08215 (SFD)Building
Address ss 52-420 t*z
Addr
4
P.O. BOX 1504NO. 0$,215
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Mailing
Address -1 5 T Ija
ctlin A13
City " Ip —' Tel.
J
�,_..� ,........ rA+3+jtA 344-1361
ress
Zip ITel.
State Lic. '• City
& Classif::.. 24U23 Lic. #
Arch., Engr:, _
Designer
Address Tel.
City Zip State
Lid #
LICENSED CONTRACfOR'S DECLARATION -
I hereby.affirm that I am licensed under pro�,isionss o(Chapter 9 (commencing with Section
000) of Di`vis'on 3 of the Business and Prtes$fons'Code, and my license is in full force and
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
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 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,.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. If, however, the building
orimprovement 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 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.)
- ❑ 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, ora certified co�thef of. (Sec. 3800, Labor Code.
Policy No. Company C
O Copy is filed with the city. ❑ Cert�i opy ttQr� yfurn( h
CERTIFICAf/EE OF EXEMPTIO FRO
WORKERS' COMPENSATION INSUR NCE
(This section need not be completed if the pem,.t is for on hundred dollars ($100) valuation
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.
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 properly filled out, signed and validated, and is subject to
expiration it 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
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number 773-2AJ;-010
Legal Description
Project Description Single FaMlY MmIling
REMARKS
ZONE:
BY:
Minimum Setback
Distances:
Front Setback from Center Line
Sq. Ft. QNo.
Size
No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑
Demolition ❑
Side Setback from Property Line
FINAL DATE
INSPECTOR
Issued by:
Date 713119n Permit
Validated by:
Validation:
Estimated Valuation
x,691
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
229.91
Const.
0
Mech.
62,00
Electrical
17-1 .711
Plumbing
50
S.M.I.
Grading
Driveway Enc.
Infrastructure
1777.30
TOTAL+d!'
REMARKS
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 713119n Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
SLAB GRADE 7 30
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
FOR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SQ. FT.
OTHER APPJEQUIP.
DRINKING FOUNTAIN.
SQ FT ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FRAMING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/. c
SEWAGE DISPOSAL
/��
LATHING
SQ.FT.GAR @ Vic
HOUSE SEWER
MESH
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK J 3� 9
9 oaIj�e 1MBING/vU
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 7 30
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
WATER SYSTEM
FINAL INSP/
GRADING
cu. yd.
$ -Plus-X$-=$
LUMBER GR.
FRAMING
FINAL INSP.
,�O
ROOFING/% !J /rte Al
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
/��
LATHING
MESH
INSULATIONISOUND O
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 7/13/90 1 Type of Permit I La Quinta
No. 10030 Permit #
Owner Name James G. Sattley Log #
No. 52-420 street Juarez
city La Quinta zip 92253 study Area 112
APN # I Tract # 1 Lot # Square Footage 11440
Type of Development Single Family Residence No. of units
Comments
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 Code 53080
in the amount of 1.58 X 1440 or $ 2,27520 have been paid to D.S.0 S.D. for
the property listed above and that building permits and/or Certificates of Occupancy for
this square footage in this proposed project may now be issued
Fees Paid By James G. Sattley, Inc. Telephone
Name on the check
By John D. Brooks
-a`:
Associate Superintendent, Business Services
'`.
Fee collected /exempted by Shelley D. Bennett
Signature
,� , • �,, r
No. 13
C'1'eZk
Collector: Attach a copy of County or City plan check application
form to is listricE`.ccpy.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
r
VK/ iK/ / f
RECEIPT NO. Issued By�-/ Date
DISTRICT: ❑ Riverside, W- Indio ❑ Hemet OPerris ❑ Rancho Calif. O Blythe /
DOH -SAN -122 (Rev.' 3rgo) _ :DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD • Plans/Reoords
rr
COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH A29689xsPn°'I NM
1-77ra5i
ENVIRONMENTAL SERVICES DIVISION —oto
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 speculations as Indicated on the attached check IIsL
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.
Q
/
VERIFY ITEMS IN SECTION A FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION ` 1'fiow
LOG #
ZAgent.
�
Contractor, Contact Person
Phone
Address &Firm
°� A eh< G S� rT
PhoneCO
�. (
C 6.4�6rc_ 1 A
City
Stat4
Zip
Job Projrty Address
legal Description Prop. (PM, Tract, lot)
U4ILI.C.
Lot Size
Water Agency/Well
Use of Permit P/P, CU, etc.
Other
�'-.,� X � fy •
icY-1 c- t +`fiY.K4
iw �6ofjf 7vrax,
Dwelling MH She Prep, etc.
