08624 (SFD)Building
Address
P.O. BOX 1504 -NO.
78-105 CALLS — ^y
LA QUINTA, CALIFORNIAORNIA 9 92253
Mailing
Address
_
Contractor
Mercier Hatt mut
Address
77720 Cha"kih%_
Zip I Tela
State Lia "— City
& Classif. Lic. #
Arch., Engr.,�
Designer R.G. Sows
Address Tel.
= City — (Zip (State I
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Sectioh
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
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 rive 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 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 1, 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.)
❑ I 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. ❑ 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 (8100) 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 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.
CONSTRUCTION LENDING AGENCY
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.)
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
08624
BUILDING: TYPE CONST. OCC: GRP., +�
A.P. Number
Legal Description
Project Description
Sq. Ft. No. No. Dw.
Size 1522 Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
3 ,
Estimated Valuation
PERMIT 7
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const. .572.04
Mech.
Electrical
ti
Plumbing
S.M.I.
Grading.t • ,20.00
Driveway Enc.'20.00
Infrastructure
Praelm Plan
2S.00
TOTAL3077—Al.
-J
REMARKS
�V14" 15 v#f .2 %77.4i
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
Issued by:
Validated by:
Validation:
INSPECTOR
Date Permit
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT.
STORAGE TANK
FORMS
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
METER LOOP
DRAINAGE PIPING
WALL SQ. FT.
OTHER APPJEQUIP.
DRINKING FOUNTAIN,
SQ FT ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
SERVICE
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIRE ZONE ROOFING:
LAUNDRYTRAY
AIR HANDLING UNIT CFM
GAR. FIREWALL
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.
SO. 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 ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE LPL.CK.FEEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK 1491141,aoGROUND
PLUMBINC�Q
NDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.�a/� 01V,
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
r
REINF. STEEL
GAS (FINAL)
TEMP. POLE
O
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
��j'
„u1 QOMN
FINAL INSP.
/i1�o%9a
r
113
16
L •tom .
GRADING
cu. yd.
$ —plus—x$_=$
REMARKS:
LUMBER GR.
FRAMING !� fyA?, A
ROOFING/rYl/ �0! O
(
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING 1119-049
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
Building
Address
Ownej t 1 1
Mailing
Address
Imo_
Designer
AMOUNT
Plan Chk. Dep.
Address
Plan Chk. Bal.
Const.
FTe.
a
City
Ltb
Electrical
Zip
a��_ST—A
te
.#
censed CONTRACTORS DECLARATION
I hereby affirm t licensed under provisions of Chapter 9 (commencing with Section
7000) of Divisi 3 t Business and Professiopj Code, andmy license is in full force and
\ OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Bushm and Professions Code: Any city or county which requires a
permit to construct. after. improve, demolish, or repair any structure. prior to its issuance also
three
requires Me
(appiiicard �,ortha�dor'9�License Low, iaptaigned ��t(commennci g with Section 7000) 000) o
ddsion 3 of the Business and Professions Code, or that. he Is exempt therefrom, and the basis
for the alleged exemption. Any Wribiio n of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a chit penally of not more Mem rive hundred dollars (41500).
O 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 Con i=Ws License Law roes 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 krprcvenents are not intended or offered for sale. t, however, the building
or krprovement is said within one year of completion. the owner-bu*fer will have the burden
of proving that he did not bund or hprove for the purpose of sale.)
0 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 brigs or irproves thereon, and who contracts for
such projects with a contractor(s) ic, , , pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec_ R & P.C. for this reason
Date Owner
WORKERS COMPENSATION DECLARATION
1 hereby affirm that 1 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. 0 Certified copy is hereby fumished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed If the iN is for one hundred dollars (41100) valuation
or less.)
I certify that in the perfc the work for which this rmit is issued, I shall not
employ any ppeerson in any as to become surpp��t t e Workeey Compensation
Laws of Calnfomia /!�
Date owner
NOTICE TO APPLICANT: it, effer nralvg this a of amp n you should become
subject to rhe Wbrkers' Cerrpensatm provisions of the Labor Code, you must forthwith
comply with such provisions or tris permit shaft be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, OW Code.)
Lender's Name
Lenders Address
This is a building permit when property 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.
