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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