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11590 (SFD)Building Address Owner Mailing Address City Pala Contractor Same- Address ,ame- Address City State Lic. & Classif.. Designer Address T 4 4 QUM& P.O. BOX 1504 78-105 CALLE ESTADO 78--655 Sactuaro LA QUINTA, CALIFORNIA 92253 Keil Stermner ]BUILDING: TYPE CONST. No. 11590 77745 Delaware 1A.1P. Number 617-393-015 Zip ITO Tel.: Lic. # Tel. ,,, Legal Description Project Description Sq. Ft. Size -1 New ❑n No. Stories OCC: GRP. No. Dw Units Add ❑ Alter ❑- Repair ❑ -Demolition. ❑ CityJZip rm"t' r State Lic. # LICENSED CONTRACTOR'S DECLARATION 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 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 EStlmated,ValUatlOn C C3 v -. 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 alleged exemption. Any violation of:Section. 7031.5 by 'any applicant for a permit ' subjects the applicant to a civil penally of not more than.five hundred dollars.($500). ". O 1, as. owner of the property, or my employees with wages as their_sole compensation, will . ;Plan Chk. Dep. • n ChK. Ba - Plal. , 17 ., crs 11 Const. — `" .77 2 . 11builds do the work, and the structure is not intended or off6red for sale. (Sec. 7044, Buisness and Professions Code: The Contractor's, License Law does not apply to an owner of property .who Mech. . - 01 or improves thereon and who does such work himself or through his own employees,. provided that such improvements are not intended of offered for sale. If, however,- the building Electrical - - y �i _ 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 puipose of sale.) Plumbing - (t(3 ❑ 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, and who -contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ I am exempt under Sec. B. t: P.C. for this reason S.M.I. A - c; n Grading 7. r, n . Driveway Enc. Date owner Infrastructure 1,852.64 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:) r6 ;, •,,,„-, , , A .. , Policy No. Company i' O Copy is filed with the city. ❑ Certified copy is hereby furnished.. • ^^ TOTAL 1.255.60, 3.it15_613 REMARKS CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed If the permit is for one hundred -dollars ($100) valuatiod, -' + 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. ZONE: BY: 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 ' Thi ' b ildi h I fill d t d d I'd t d d' b' t t i + s s a u ng pe w an p oper y I e ou , slgne an va I a e , an Is su iec o expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the abo4e 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 y,'to enter the abovew. mentioned property for inspection purposes. Signature of applicant Date Mailing Address GIty State, Zip Issued by: Date Validated by: Validation: Permit CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ® $ UNITS 2ND FL. SQ. FT. COLL. AREA YARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS CAR P. SO. FT. STORAGE TANK DRAINAGE PIPING WALL r SQ. FT. S@Ne"R SEPTIC TANK DRINKING FOUNTAIN. SQ FT ® URINAL ESTIMATED CONSTRUCTION VALUATION $ FOUND. REINF. WATER PIPING NOTE: Not to be used as property tax valuation METER LOOP FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM. FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER TEMP. POLE GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM GROUT 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. SQ. FT.® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1 V. c SEWAGE DISPOSAL FRAMING lh-?A�a-v SQ.FT.GAR ® 3/4c HOUSE SEWER Ct / �W yap �l�-%l ��J GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBLTOTAL 1 FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE / PLUMBING -t ELECTRICAL HEATING & AIR GOND. SOLAR' SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS S@Ne"R SEPTIC TANK ROUGH WIRING. DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. 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. 6,f ll FRAMING lh-?A�a-v FINAL INSP. / 6 ROOFINGZ Ct / �W yap �l�-%l ��J �"� D � to Z U a 1 I 7/ �{ REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING I 10lGCFi �� INSULATION/SOUND 3 FINISH GRADING FINAL INSPECTION CERT. OC FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL t P.O. BOX 1504 APPLICATION _ONLY Building / `..Lr 5a 6(k 0 7&105 CALLS CALIFORNIAESTAD9 Address t/L//���JJJJ LA QUINTA, ORNIA 92253 - Owner�j �" N BUILDING: TYPE CONST. OCC. GRP. Mailing Address �(' ,G( A,.JN\Lz A.P..Number Cit `j Zip Tel. i�`w. f tZGO Legal Description Contractor Project Description µ `Address' City Zip Tel. State Lia City & Classif. 599 q 1 3-7 Lic. # Sq. Ft. No. No. Dw. Size Stories Units Arch., Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ - Demolition ❑ Address Tel. City Zip State Lic. # otha LICENSE CO TRACTOR'S DECLARATION I hereb Of rryli ansa u ddei movisions!!e5a er 9 (commencing with Section 7000) of iSBmsin a Professions d 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 reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a _ 1f permit to construct, alter, improve, demolish, or_ repair any structure, prior to, its issuance also— requires rhe applicanf4or such -permit to file,a signed statement that he is licensed pursuant to""-'� PERMIT AMOUNT p'r""iOn.,,ol the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 oFfhe Business a 7 nd Professions Code, or that.he is exempt therefrom, and the basis Plan Chk. Dep. - for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit p / subjects the applicant to a civil penalty of not more than five hundred dollars ($500). 1 I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. ,do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 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 Ior through his own employees. Mech. provided that such improvements are not intended or offeredfor sale. If, however, the building orimprovement 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 1 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 S.M.I. such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading f Il I am exempt under Sec. B. & P.C. for this reason Driveway Enc. Date Owner Infrastructure 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. 1 '7 �iry �-�- �� ^ ^�-_"• �' —i t'�-•—�°- 14 �(7 TOTAL: H� CERTIFICATE OF EXEMPTION FROM REMARKS — T WORKERS COMPENSATION INSURANCE .,,(This isection nepd nof•be:c�gmpleted if, the permit, is for.one hundred dollars (S 100) valuation _.. . , _ 1. n:. .x certify that to the perfor�,mance 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. , iDate 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 i I here, y affirm that there is a construction lending agency for the performance of the from Property Line work for which this permit is issued. (Sec. 3097, Civil Code.) Side Setback ►, Lender's Name Lender's Address d This is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE - INSPECTOR expiration if work thereunder is suspended for 180 days. 