1 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
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number
,Legal Description
Project Description
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add 0 Alter D Repair 0 Demolition O
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
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 Permit
Validated by:
Validation:
I
1
OFFICE OF
AGRICULTURAL COMMISSIONER
AND
+4-ri*I" WEIGHTS & MEASURES CALVIN C. KAMINSKAS
JAMES O. WALLACE 4000 LEMON SIREEL ROOM 14 nl+I+ro�i comml++lohe+
A7kvftotComml+'lo""r RIVERSIDE. CALIFORNIA 91501 CLEMENT BENVENISIE
OWN d welghli A Mealues (714) 787-2561
Sealer
49613 Highway 86,. Suite B12
Coachella, Ca. 92236
�D// /r�� (619) 342-8291
DATE 1 cnsE HD. -�-�-- /oma/Fo C_
DEVELOPER'S NN'!
ADDRESS t 7 2 -7 C
1ELEP11CNE:
' .�' 1-- 7 � s rs�•�� � lam- c�
Dear Developer:
After reviewing your landscaping plans, all plant material listed is not in
violation of quarantine -laws governing the Coachella Valley. If substitutions
do occur slid they differ from plant material listed, this office 11Iust be notified'
iinnediately.
'Ifiank you for protecting and preserving the Coachella Valley's pest-free.environment.
Agricultural Can ss one s Office
e
cei Indio and Riverside Office
!
r j,I
,!1 •
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 10/1/90 Type of Permit I La Quinta
No. 10176 Permit N
Log it
Owner Name William O. Wilkinson
No. street See Below
city La Quinta zip 922M study Area 0
APN li J Tract #► Lot N Square Footage 112,448
Type of Development Single Family Residence No. of units
Comments _J;1_Rd11; Ramirn7 Nd -19.(1 Rnhin .9_9.9()Mnnrin7n _J;9_QA0 NaVarrn K1_RR(1
At the present time, the Desert Sands Unified School District does not collect fees on
garages/carports, covered patios/walkways, residential additions under. 500 square feet,
detached accessory structures or replacement mobilehomes. It has been determined
the above-named owner is exempt from paying school fees at this time due to the
following reason:
EXEMPTION NOT APPLICABLE
1 -his certifies that school facility fees imposed pursuant to Government Code MW
in the amount ofFl—.58-1 X 112,448 1 or $ 19,667.84 have been paid to D.&U.&D. for
the property listed above and that building permits and/or Certificates of Occupancy for
this square footage in this proposed project may now beissued.
Fees Paid By William O. Wilkinson Telephone
Name on the check
By Richard M. Beck
Director, Facilities Planning & Development
Fee collected /exempted by Shelley. D. Bennett
Signature -
PaYMent .Fecf;J'Lved
. t CF:eck No. 019694
Collector: Attach a copy of County or City plan check application form to bluti ct copy.
Embossed Original- Building DeptJApplicant Copy - Applicant/Receipt Copy - Accounting
I 'N-
)
a COUNTY OF RIVERSIDE ENVIRONMENTAL Assassofsf�n�MlNo.
--r--- Issued By
HEALTH SERVICES DIVISION
' PERMIT APPUCATION 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 IWL
A noi5-re-fundable filing fee (sde bbelow)yis required when the application is submitted. Check must be made payable to the County of
Riverside. fi4pgroval of tktis app.onhall 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 #
Agent, Contract , Contact Pqrson
Phone
Address & Firm
�� 1�/t 9 2
Me -
D Caro ee 210
r%t r
Phone
Melling Add
so
l e e Riva -
City �a r-_ - --, J�S_tate
fL!
Zip Job Property Address
�LegalD escript Prop. (PM, Tract, Lot
• a
.
