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002354 (SFD)414 l�GliltrGv P.O. BOX 1504 No. €002354 Building53._210 ,LZ�sfag.� 78-105 CALLE ESTADO 1' Address LA QUINTA, CALIFORNIA 92253 Owner Pink Mailing Address 52-625 EiSenhouVi 3XIVra City Zip Tel. . La eta . . 32353 1 564-0046 Contractor :Address . -. ty lZip State Lic. I City & Classif.- 39%91 Lic. # 680 Arch., Engr., - Designer Address Tel. CityI Zip I State Lic. # LICENSED CONTRACTOR„$ DECLARATION I herebyaffirmthat 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 OWNEk-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 for 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 or 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 rive hundred dollars ($500). - . ❑ j, 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 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.) O I, as owner of the property, am exclusively contracting with licensed contractors to -con- struct the proiect.-(Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner or 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 O Copy is filed with the city. 0 Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is forone 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. BUILDING: TYPE CONST. OCC: GRP. A.P. Number 774-052-011 Legal Description LOT 14 Project Description _Single'fadly dweniM 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 comply with such provisions or this permit shall be deemed revoked. Sq. Ft. Q j No. Size - �;^- Stories No. Dw. Units New E�,f Add ❑ Alter ❑ Repair ❑ Demolition ❑ reidg &1w iwindes 140 lig. ft. of 3 --foot hicth 'bLack retainincr mall. Rear Setback from.Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line Ihereby affirm that there is a construction lending agency for the performance of the Estimated Valuation q{� ��+ nr� �4 =+ �j ` /�� . f i�7t r 56...1.00 ��ia a i-� � 21:00.01 ) 79.515.00 :PERMIT AMOUNT Plan Chk. Dep.. Plan Chk.. Bal. 85#41 Const. 339.50 Mech. 30.00 Electrical 76.08 Plumbing 103.00 S.M.I'. 5.09 Grading 20.00 Driveway Enc. 20.€ 0 Infrastructure 1,146.23 mentioned property for inspection purposes. Validated by: Signature of applicant Date 'Mailing Address ' TOTAL 2.135.0- 11885.5r ` .REMARKS A 5 5 4 6 5 7 1885,31 it HARD COPYT 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 comply with such provisions or this 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 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.) _ 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 expiration it work thereunder is suspended for 180 days. I 5�7�8 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 of this city to enter the above- mentioned property for inspection purposes. Validated by: Signature of applicant Date 'Mailing Address ' Validation: City, State, Zip + A 5 5 4 6 5 7 1885,31 it HARD COPYT CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS A.C. UNIT 2ND FL. SO. FT. ® SLAB GRADE YARD SPKLR SYSTEM FOR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ, FT, @ POWER OUTLET ROOF DRAINS CAR P. SQ. FT. ® SEWER OR SEPTI Aft�PROUGH DRAINAGE PIPING WALL SO. FT. ® DUCT WORK DRINKING FOUNTAIN SQ. FT. ® G URINAL ESTIMATED CONSTRUCTION VALUATION $ HEATING (FINAL) OTHER APPJEQUIP. I�REINF. STEEL WATER PIPING NOTE: Not to be used as property tax valuation TEMP. POLE L FLOOR DRAIN MECHANICAL FEES WATER HEATER SERVICE FINAL INSP. 6, t,/ -d WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GRADING yd. $ —Plus—X$—=$ LUMBER GR. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED X&RAMING LAUNDRY TRAY AIR HANDLING UNIT CFM ROOFING 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER GAR. FIREWALL 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 GROUND PLUMBING ',C UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTI Aft�PROUGH WIRING DUCT WORK ROCK STORAGE / 10, FOUND. REINF. / G GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. I�REINF. STEEL GAS (FINAL) TEMP. POLE L GROUT WATER HEATER SERVICE FINAL INSP. 6, t,/ -d BOND BEAM SWATER SYSTEM GRADING yd. $ —Plus—X$—=$ LUMBER GR. (,& FINAL INSP.&) 11Wcu. X&RAMING ANAL INSP. lO aL!