07110 (RER)T 0
1 . Wyl 4
Address 50-980 Calle Obi
Owner
J.E. Palmer
Address
City lZip Tel.
Construction
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
P8 Box 2982
City Zip Tel
Pale Dese4 92261 341-68417
State Lic. City
BClassif.4W121 8„1 Lic.#
Arch., Engr.,
Designer JiM Fetridp
Address Tel.
73-965 HWY 111 S1.. B 568-56133
City Zip State
Palim Deser 922610 Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirrn'that I am licensed under provisions of Chapter 9 (commencingrwith Section
7000) of Division 3 of the Business and;Professions Code, and my,licenseJ n full force and
effect
SIGNATURE - I' DATE
OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5.8usiness 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
requires the applicant for such permit to We a signed statement that he is licensed pursuant to
the provisions of the Conti -actor'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 civ9 penalty of not more than five 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, Suisness and
Prolessions Code: The Conftctor's License Law does not appy 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. ff. 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.)
❑ 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 contractors) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
1 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 (E 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
N077CE TO APPLICANT 8, after making this Certificate of Exemption youshould become
subject to the Workers' Caopensation provisions of the Labor Code, you must forthwith
comply wish 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
Lenders Address
This is a building permit when property filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certity that 1 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
BUILDING: TYPE CONST.
A.P. Number 769-072-010
Legal Description Lot 82
Project Description S.F.D.
No.
OCC: GRP.
07110
REMARKS :,g ; o^. 40 0,141 ,4, .J P—Qci i Ll
lu IIAI: 11 i I1J1k. i r f
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 2%8/90 Permit
Validated by:
Validation:
Sq. Ft. 2640
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
z60.uu
Plan Chk. Bal.�i,'
<i
Const.
4413. o
Mech.
5.i. DU
Electrical
1bb.LI
Plumbing
1W. tlu
S.M.I.
I U . W,
Grading
ZU. Uri
Driveway Enc.
Lu. U
Infrastructure
J, J 4. J!
TOTAL
��s•
REMARKS :,g ; o^. 40 0,141 ,4, .J P—Qci i Ll
lu IIAI: 11 i I1J1k. i r f
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 2%8/90 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
+ 1ST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL. SQ. FT. ®
STORAGE TANK
FORMS
MOB]LEHOME SVC.
_
BAR SINK
POR. SQ. FT. ®
ROCK STORAGE
FOUND. REINF.
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
DRAINAGE PIPING
CAR P. SQ. FF.®
GROUT
WALL SQ. FT.
WATER HEATER
DRINKING FOUNTAIN.
FINAL INSP.
URINAL
SO FT ®
WATER SYSTEM
ESTIMATED CONSTRUCTION VALUATION $
=$
WATER PIPING
NOTE: Not to be used as property tax valuation
FRAMING ' ` t' FINAL INSP. L
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
I
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 ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/4c
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 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 APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM Z
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP. ��
FRAMING ' ` t' FINAL INSP. L
;.,REMARKS:
ROOFING /?✓
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWAI#
LATHINGr
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
ccnurc ciuei
Sep ,C �a�. ^?�-{2�� c(d
Nick
�1'//
y/e,
SIGNATURES11NITIALS
GARDEN WALL FINAL
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
OF
SCHOOL FACILITY FEES
TO: City of La Quinta DATE:
Department of Community Development
1 d
�40
78-105 Cal a Esta o
La Quinta, CA 92253 NOTICE: THIS DOCUMENT CANNOT
13E DUPLICA'rED,
This is to certify that ]''
developer of , which is
located at 50- Q , within
this District, has paid school facil ty fees imposed pursuant to the
authority generat d by o Government Code Section 5 080 in the amount
S (/0O
covering a total of square feet of (1< residential or
( ) industrial/commercial development and that building permits for
this footage in this development may now be issued by your jurisdiction.
for DESERT SANDS•UNIFIED SCHOOL DISTRICT
White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer
(I 0)-37
Date—
A
RECEIPT N0. /"t 19 (JO ( p Issued
BY Date ' k0 ' U
DISTRICT:" ❑ Riverside, ❑-ladioo_0'❑ Hemet q Perris ❑—Rancho ❑ Blythe
DOH -SAN -122 (Rev. 7/89) DISTRIBUTION: WHITE . Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records
I
k
4 COUNTY :OF RIVERSIDE. ENVIRONMENTAL Atenteorlt P.rt1 N°'
q
HEALTH SERVICES DIVISION
' -PERMIT APPUCATION FOR A-SUBSURFACE:SEWAGE DISPOSAL SYSTEM
Appik:ant ' Submit this form with four copies of a scaled plot plan (.1-20 scale'Arawn to,Couny speculations as Indicated on the attached checklist: .
