04790 (SFD)4
n�jgo
.. a r..� nrrl v t^17t- 1 RCDDIQ r%'nNITAINIE
P.O. BOX 1504 nl a r �.. a-„,..... -._ . _ ---
Building 78-105 CALLE ESTADO 3S REQUIRED ON THE !Ds -SITE DURING
Address 49-455 Coachella LA QUINTA, CALIFORNIA 9225 ALLPHASES OF CON$iRUCTIONI`
Owner
Dan Hi1yE2sMailinBUILDING: TYPE CONST. OCC. GRP.
Address •
A.P. Number -- - 617-680-005
CityZip Tel.
Legal Description
Contractor Project Description
Address
City IZip ITel.
State Lic. I City
& Classif. Lic. #
Arch., Engr.,
Designer
Address Tel.
City I Zip I State
Lic. #
,f LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 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,Buslness and Professions Code: Any city or county which requires a
permit to construct, atter. 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) or
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).
0 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
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 ownemployees,
provided that such improvements are not
in or offered for sale. If, however, the building
orimprovement is sold within one year of completion, the owner -builder will have the burden
or 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, aid 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 rex ontt
Date t�.fr2' 4(('_ Owner -
t or
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 ($100) valuation
or less.) if
1 certify,that in the performance of the work for which this permit is issued, 1 shall not
employ any person in any manner so as lo-become'subject to the Workers' Compensation
Laws of California.'✓ j
Dater f ` y� 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 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
Sq. Ft. No. No. Dw.
Size 6900 Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Nom No pool or wall included in this
permit.
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
Estimated Valuation
$515,,648
by:
PERMIT
Validated by:
AMOUNT
Plan Chk. Dep.
V250.VU
Plan Chk. Bal.
M411 U9,% ,% • 1 5
Const.
i4 J 3 • Tv-
Mech.
luo - uu
Electrical
Z73-1 • 3 5
Plumbing
f + C3
S.M.I.�•`il
Grading
Driveway Enc.
Id l! i, uui
Infrastructure
b r Tiou • UU
TOTAL
:1 �)
REMARKS
*A ";!5p/
JI -J9-90 i n
AV i.rlali .t i1011T1. If f4jo.1-r
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
by:
WROIssued
Date 1/ -Permit
Validated by:
Validation:
1
WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE
�. , :,.. .._ - •....� ..,..' _,:.._,.... �. .-e �. , .,, _. ., � . ,. .... ass. ,.. ,.. r.. ._ «_ � ...a._
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING TEE'S
IST FL SO FT rp $
UNITS
ROUGH PLUMB BONDING
HEATING (ROUGH)
STORAGE TANK
YARD SPKLR SYSTEM
2ND FL SO FT. a
DUCT WORK
ROCK STORAGE
FOUND. REINF. /L,/
✓✓
MOBILEHOME SVC.
BAR SINK
POR SO FTa
REINF. STEEL
000
GAS (FINAL) TEMP. POLE
POWER OUTLET
ROOF DRAINS
GAR SO. FT.
FINAL INSP.
BOND BEAM
WATER SYSTEM
DRAINAGE PIPING
CAR P. SO FT. a
LUMBER GR. FINAL INSP.
/
FRAMING �/l�j%� F NAL INSP.
ROOFING
VENTILATION
FIRE ZONE ROOFING '212) 90
FIREPLACE
SPARK ARRESTOR•
GAR. FIREWALL
LATHING ' 7
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
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1Y
DRINKING FOUNTAIN
WALL SO. FT. a
p
URINAL
SO. FT. Id
ESTIMATED CONSTRUCTION VALUATION S
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN .
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
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 114 c
SEWAGE DISPOSAL
SO.FT.GAR Y c
HOUSE SEWER
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 8 AIR COND. SOLAR
SETBACK
UND PLUMBIC UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE g
ROUGH PLUMB BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS -
499Qfi2-O EPTIC TA K ROUGH WIRING "
DUCT WORK
ROCK STORAGE
FOUND. REINF. /L,/
✓✓
S (ROUGH) METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL
000
GAS (FINAL) TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_ $
LUMBER GR. FINAL INSP.
/
FRAMING �/l�j%� F NAL INSP.
