑ Existing 13,14ew ❑ Replacement Bedrooms, 5ixtureMnits �i r 'Grease Intcp I eJ.n� /bulgy 4,alf lilma Gal —Gal r v (2)sLeach Line Sq. Ft. Sidewall allowance Install Line(s) fL long ft wide with Leach Bed sq. R Botttrench area ft. rock/sq. ft. min. inches -k below drainlines or �bf-bottom area r per running ft. ;pO�Nq Leachlines/bed special design for slope: Applicable -� (3) Pit Diameter No. Pits Pit Below Inlet (eq Seepage Pit lal Depth 'Other. °depth ❑O1* 6 3 N/A Overburden factor JJ1.------ Max. Aiwa t/le No. 2 System REMARKS: PPROVE DENIED. for B This application is the category checked in SECTION above, regarding the design of a subsurface disposal system as indicated on the accompanied to 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. 7 • e e- r+` Vu 4'__ (1) Septic tank and sewer lines must be 50' minimum from any wells Rf / 0ra'411(0) 2. Leach lines must be 100' minimum from any wells, including expansion are�no c.✓ 1rti Gtr.. (3) Seepage pits must be11,50, miinimuum/ from any wells, includingexxppaansion ar e/ ^ Com/ (tet/ C l Signature of Health Official L!~�✓ .[ /r _ ,� C Date– RECEIPT NO. �`Issued By ,r'r Date �' U DISTRICT: ❑ Riverside, ® Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept. GOLDENROD Plans/Records �a 4 • �i ie=t:trar•b� �. 1 V t -e Too 9 .,-.. , 1)I1It;E l7F AGRICULI URAL CUtiIN1IS510NL1t AN 1) WI:IC;I I I'S b. NILASURL 49-613 tluy Oti, s�lee D-12 2l6 E. tEotl SPAUGY )n�lES U v;ALLACF. �SSIStr�t :� .t�.t•.nS4iu�t.n CIE�IEv� aF`�VEtvIS1E 619-J42-0.291 ,t�9. �e cnsc lu. UNFE DEVEIormi's Id11F1Et '.. AUUItESS� Qr � S I • TELM,i►orast 56 T S3—O So i{veK.; - `i „t:reZ l C.0 Qu:k� e-04 Dear IUevelopert is Ilot 3.11 I►Eter reviewing your landsciphiq plalls, Ull Elaut it keti11 if subsl•ituLiotls violation of yuarantinie 1,)•4s l�uvettliny the Cvaclnellvalley. do occur anlci they 11iE[er {xun 1►lalnt tl�alerial listed, tills o[Elce Must be tnotil:ied i1unedlately- atld pleservilly the Coachella valley's Lest -free envlrvtment. '1'11ank you Lor pro y n rq cultural . Camli otler� s ul [ ice ccs ludio Eund Rivet'side Ul[ice IIETTV zg5 i j i �k_r{• z �' OF Tt@9w °�, f i I �I 3 ,. , a _ ,�►ut to u ��t P#Wt t ton , �� -Ibis -Certificate issued Pursuant to the requirements of Section 306 of the Uniform Building! ' I ; j j Code, certifying that,at the time of issuance this structure was 'in compliance with the various. nances of the City regulatin' building construction or use. For- the following: 9 I its BUILDING ADDRESS 53-080 Ramirez �li�• .. Use,Classificotion SFD -Bldg. Permit No. 06212 Group Type Construction VM Fire -Zone use zone SR P.O. Box 59 Charjac,,Inc. Owner of Building Address city "La 'Ouinta, CA 92253 By: Mark Harold Date; 9/7/90 Building Official fficial POST IN A CON61PICUOUS PLACE