.,.'A non-refundable filing fee (see below) is required when the application is submitted. Check must be•makie payable to the County of
Riverside: Approval of -this application'shall remain *slid fora period ;not to exceed one year from date Of
approval, .
VERIFY. ITEMS IN;SECTION A FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG # ar 1y"'
Z Agent, Contact Person
Q Phone Address 8 Firm. v
U.1 ��► Phone Mailing Address IF
In l c A u-000 f\ .
city State Zip Job Property Address Description Prop. (PM, Tract, Lot)
G b 's u AQ
Lot Size l!�,)L4�iterAgencyl_I . Ilse of PermitP/P,CU, etc. � 4 (� . .� � ,. -�+
Dwelling,' Site P , etc 976y ��(f�f Vhf 4 Q V 4
Signature of Applicant
Data
CATEGORY: REV CODE _ , E-- - CATEGORY: REV CODE FEE
SUBSURFACE DISPOSAL 1238 , $ 57.00 ❑ SITE EVALUATION UPON REQUEST 7349 $ 43.00 '
CD ❑ MULTIPLE PARCELS WITHIN SAME. (NO PLOT'PLAN)
LAND DIVISION ❑ SEWER/SEPTIC VERIFICATION 7348 $ 17.00
Z a 1 at 4 Parcels (Each) 1238 $ 57.00 (Less than 1 year)
O
b., Each Percel after 4 7344 $ 24.00 ❑ PRELIMINARY ELECTIVE 7352 $ 23.00
W 0 Rereview (2nd review same parcel) 7344 • $ 24.00 EVALUATION (Attach DOH SAN 53)
U)'• 0 Site Evaluation in Conjunction with ❑ HOLDING TANK 7351 $. 47.00
Critical Area = 7348 $111.00 ❑ ALTERNATIVE/EXPERIMENTAL 7345 $222.00
• ❑ Site Evaluation Lot Less than SYSTEM
10,000 Sq. Ft. 7347 $ 87.00
ITIAL
oJTE 9�
Holding Tank Agreements Completed ❑ Yes OytJ
Certification of Existing S.D. System Required ❑ Yes
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 ��No;
Detailed Contour Pk)t Plans Required (1 to 5 It. interval) ❑ Yes O'N�
DOW ❑Yes
Staff Specialist Lot Inspection Required ❑ Yee t�'No
_ Lot Inspection Date
Solis boring report by Project g --
U Soils,- Map. Page f /el Sol Type 77c Approved by &1� Date
No. of Systems T of Systems) No. Dwelling UnRs /) (1) Septic Tank Soil Rate t3rease/Sand
0. �Pf�irig Tank ❑❑ ExWReplii wd _. .- Bedrooms, Fixtare�Mmitsa Grlean 1
3134x4,. 2A 947NMsf.
, VA
( Leach Line Sq. FL Sidewall allowance I Lines) It lom fl wide with Leach Bed sq. R
trench area K rock/ _
sq' ft• min. below drafnlines or area
per running It
7
Leachlines/bed special design for slope: (3) Pit Diameter No. Pits PR,Below Seepage PR Total Depth Other:
Applicable - . // Inlet481)a (TD) f�/)
N/A Overburden tactor �-� CDS (�i1 / Max. Allowable Depth
-1 0
No. 2'System f 1! 1
REMARKS: f �J
This application issAP R� OVEd ENIE for the category checked in SECTION B above, regarding the design of a subsurface disposal s
� on the accom � e� g g Po system as indicated
paned p t p n, using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the 4
Z above -designed system. No construction is permitted in the required reserved 100% expansion area.