1'c,Ertify 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 BUILDING DIVISION I_ CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. @ $ 2ND FL. SO. FT. Ltq POR.SO. FT. GAR. SO. FT. @ CAR P. SD. FT. 0 WALL SO. FT. fQ SO. FT. p ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used as property tax valuation BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER I VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEOUIP. LAUNDRYTRAY AIR HANDLING UNIT CFM TEMP. POLE 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 @ ?Ac HOUSE SEWER REMARKS: VENTILATION 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. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. 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. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE ' SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL 1M.rM, 1 UK J ARUPIA 1 UMtZi I N1 I IALS GARDEN WALL FINAL .k DESERT;SANDS UNIFIED SCHOOL DISTRICT 82 879: Highway 111 NOTICE: z,� r ;Indio, CA t92201...- Document Cannot Be ,Duplicated (619) 347-8631. Date 112/17/M] Type of Permit ha Quinta . No. 119.04. Permit # 11590._ t_og. Owner Name Ken. Stemmer:, ,. No._ 78-655 t. street:. Saguaro city La QWhta Zip 92253 Study Area APN # Trac t#1 Lotti 0.1.. Square Footage.: 1425 Type of Development SingleFamily'•Residence` . No. of units 0 Comments At the present time, the Desert Sands Unified'Scl ool 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 schoohfees'at this time due to the following: reason: EXEMPTION NOT APPLICABLE 1 ' This certifies that school facility fees imposed pursuant to Government -,Code 53080 in the amount of 1.58 x ;1435"' or $ n2251.50 have`been paid to D.S.U.S.D. for yr the property listed above and that building permits and/or Certificates of Occupancy. for this square footage in'this proposed project may now be ` ssued. Fees Paid By Ken. Stemmer Telephone -: Name ori the check By Tames•F. L.ivelyT Assistant Superintendent, Business Services- _ Fee collected /exempted by Layne Arthur ; Payment Received? Signature check, ivor�1. -067- Collector: Attach a copy of county,or city plan check application form. to district copy.for all wavers.:.+: Embossed Original- Building De Copy -Applicant/ReceipE ' Copy : Accounting t, bEC 17 "9i' 11:23 PALM DESERT ESCRCl14 Order No,,3689Z Escrow No, 92528841A Loan No. WHEN RECORDED MAIL, TO: . Mr. and Mrs. Kenneth E. Stemmer 77145 Delaware Place Palm Desert, CA 92260 MAIL TAX S'rATEM[N rS 'I(.); SAME, AS ABOVE APN 617-383-015 SPACE ABOVE THIS LINE FOR ALCORDER'S USE DOCUMENTARY TRANSFER TAX S...5;3Cl •.. Computud on the consideration or value of property conveyed; OR Computed on the consideration or value less liens or encumbrances r remaining at time of sale. Signature vi Ueclprnt or ggentctetnrmining tax -Firm Name CORPORATION GRANT DEED FOR A VALUABLE CONSIUERATI.ON, receipt of which is hereby acknowledged, .J'AIL DEVELOPMENT a Corporation organized (1n<ter the laws of the State of California GRAN -r to KENNETH E. STEMMER and PEGGY STEMMER, husband and wife as joint tenants the real property in tyle City of La Quin to County of Riverside does hereby State of California, described as ill 11.5 or cesof glob Manor 'Tract No. 1, as per magi recorded if) Book ? � ill the office of the County keCorder of said County. 2' Page '3 of Maps, Dated '1 2,—j_992_... STATE OF CALIFORNIA l COUNTY OF__- _ RIVE RSII)E ),a On,__„ Agri l t6torerne, the undersigned, a Notary Public in and for said State, personally appear. DECK W.