003411 (SFD)a 44 . .
V
P.O. BOX 1504 No. 003411
Building 78-105 CALLE ESTADO
Address — l J-11 otz LA QUINTA, CALIFORNIA 92253
Owner
BUILDING: TYPE CONST. OCC: GRP.
Mailing.
Address a ir' M-1-4 A.— 'Mr- _ A A P. Number77A-1 Q'A-0l at
City .� _ .. .... Zip,..,x.� W:...�..� ]TI51. W`= . _ -
PrA'j-m Snri.)F'Sf ifs 922F2 � '17 210- 10 2 11 Legal Description
Contractor P,,oject Description C3,s+� s. S!jft"4 11.x. r"4w-%1 1 d "xw
Address t _ fi3 t para
City Zip Tela
State Lic. City
& Classif. 387934 Lic. # $9s
Arch., Engr.,
Designer
Address Tel.
City Zip State
- Lic. #
LICENSED CONTRACTOR'S DECLARATION.
I hereby affirm that I am licensed under provisions•of Chapter 9 (commencing with Section
70 OO) of Division 3 of the Business and Professions'Code, and'my license is in full force and '
effect. e
_SIGNATURE DATE
/t I OWNER -BUILDER DECLARATION '
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 .
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.)
❑ I am' exempt under Sec. B. & P.C. for this reason
� Sq _Ft- 1,410 No.
New ❑ Add ❑
Estimated Valuation
LR _
PERMIT
Plan Chk. Dep.
Plan.Chk. Bal.
Const.
Mech.
Electrical"
Plumbing
S.M.L.
Grading
Driveway Enc.
Date Owner, Infrastructure
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 making this Certificate or Exemption you should become
subject lo' 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
Ihereby 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 if 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
HARD COPY
TOTAL
REMARKS
No. Dw.
Units
Demolition ❑
Alter ❑ . . Repair ❑
-AMOUNT
4 as x A
L:' A r' A
�w1w RA
2Q,. nn
20.00
1.121.12
-i•.WA 4h__1�C,
iii' i�ttafil !"-itTttfi: i !. c + r. r
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 29 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
2ND FL. SO. FT. ®
POR. SQ. FT. ®
GAR. SO. FT. ®
CAR P. SQ. FT.
WALL SQ. FT. ®
SO FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
6 '&57
LAUNDRYTRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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.
SQ. FT. @ c
BATH TUB
BOND BEAM
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1+/4 c
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FRAMING �g
FINAL INSP.
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 GRADE f 49
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS 24
SEWER ORS IC TA
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
6 '&57
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.,
$ plus x$
=$
LUMBER GR.
�j�,
FINAL INSP. ( __f n�
FRAMING �g
FINAL INSP.
ROOFING
C
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING ,
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
.FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS,
GARDEN WALL FINAL
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 NOTICE:
La Quinta, CA 92253
DATE:
4A
44
I Jaq
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THIS DOCUMENT CANNOT
BE DUPLICATED.
This is to ce_rtif that Uri 4 ,
developer of 01 T3), which is
located at j S - tI within
this District, has paid school facili y fees imposed pursuant to the
authority generated by Government :L�tion in t e ounto,,,f.
$ sa3 (
covering a total of 3 square feet of ( vire idential or
( ) industrial/commercial development and that building permits for
this footage in this development may now be issued by your jurisdiction.
for ESERT SANDS•UNI I D SCHOOL DISTRICT
17
White - Building Department • Yellow - Facilities Planning 0
Pink - Accounting 0 Gold - Developer
Y ,
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Mgr 9, E
Dear Developer/Landscaper:
OFFICE OF
AGRICULTURAL COMMISSIONER
4080 LEMON STREET, ROOM 19
RIVERSIDE. CALIFORNIA 92501
(714) 787.2561
49-613 Hwy 86, Suite B-12
Coachella, CA 92236
(619) 342-8291
0
E. LEON SPAUGY
COMMISSIONER
JAMES O. WALLACE
ASSISTANT COMMISSIONER
Thank you for inquiring with the Agricultural Commissioners Office regarding
local quarantine laws.
Any diseases or insects associated with the plants/landscaping material presented
on your landscaping plans do not pose a threat to the Coachella Valley Citrus,
Date, Grape, Vegetable, or Field Crop industry. We therefore approve your
landscaping plana.