0 (' Septic tank and sewer lines must be 50' minimum from any wells / Q T�.r QP�s
t-Leach lines must be 100' minimum. from any wells, including expansion res
� 3] Seepage pits must be 150' minimum fr
'''1;13
o�m�any�well�s, including expansion%area
Si I nature of HeaBh�Offx:ial�-
Date—
A
RECEIPT N0. /"t 19 (JO ( p Issued
BY Date ' k0 ' U
DISTRICT:" ❑ Riverside, ❑-ladioo_0'❑ Hemet q Perris ❑—Rancho ❑ Blythe
DOH -SAN -122 (Rev. 7/89) DISTRIBUTION: WHITE . Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records
I
k
4 COUNTY :OF RIVERSIDE. ENVIRONMENTAL Atenteorlt P.rt1 N°'
q
HEALTH SERVICES DIVISION
' -PERMIT APPUCATION FOR A-SUBSURFACE:SEWAGE DISPOSAL SYSTEM
Appik:ant ' Submit this form with four copies of a scaled plot plan (.1-20 scale'Arawn to,Couny speculations as Indicated on the attached checklist: .
.,.'A non-refundable filing fee (see below) is required when the application is submitted. Check must be•makie payable to the County of
Riverside: Approval of -this application'shall remain *slid fora period ;not to exceed one year from date Of
approval, .
VERIFY. ITEMS IN;SECTION A FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG # ar 1y"'
Z Agent, Contact Person
Q Phone Address 8 Firm. v
U.1 ��► Phone Mailing Address IF
In l c A u-000 f\ .
city State Zip Job Property Address Description Prop. (PM, Tract, Lot)
G b 's u AQ
Lot Size l!�,)L4�iterAgencyl_I . Ilse of PermitP/P,CU, etc. � 4 (� . .� � ,. -�+
Dwelling,' Site P , etc 976y ��(f�f Vhf 4 Q V 4
Signature of Applicant
Data
CATEGORY: REV CODE _ , E-- - CATEGORY: REV CODE FEE
SUBSURFACE DISPOSAL 1238 , $ 57.00 ❑ SITE EVALUATION UPON REQUEST 7349 $ 43.00 '
CD ❑ MULTIPLE PARCELS WITHIN SAME. (NO PLOT'PLAN)
LAND DIVISION ❑ SEWER/SEPTIC VERIFICATION 7348 $ 17.00
Z a 1 at 4 Parcels (Each) 1238 $ 57.00 (Less than 1 year)
O
b., Each Percel after 4 7344 $ 24.00 ❑ PRELIMINARY ELECTIVE 7352 $ 23.00
W 0 Rereview (2nd review same parcel) 7344 • $ 24.00 EVALUATION (Attach DOH SAN 53)
U)'• 0 Site Evaluation in Conjunction with ❑ HOLDING TANK 7351 $. 47.00
Critical Area = 7348 $111.00 ❑ ALTERNATIVE/EXPERIMENTAL 7345 $222.00
• ❑ Site Evaluation Lot Less than SYSTEM
10,000 Sq. Ft. 7347 $ 87.00
ITIAL
oJTE 9�
Holding Tank Agreements Completed ❑ Yes OytJ
Certification of Existing S.D. System Required ❑ Yes
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 ��No;
Detailed Contour Pk)t Plans Required (1 to 5 It. interval) ❑ Yes O'N�
DOW ❑Yes
Staff Specialist Lot Inspection Required ❑ Yee t�'No
_ Lot Inspection Date
Solis boring report by Project g --
U Soils,- Map. Page f /el Sol Type 77c Approved by &1� Date
No. of Systems T of Systems) No. Dwelling UnRs /) (1) Septic Tank Soil Rate t3rease/Sand
0. �Pf�irig Tank ❑❑ ExWReplii wd _. .- Bedrooms, Fixtare�Mmitsa Grlean 1
3134x4,. 2A 947NMsf.
, VA
( Leach Line Sq. FL Sidewall allowance I Lines) It lom fl wide with Leach Bed sq. R
trench area K rock/ _
sq' ft• min. below drafnlines or area
per running It
7
Leachlines/bed special design for slope: (3) Pit Diameter No. Pits PR,Below Seepage PR Total Depth Other:
Applicable - . // Inlet481)a (TD) f�/)
N/A Overburden tactor �-� CDS (�i1 / Max. Allowable Depth
-1 0
No. 2'System f 1! 1
REMARKS: f �J
This application issAP R� OVEd ENIE for the category checked in SECTION B above, regarding the design of a subsurface disposal s
� on the accom � e� g g Po system as indicated
paned p t p n, using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the 4
Z above -designed system. No construction is permitted in the required reserved 100% expansion area.
