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9802-124 (SFD)41 - N_ LLI �dU-) 'w� o Z r- ZO O11 r� 0 (D LLJ W U) Z t LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of 4Chapter 9 (commencing with Section 7000) of Division 3 of the Business and 'Professionals Code, and my License is in full force and effect. ' License # Lic. Class Exp. Date 693241 8/31NO ©ate i}�7`��'f Signature of Contractor.' ontractor f� -f • i� Vii/ - OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ( ) .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, Business & Professionals Code).. ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). ( ) I am exempt under Section B&P.C. for this reason Date Signature of Owner WORKER'S COMPENSATION DECLARATION I hereby affirm. under penalty of perjury one of the following declarations: ( ) I have and will maintain,a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ( ) I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier & policy no. are: Carrier Policy No. � .1 r 1 E�inti) ,!G7��-97 (This section need not be completed if the permit valuation is for $100.00 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, and agree that if I should become subject ,to the workers' compensation,provisions of Section. 3700 of the Labor C,odre, I shall- forthwith comply with those provisions) / „Date: i,t 0 Z APPlicant--n--4 -d f l✓ E % P� �,} Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for, inspection purposes. 1 1 { any Sl�ture (Owner/A ent)'"'' �f 14Y_ Date 1l91 ` PERMIT # CONTROL # BUILDING PERMIT 9807-124 DATE / VALUATION $214t74N " LOT 14 * TRACT Q A o (� i t^l7/q a JOB SITE ADDRESS t 49-265 AV-1711NI M r EL NI O APN 631-3411-01.3 OWNER CONTRACTOR/DESIGNER/ENGINEER #7;) N,IC 10LS0N E,1C".1ARD IC)ODSON CONaS"1'tU TION 7 tl1ERIULL DR P.O. BOX 1.71 1-IAAI}'"1`f N Nib 0394`? LA QUIN'1`A CA 9225: (760)564-7240 CEILH 31173 USE OF PERMIT S"gNGLE FAi►IRX MWEi.L NG' CUSTi~ XI CONSTRUCMUN 2.475.00 :;i< P0.1101N:'AT O 480.00 $i' (a AR AjUFJC:: AFt"1K)WJ' 794 0) Sl: lrlj l.tl.Itil'►10:. ev. \.'1,I.38 l/k�i'�rv.i�. ii�eti. A�.i6Ai4 Z14,743,9P7 . 1"CR IT FEU, SI.TMi1'btt#RY CON6'1'RUC, .10N FIT 101-000-418-000 $1,042.00 PLAN (`f•1'l CK IT;f 1()1.•,,1t►fl-<119_3 (�{ �R6y,(1 J 11, lti,t•Rt}O..rJ3,��3it S3t1tt.()is NfECFdMICALHlf 101-0W-121�000 ►.?LI <C170C AL ME 101.4)00-42.0-000 5.182.51. Pi .4JMBI0.(9) S7'I.10140 Tv4OMN r17,' - RFS1.D 101,090-241-000 $V.47 ORAJANCI I' SE, 101-000-423-000 $29.114 Ii VR_AS'1"I tX;f'iiTWFE.E .22.8 -NO -443-3412 541688.22 A. "� 1�iSt3'i,tf; f'14AI tr`4 - it1 ?I (l t (li1:i ..5ti 1i(1{D 5286.87 ro I� } P , �`4 37gA1. CONtiMUCTION AND PLAN CHFiCK PRE-PAI'D FEES W 00 OCTLESS ®�199a ,j,�.. '1'� , ,�. ,. CA1, 4 E 4419 aT 3+ Elk,8 11LI to 1` 0W $6,839.59 LPI RECEIPT DATE BY 1l DATE FINALED INSPECTOR L INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms 8 Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath .a—f IF, Final Final POOLS - SPAS BLOCKWALL APPROVALS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines �� �2 Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans A O.K. for Finish Plaster ate a - 7Pool Cover Encapsulation Gaas PUp aping Gas Test — c Appliances Final COMMENTS: 00.40. f SCS AftACWe D ,$W"r ! Final Utility Notice (Gas) ELECTRICAL A PROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G. F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) Desert Sands Unified School District 47-950 Dune Palms Road Notice: La Quinta, CA 92,253 Document Cannot Be Duplicated 760-771-8515 CERTIFICATE OF COMPLIANCE Date 10/9/98 No. 17877 Jurisdiction Owner NameEd Nicholson No. 49-265 street Avenida El Nido City La Quinta Tract # Lot # 118 Type of Development Single Family Residence Comments APN # 631-341-013 La Quinta Permit # ' Log # zip 92253 Study Area Square Footage 2,475 No. of Units 1 At the present time, the Desert Sands Unified School 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 school fees at this time due to the following reason: EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Government Cgde 53080 in the amount of r 1.93 X 2,475 or S 4,776.75 the property listed aboveand that building., permits and/or Certificates of Occupancy for this square footage in this proposed project may nowe issued'r .ate v Name on the check By Dr. Doris Wilson Superintendent Fee collected /exempted by Signature %ami Juanita Green Payment Received $4,776.75 •Check No. 176884 NOTICE: Pursuant olAssembly Bill 3081 (CHAP 549, STATS. 1998) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified above will begin to ruh from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to collect them on the District('s)(s') behalf, whichever is earlier. Collector: Attach a copy of county or city plan check application form to district copy for all waivers. Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting 0 Commun.i..ty Azzoc.i.at-ion P. 0. Box 162 La Quinta Ca 92253 Telephone: 760/564-2177 FAX: 760/564-4882 April 22, 1998 Planning Department CITY OF LA QUINTA P. 0. Box 1504 La Quinta CA 92253 RE: PROPOSED CONSTRUCTION Lot 118/La Quinta Golf Estates Ladies and Gentlemen: Please be advised that the Architectural Committee of La Quinta Golf Estates has reviewed the plans for proposed construction of residence of- Mr. & Mrs. Eddy Nicholson, Lot #118 on Avenida El Nido. The Committee finds these plans confirm to all criteria as specified in the CC&Rs governing this Association. If you have any questions, please contact our office at the number listed above. Yours truly, J MORGAN U. WARD, JR. Chairman Architectural Committee TK/at C:\WS2OOO\DOCUMENT\GI\NICHOLSO.98 WIRE MESH LI v I.r1fj, A 475sQ. FT. � ;-794 k !Q `T r Vii(% ' INd Loi c- _,.ITr_ N�Tc w. METES $ 5ouND6,:YAF-P iA.:-�.::, GFAaf'N.;., pL.ANTIN ;,'9R. - i f 36 i I { •. V .y J. DATE R.M5to N5 FBUD F LA OUINT A BUILDING- & --SAFETY DEPARTMENT DITIONALLY OR CONSTRJCTION IN AS PER ANDA i t G Rt"( J `t COUNTY OF RIVERSIDE HEALTH SERVICES AGENCY DEPARTMENT OF EIIVIRONMENTAL HEALTH Food t/Sawage Disposal , Trailer Park (i2aOGal. Septic Tank 2 {9� Motel, Apt., Ho)el Sq. Ft of Leach e a � 2 f/Dwelling 3kdirw'. �—too. -Dia BIND_, MD Seepage Pit Commercial Building Connection o ewer Swimming Pool Connect to Existing S.S.D.S. bio on -sits regenerating water softening devices may be discharged into the individual sewage disposal sy:siijm herewith approved without clearance from the Water Quality Control Board. 