D `
47
Agerrcyfy,4dll
Lot Size r
Use of Permit P/P, CU, etc. a �) , ii , fj
-Othef e C
�ox
�Srtrep,etc-
Q
.�
Dwelling
�(/
Signature of Applicant 3•
Date
CATEGORY: REV CODE FEE
CATEGORY: REV CODE FEE
❑ SUBSURFACE DISPOSAL, 1238 $ 57.00
❑ SITE EVALUATION UPON REQUEST 7349 $ 43.00
`❑ MULTIPLE PARCELS WITHIN SAME `"'
NI SPLOT PLAN)
LAND DMSION
,� IISEWERro _1C VERIFICATION d_3�4 $31700
a. 1 at 4 Parcels (Each) 1238 ./ $ 57.00
(Less than 1 year)
b. Eacti Parcel after 4 7344 $ 24.00
❑ PRELIMINARY ELECTIVE 7352 $ 23.00
❑ herevlew,(2ndieview same parcel) 7344 �.o, $ 24.00
EVALUATION (Attach DOH SAN 53) ,
❑ Stte Evaluation in Conjunction with
❑ HOLDING TANK 7351 $ 47.00
Ciithl`'Area 7348 $111.00
� `
❑ ALTERNATIVE/EXPERIMENTAL 7345 $222.00
❑ Slid Evaluation Loot Less than�f
SYSTEM r ''
10,000 Sq. Ft. 7347 $ 87.00
- - IN IAL DATE
Holding Tank Agreements Completed ❑ Yes Eev
Certification Of Existing S.D. System Required❑Yes o�
WOCB Clearance required. (Attach Form ❑ Yes Q No
DOH SAN 007, Santa Ana Region Only) /
Solls Percolation Report Required. \ ❑ Yes a
///
Special Feasibility Bong Report Required. ❑ Yes f
Detailed Contour Plot Plans Required (1 to 5 ft interval) ❑ Yes
Oder, ❑ Yes t7
Staff Specialist Lot Inspection Required - ❑ Yes ❑ No
Lot Inspection Date
Solis report by PrOjeGt � Date
Soils Map Page SoA Type Approved by ate
No. of Systems
Type of Syet
No. Dwelling Units (I %
(1) Septic Ti
Soil Rath
Grease/Send
❑ Holding Tank ng
Bedrooms, F3xture-+Jrdtsa
Grease Intop
❑ New ❑ R
/)
!�
Gal
Gel
(2) Leach Line Sq. FL
» * - Sidewall allowance Lines) tL long it wide with
Leach Bed sq. It.
Bottom trench area
per running,fl�w min. wiehee rock below draMlines or
of bottom area
AL�Ell NA
Leachlines/bed special des' r slope:
(3) Pit Diameter
No. Pits
Ph Below
it
Seepage PT 1D th
Other..
r.
Applicable
Inlet (BI)
(TD)
Max. Allowable Depth
_> Overtxirden factor
❑ 5 ❑ 6
\�
No. 2 System
REMARKS: {'
s
This application�A�PRO�+ :NI _ L? for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated
on the accompanied plot plan, using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the
above -designed system. Pio-eonstreetiarris-permitted-ire-the-regni xpartsiore-arear
�C. B��_ ,,
i -Septics--tank-end Sewer lines must be 50' minimum from any wells
—t2t-Imaeh*lirwe-musWao-4AOpimum-frena-any weUs,inaudiag_8xparts ; r
-(3)—"SN"-TSAg'9"ptts most-be"//11'S(��%�',nm, inimarra/qtror/aterDt�wells�ineludici(g.eaapansie/warea �
/cies-
�
Si nature of Health Official 0'[x'+%7 W �C _G��.. f /r Date
RECEIPT NO.
--r--- Issued By
!w Date
DISTRICT: ❑
Riverside, f9' Indy ❑ Hemet q Perris
❑ Rancho Calif. ❑ Blythe
DOH -SAN -122 (Rev.
7/89) DISTRIBUTION: WHfTE - Office file YELLO
Applicant PINK • Bldg. Dept GOLDENROD - Plans/Records
/ �}
E0
Zvi
of 'Ila Quinta
7-JaUttbtltanb $a�P��T �IkIi£4iIIIi
This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building
Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following:
BUILDING ADDRESS 51-745
Avenida
Bermudas
Use Classificotion
SFD
Bldg. Permit No. 08624
Group R3
Type Construction VN
Fire Zone
Use Zone SR
Owner of Building
William O. Wilkinson
Address
11716 Beverly Blvd.
city Whittier.
CA 90601
By;
Doted
lark Harold
February 13, 1991
Building Official
POST IN A CONSPICUOUS PLACE