ROOFING
VENTILATION
FIRE ZONE ROOFING '212) 90
FIREPLACE
SPARK ARRESTOR•
GAR. FIREWALL
LATHING ' 7
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
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REMARKS:
p
INSPECTOR'S SIGNATURESIINITIALS "
GARDEN WALL FINAL
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
OF
SCHOOL FACILITY FEES
-N6i lde: If NIS ii()C�l+ M ENT CANNOT
TO: Ci �j MMLJCtrsnnt� �� DATE:
Department of Community Development
78-105 Calle Estado
La Quinta, CA 92253
lC.l3
:LuJ
is a 88
This is to ertify t a / 1 v �O
developer of whzVh is
located at Qile� w' thin
this District, has paid school facility fees impose pursuant t the
authority generat d by Gove nment Code Section 5 80 i the mount of
S i % ( �)
covering a total of qu re feet of ( ) residential or
(. ) industrial/comme cial development and that building permits for
this footage in this development may no a issued by your jurisdiction.
r ESERT SANDS U9IFIEk SCHOOL DISTRICT
White
4�-
Building Department 0 Yellow�- jFacilities Planning 0 Pink - Accounting 0 , Gold - Developer
4
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«-.�-.vs:r.,_�.�.r-,_:r+ e•.t..�r�.c.,5 �:.arr�y�;=-+'�i.:�:lr''.i. i,,,v'wri;{-b>.-.=-...-�:-�;--'}��....., .." � f.
COUNTY OF RIVERSIDE DEPARTMENT OF HEALTHAssessors Parcel No.
I &I7 —
ENVIRONMENTAL HEALTH SERVICES
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 theiapplicationis 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' #
Agent Contractor, rson ,,, A
lion-t Address & P y �, `�-�T� E 4C I
V l
r�
AV64C
,
Job Property Address Legal Desc pt' n Prop. (PM, Tract, Lot)
1L.�i10EfEtE�-O • (DTZ S.W.`1E-GT.31
Lot Size
ter A nc Use of Permit P CU etc. A W/ 771 , a -Asher C•ybU, �/
WOO. ��•jt3�.t
•%1 f�G.t
�+ - s1�l�J r,
'
weiif Site Prep, c. L a (0 t7V, G.zAvu 004,1
f O • ' �
- !�-7 c.�Qli 1
Signature of Applicant
Data
CAGOR REV CODE
CATEGORY: REV CODE FEE
SUBSURFACE DI SAL 1238 $45.00
❑ SITE EVALUATION UPON REQUEST 7349 $42.00
❑ MULTIPLE PARCELS WITHIN SAME �-
(NO PLOT PLAN)
LAND DIVISION 1
❑ SEWER/SEPTIC VERIFICATION 7348 $11.00
a. 1 at 4 Parcels (Each) 1238 $45.00
(Less than 1 year)
b. Each Parcel after 4 7344 $16.00
❑ PRELIMINARY ELECTIVE 7352 $45.00
❑ Rerevlew (2nd review same parcel) 7344 $16.00
EVALUATION (Attach DOH SAN 53)
❑ Site Evaluation in Conjunction with
❑ HOLDING TANK 7351 $45.00
Critical Area 7346 $86.00
❑ ALTERNATIVE/EXPERIMENTAL 7345 $13200 -
[3 Site Evaluation Lot Less than
SYSTEM
1-10,000 Sq. Ft. 7347 $86.00
�L
Holding Tank Agreements Completed ❑ Yes CSN"/�- - 10 Z %
Yes, re N!!
Certification of Existing S.D. System Required ❑ Ye
WQCB Clearance required. (Attach Form ❑ Yes No
DOH SAN 007, Santa Ana Region Only)
Solis Percolation Report Required. ❑ Yes
Special Feasibility Boring Report Required. ❑ Yes
Detailed Contour Plot Plans Required (1 to 5 n interval) ❑ Yes o
Outer ❑ Yes - -
Staff Specialist Lot Inspection Required ❑ Yes No
Lot Inspection Date
Solis boring report by / # Date 66
4_44VApproved
//��//%}Q,, �n
Solis Map Page ` SOA Type by /&x�Z— Date
No. of Systems
TX of System(a)
0 Holding Tank ❑ Existing
No. Dwelling Units /
Bedrooms,
(1) Septic Tank
Soil Rate
/Send
G rttcp
❑ Replaoertrent
r%$®/ZM %Q�%�/�
�
,p�W Gal
• , �
Ga!
