05587 (SFD)Building 49--240 EL NIDD
Address
Owner
4
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Bud & Lois Buettner
Mailingr r
Addres ` f ti �._ ,:� f ' �. 1'� L L .., _� •L .
City ti
Zip
Tel. r ;
�7
Const.
♦ • 50
Contractor
L.✓1`--r'
Address.7 t
,. Cityi �' m -
Zip
Te y/
State Lia{ C _
f & Classif. ``� y >» (
City
Lic. #
Arcn., tngr.,
Designer Noon Sund
Address Tel.
..P.O. Box 1575 619/564-'3363
City Zip State
La :Quints 92253 LiC-# 013625
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chaptei 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.! / ;l �s.,�,,�^^ j 1 , f
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,8usiness 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 Rte 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 civi penally of not more than rive hundred dollars (5500).
❑ 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. R, 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 PropeM who builds or improves thereon, and 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 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 i✓ ` ^
❑ Copy is filed with the city. O Certified copy is hereby fumished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be cor pleted ff 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
NOTICE TO APPLICANT: ft, 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 pemut shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
Ihereby 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
No.
UILDING: TYPE CONST. OCC. GRP.:
.P. Number 631--342-r006
egal Description Lot 326
roject Description SPID
05587
Sq. Ft. No. No. Dw.
Size 3037. Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation $237,964.06
PERMIT
AMOUNT
Plan Chk. Dep.
250.00
Plan Chk. Bal.
085. 101
Const.
♦ • 50
Mech.
102 • 50
Electrical
191.32
Plumbing
.1 •
S.M.I.
16 •
Grading
2U. U0
Driveway Enc.
ZU • QV
Infrastructure
♦ •
TOTAL
REMARKS
fig
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 3/31/89Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING F
1ST FL. SQ. FT. ® $
UNITS
COLL. AREA
SLAB GRADE S
OUGH PLUMB,
YARD SPKLR SYSTEM
2ND FL SQ. FT. @
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
DUCT WORK
ROCK STORAGE
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
DRAINAGE PIPING
CAR P. SQ. FT.
GAS (FINAL) �/ 'd(J ��% TEMP. POLE
WALL SQ. FT.
DRINKING FOUNTAIN.
WATER HEATER
SERVICE
URINAL
SO. FT. ®
BOND BEAM
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
$'
WATER PIPING
NOTE: Not to be used as property tax valuation
LUMBER GR.
FLOOR DRAIN
MECHANICAL FEES
/L�
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
KITCHEN SINK
ABSORPTION SYSTEM S.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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
INSULATION/SOUND
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FINISH GRADING
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
_4 -A---
SETBACK
A
SETBACK
GROUND PLU I G
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE S
OUGH PLUMB,
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
"EWER OR SEPTICaheA/
UGH WIRIN
00,.
DUCT WORK
ROCK STORAGE
FOUND. REINF.� T
AS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL) �/ 'd(J ��% TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
FINAL INSP.
$'
GRADING
-cu. yd.
plus x$
-$
LUMBER GR.
FRAMING
ROOFING
VENTILATION
/L�
�/���
(
Q�
C!�
_
\0
a
o �t
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH.
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES11NITIALS
GARDEN WALL FINAL
Building g _ O G�
ArlttrPcs tel'
•
ty/ 4 4 Qght&
P.O. BOX 1504 APPLICATION ONLY
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Owner�b
Mailing
Address
City I Zip ITel.
Contractor
State Lic.I City -
& Classif. Lic. #
Arch:, Engr., /O,0/4 8JN ,^
(�
Designer �
Address0, n _ v 1575 Tel. __ , I �
City
}/\ Zip State
/.l a! 11 Alr%� Lic.
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section
effect.. Division 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirin that 1 am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Busiress and Professions Code: Any city or county which requires a
permit to construct, ager, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rile 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 exe»pfion. Any tdolation of Section 7031.5 by any applicant for a permit
subjects the appficant t0 a c" 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 empkiyees,
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
o1 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, and who contracts for
such projects with a confracton(s) licensed pursuant to the Contractor's License Law.)
