05335 (SFD)Building
Address
TWY� 4 4 a"
46-440 ROUDEL Lit
MUM CONMUCTM
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Mailing
Address n-757 DPW WARMGs 18
City Zip Tel.
PATJ1 DESERT 922610 340-530,,
Contractor
SAME
Address
State Lic. City
& Classif. B-232366 Lic. #
Arch., Engr.,
Designer
Address Tel.
CityI Zip I State I
Lic. If
I hereby affirm'that I amJicensed under provisions 0 Chaptei gg��ee��nmmencing with Section
7000) of Division 3 of the usiness and Professions<Code and fiylicbnse is in full force and
effect. 410 �� 7L 5 d•fO�ss
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, demofsh, or repair any structure, prior to its issuance also
requires the applicant for such permit to lie a signed statement that he is licensed pursuant to
the provisions of the Contractors 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 cNd penalty of not more than five hundred doffm ($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 hrnseff or through his own employees,
provided that such improvements are not Intended or offered for sale. It, 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 safe.)
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 bolds or 6nproves 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. R_ & 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 tbfi reof. (See.'f3800, Labor Code.)
Policy No. Company �'`•', a"x_" l
❑ Copy is filed with the city. ❑ Certified copy is hereby fumished.
CERTIFICATE OF EXEMPTION FROM
WORKED' COMPENSATION INSURANCE
(This section need not be completed ff 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. ff, after malug this Certilcate of Exemption you should become
subject to the Workers' Conpensagon provisions of the Labor Code, you must forthwith
comply with such provisions or this pem* 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, Civif 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
No. 05335
BUILDING: TYPE CONST. - OCC: GRP.
A.P. Number .617-102-005
Legal Description
Project Description SFJ)
Sq. Ft. 2�7i No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ 'Demolition ❑
Estimated Valuation 121,299
PERMIT
AMOUNT
Plan Chk. Dep.•
Plan Chk. Bal.
•2
Const.
7ib.50
Mech.
60. 00
Electrical
131*14
Plumbing
1 '4F50
S.M.I.
8.54
Grading
20.00
Driveway Enc.
. 2Q.00
Infrastructure
2,586.60
Ivige ' oed Yee
TOTAL
REMARKS
il3t��i�111 ti�l�a ..._dye { w i i a -
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
2/7t89
Issued by:
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
SLAB GRADE
2ND FL SO. FT.
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CARP. SO. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT.
OTHER APPJEOU1P.
DRINKING FOUNTAIN-
OUNTAIN.SO
SO.FT ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOXDISH)
APPLIANCE DRYER
FRAMING U `
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
i
O�
LAUNDRY TRAY
AIR HANDLING UNIT CFM
REMARKS:
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1+/. c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
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 & AIR COND. SOLAR
-- — —
SETBACK
GROUND PLU14 MBING
UNDERGROUND
A.C. UNIT
COLL AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC
F
H WIRING
DUCT WORK
ROCK STORAGE
FOUND. 0110W. (�
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOU1P.
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. �Z y
FRAMING U `
INAL INSP.
ROOFING 7 1 _
i
O�
A
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING J(/(A/
MESH
INSULATIONISOUND 7 Z
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
4 4 Qum&
P.O. BOX 1504 APPLICATION ONLY
Building 7&105 CALLE ESTADO
Address Yd - `1'r YO 120 uQE L L N. LA QUINTA, CALIFORNIA 92253
Owner
G * /¢Z -14A, iIv S % BUILDING: TYPE CONST. OCC. GRP.
Mailing
Address ;7L _ %SCAW wA.rL /AIG RA- 574 -EP A.P. Number %
City Zip Tel. 4-.0
n 44A,v� _ ZZ` O 61 3Viz _5 3 Legal Description
7 I
Contractor _ Project Description
Address
Tel..
State Lic.I City
& Classif. Lic. #
Arcn., tngr., I
Designer
Address Tel.