- LEENEY pers6n,ylly known to rng (or prpv<;d to me on the basis of satisfactory evidence) to be the persons w1*10 execulid the within InStrument as President and JWI: .DEVELOPMENT 'JACK W. LEENEY President By — — Secretary Secretary, onbehallof_._JWL DEVGL,0i)mFNT --- �FFIC 1AL SEAL the corporal, �� ""acol:Pt,+�2ift7P1114 on Itlerein named. ru..! p�J(g0vrf �dge<1 to me that such cor f AIY� c.�.�No„ .....:.-....n u,., ..:,,.... ,.r�....:........,..,.�..�.., t-.79i�1.f/ URJt,/I�lr y -laws or d WfrNESS nly hand and official �f' Cnrom E)tp, tact 13, 19" Signature c MAIL TAX (Thea area for Official rwterial ;eyl) STATEMENTS AS DIRECTED ABOVE 1144 (6/82) d, I:t�3+,tt;7.('+'*^C•a:;-;�i(�'?•+�i..csn"'+""�,�.'y;;y;j�j� ',�1�'�i$t�� 7a�r��<^�wR•`�!""'^"'I`°a"r.�'9�70�`?�'•NM;*"�1if,��..i�MrSgkiay+`�v'y''�'�1.'a►:f'�'�"•�?,�,�'yw�f�°"'.'%'r•'chu,• COUNTY, OF' RIVERSIDE HEALTH SERVICES AdE'NCY FAssessors Parcel,No. DE0AATMENT OF ENVIRONMENTAL: PERMIT -APPLICATION -:FOR A. tUBSUIiFACESEWAGE D.ISPOSALISYSTELjA Applicant: --Submit this form mith four copies of4a;SCALED plot•plan (1.20 SCALE)ldrawn to County:gpeculations as.indtcated, 'n the attached check list. ;- A non-refundable filing fee (see below) is required' when' the application is submitted. Check must be`rnade,payable to the County'of f3iverside. sp�rq tai of thiiS�ap`p'l`ica' n-shall-remikin;valid'for a'period "not to exceed one year''from date -of approval: • W r' V ale.. A !'•�""WJ. —�._,`. `•�.. - i LOG #• " -� ERIFY ITEMS IN, SECTION A FROM'A, NON-FEEiBU1LOlNG: & SAFETY"(goldenrod)! APPLICATION Agent; Contr q ntact Person Ph'iine Address City e :,btato Zip Owner`j Pfiorjei ".;g, Address` ­, F•• City^j, State-„ = Zip Job Property AcTdiess5Ab QN r d City ate ' ip Legal pescnptiii Pr M; Tract,, Lot) • Lot Size ater Agenc + ' Use'of: Permit PIP, CU,,etc. .•Other AcT# �QQ D'n H Slte'Prep etc. Si nature of'Applicant .' r Date"',i=u• " - r CATEGORY - REV CODE' ­ **E9 '7 ;, CATEGORY, ' REV CODE, FEE SUBSURFACE DISPOSAL (per system)`, + -.1238 153.00 ,x, f SITE EVALUATION,•UPON'REOUEST -A u ' 7349 '$120.00' ❑ MULTIPLE PARCELS WITHIN SAME LAND DIVISION "', (NO'PCQT PLAN) :, ❑ SEWER/SEPTIC VERIFICyATION 7348 • $ 58.00' a. 1 st 4 Parcels (Each) 1298 •$153.00 ^ r '. q PRELIMINARY ELECTIVE, EVALUATION - b., Each Parcel after 4 7344 $ 55.00 (Attach DOH SAN -53), ` y 7352,'^ . $.,A9.00,'' E]REREVIEW (2nd review same parcel) 7344 $ 55.00 EI HOLDING TANK."y A, '..7351 ' $119.00 ❑ SITE;EVALUATION In Conjuction with Critical Area 7346 $197.00 ❑ ALTERNATIVE EXPERIMENTAL SYSTEM 7345 $656:00 ❑GRADING PLAN REVIEW DETAILED 1238 $104.00 ❑ SITE EVALUATION Lot Less than 10,000 Sq. Ft. 7347 $172.00 ❑GRADING PLAN REVIEW CURSORY 1238 $ 55.00 ❑ SECOND FIELD VISIT (SITE EVALUATION) 7346 $ 85.00. ❑ COPIES (LAND USE) 7786-81 $ 50 INITIAL DATE Holding Tank Agreements Completed ❑ Yes No I �4 9 '? —,9 =r _ Certification of Existing S.D. System Required ❑ Yes No /. OCB Clearance Required ❑ Yes lQ No (Attach. Form' DOH SAN 007, Santa Ana Region Only) 'Soils Percolation Report Required ❑ Yes B' No Special Feasibility Boring Report Required 0es PN Detailed Contour Plot Plans Required (1 to 5 ft. interval) ❑ Yes q�l 'Grading Handout Handout Provided ❑ Yes o° 'Staff Specialist Lot Inspection Required ❑ Yes o , Maintenance Booklet Provided ❑ .Yes 2o. Lot Inspection Date Initials C/42 / Soils Percolation Boring Report by Lic/Project # Date "Map M7Soil lb