❑ 1 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 ($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: It. 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 shalt 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 property 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 taws 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 DIVISION
BUILDING: TYPE CONST. !/ OCC. GRP.
A.P. Number (� 3— 3 T Z `— 0 0
Legal Description .�� D . ! 2
Project Description `I , � 0 ,
Sq. Ft. -23 -7 No.
Size / Sto
No. Dw.
Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
vi Z3 7� t���✓
PERMIT
AMOUNT
Plan Chk. Dep.
5-0,0 p
Chk. Bal.
,30CoPlan
57,30—
nst.
Const.
Mech.
2 -
Electrical
Electrical
g /
Plumbing
Z3-7 , p d
S.M.I.
6-
Grading
Z-0. OO
Driveway Enc.
2.0 , ma
Infrastructure
2_0
TOTAL
REMARKS
O0SJA? 44 RQ1,)4
oz -,in -0c)
10 CASH 1 *TOTAL F 25W 00
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:
CONSTRUCTION ESTIMATE
GROUND PLUMBING
NO. ELECTRICAL FEES
NO.
PLUMBING,.7*
-7
UNITS
BONDING
HEATING (ROUGH)
STORAGE TANK
z 4
1ST FL. SQ. FT. ®
ROUGH WIRING
DUCT WORK
ROCK STORAGE
Z YARD SPKLtSYSTEN,�
GAS (ROUGH)
2ND FL. SQ. FT.
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
q
/ 3-2-0
GROUT
MOBILEHOME SVC.
SERVICE
FINAL INSP.
BAR SINK
—
POR. SQ FT ®
/
GRADING
cu. yd.
$ plus—x$—=$
LUMBER GR.
FINAL INSP.
GAR. SO. FT. ®/ 00
'!
POWER OUTLET'
ROOFING
ROOF DRAINS
46
REMARKS:
VENTILATION
DRAINAGE PIPING
CAR P. SO. FT. ®
FIREPLACE
WALL SQ. Ff. ®
SPARK ARRESTOR
-
GAR. FIREWALL
DRINKING FOUNTAIN
SQ. FT. ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
r
FINISH GRADING
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSPECTION
FLOOR DRAIN
MECHANICAL FEES
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
WATER SOFTENER
VENTSYSTEM FANS' EVAP.000L HOOD
3 Z
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
-�
AIR HANDLING UNIT CFM
KITCHEN SINK
C>�
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
2
COMPRESSOR 2 HP
3
POLE, TEMIPERM
LAVATORY
Z
HEATING SYSTEM Z FORCED GRAVITY
Z
AMPERES SERV ENT
-7 d
3
SHOWER
BOILER B.T.U.
SQ. FT. ®c
BATH TUB
SO. FT. ®c
2WATER
HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/. c
SEWAGE DISPOSAL
6f —
SQ.FT.GAR ® 3/ac
17
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
r
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECHHO
PL.CK.FEE
CONST. FEE
ELECT. FEE
SMI FEE
PLUMB. FEE
Ito 2.
�q I, 3st
2,31, °tv'
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 APP./EQUIP.
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
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
OF
SCHOOL FACILITY FEES
NOTICE; THIS DOCUMENT CANNC `
TO: City of LaWRiMPLICATED, DATE:
Department of Community Development
78-105 Calle Estado
La Quinta, CA 92253
CA
to
This is to certify that �Cs2
developer of which is
located at within
this District, has paid school facility fees imposed pidrsuant to the
au hor' y enera d by vernment ode S ct' 530 0 •n the amount qf/
$ i ( �j
covering a total of square feet o ( ) tesid.n.tial or
( ) industrial/commercial development and that building permits for
this footage in this development may now be issued by your jurisdiction.
Com. -0- b ��� f),
for DESERT SAN S•UNIFIED SCHOOL DISTRICT
White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer
-
(10)-37
�"�"`�`•� ya`,+r�-� � ...•' � L�`!'r� °�""� �' �t � �.Z, ,. i %t[.r, v. _,,�y� . -x ��y"'p�`..',5 "" "�lf-��r � ^,r . r `<r '��`„
v
Q
Z
0
W
V)
M
Z
O
H
U
W
V)
T
0
Z
O
H
U
W
to
COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH10� AssessorsParcelNo.