City IZip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section
71100) of bivision 3 of the Business and Professions Code, and my license is in full force and
effect
gJGNA,nJRE DATE
OWHIMBUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Bisioss and Professions Code: Any city or county which requires a
permit to oorstrud, alter, irpmve, denhoish, or repair any structure, p to hs issuance also
requires the appicarht for such permit to lie a signed statement that he is licensed pursuant to
t
the provfsbrts of e Canbacor^s license Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the liisihess and PFofess- Cade. or that. he is exempt therefrom, and the basis
for the aseged ozermpton. Any violation of Section 7031.5 by 'any applicant for a permit
surbje . the to a civilpenally of not more than tie 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 own employees,
provided OW such rrWovemenis are not idended or offered for sale. If, however, the building
or improvements said wdhih orte 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, Basi= and Professions Code: The Contractor's License Law
does not apply to an owner of property who darts 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 Sem 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
Workefs 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 B 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
M077CE TO APPLICANT: t, alter mall tg 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.)
Lenders '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 1110 days.
I certity 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 Addrr cc
City, State, Zip
FINANCE
Sq. Ft. No. No. Dw.
Size 2 O 77 Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
r
Estimated Valuation
PERMIT AMOUNT
Plan Chk. Dep. Z —O, c -a
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
1zl"40 r0,60
TOTAL D a to
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:
A
.r Assessors Parcel No `
COUNTY OPRIVERSIDE DEPARTMENT OF HEALTH y
ENVIRONMENTAL HEALTH SERVICES 617 102, -, 005• . k
//'�'i �"'
PERMIT•APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM
plk:ant Submit this formwith four copies of a scaled plot plan (1-20 scale) drawn to County speculations as indicated on,„the attached check list `.
Anon -refundable filing fee (see below) is required when the application is submitted. Check must be madepayableao.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'*
tact Person
gent, PTO.
�era�1°P T �tiazan, Inc. 619
e
AV15369
d P e
%t ` 51 ��•ed Waring Dr., '4/:8, P. D.' 92260:
Owner
Gerald J. Chazan, Inc. 8181246-7268
Phone
Mailing Address
431 N. Brand Blvd., 4101
City State
Glendale CA
Zi
9T203
Job Property Address
46-440 Roudel Lane
al Desc ' n Prop. PM, Tract .
,Ot Tract 1 69,`
Siz{/e
er A e
use of Perm cu, oto. a nLa
. Other
/L%
�P///P,
elfin ite Prep, etc.
Jan. 5, 1989
Signatu of Applfca tl.:.' r
Date c
CATEGORY,. REV CODE FEE
CATEGORY: REV CODE .-FEE
❑� DISPOSAL 1238 $45.00
❑ SITE EVALUATION UPON REQUEST 7349 $42.00
__SUBSURFACE
LMULTIPLE PARCELS WITHIN SAME
(NO PLOT PLAN)
LAND DIVISION
❑ SEWER/SEPTIC VERIFICATION 7348 $11.00'
a. 1 st 4 Parcels (Each) 1238
(Less than 1 year)
b. Each Parcel after 4 7344 9A 6.00
❑ PRELIMINARY ELECTIVE 7352 $45.0.0 .
❑ RerevidGM2nd review same parcel) 7344 $16.00
EVALUATION (Attach DOH SAN 53) y
❑ Site Evaluation in Conjunction.with
❑ HOLDING TANK 7351 $45.00
Critical Area 7346 $86.00
❑ ALTERMATIVE/EXPERIMENTAL 7345 $132A0
❑ Site Evaluation Lot Less than
SYSTEM
10,'000 Sq. Ft. 7347 $86.00
Q.
fO���
(f '�D �0
Aj ❑ Ye� o
Holding Tankg
Certification of Existing S.D. System Required ❑Yes AN
i WQCB Clearance required. (Attach Forth ❑ Yes t No
DOH SAN 067, Santa Ana Region Only)
Soils Percolation Report Required. ❑ Yes .. � No
Special Feasibility Boring Report Required. ❑ Yes No
Detailed Contour, Plot Plans Required (1 to 5 tL interval) ❑ Yeses la
Other ❑ Yes.