If however, any substitutions of plants/landscaping materials within your plans
occurs between now and the actual planting date, you must contact this office
within 48 hours before delivery into the Coachella Valley. Also, the substituted
plants/landscaping material must be held for inspection upon arrival. Any sub-
stituted landscaping material found infected/infested with quarantine pests will
be immediately treated or shipped out of the Coachella Valley at the discretion
of the Agricultural Commissioner's Office.
Under penalty of perjury, I the undersigned will comply with the above.
Authorized Agent:
Permit Numbers
Developer .d�...�. (o , Address
AGRICULTURAL COMMISSIONER'S APPROVAL
Date—/0 - _2_57—
cc:
S=
Authority cited: Agricultural Code; Sections 6301, 6461, 6462, 6464, 6501, 6521-
6524
cc: 2 Plan Check, Indio Office, Riverside Office
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RECEIPT NO. �? - Issued by_ -,><r Dated % UPS
District: E)Riverside `®I d ElHemet ElPerris ElRancho Calif.v 11Blythe / "'� d.
Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File
DOH -SAN -122 (Rev. 6/86) it
i�
I n'
COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION pp
PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM 171 i4'
Applicant: Submit this form with four copies of a scaled plot plan (1-20 scale) drawn to County specifications required on the attached check list.
A non-refundable filing fee of Vis required when the application is submitted. Check must be made payable to the County of Riverside.
Building Department ApplicationSLog #
Name (Owner, Agent, Contractor, Etc.)
Mailing Address
•� �.•+
l',.l-j4GAC LA PIAL C LaIIID b � 5
.. ,r.:
01411 i /. II G �'� 1 f+
City ,
State
Zip Code
Telephone
Job Property Address
I�C/G nI iafl
City o Community-
Legal Description of Property. (Lot, PM, TR)„#EiY Cs s
fy
Assessor's Parcel No.
/Nlatelgejn��vy�or;WellT
iq- /j�/„_� !,r l ,/
Use of Permii<G<!'ClC3r tid+�P� .t 7iT,PlBAing Case #
Lot Size
i
7-74 -193 - yr 9
! / VA5 i, /� �((A
f/
SFD, MH Site Preparation Etc. 450r/0;4,
�
Signature of Applrcant Date -�' +. �.6, � •
'The above information must be verified from Building Application
STAFF USE — DO NOT WRITE BELOW THIS LINE
Initial Date
Certification of Existing S.D.'System required. El Yes No 7
�® r Atf ^
WQCB Clearance ❑
required. Yes p000.o/
NDee'j
Soils feasibility report required. f ❑ Yes ❑
Detailed boring report required. ❑ Yes ,Lf o
Detailed contour plot plans required. ❑ Yes �o'
Staff Specialist approval required. El Yes �J No Lot Insp toce ni Date
Soils/boring report by q 2 Project # Date
Soils Map Pag� f Soil Type f / Approved by
'
Type of System: V
No. of Bedrooms
(1) Septic Tank
Soil Rate Required
❑ Existing ®N ❑ ❑
ew Additional Replacement
t+ i
Gals.�p�sZ�
(2) Leach line sq. ft.
(Bottom ttrenc
Sidewall allowance
ft.
Install Lines) Ft. Long, �'`Lead
P
h' bed Sq.
area)
rock/ Sq. Ft.
running ft. ❑-NrA--~
Ft. wl e'Iwit min. inches
below
Ft. ofTbottom
per
rock drain lines
area
Leach lines/bed-special design for slope:
Applicable ..'r”`
(3) Pit Diameter
.off
No. Pits
Pit BI
i
Seepage Pit total depth% r
/
N/A 6'°°rOverburden factor
Max. allowable depth
IV
q �
This applicationsapp'" ovecl denied for the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements
set forth in Section B above. A building permit is necessary for the installation of the above -designed system.
1) Septic tank and sewer lines must bef50' from any wells*/ /d 766211 A "% J^
any
(2 Leach lines must be 100' min. from wells including expansion area 4•t/�-
(3)) Seepage pits must be 1,50' min. from any wellslincluding expansion area,f f, '' ✓ of . I'y^tt .e .
/4 9—,-,2,v -,;f"-2
Signature of Health Official Date
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RECEIPT NO. �? - Issued by_ -,><r Dated % UPS
District: E)Riverside `®I d ElHemet ElPerris ElRancho Calif.v 11Blythe / "'� d.
Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File
DOH -SAN -122 (Rev. 6/86) it
i�
I n'