-3 2 — 006
ENVIRONMENTAL HEALTH SERVICES
PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM
Appkicant: 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 the application is 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 8 SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG*
Agent gCont ctor, Coptact Person
Phone
Address & Phone
:55
%� 1��✓2--
hone
ing Address
SIT / 07 LCA a t'Z
C
c ,�
/State
Zip
G
Job Property dress
`4
!lagel pescriptan Prop. (PM, Trect Lot)
7`�"
C.✓f'
/ ���
� 200 EL �Id Q
Lot Size
Water Agency/Well
Use of Permit P/P, CU, etc.
Other
t I
`� �° •"
160'
well$ , MH Site Prep, etc.
�I't7
S15
'bate
Sig re of Apt
CATEGORY: REV CODE FEE
CATEGORY: REV CODE FEE
a SUBSURFACE DISPOSAL 1238 $45.00
❑ SITE EVALUATION UPON REQUEST 7349 $42.00
❑ MULTIPLE PARCELS WITHIN SAME
(NO PLOT PLAN)
LAND DMSION
❑ 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
❑ Rereview (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
❑ Site Evaluation Lot Less than
SYSTEM
10,000 Sq. Ft. 7347 $86.00
INITIAL DATE
Holding Tank Agreements Completed ❑ Yes No
Certification of Existing S.D. System Required ❑ Yes No
WQCB Clearance required. (Attach Form ❑ Yes No
DOH SAN 007, 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 ft interval) ❑ Yes No
Otter ❑ Yes No
Staff Specialist Lot Inspection Required ❑ Yes No
Lot Inspection Date
Soils boring report by rCi �� Project Date
Soils Map Page - Soll Type S /1" Approved by Date
No. of Syslams
Type of System(s)
No__Dweliing Unita
(1) Septic Tank
Soil Rate
Grease/Sand
❑ Ho ding Tank ❑ Existing
�roome, xture Units
Iniap
N L
g�� ❑ Replacement
-3 M 4)':
�p C�0
/ q./"P/Grease
/' /
Gal
✓
Gal
(2) Leach Line Sq. Ft
'� Skiewall allowance
Install Llne(s) ft song R wide with
Leach Bed sq. ft
Bottom trench area
— It. rock/_ s4 fl
pef Nrml
min. inches rO . /M drahll'u>ae or
/
of bcpwr6ea
❑ .NA
kirk
leachlines/bed special design for slope:
(3) Pit Diameter
No. Pits
Pit Below
Seepage Pit Total Depth
Other.
Applicable 1-1
Inlet (BI)
if -3 '
Max. Allowable Depth
N/A rden factor
115 &-16
0 "`� k
4o'
No. 2 System
REMARKS:
This application is APP OVEN ENIED for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated
on the accomp�, using the requirements 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.
C( Septic tank and sewer lines must be 50' minimum from any wells
Leach lines must be 100' minimum from any wells, including expansion area
(3), Seepage pits must be minimum from any wells, includi expansion area
%1
�
J � v — f
Signature of Health Official �b'�� Date
RECEIPT NO. �_ 2 2 Issued By 'S'K Date P
DISTRICT: ❑ Riverside, t- radio ❑ Hemet q Perris ❑ Rancho Calif. ❑ Blythe
DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records
La Quinta Golf Estates
Community Association
P. O. Box 162
La Quinta, Ca 92233
619/564-2177
April 14, 1989
CITY OF LA QUINTA
Plannin Department
P. 0. Box 1504
La Quinta Ca 92253
RE: Architectural Committee Approval
New Construction - Lot #126
MR. & MRS. M. B. BUETTNER
Gentlemen:
The Architectural Committee of La Quinta Golf Estates Community Associ-
ation has reviewed the plans submitted for above referenced residence.
The Committee has approved these plans and the contractor, Tom Kennedy,
has signed the necessary Indemnity Agreement and has deposited with the
Association the required fees.
If you have any questions, please contact me.
Sincerely,
WILLIAM 0. THAGARD
Architectural Committee
WOT/at
cc: Mr. & Mrs. M. B. Buettner
Tom Kennedy Construction