Staff Specialist Lot Inspection Required , ❑ Yes iD No
Lot Inspection Date
ar-63,
Soils boring report by # Date
` y' ' �—
Soils Map Page Sal Type by( Date !/-0
No. of S to
T of System(s)
❑ Tank ❑ Existing
No. Dwelling Units
Bedrooms,
(1) Septic Tank
Soil Rate
Grease/Sand
Uolding .
y�New ❑Replacement
nr - rr�`
/,Q�4�
G%ase
3 v1J�'t� a - Im
!1LGaI
�/
7 d
Gal
Leach Line Sq. Ft
Sidewall allowance
Install Lines) It. kxrg wide
Leach Bed
lloom trench area
It rock/ sq. It.
min. mcnes drainlines or
of botto
per running ft /
t
Leachlines/bed special design for slope:
(3) Pit Diameter
No. Pits
Pit Below
Inlet (BI)
. Seepage Pii yDepth
��/•
Oche
Applica�ble
-09 M5 f.-
�,�
N/A Overburden facto
Max. Alloyr� I� Depth
No. 2 System
REMARKS: v
/S
This ap licatic i PPRO D ^-NIEF?efor the t pry checked in SECTION B above, regar ng the design of a subsurface disposal system as 'indicated
on t accompani plot --pan, using the req laments 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.
Septic tank and sewer lines must be 50' minimum from any wells ' �Q0/
Leach lines must be 100' minimum from any wells, including expansion area Qrf J
Seepage pits must be 1,N,?' minimum from any X!ells, including expansi n ar
/
Q/�
” " l Ajj/ �,/
Signature of Health Official Date
RECEIPT NO. O8a 90 Issued By
//'�'i �"'
Date ✓ �O ^[2 /
'
DISTRICT: ❑ Riverside, J-* hdio ❑ Hemet ❑ Perris
❑ Rancho Calif. `-. ❑
Blythe
DOH SAN •122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept. GOLDENROD - Plans/Records
th.
�I �n buttress
April 24, 1989
_CITY OF LA QUINTA -
78105 Calle-Estado.
P. 0. Box 1504
La Quinta,, CA 92253
Attention: City Engineer
` Re: Lot 28, Tract 2667
.l 46440 Roudel.Lane;
Pad certification Tetter _
Dear Sir:
I, Denise -R. Poeltler` of THE FLYING BUTTRESS, verified -the
finished floor elevation of the project referenced -above.
I shot- an average Felevation of 99•.23 as compared to` 99.25 as '
shown'on the approved grading plan.
These 'elevations are in substantial conformance with the
,grading plan'pre.pared by -my firm.
Respectfully submitted, „
C&
DENISE R..POELTLER,"Inc.,
-THE FLYING BUTTRESS -
Denise.R. Poeltler - -
R.C.E. 33446 -
DRP -/lm
CC: Chazan Construction `
TFB # 88-357'
72-757 Fred Waring Drive • Suite 5,• Palm Desert, California 92260 • (619) 3t6-5445
� r • �.w � . . /f� Lr �+rii7TTa>
q—�
GU I
DAILY FIELD REPORT
No:
Job Name: r�ZQn
Project No .:'S-310
Dater_
0
Location :
Uu� el
128.
Weather: P. C d
Day: �•
Contractor:
Foreman:.
.
Field Technician:
Miles:..
Hours:' S—
Equipment Working:
0
Inspection / Testing of
Test
No.
Test
Location
Elevation
or Depth
Soil
Type
Optimum
Moisture
Field
Moisture
Maximum
Density
Fleld
Density
Rel.
Comp.
Z
� � C.v�rn•er
� -
-
. �
% .s
Summary of
Operations:
d al„
_<,j, 0- -k)
z:w' 0^1
0a_
uv
Q cl rA#
J5
6(11 '11�1
k c) mA CIA �6)
C—aL4"nVcJ?aA.
/r ►r
Supervisor :
1, .'..�•
/�'
Engineer:
Geologist:
Todays Y
�rg e:
Yardage to Date:
LEIGHTON and ASSOCIATES
17975 Sky Park Circle, Suite E, Irvine, California 92714
Tel: (714) 556-1421 556-1422
100A (4.77)
WHITE — File Copy YELLOW — Client Copy PINK — Field Copy GOLD — Office Copy