04754 (SFD)Building •53-405 Juarez
Address .
Owner, _r -t meq+ hq p
4
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Address ; ' 5"4(0 Crxs2iza
City Zip Tel...
L$-Qu'92253
Contractor
Address
W. -
State
State Lic. City
& Classif. Lic. # r
Arch., Engr.,
Designer
Address
V
City Zip State
Lic. #
LICENSED CONTRACTOR'S 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. _
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that l 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).
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 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
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 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 /: r+. r : i 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. O Certified copy is hereby furnished.
r .
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This s;ction need not,be completed if the permit Is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of lhp 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.
BUILDING: TYPE CONST. OCC. GRP.
04754
A.P. Number. - 774-034-020
,Legal Description
Project Description ✓*•
4 -
Side Street Setback from Center Line
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.)
Sq. Ft. 1522
Size
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
FINAL DATE
INSPECTORd
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.
v
I certify that I have read this application and state that the above Information Is correct.
Issued by:
Date Permit
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.
Estimated Valuation
$84t,,226
Signature of applicant Date
PERMIT
AMOUNT
Plan Chk. Dep.
$250.00
Plan Chk. Bal.
78.41
Const.
388.00
Mech.
36.00
Electrical
cg
Plumbing
105.00
S.M.I.
•5.92
Grading
20.00
Driveway Enc.
20.00
Infrastructure
►�3$
t
TOTAL
REMARKS
c VI,�:►i til 7:3 Y_X-',7�f^iic1 3J
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
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.)
Side Setback from Property Line
Lender's Name
Lender's Address
FINAL DATE
INSPECTORd
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.
v
I certify that I have read this application and state that the above Information Is correct.
Issued by:
Date Permit
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.
Validated by:
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE
* u
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1S7 FL 50 F7 (p S
UNITS
A.C. UNIT
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL SO FT. 8
BONDING
HEATING (ROUGH)
MOBILEHOME SVC
BAR SINK
POR SO FTCt
R OR SEPTI T �
(,LAOUGH WIRING
GAR SO. FT. O
POWER OUTLET
ROOF DRAINS
FOUND. REINF.
DRAINAGE PIPING
CARP. SO FT. Ct
HEATING (FINAL)
WALL SO FT. 0
REINF. STEEL
DRINKING FOUNTAIN
GAS (FINAL)
TEMP. POLE
URINAL
SO. FT. fd
GROUT
ESTIMATED CONSTRUCTION VALUATION S
WATER HEATER
WATER PIPING
NOTE, Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTOHDISHI
APPLIANCE DRYER
LUMBER GR.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
q
r
/ FRAMING " 3 I{
�V
LAUNDRYTRAY
AIR HANDLING UNIT CFM
I 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.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID g t V: c
SEWAGE DISPOSAL
SPARK ARRESTOR
SO.FT.GARsg 3/4c
HOUSE SEWER
GAR. FIREWALL
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 8 AIR COND. SOLAR
SETBACK
PLUMBIN
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
TGROUND
H PLUMB— 7
✓
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
R OR SEPTI T �
(,LAOUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
S
GRADING
cu. yd.
plus—x$—=$
LUMBER GR.
FINAL INSP,/2V_
q
r
/ FRAMING " 3 I{
�V
--[—
FINAL INSP.
I I
ROOFING
Q f f �^ f� /�/. Cil ���
/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
THING (1O4
MESH
I ULATIONISOUND�/�a/��
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESIINITIALS
GARDEN WALL FINAL
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
NOTME.�41yy5 r)OC OF 1-k A`
1�SeHQOL#,,FAC,ILITY , FEES kA
BE DUPLICATED.
�+ s�
j CW
TO: City of La Quinta DATE:
Department of Community Development
78-105 Calle Estado
La'Quinta, CA 92253
This is to certify that-
developer of which is a
located at within
this District, has paid school faci ity fees imposed pursuant to the
authon't� a er( d by Government god�ip tt53 80 'n the amou t Of�,�fj�
ni
c����11
covering a total of j are feet of ( ) res dential or
( ) industrial/commercial development and that building permits for
this footage in this development may now be issued by your jurisdiction.