'water supply serving this installation must be from an approved source _All sewage disposal installation must conform with requirements of curvnt Uniform Plumbing Code. e/ Any cutting, grading or filling in excess of two(2) feet will null0ly sewage disposal appm. val. Approval has been obtain.'ed from the Regional Water Quality Controi Board for tnsiallation ci the se- age disposal system. This is to certify that the Riverside County Environmental Health Services approves the subsurface sewage disposal plot plan to obtain building permit for installation, construction. �f DATE _ _ ( BY /L1 i J 49tf�w v��t� G-7' _ {��% �o :sq _ 2S�•2 /f. s �y�/i Septic tank and mwer fines must be 50 ft. from any welts, including expansion areas. DEPARTMENT OF PUBLIC HEAL lsar.h lines must be 100 ft. mMmrune and IS VALlOJOR ONE (SeepW is must be 150 ft. minimum frothFROi� DA °E OF APPROV any wells. t MAINTAIN joc% EXPANSION AREA. MIN.`�FROAAANYWELI , CAIN. 1o' FROM ANY LARGE TREE OR WATER MAIN— . c ('� i` n Nj-! ` .ry „rr. n i ,: v K'.:: �'imt+„ r�• y 'Kt�;'J1'c .,,3� t. ASSESSOR'S PARCEL NUMBER COUNTY OF RIVERSIDE HEALTH SERVICES AGENCY 163 J DEPARTMENT OF ENVIRONMENTAL HEALTH 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 specifications as indicated on the attached check list. A non-refundable filing fee is required when the application is submitted. Check must be made payable to the Couny,.of`RNgff ide.tp�prp �l sof this applica� tion shall remain valid for a period not to exceed one year from date of payment. 5135 $214.111 LMS # CHK $214- 011.` Agent, Contractor, Contact Person Address City State Zip Telephone .DALL441A CPM57R, W,'14k T030S Co9G>lfie�” (::�If 9O -U6 393 -ssoV Owner Address City State Zip Z Job Property Address '/1- 265- rt A//&O City tti- 44i1i T Zip 9 53 i t WLot Size Water Agency/Well Use of, Permit, P/P, SUP, PUP, etc. Legal Description J �•` des � La a�f� �dlF � 1 Dwelling, MH Site Prep., etc. 1/9, Signat ' D tnJ - i CHECK BOX IF REQUIRED If any box is checked, this application shall be considered rejected until ❑ Detailed Contour Plot Plans Required (1 to 5 foot interval) the information is provided and the fee paid. Resubmittals later than 90 days after date noted below may require repayment of fees. ❑ Staff Specialist Lot Inspection Required Co ❑ Holding Tank Agreements Completed Thomas Bros. Page Grid Z O ❑ Certification of Existing S.D. System Required' Gate Lot Inspection Completed: I`— 1' 1 P Initials Iq fir ~ W ❑ WQCB Clearance Required (Attach for DOH -SAN -007, Santa Ana Region Only) Remarks: �YQLra p ❑ Soils Percolation Report Required 2 s • �3t v' k Cl Maintenance Booklet Provided ❑ Special Feasibility Boring Report Required ❑ Final Inspection by Department of Environmental Health is required. ❑ Rereview Required • Initials Date Please call 24 hours PRIOR to inspection. C/42 / Soils Percolation Boring Report by E2 Q Lic/Project # Date /0 Soils Map Page Soil Type Approved By a1w r Date No of Systems T pe of Systems) Holding Tank Replacement New Addition No. Dwelling Units Bedrooms, Fixture Uni s fl-/ (1) Septic Tank �/ Soil Rate / �i2 �( ya�J Grease/Sand Grease Intcp/Lint Trap Existing � �YlP V� 7' L ©V Gal. Gal. / Sq. Ft. Total Linear Sidewall Allowance Leach Bed sq. ft. of Bottom Area Ft. Bottom Area ft. rock/ sq. ft. running ft. Install Line(s) ft. long ft. wide with Inlet Tested Depth ❑ NA