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06434 (SFD)4 P.O. BOX 1504 Building78-105 CALLE ESTADO Address 51--3, Juarez LA QUINTA, CALIFORNIA 92253 Owner maning Address 'City Zip Tel.-. 1 Contractor City Zip State Lic. # I . i LICENSED CONTRACTORS 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. r SIGNATURE DATE F OWNER -BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Busimess and Professions Code: Any city or county which requires a permit to construct, after, krprove, 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 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 civilpenally of not more than five hundred dollars ($500). O 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 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. If, 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.) ❑ I, as owner of the properly, 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.) ❑ 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 ($100) valuation or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT' If, after mafvmg this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when property filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certity that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above-. mentioned property for inspection purposes. Signature of applicant Date Mailing Address t City, State, Zip' No. BUILDING: -TYPE CONST. r OCC: GRP. A.P. Number 773-042-008 06434 Legal Description Project Description S1FD Lot Line Adjust 112 Wraistructliure Feer. Sq. Ft. 2550 No. No. Dw. SizeStories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Block wall included Pool NOT included Estimated Valuation PERMIT City Zip Tel:*-. State Lic. & Classif. 3$�$�1 City Lic. # Arch., Engr., Designer Address Tel. City Zip State Lic. # I . i LICENSED CONTRACTORS 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. r SIGNATURE DATE F OWNER -BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Busimess and Professions Code: Any city or county which requires a permit to construct, after, krprove, 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 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 civilpenally of not more than five hundred dollars ($500). O 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 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. If, 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.) ❑ I, as owner of the properly, 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.) ❑ 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' If, after mafvmg 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.) 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 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 Address t City, State, Zip' No. BUILDING: -TYPE CONST. r OCC: GRP. A.P. Number 773-042-008 06434 Legal Description Project Description S1FD Lot Line Adjust 112 Wraistructliure Feer. Sq. Ft. 2550 No. No. Dw. SizeStories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Block wall included Pool NOT included Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. $250.00 Plan Chk. Bal. $ 70.20 Const. 108..03 Mech. Electrical Plumbing S.M.I. .€13. Grading Driveway Enc. Infrastructure 2.1119.11 TOTAL 1 $2„547.94 1 ice! REMARKS ir tt((]]��ai.iA rte^` ¢�W.F 7y[,i6 A,t"'y r, ,c +s('] 9 i V•- i. t•'{�i{ � 1 lr�: Elm .R. �.. �� % i L 1 .1 y 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; I0/2/89 Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. @ $ UNITS r COLL. AREA SLAB GRADEf! �:� YARD SPKLR SYSTEM 2ND FL SO. FT. @ BONDING HEATING (ROUGH) MOBILEHOME SVC. BAR SINK POR. g0. FT. @ EPTIC TA K ROUGH WIRING GAR. SO. FT. @ I 1POWEROUTLET ROOF DRAINS FOUND. REINF. `t DRAINAGE PIPING CAR P. SO. FT. @ HEATING (FINAL) WALL SO. FT. @ REINF. STEEL DRINKING FOUNTAIN SO FT @ TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation WATER HEATER FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTOXDISH) APPLIANCE DRYER $ GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM FINAL INSP. I! /90 Th/ 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 @ 11/. c SEWAGE DISPOSAL SO.FT.GAR @ 3Lc HOUSE SEWER INSULATION/SOUND 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 PLUMBIN - UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADEf! �:� ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS EPTIC TA K ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. `t 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. �� T FRAMING / S 0 �j�� ��f��Yl� FINAL INSP. I! /90 Th/ ROOFING ! O� � �n' „ /� /�a7O /lj � I (ate 2 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL • , 1 i 4 4(4j 78-105 CALLE ESTADO — LA QUINTA, CALIFORNIA 92253 - (619) 564-2246 FAX (619) 564-5617 ` February 20, 1990 Mr. Raymond Baldhosky SUBJECT: SETBACK ADJUSTMENT 90-013: APN 773-042-006 AND THE SOUTH HALF OF 773-042-007 Dear Mr. Baldhosky: Your application for setback adjustments as shown on the attached Exhibit "A", is hereby approved. The City of La Quinta Planning and Zoning Regulations state the following: '9.188.080 Conditions for Setback Adjustment. No request for a Setback Adjustment shall be granted unless it is determined that the adjustment is consistent with i -the intent and purpose of_ this title; that there are - special circumstances applicable to the property, including such factors as size, shape, topography, location or surroundings that justify the approval of the adjustment of the setback requirement, and that the adjustment will not be detrimental to the health, safety and general welfare of the community or be detrimental to ! property in the vicinity of the parcel for which the ! adjustment is requested. i In the above case it was found that: 1. The SR Zone requires a rear five foot setback for ! swimming pools, spas, and related mechanical equipment. l y- I 2. The Applicant has requested a setback of three feet along the rear side of the property for the swimming pool and spa. 3. A setback reduction was also requested for the air conditions units and swimming pool and spa equipment. This Department has determined that a three foot setback would allow sufficient access space behind the mechanical structures in question. , i BJ/LTRGL.103' - 1 - MAILING ADDRESS - P.O. BOX 1504 LA QUINTA, CALIFORNIA 92253 4. The Applicant has also requested a setback reduction from I five feet to three feet between the house and the swimming pool. This is considered acceptable if the Applicant complies with the pool reinforcement building code requirements. 5. Neither the pool, spa or related equipment encroach into the five foot sideyard on either side. 6. The waterfall proposed is allowed to be located within the rear setback. 7. The rear side of this lot abuts open space and a wash. 8. This setback adjustment is therefore in compliance with the La Quinta Planning and Zoning Regulations. In particular, the adjustment to the rear setback will not be detrimental to property in the vicinity for which the adjustment is requested due to the presence of a wash to the rear of this property. Should you have any questions, please contact the undersigned. Very truly yours, JERRY HERMAN PLANNING & DEVELOPMENT DIRECTOR Glenda Lainis Assistant Planner GL: bja cc: Building Department File BJ/LTRGL.103 - 2 - Desert Sands Unified School District CERTIFICATION OF PAYMENT OF SCHOOL FACILITY FEES TO: City of La Quinta Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 NOTICE DATE:lei THIS a?C MEET CANNOT BE DUPLIWEDt This is t ertify that c7(J developer of a?� which is located at within this District, has paid school facility fees imposed pursuant to the authority generateq by Goverpment Code Sec�tioii3080 i the arnount of ' covering a total of square feet of ( ) re i n ial or ( ) industrial/commercial development and that building permits for this footage in this development may now be issued by your jurisdiction. co for DESERT SANDS UNIFIED SCHOOL DISTRICT <1 White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer (10)-37 RECORDING REQUESTED BY (-,-q AND WHEN RECORDED MAIL THIS DEED AND "LESS . .AWISE SHOMN SELDTr MAIL TAX STATEMENT TO: Nnma r Mr. & mrs. Raymond D. Baldhosky Street %ddren city State L J SPACE ABOVE THIS LINE FOR RECORDER'S USE GRANT DEED � LOT LINE ADJUSTMENT THE UNDERSIGNED GRANTOR(S) DECLARE(S) DOCUMENTARY TRANSFER TAX is $ None ❑ computed on full value of property conveyed, or ❑ computed on full value less value of liens or encumbrances remaining at time of sale. ❑ unincorporated area ❑ city of _ , AND FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, RAYMOND D. BALDHOSKY AND MARY LOUISE DAVIS, husband & wife as joint tenants, hereby GRANT(s) to RA)a40M D. BALDHOSKY AND MARY LOUISE DAVIS, husband & wife as joint tenants, �- the following described real property in the County of Riverside , State of California: Lot 8 and the -south half of lot 7 IN BLOCK 50, UNIT NO. 4 OF SANTA CARMELITA -AT VALE LA QUINrA, AS SHOWN BY MAP ON FILE IN BOOK 18, PAGE 62 OF MAPS, RECORDS OF RIVERSIDE COUNTY. Lot Lin Ad'us ant This deed reflects a Parcel �Ierg�r fro. 89-078 Quinta. Dated Q t,.c, u .N-1 1 \ Ci a STATE OF CALIFORNIA _. (ss. COUNTY OF ' -:'� ; � : �' z 9 On this day of 0 sAc—in the year -gR, before me, the undersigned, a Notary P` lic in and for said State, personally appeared rb c 'AN-%r'S �N -t)1 • c f �P_ "� 0 personally known to me la proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to this instrument, and acknowl. edged to me that he (she or they) executed it. Signature NOTARY PUBLIC IN AND F SAiD STATE as approved by the City of La n aOweoaraes� IRENE E: RING �,e. NOTARY PUBLIC • CALIFORN;A PRINCIPAL OFFICE IN RIVERSZE COUNTY ' My Cour, ;:ion Exp. Sept. 14. 