TNtQT] i.�- 1�o70- p.e~
IQo(�1 I �I8 dab
,for DESERT S NDS UNIFIED SCHOOL DISTRICT
IG
White - Building Department • Yel v< - Facilities Planning • Pink - Accounting • Gold - Developer
(10)-37
,UIVIIVIUIVVVCHL in LMIVU 1 I I ww-
Order No.
Escrow No.
Loan No. zz�
':7 JK
� n' e ti
t m d
WHEN RECORDED MAIL TO:y
J :.;' t:l r— b
Mr. Carl Mueller ; .In ,<W A6 ef+
o
P. 0. Box 66 8 =g
La Quinta, CA 92253 �; a
Id
u_
SPACE ABOVE THIS LINE FOR RECORDER'S USE
MAIL TAX STATEMENTS TO:
DOCUMENTARY TRANSFER TAX$..8:25...................................
Same as above ......Smputed on the consideration or value of property conveyed; OR
...... Computed on the consideration or value less liens or encumbrances
remaining at time of sale.
Signature` ocTera or' o'owtdetenn Ing tax — Firm Name
GRANT DEED
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
ROSSER DONLEY, an unmarried man
hereby GRANT(S) to
CARL MUELLER, a single man
the real property in the City of la,
County of Riverside State of California, described as
LOT 8 of BLOCK 182 SANTA CARMELITA AT VALE LA QUITNA UNIT NO. 18
as per map recorded in Book 19, Page /d,an Maps, Records of Riverside County
California. **
Assessor's parcel number i -s— -4---U3-47--07U:: 9--.
**Excepting therefrom 1/16 of all coal, oil, gas and other mineral deposits contained in
said land, as reserved in the Patent from the State of California, recorded
July 26, 1934 in Book 182, Page 463 of Official Records of Riverside County, California.
Dated---jUne—r8, !QA7
I ROSSER DONLEY
m
Z
O
.I—
C)
FU
W'
m
W
Z
0
W
COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH Assessors Parcel No.
ENVIRONMENTAL HEALTH SERVICES
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 checklist.
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 & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG #
Agent, Contractor, Contact Person
Phone Address & Phone
'
Own r-
/ �
Phone Mailing Address
/
nY /
v r/I /,4
State
6 �
zip
2ZS
J b Property yA`d�ddr ass
l�c!�+vl�1A-�c/A2e��
Legal Description Prop. (PM, Tract, Lot)
��/��
k
Lot Size
ater A ency
Use of Permit P/P, CU, etc. CLQ UVB V7;#-
Other A( V4 CQ 14 QuIv*'
%cam
in Site Prep, etc.
g
Ygnature of Applicant
Date
CATEGORY: REV CODE FEE
CATEGORY: REV CODE FEE
IEISUBSURFACE DISPOSAL 1238 5Ap�
❑ SITE EVALUATION UPON REQUEST 7349 $42.00
❑ MULTIPLE PARCELS WITHIN SAME
(NO PLOT PLAN)
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
l ITI DATE
00
VP
Holding Tank Agreements Completed ❑ Yes?No
Certification of Existing S.D. System Required ❑ Yes
WQCB Clearance required. (Attach Form ❑ Yes
DOH SAN 007, Santa Ana Region Only)
Soils Percolation Report Required. ❑ Yes
Special Feasibility Boring Report Required. ❑ Yes
Detailed Contour Plot Plans Required (1 to 5 ft. interval) ❑ Yes
'Other ❑ Yes d
Staff Specialist Lot Inspection Required ❑ Yes No
Lot Inspection Date
Soils boring report by' ProjDate
—
Soils Map Page Soil Type %dc� Approved by Z/�
Date
No. of Systems
T of System(s)
No. Dwelling Units <��
(1) Septic Tank
Soil Rate
Grease/Sand
Holding Tank ❑ Existing
34New ❑Replacement
Bedrooms, Fjxtecedlnits,.
�,q,��
se Intcp
!�/U(�Gal
Gal-
�2) Leach Line Sq. Ft.
'go
Sidewall allowance
Install _ _% Line(s) ft long ft wide with
Leach Bed sq. ft.
om trench area
ft rock/sq. ft.
min. inchesn�rock=bel w drag inlines or
f bottom area
per running ft.