min. inches rock below drainlines or U Proposed Bottom Tested Depth Z Leach lines/bed special design for slope: (3) Pit Diameter No. Pits Pit Below Inlet (BI) Seepage Pit Maximum Other: p Applicable 2S- r p fp ^ Total Depth 2g • Allowable Depth LUN/A Overburden Factor E]5' MIT TD Well Review Approved: Date: Well Drilling Permit # SIGNATURE Grading Plan Approved: Date: SIGNATURE Sewer Verification Approved: Date: Plan Check Only Approved/: ate• / j o REMARKS: DlcoxsfC – �' _ 4 V Stc obavt This application is PPROVED/ NIED for the category checked in SECTION B disposal �/��%Lia �FOR OFFICE USE ONLY 3 T above, regarding the esign o subsurface system as indicated on the forth in SECTION C A build- acompanied plot plan, using the requirements set above. 5 / S 2� Ing permit is necessary for the installation of the above -designed system. No con- struction is in the required reserved 100% expansion area. Revenue code Fee $ permitted 5 (1) eptic Tank must be 100' minimum from any wells. Check # l (2) Leach lines must be 100' minimum from any wells, including expansion area. Date initial r (3) Sewer lines must be 50' minimum from any wells. t�'Q,'1'. -fit yoo 9, o Z O 1 (4) Seepage pits must be 150' minimum from any wells, including expansion area. _ CA -1 .�# Li r% a cn i 0 n ulr k ..i!%.4 Mk rt MoUJ Sig re of Health Official O ���JJJ �ati rr�J99 • o �.1 -4. Dat r ' h r #P .tp, 9 tp W O is DEH -SAN -122 (Rev 9198) >; Distribution: WHITE—Office File; YELLOW—Applicant; PINK—Bltg aDt. QgLiWNROL—Plans/Records C3 C) 's7 0 -11 CARLOS ELIAS. REGISTERED CIVIL ENGINEER 38825 Charlesworth Drive Cathedral City, California 92234 Telephone (760) 328-7271 January 11, 1999 City of La Quinta Building & Safety Department 78495 Calle Tampico La Quinta,-Calif. 92253 Gentlemen: This letter concerns the residential structure being con- structed.at 49265 Avenida Nido, La Quinta,'California. I conducted- a framing inspection this morning and found, the construction to be in conformance. with the architectural plans. oQRpFESS/ pNq` Very truly yours, S C13E��9NFy2 CD 6/iD m No. 16839 '° Carlos Elias CF: j s FGF CAO TPSTATEhatd Surrepa 4 etvri sngtteem 78-035 Calle Estado, La Quinta, California 92253 (760)564-0271 (800)363-6306 FAX (760)564-0279 November 5, 1998 Mr. Marcus Fuller CITY OF LA QUINTA DEPARTMENT OF PUBLIC WORKS/ENGINEERING 78-495 Calle Tampico La Quinta, CA 92253 RE: Pad Certification Dear Mr. Fuller: This letter is to certify that a field survey was made of the exisitng pad at 49=2'65�VAvem.d EI-tNi_dot _ La Quinta, and that it is 12" above the centerline of street at the midpoint of the lot. R Sincerely, Neil C. McAnally L.S. 4820 i!eil C. McAnafty L.S.4820 J!' '' rA11F�� JN&R Eddy G. Nicholson FINANCIAL, INC. Chairman 7 Merrill Drive P.O. Box 5151 Hampton, New Hampshire 03842 (603) 929-4040 • (603) 929-0599 fax August 13, 1998 Mr. Mark Harold Department of Building & Safety City of La Quinta P.O. Box 1504 La Quinta, CA 92253 Dear Mark: This letter is to notify you that Ken Stemmer has been released as the contractor for construction on my property located at 49-2W Avenue El Nido (APN #631-341-0138), La Quinta, California. ` Z6— Should you have any questions, please contact Mike Kiner at (760) 773-3390. Sincerely, EGN/dsa cc: We Kiner