NQ Leach Line Sq. Ft
h area
Sidewall allowance ;
n rock/
n
Install Une(s) it long _ft wide with
min. inches drainfl es or
Leac sq. n
of bottom
per running
;NA
Leachiines/bed special design for slope:
(3) Pit Diameter
/
No. Pits
Pit B81o�i
Seepage�P1t Total Depth
App
len
#
/
N/A factor
40=5" 6' 6
Tqq
Max. AI owabJ Depth
No. 2 System4
01,
Qt,�itlfit'
/!0
REMARKS:
AW
davoto ce,,& C.A c. e1
or
44 4}2le
This application ' V IED fVo, the category checked in SECTION B above, regarding the design of a subsurf& 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
bover-designed system. No construction is permitted in the required reserved 100,% expansion.. area.
Septic tank and sewer lines must be 50' minimum from any wells 71; /
(� Leach lines must be 100' minimum from any wells, including expansio; ar
Seepage pits must b&11501 minimum fro any wells,uQding expansion
nnparrea a%0
'
t /, '.27
Signature of Health Official .2 OO e
;ef - -- yV-:er-
.-
RECEIPT NO.� Issued By .� Date—
DISTRICT:
ate DISTRICT: ❑ Riverside, l" O hdio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe
DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records
7
11
REGISTERED INSPECTOR'S WEEKLY REPORT;
TANDY'S INSPECTION
SERVICE 4
3580 Condalia Ave.
Yucca Valley, CA 92284
(619) 365.5045
TYPE OF
INSPECTION
PERFORMED
❑ REINFORCED CONCRETETRUCT. STEEL ASSEMBLY ❑ 1— ( 2 ` 0
❑ POST TENSIONED CONCRETE ❑ ASPHALT "(OTHER
❑ REINFORCED MASONRY ❑ FIRE PROOFING
JOB L C ON
.� QA CN El I A DQ
, Hriy S RAS
L; IN�
REPORT SEQUENCE NO.
TYPE OF �,TRT`E
PERMIT N0.ID
7
MATERIAL DESCRIPTION
F}-3fo
AR"TECTSP
K014c-f4 ' ITi
CTOR
la
HRS. CHARGED
�GINEER
A`
ASSISTANTS
HRS. CHARGED
INSPECTION;—�—
DATE (�•H e � W1 11 �
� ` I�S S �
0J9S0kUe--0 F -p Wei.so rN 5 6-� Il'wo -e-e, -1 (0 k b
CCF
It) W i k KSS d
E. 10- Wt L o S Su
i_
0- c r rI2 Co Le,Ten
w
FF Q 1090
CITY OF LA UuiNTA
PLANNING 8' DEVELOPMENT DEPT.
U)et,oe2 `. (--tvc S opke
--roc�d wxees
00 is v ''e-s
S- P S Ll J Ck-o:V2k
a�
COPY SENT TO CLIENT
CONTINUED ON NEXT PAGE ❑
PAGE
OF
CERTIFICATION OF COMPLIANCE /
I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY
KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE
NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED
PLANS, SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE
GOVERNING BUILDING LAWS.
\l
6I NATURE OF REGIST D INSPECTOR
a--�-►-go o - C_
DATE OF REPORT REGISTER NUMBER
REGISTERED INSPECTOR'S WEEKLY REPORT;
TANDY'S INSP-CTION
SERVICE
3580 Condalia Ave.
Yucca Valley, CA 92284
(619) 365.5045
TYPE OF
INSPECTION
PERFORMED
❑ REINFORCED CONCRETE STRUCT. STEEL ASSEMBLY ❑
❑ POST TENSIONED CONCRETEASPHALT OTHER
❑ REINFORCED MASONRY ❑ FIRE PROOFING SNS®
JOB LOCA 0 �J � O�
�� QV L�-v�
f -F
J4 WS
''
REPORT SEQUENCE NO.
TYPE OF STRUCIE� -
PERMIT NO.
DATE (Q-
DAVE N 0 �E ;K
MATERIAL DESCRIPTION
ARCHITECT
IV�R�
HRS. CHARGED
ENGINEER
ASSISTANTS
HRS. CHARGED
INSPECTION
DATE
,D-19-'90
D 06 SEZ UE- J We -�
o -F' CD 1-S
1 A o X�
FFB "tj 109
CITY O3 LA QUINTA
PLANNING & DEVELOPMENT DEVT.
COPY SENT TO CLIENT
CONTINUED ON NEXT PAGE ❑
PAGE OF I
CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY
KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE
NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED
PLANS, SPECIFICATIONS, AND APPLICABLE SECTIONS OF THE
GOVERNING BUILDING LAWS.
NATURE OF REGISTERE SPECTOR
-/ c! �y \SRa 0'C.
DATE OF REPORT REGISTER NUMBER