Signature of Applicant
Data
CATEGORY: REV CODE FEE,
CATEGORY: REV CODE FEE
SUBSURFACE DISPOSAL 1238 $ 57.00
O SITE EVALUATION UPON REQUEST 7349 $ 43.00
Co
❑ MULTIPLE PARCELS WITHIN SAME
(NO PLOT PLAN)
LAND DMSIQN
❑ SEWER/SEPTIC VERIFICATION 7348 $ 17.00
ZO
a. 1 at 4 Parcels (Each) _ 1238 $ 57.00
(Less the i -1 year) -
b. Each Perbel after 4 7344 $ 24.00
❑ PRELIMINARY ELECTIVE 7352 $ 23.00
W
❑ Rereview (2nd review same parcel) 7344 $ 24.00
EVALUATION (Attach DOH SAN 53)
❑ Site Evaluation in Conjunction with
❑ HOLDING TANK 7351 $ 47.00
Crftk:al Area 7348 $111.00
❑ ALTERNATIVE/EXPERIMENTAL - 7345 $222.00
❑ Site Evaluation Lot Leas than
SYSTEM
10,000 Sq. Ft. 7347 $ 87.00
INITIAL DATE
Holding Tank Agreements Completed ❑ Yes No Ile 1! 5 r ?
i
Certification of Existing S.D:"System Required ❑ Yes No
WOCB 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 Piot Plans Required (1 to 5 R interval) ❑ Yes No
r
Other ❑ Yes No
Staff Specialist Lot Inspection Required ❑ Yes No
Lot Inspection Dale
Soils boring report by { ' �� project ie Data
}'f
Soils Map Page '/ , Sol Type Approved b 1/Q Date
U
No. of Systema
Type of Systems)
Tank
Dwelling Unita
Bedrooms xture Unita
(1) Septic Tank
Soil Rate
Graeae//h�aanndd
G
i
O❑ RExreti
New
ntcp
Wy, ate ,«
4000��
Gel
�
(2)1 Line q. Ft
Sidewall allowance
Install Line(s� �_ R long with
leach Bed aagA
r
t it rocW sq. ft
min. �/rodk below dralnl'
of t�oltprt area
per running
/
.fJ NA
r
Leachlinee/bed special design for slope:'
Applicable
(3) Pit Diameter
No. Pits
Ph Below
Inlet (BI)
Seepage Pit Total Depth
(TD) L5!
Other:
Max. Allowable Depth
V
O 5 43 6
!
i
N/A O.Wrden f or
rt J
No. 2 System --
REMARKS: 1A34 <-Ynk T �F _oO / >� Ir�.T9ir� P a � t�p v
n i Q S ! rl�v` ✓tli~k yr Cr C%
I//`� n4 l/.' r
/
pit%IA f6&, irlCJl9r 7`F3�iCP 7t7 eta d P /%�v
F
0
This application isPPROVED ENIED for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated
on • the accompanied plot plan, using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the
Z
vabove-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
(2� tach lines must be 100' minimum from any wells, including,expansion area
U.
1 . Seepage pits must be 150' .minimum from any welts, including expansion area
CD
Si ynatu -a of. Heahh Official
r
VK/ iK/ / f
RECEIPT NO. Issued By�-/ Date
DISTRICT: ❑ Riverside, W- Indio ❑ Hemet OPerris ❑ Rancho Calif. O Blythe /
DOH -SAN -122 (Rev.' 3rgo) _ :DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD • Plans/Reoords
rr
DAVID C. BREIHOLZ AND COMPANY, INC.
Engineering
Design
Construction .
1852 Lomita Boulevard
Lomita, California 90717
213 530 3050
FAX: 213 530 0184
August 3, 1993
Mr. Paulden Evans, ISID
• • DESIGN CENTER, INC.
1525 3rd Street, Suite F
Riverside, CA 92507
rA`n: 9v9-70'0'-4322 -
RE: Evans Single Family Residence
Q2420 Avenida Juarez
La Quinta, CA 92253
Project #93-053E
Dear Mr. Evans,
To follow up our telephone conversations and your recent FAX, your standard
plan details No. 1 and No. 7 are not applicable with the concrete bearing wall
alternate you used for the above reference residence.
The poured -in-place exterior concrete bearing walls support all vertical and
lateral loads from the clear -span trusses such that the interior steel studs are not
required to resist any loads beyond nominal partition loading.
I appreciate the opportunity to be of service. Should you have any questions
please call me.
Very truly yours,
J
David C. Breiholz, P
President
DCB/jks:93-053E
Civil Engineering Seismic Hazard Reduction
Structural Design Plan Check Service
Q�pFESS/0N
o G�
WNo.17428 A m
Exp. ofune 30, 1997 ZID
cf' CFVR.- �P
glFOFCNU
Construction Supervision
Inspection Service