0 (' Septic tank and sewer lines must be 50' minimum from any wells / Q T�.r QP�s
t-Leach lines must be 100' minimum. from any wells, including expansion res
� 3] Seepage pits must be 150' minimum fr
'''1;13
DAILY REPORT OF
GRADING CONTROL
e7 SOIL and TESTING
ENGINEERS INC.
JOB LOCATION
La C����►�
CLIENT OR OWNER
. Qv 14 C srr��n
REPORT SEQUENCE NO.
l
GENERAL LOCATION.OF FILL
50-790 N!% 0�vs
PURPOSE OF FILL OR NATURE OF STRUCTURE TO BE SUPPORTED
Hcv�
DATE
`/x-19'90
DAY OF WEEK
-ThP7 r>,
GENERAL CONTRACTOR
GRADING OR EARTHWORK CONTRACTOR
JOB ENGINEER
M3
HRS. CHARGED
210
CONTRACTOR'S SHIFT
CONTRACTOR'S SUPT. OR FORMAN
ASSISTANTS
HRS. CHARGED
SOURCE & DESCRIPTION OF FILL MATERIAL & MAXIMUM DENSITY & M/C
Soy I -T` zv- y'`/� op"(_
WEATHER
goat
I
110,0 �y.o
APPROXIMATE YARDAGE
PLACED THIS SHIFT TOTAL TO -DATE
TEST.
NO.
TEST LOCATION
ELEVATION
IN
FEETt
COMP.
CURVE
NO.
TEST
MOISTURE
%
TEST
DRY
DENSITY
LBS./CU. FT.
RELATIVE
COMP.
%
RETEST
NO.
NOTES
LOT
I
SOIi� r.Rs 1 S nDh OI �Iq D
/00,57
I
I I
(7l
Q^
�
I>
2
CevLter bec-'noti-
o� ��l-p
995
i
yD,a
p�,o
93
3
���s
I
iy, I
i DT -7
77
SUPPLEMENTARY REPORT (DESCRIBE EQUIPMENT USED FOR HAULING, SPREADING, WATERING, CONDITIONING & COMPACTING; ALSO REPORT THICKNESS OF LIFTS, AND
AND NUMBER OF ROLLER TRIPS.)
I(�Gln
-:PsiCGf ���1 Gt`. %7ct%iv- So��J oh
h'oLX / (Lp7--f2)
4 r -
• � �(e�a7oti
�� NG�k�c-e� 'i'p P,r,� T-'+' C�V6 �"Crr�' �
Sc,.�, o? �o�.
_rlon DICI.YG Le 700 •c�,
JOB N0. 903/02-0
COPY SENT TO CLIENT b CONTINUED ON NEXT PAGE 0
PAGE OF
1 D6 - R/RR
,4 �'''. OFFICE OF b
r AGRICULTURALiCOMMISSIONER s
AND',. c
WEIGHTS"& NIEAMURES
�,.� •. CALVIN C. KAMINSKAS
JAMES O. WALLACE 4080 LEMON STREET; RM OO197b4islon}Commt�stoner
Agrtculfural Commtestoner RIVERSIDE: CAUFORNIA'`'92501 { .'CLEMENT BENVENISTE
DUector of Welghts'd Measures (7:14) 787.2561 Seater
4.49613, Highway 86.,. Suite Bl`2
Coachella, Ca 92236
DAIE o2 - i = 9 CASE ivo C, 3
DEVELOPER'S NAMEQj. _, \ DQ j1`�,:1lP C qy �bt
ADDRESS: V.
TELEPHONE. -(C3y� �6Y-Or
Dear Developer.-
.After
eveloper:.After reviewing:your landscaping ;plans; :all plant material listed is not in
violation of quarantine laws governing':-the }Coachella�Valley, If substitutions
do occur and they differ from plant material listed, fhis office must be notified
isml-diately. y {
Thank you for.prote' ing an, presery ng the-Coachella valley'`s pest-free environment.
Y