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001593 (SFD)Ti4 4 .4�Q�rw P.O. BOX 1504 No. 001593 Building r,�syQ ��LA QUINTA78-105 C Add CALIFORNIA 92253 Owner' VN P3 BUILDING: TYPE CONST. • OCC: GRP. Mailing Address 45-7000 iwicho ag A.P. Number 774-M-008 Imo`. 17 City Zip Z' Tel. " MUM TABUS 34935 Legal Description Contractor Project Description Address .... City AbOW Zip above Tel. State Lic. City & Classif. Lic. # Sq. Ft. EM 2592 No. No. Dw. - Size - t • ¢90 Stories Units Arch.; Engr., - .. ... Designer New ©2 Add ❑ Alter ❑.. - Repair ❑ Demolition ❑ Address Tel. City Zip State _ Lic. # LICENSED CONTRACTOR'S DECLARATION A _ 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 R�q �q ',��j�°!l �`3�i . reason: (Sec. 7031,5,Susiness 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 the Any Section 7031.5. by 'any for Plan Chk. Dep. alleged exemption. violation of applicant a� permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).- Plan Chk. Bal. - ❑ 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 Const..ai�t . 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. . 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 Electrical 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- Plumbing. 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 $-M•l- such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - Grading - O 1 am exempt under Sec.—B..& P.C. for this reason . . Driveway Enc.rti Date Owner Infrastructure WORKERS' COMPENSATION DECLARATION 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. ❑ Certified copy is hereby furnished. 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 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 ZONE: BY: subject to the workers' Compensation provisions of. the Laboi 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 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 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 6'°"27^'85 Permit I agree to comply with all city and county ordinances and stale laws ielatino 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— ateMailing MailingAddress Validation: City, State, Zip I A1771 6 28 18851,6 Ck - HARD COPY . ,-- CONSTRUCTION ESTIMATENO. ELECTRICAL FEES c. NO. PLUMBING FE=I- UNDERGROUND A.C. UNITA � — --� 1ST FL. SO. FT. ® $ UNITS ROUGH PLUMB. S � 2ND FL. SO. FT. ® HEATING (ROUGH) YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SO. FT. ® DRAINAGE PIPING WALL SO. FT. ® HEATING (FINAL) DRINKING FOUNTAIN SO. FT. ® URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. BOND BEAM FLOOR DRAIN MECHANICAL FEES GRADING —CU. yd. $ plus x$ WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. 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 SPARK ARRESTOR SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER MESH �w wmop 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 UNDERGROUND A.C. UNITA � — COLL. AREA SLAB GRADE ROUGH PLUMB. S � BONDING /! / HEATING (ROUGH) STORAGE TANK FORMS ` SEWER OR SEPTIO j' o ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) �I TEMP. POLE G GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING —CU. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. 'GOOFING iaT �0�7 - REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH �w wmop T NSULATION/SOON , 2 T 1 } FINISH GRADING � a Ir l`1(/FINAL INSPECTION / y� (J CERT. OCC. FENCE FINAL ' INSPECTOR'S SIGNATURESIINITIALS, GARDEN WALL FINAL s\FIE40p =o Desert Sands Unified School District y BERMUDA DUNES r RANCHO MIRAGE 82-879 HIGHWAY 111 O INDIO, 'CALIFORNIA 92201-5678 O (619) 347-8631 INDIAN WELLS H PALM DESERT May .j 5',' 1985 LA OUINTA' dO .INDIO y� City of La Quinta. Department of Community Development 78=105 Calle Estado La Qui'nta, CA 92253 Re : :lot 17, Avenida' Rami rez Block 122 Gentlemen The developer of the above referenced lot has mi ti.gated 'its impacts. on o,ur overcrowded schools by, payment of'the amount of $628,per unit to be ,app.1ied to the'cost cf district educational facili'tie's made necessary by such. new - development. Sincerely, John D: Brooks . Assistant Supe.rintende.nt Business Services JDB/crm Receipt No. �j'' G Issued By District: Riverside ❑ Indio -El' Hemet ❑ Date DISTRIBUTION: WHITE - Office File YELLOW - Applicant PINK - Building Dept. GOLDENROD - Pending File DOH SAN 122 (Rev 10/84) COUNTY OF SIVERSIDE, DEPARTMENT OF HEALTH PERMIT APPLICATION FOR A SUBSURFACE DISPOSAL SYSTEM Applicant: Submit this form with three copies of a scaled plot plan drawn to county specifications required on the attached check list. A non refundable filing fee of $15 is required when the application is submitted. Check must be made payable to County of Riverside. Name Mailing Address 747,f Cf1/3c� City State Zip Code Phone `Property Address 'City oryCQM-Tunit-y, `Legal Description of Pro/perty (Lot, Parcel Map, Tract) �1 s�'7 pis j�?/'�1u' `Assessors Parcel No. s Water „Serving From Lot silze9 /Property �i!"�i�4 � ' f � `�" f, / f�- i.'•�``�ir/.wn..�''?-.lid`'": .rs'' ;s�"'f i�' ! '� f G Sibnetureof Applicant Q �' Date `The above information must be verified from Building Application Staff Use — Do Not Write Below This Line ,initial Date WQCB Clearance required Yes ❑ No K Soils feasibility report required Yes ❑ No ® I s Detailed boring report required Yes ❑ No Detailed contour plot required Yes ❑ No � Comments: Soils or boring report by Date Approved by Date / A?Tract Soil Type Map Page File No. Other Number of Bedrooms Septic Tank Size (gallons) Rate Required Type of System New Addition Replacement Leach line sq. ft. of bottom area trench `° Leach bed (sq. ft 'of bottom area bed) Seepage Pit Diameter Number of Pits Seepage Pit Depth B.I. Total Depth of Pit FIT v Location of System AdditlonalAequirements _ A permit its-ap'pro�fcfen-red for the design of a subsurface d)j posal 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. Signature of Health Official Date Receipt No. �j'' G Issued By District: Riverside ❑ Indio -El' Hemet ❑ Date DISTRIBUTION: WHITE - Office File YELLOW - Applicant PINK - Building Dept. GOLDENROD - Pending File DOH SAN 122 (Rev 10/84)