Soils Page Type /f' a Approved By -44 Date 40 "t 7 No. of Systems j Type of System(s) No. Dwelling Units / (1) Septic Tank Soil Rate Gee�Sand UntTrap cp/❑ _ UrNew ❑ Addition , 1 ❑ Existing 49A An.Gal: 6 Al V1 y Gal. kq. Ft. Total Linear Sidewall Allowance Leach Bed sq. ft. t BO Om Area r t Ft. ft. rock/ sq. ft. per running ft. Inlet Tested Depth Install Line(s) ft. long ft. wide with min. me slow drainlines or of Bottom Area —_ Proposed Bottom Tested Depth 'Leachlines/bed special design for slope: Applicable (3) Pit Diameter No. Pits Pit Below Inlet (BI) S eepage Pit Total Depth 1 r / Dep (TD) ✓ aj Max. Allowable Depth � 91&6 f � I N/A Overburden Factor Q ' r Well Review Approved: Signature Date Well Drilling Permit # Grading Plan Approved: Signature Date }! REMARKS: 14 This application is PROVE IF3'f5r the category checked in SECTION B above, regarding the design'of a subsurface dispgsal+sjrstern,as indicated on the accompanied plot plan, using the requirements set forth in SECTION C abovd:`Abuilding permit.is necessary'for thd4hpiallation of the above=designed system. 1): Septic tank must be ! minimum from any wells Leach lines must be 100' minimum from any wells, inc lu ng ansion area Seepage pits must be 1 0' minimum from any wells, int�udi expansion areaar d Si nature of Health'Official I.g /[ C Date9a-- O CASH.%%'UICHECK NO. of jam• , RECEIPT NO. �?� Issued. By Date DISTRICT' ❑ Riverside LYladP- ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ "Blythe y DOH-SAN-122(Revt/92) / DISTRIBUTION: WHITE—Office Ilse YELLOW=Applicant PINK—Bldg. Dept: , GOLDENROD--:Plans/Records ` 1 l , 17 T P.O' Bi X 1 X04 78-105 CALLE EST AGO LA QUANTA, CALIFORNIA 92253: CONTRACTOR:--- OWNER ADDRESS-, JOE ADDRESS:. LA Q PINTA i_IT'•r LICENSE NO. EXPIRES: BLDG. PERMIT NO. this form shall be posted on the job with the building inspection card and'7t shall be the duty of the general contractor or if owner --builder- permit, the owner to see that all sub-con+ractors,sign this card, giving his City of La Quinta business license number, conrtactors licens' e number and a. current certificate of workman's compensation insurance ' certificate --.-then he _tarts the j9b. failure to comply rrfay cause building, inspectors to stop -viork, or c6niplaints to be filed against such contractors or owners., { 1 ;SU6-CONT•RACTQRS NAME. CITY LIC. NO. EX PtRES CONT. L1C.NO. EXPIRE 1 . GR AGE Y EXCUB ATE DATE L AND '031 ' . 12/3/92 312854 9/3/92 2. PIPELINES NONE i 3. C61ENT-FOUND AT IONS DESERT CIT IES z502764 1/31/93 4. CEMENT-FLATWORK SAME -AS :1�3 , 5. ASPHALT PAVING NONE b. FR AM ING RON RUFF 582. 12/31 /92 458575 2/'31 /94. 7. STEEL STRUCTURAL NONE 8. MASONRY NONE 9. PLUi1BING EDW ARDS. <..="vNS22 1 U €,: 1 r moo, 4 5835 10 3/31 /94 10, LATHING PAUL 'SHITE 248 7/1/93 289676 8/31./92 1 1 . DRYWALL P'1ARKIAURIETTE 1280 12/31/92 '115124 1/31 f92 � ' 12 PLASTERING SAME AS #11' , 13. -HVAC r ART IC AIR 9.30 026/9_ 351544 .,2/31/94 14.-ELECTRIAL RACEWAY ELEC. 6220 6-/26/93 529649- 12/'1 /'-� ' ,15. ROOFING RUB IN'VAS UEZ 1157 5 /31 /93 456498 8/31/93 - 16. SHEET METAL :FAME AS #1 8 17..FLOORS- ALL TYPES' OWNER 18. GLA^ -.S -GL AL' INN 05;;'NER 19. INSUTLATION SCHNM ITT30x2 r'' 93 151 7 1'/31,/93 - - 20.. SEWAGE DISPOSAL S AME .AS #'i . 21 PAINTING' OWNED... � 22.'T ILE OWNER t 23. C AB INETS- INST ALL D I AN AB iNETS 739 3 /5 /'93 • 487322 ' 4/1193 .24. ORNAMENTAL METAL NONE ` 25. FENCES/BLOCK"s. ALL OWNER 26. LANDSCAPING' OWNER, ' 27. OTHERS