Q1,� PiA
Leachlines/bed special design for slope:
(3) Pit Diameter
No. Pits
Pit Below
Inlet
Seepagte P.it T tal Depth
��
Otic
Applicable
(BI)/
Max. Allo bj Depth
N/A L=2e &erburden factor
/ !!!
QQ
No. 2 System /A
REMARKS: L2�c--a��a. �_ . l/��/jG+23 'yt�_-t.�e•-e,r-.. .:,. _._
This application APg. OVED' ,:� for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated
on the accompanie pldt'pan, using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the
bove-designed system. No construction is permitted in the required reserved 10096 expansion area.
1) Septic tank and sewer lines must be 50' minimum from any well6-,/ Q it1lPLJ �G��r�.
Leach lines must be 100' minimum from any wells, including expansion reg
�
ansion area
3) Seepage pits must S0' minimum from any wells, includinGg210154
Signature of Health Official _
RECEIPT NO. '1� I? Issued By
DISTRICT: ❑ Riverside, Or Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe
DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept. GOLDENROD - Plans/Records
R.
UI 111,E of
A6111CUt_ (URAL. CUMMISSIO'ILlt
AND
W(:ICjj I S b.. MEASURES
49-blJ Ilt,y oGo Hulce ►I-12
CvttcIse I Itit CA 92236
619-342-U'l91
CASE 1u.
E. lEort SPnt7GY
CO'.t�n,;ur..tn
)n�iFS o v;ALtAt:F.
�SStStr�t r,��.t•atSSn)�t.n
CLUME-41 1ANVENISIE
SLAW
UEVEIAmil' S I W -W l
• >\UUItES5 �
0 M-
5 -3 -yd--
Dear Ueveloperi
Alter reviewing your lanciscell)i.itc1 plans, ttll plant n3terial lis
,ted
violatlon of yuaralltine laws tjove�niny the Co7cl�ella Valley.
do occur mid, they differ [rt_nt plant nv.iLerial listed tills office nlUst be nvtiEied
bm>edlately .
Thauik you Lor prvtectiliy and pteserviny the Coachella Valley's ,est --free enviroment.
s
Patura Camtissl i er I s ul [ice
cci lndlo Haid Riverside Mice
Buena Engineers, Inc.
i 79-811 Country Club Drive, Suite 4
k Bermuda Dunes, CA 92201 • (619) 345-1588 / 328-9131
Client
Client Address
Client Phone
DATE
1219I'),cs
TEST LOCATION
. v 4
JOB NO.
6 -filo iz_p �
PROJECT
53 - C_(v�5'
0��
LOCATION
L1 t
CONTRACTOR
MOISTURE
CONTENT
%
OWNER
WEATHERTEMP.
rl C Gi ✓
MAXIMUM
DRY
DENSITY
lbs./cu. ft.
o at AM
r _ Q -at .. ;; .. PM
PRESENT AT SITE
�_b
l o(_7
10S,
TEST
NUMBER
TEST LOCATION
. v 4
LOT ,
NO.
ELEVATION
FIELD TESTING
REFERENCE CURVE
MOISTURE
CONTENT
%
DRY
DENSITY
IbsJCu. ft.
MAXIMUM
DRY
DENSITY
%
MAXIMUM
DRY
DENSITY
lbs./cu. ft.
OPTIMUM
MOISTURE
CONTENT
%
I
�_b
l o(_7
10S,
�k
-.:tzY'»',=+
!�?(,K : r-`r:'i�''SC.Si'°+;:.:"3M.A.i 'A•.".f.C{9." 7`f Y-.... .,�.=}s?4.�„1c.;±.�t�t�,'�'.::.\'A
.,.:X?7�
'�' .a:'tt�'.
0.i_,•.
'^•` '. }.
;v,
...y.,
w
f
REMARKS ���'� --� q•%
�L) t i.'vuC'.x o F 4_ke q%ro Id,'e? hs+s
ai (,,J Je #" 7 1L.11 r CCUOUS
Croy Sy,t• �� ``
�'y 5 3 v a c o�•-i
FIELD REPORT
r h A. 1� ,
CLIENT REPRESENTATIVE SIGNATURE TECHNICIANS SIGNATURE
354