1990 •�, mc�+eow..�—eco- (Tris area for official notarial ssal) T-=" WAIL TAX STATEMENTS AS DIRECTED AROVF MAIL TAX STATEMENTS TO Name F Street Return address above Address city a State 1 1 J TITLE ORDER M0. ESCROW N0. SPACE ABOVE THIS LINE FOR RECORDER'S USE GRANT DEED � LOT LINE ADJUSTMENT THE UNDERSIGNED GRANTOR(S) DECLARE(S) DOCUMENTARY TRANSFER TAX is $ None ❑ computed on full value of property conveyed, or ❑ computed on full value less value of liens or encumbrances remaining at time of sale. ❑ unincorporated area ❑ city of _ , AND FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, RAYMOND D. BALDHOSKY AND MARY LOUISE DAVIS, husband & wife as joint tenants, hereby GRANT(s) to RA)a40M D. BALDHOSKY AND MARY LOUISE DAVIS, husband & wife as joint tenants, �- the following described real property in the County of Riverside , State of California: Lot 8 and the -south half of lot 7 IN BLOCK 50, UNIT NO. 4 OF SANTA CARMELITA -AT VALE LA QUINrA, AS SHOWN BY MAP ON FILE IN BOOK 18, PAGE 62 OF MAPS, RECORDS OF RIVERSIDE COUNTY. Lot Lin Ad'us ant This deed reflects a Parcel �Ierg�r fro. 89-078 Quinta. Dated Q t,.c, u .N-1 1 \ Ci a STATE OF CALIFORNIA _. (ss. COUNTY OF ' -:'� ; � : �' z 9 On this day of 0 sAc—in the year -gR, before me, the undersigned, a Notary P` lic in and for said State, personally appeared rb c 'AN-%r'S �N -t)1 • c f �P_ "� 0 personally known to me la proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to this instrument, and acknowl. edged to me that he (she or they) executed it. Signature NOTARY PUBLIC IN AND F SAiD STATE as approved by the City of La n aOweoaraes� IRENE E: RING �,e. NOTARY PUBLIC • CALIFORN;A PRINCIPAL OFFICE IN RIVERSZE COUNTY ' My Cour, ;:ion Exp. Sept. 14. 1990 •�, mc�+eow..�—eco- (Tris area for official notarial ssal) T-=" WAIL TAX STATEMENTS AS DIRECTED AROVF ;,' r(� � �� r ��'t`M'i.{ l'r.S1r aZ;wx---C!�yt..� '�i;ni�..�... .. T.�' .. ..�+�..,i , '7r''fl l Y�!1", fy1H• ..-i _ R� tib ��'fy ; ,T. � 1 \1 � yv+ •1'•if :j�.'A''. L'.v ��, idtfi'� hI'4 `i"�}.-'Mt4 �• �''�+ l�h•+y" +'r" -M" 1�'`-r l Riverside. Approval of this application shall remain valid for a period not to exceed one year from date of approval. 1 Agent, Contractor, Contact Person Phone Address & Phone 84 / S1 �� - — wner ,1_y0,6A__1 /��1 ��eAgair Phone Mailing Address City State ev} Zip zz6v Job Property Address s-/-3ys"� q2�Z Legal Description Pro(P Tract, Lot) cor �� rp.'zW9� _�y2wr Lot Sizer ater Agen ell Use of Permit P/P, CU, etc. I-47Fw7iW774 here r�7 D C vu'f ) tc. Dwellin Site _PepXZ Date Signatureof Applicant CATEGORY: REV CODE FEE CATEGORY: REV CODE FEE 21- SUBSURFACE DISPOSAL 1238 i �,�`g7, � ❑ SITE EVALUATION UPON REQUEST 7349 $42.00 ❑ MULTIPLE PARCELS WITHIN SAME (NO PLOT PLAN) 1 LAND DIVISION ❑ SEWER/SEPTIC VERIFICATION 7348 $11.00 a. 1 st 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 $132.00 ❑ Site Evaluation Lot Less than SYSTEM 10,000 Sq. Ft. 7347 $86.00 41TI L/ DATE Holding Tank Agreements Completed ❑ Yes s No 1011rte— Certification of Existing S.D. System Required ❑ Yes + N WQCB Clearance required. (Attach Form ❑ Yes * No DOH SAN 007, Santa Ana Region Only) Soils Percolation Report Required. ❑ YesN Special Feasibility Boring Report Required. ❑ Yes N Detailed Contour Plot Plans Required (1 to 5 ft. interval) ❑ Yes Nom Other ❑ Yes C] No Staff Specialist Lot Inspection Required ❑ Yes 0 f Lot Inspection Date Soils boring report by Rr`b ectt /# Date �! Soils Map PageSoil Type Approved ' by J:� Date u No. of Systems T of System(s) Tank ❑ Existing P No. Dwelling Units/l Bedrooms, (1) Septic Tank Soil Rate Grease/Sand M� �Foo.l mg ew ❑ Replacement F�ixtur�iteas 3 Q(.l't�� Z�i94 Ar q.t / 7w/► 06GaI 3 G( I tcp r/ 0 Gal N%QLLeach Line Sq. Ft. Sidewall allowance Install, Lines) ft long ft wide with `i�in"�Ae Leach Bed sq. ft. m trench area It. rock/ sq. ft min. r k below drainlines or of bottetn�� per running ft. 10`1 A """^� Leachlines/bed special design for slope: (3) Pit Diameter No. Pits Pit Below Seepage Pit Total Depth er: Applicable V5 Inlet (BI) 1 Max. Allowable Depth N/A Overburden factor 09 ©� No. 2 System , REMARKS: %Rh` as pplication • AP ED or the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated (( o the accompain e p o plan, 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. 1) Septic tank and sewer lines must be 50' minimum from any well<G % rar.a' Leach lines must be 100' minimum from any wells, including expansion (3) Seepage pits must be 1 0' minim_ um frolm any well including expaannnssiio Signature of Health Official AqAe4 RECEIPT NO. �9�� Issued By Date— T DISTRICT: ❑ Riverside, ndio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept. GOLDENROD - Plans/Records r L 17--A S0