-� �p ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING - MESH pN�S ST!90 OUND 7%�Gt7 FINISH GRADING iq&INAL INSPECTION 6-6yj-rf CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL 4 d�FI ED 0 0 Desert Sands Unified SchoolDistrict BERMUDA DUNES RANCHO MIRAGE 0 82-879 HIGHWAY 111 0 INDIO, CALIFORNIA 92201:-5678 0 1619) 30-8631 INDIAN WELLS ti PALM DESERT -b P LA QUINTA INDIO May'6, 1986 City of La Quinta Department of 'Community Development 78-105.Calle.Es-tado La Quinta, CA 92253 Re- Plot Plan 86-289 Gentlemen: The developer of the above referenced lot has mitigated Tts i'mpact§.on our overcrowded schools by payment of the amount of $628 per unit to be applied to the 'cost of. district educational faci'lfties made necessary by such new development. Sincerely, J-% John D. Brooks Assistant Superintendent Business Services JDB/crm COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION7_ PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL, SYSTEM � � � - � �Z Cxjah pplicant: Submit this form with four copies of a scaled plot plan (1-20 scale) drawn to ounty specifications required on the attached check list. A non-refundable filing fee of 30 is required when the application is submitted. Check must be made payable to the ounty of Riverside Building Department Application Log # Name (Owner, Agent, Contractor, Etc.) Mailing Address 0c r\ 7tC��_ ��\Pik Y� .4 � � � � �1_� i.\�c.e1\l"-,vJ('4�J City State reqd. Yes [ Zip Code Telephone 7 0 *Job Property. Address. *City or Community L, *Legal Description of Prpty. (Lot, PM, TR) fir,,,4,e7. �?�•n\ \.�\ 1r<'t- �-\r Uk+ t- XA *Assessor's Parcel No. Flater Agency Use of Permit Lot Size Or e'1 SFD, MH Site Prep Etc. 7 Nof# ] Planning Case #� Detailed contour plot plans reqd. Yes[ 7 Nor. 7 r ure of Applican-_ Date *The above information must be verified from Building Application Type of System: No. of Bedrooms (1) Septic Tank Soil Rate Required Existing New Addition Replacement . i 11-`00 Gals. [ ] IM [ ] [ ] (2) Leach line sq. ft. Sidewall allowance Install Line(s) Leach bed (Bottom trench area) ft.. rock/ Sq. Ft. Ft. Long, Ft. wide Sq. Ft. of per running ft. with Min. inches rock bottom N/A [ ] below drain lines area Leach lines/bed-special design (3) Pit Di eter No. Pit Seepage Pit total depth { '� for slope: Applicable 5' [ ] ' (Ir Pits BI N/A Overburden factor ' ! y Max. allowable depth \., k. (kit, , S i f C>C� C% M-. X (�Cr L ddr! V' c t c(k f � l F r c ( � rr t { G x This application is approve l/denied for the design of a subsurface disposal s --stem as indicated on the accompanied plot plan using the requirements set forth in Section B above. o A building_ permit is necessary for the installation of the above -designed system. H((;,))Septic tank and sewer lines must be 50' from any wells P (2�`)Leach lines must be 100' min. from any wells including expansion area W (,'3P Setlepagepits must be 150' minfrom any wells including expansion area Signature of Health Official Date RECEIPT NO. ) Issued by !.. C. Date District: Riverside [I Indio Hemet [ ] Perris [ ] Rancho Calif. [ ] Blythe[ ] Distribution: WHITE -Office file YELLOW -Applicant PINK -Bldg. Dept. GOLDENROD -Pending File DOH SAN 122 (Rev. 2/86) Initial Date Certification of Existing S.D. System reqd. Yes [ ] No 11 7 WQCB Clearance reqd. - Yes[ ] No[ ] j Soils feasibility report reqd. Yes[ ] No Detailed boring report reqd. Yes[ 7 Nof# ] z Detailed contour plot plans reqd. Yes[ 7 Nor. 7 r 0 H Staff Specialist ipfr`oval reqd. Yes[ 7 No_ 7 Lot Inspection.Date c� w co Soils/boring report by �7 Proj. # Date Soils'Map Page Soil Type Approved by Date Type of System: No. of Bedrooms (1) Septic Tank Soil Rate Required Existing New Addition Replacement . i 11-`00 Gals. [ ] IM [ ] [ ] (2) Leach line sq. ft. Sidewall allowance Install Line(s) Leach bed (Bottom trench area) ft.. rock/ Sq. Ft. Ft. Long, Ft. wide Sq. Ft. of per running ft. with Min. inches rock bottom N/A [ ] below drain lines area Leach lines/bed-special design (3) Pit Di eter No. Pit Seepage Pit total depth { '� for slope: Applicable 5' [ ] ' (Ir Pits BI N/A Overburden factor ' ! y Max. allowable depth \., k. (kit, , S i f C>C� C% M-. X (�Cr L ddr! V' c t c(k f � l F r c ( � rr t { G x This application is approve l/denied for the design of a subsurface disposal s --stem as indicated on the accompanied plot plan using the requirements set forth in Section B above. o A building_ permit is necessary for the installation of the above -designed system. H((;,))Septic tank and sewer lines must be 50' from any wells P (2�`)Leach lines must be 100' min. from any wells including expansion area W (,'3P Setlepagepits must be 150' minfrom any wells including expansion area Signature of Health Official Date RECEIPT NO. ) Issued by !.. C. Date District: Riverside [I Indio Hemet [ ] Perris [ ] Rancho Calif. [ ] Blythe[ ] Distribution: WHITE -Office file YELLOW -Applicant PINK -Bldg. Dept. GOLDENROD -Pending File DOH SAN 122 (Rev. 2/86) t'- •�C rr °%�` `"r�r: ::,c -f+;tet ,�:«:y,C ",: �.�-.ilii �c�G.'fl}�_yECi`:Nx+,.,�- r >�'•as ic.' ,��_�y�- �� .�;��.c�:�..':1�/�sG��.:�:•:i�r�_C�:;i���;1��2{:.�j;�y:,7:.a�:r>:Y1","1����;i'�i.'�:�'�'/,�rQ_�`�•. C,�.{ � r .,, �i. !. �,.;: .o,.�,� ��:�. '.p..�i. vt�•r, :�,°5 '��;Cir•�!^•' 'J'i�6�/ r �� •1tP�.'^ .�. f.,.if„(,�fa._'w��..J••.•��:-�!•r-F. lri�T J;'' v��'^''�'. t..:. ��i-�.1�'� ti`��'zV�•' 7'� �y;{.na, i+' t ry: ,,( .�.,, A•,'�, 1.-•:+ 5, ) rt�y.l1,:�.�! 'EI 1, 'y, 'l'� y. �`,. 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