04554 (SFD)04554
P.O. BOX 1504
Building54"470 �luarez 78-105 CALLE ESTADO
AddresLA QUINTA, CALIFORNIA 92253
Owner
Western American Const
Mailing BUILDING:'TYPE CONST. OCC. GRP.
Address P. 0. BOX 1379 A.P. Number 774--174.012
City Zip Tel.
La Q Lnta $2253 5iI64--7431 Legal Description
Contractor'
G• ynolds Conga` Project Description • • +
Address
Cityl000 PalmsZip �227�i Tel. ,.34-1-2671.. . ....» r�.
&tate Lic. Cia sif. Lio # ,1� 14 a . , 1872 - .
�����7 - - Sq. Ft. - No. - No. Dw.
,
Size Stories Units
Arch., Engr.,
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lic. #
1LICENSED 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 F - DATE -
OWNER -BUILDER DECLARATION Estimated Valuation t� rtn y
I hereby affirm that I am exempt from the Contractor's License law for the following 9a � V 2 !
reason: (Sec. 7031.5,Buslness 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 PERMIT AMOUNT
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 Plan Chk. Dep. $250.00
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 Plan Chk. Bal.
do the work; and the structure is not intended or offered for sale. (Sec. 7044, Buisness and ++�� ty Q �f
ProfessiorisrCOr1S
Code: The Contractor's License Law does not apply to an owner of property who t. $ 30.50
buids'or',JMpioves thereon and who does such work himself or through his own employees, Mech.
.3 provided¢tAat;'such Improvements are not intended or offered for sale. If, however, the building
or,improvemenvis sold within one year of completion, the owner -builder will have the burden Electrical
• • of proving tnahhe did not build or improve for the purpose of sale.)
O'I, a's owner of the property, am exclusively contracting with licensed contractors to con- Plumbing
struct. thei 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 S.M.I.,
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ I am Grading
exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date owner Infrastructure 1*082.21
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
O Copy is filed with the city. O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE �v �t�k r7 t ]
(This section need not be completed if the permit is for one hundred dollars ($100) valuation`i[tr'i?51�¢! it�i.f.[rf �irir'l.ri'iai.?'`; ;ii io
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 of Exemption youshould become ZONE: BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked .fi
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 -INSPECTOR
This is a building permit when properly filled out, signed and validated, and is subject to� j
expiration if work thereunder is suspended for 180 days. 82098
8
1 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
CONSTRUCTION ESTIMATE NO. I ELECTRICAL FEES NO. I PLUMBING F,
IST FL SO FT rp S
UNITS
UNDERGROUND
A.C. UNIT
COLL. AREA
YARD SPKLR SYSTEM
2ND FL SO FT. M
BONDING
HEATING (ROUGH)
STORAGE TANK
MOBILEHOME SVC.
BAR SINK
FOR SO FT at
DUCT WORK
ROCK STORAGE
GAR SO. FT. Cl
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER APP.IEOUIP.
DRAINAGE PIPING
CARP. SO FT. a
TEMP. POLE
WALL SO FT. Q
GROUT
DRINKING FOUNTAIN
SERVICE
FINAL INSP.
URINAL
SO. FT. 4t
WATER SYSTEM
ESTIMATED CONSTRUCTION VALUATION S
=S
WATER PIPING
NOTE, Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
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 I IA c
SEWAGE DISPOSAL
SO.FT.GAR rg 3/.c
HOUSE SEWER
FINISH GRADING
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
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SMIC TA $
ROUGH 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
GRADING
cu. yd.
j -Plus-x$
=S
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
( V
C/•�I u Jl -l-
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
VG INSULATION/SOUNq/ . CO -
FINISH GRADING
&'F/INAL INSPECTION /^3
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL :d
a Order' Nb.
Escrow No. 10-4338
Loan No,
COMMONWEALTH LAND TITLE CO.
WHEN RECORDED MAIL TO:
WESTERN AMERICAN CONSTRUCTION CO.
P. 0. Box 1379
La Quinta, CA 92253
COPY
�
COPY of Document Recorded
on 1 198lis No.i
has not been compared'W�
original.
WILLIAM E, 1j)N.ERLY
County fte,,zrcer
RIVERSIDE COUNTY, CALIFORNIA
SPACE ABOVE THIS LINE FOR RECORDER'$ USE
MAIL TAX STATEMENTS TO;
DOCUMENTARY TRANSFER TAX $ ..9 :90 ...................................
1 SAME AS ABOVE X... Computed on the Consideration or value of -property conveyed; OR
! ...... Computed on the consideration or value less liens or.6ncumbrancea
remaining at time of sale.
Signature of Declerent or Agent determining tax.— Firm
I,11N''am•
GRANT DEED
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
DONALD A. TRESTIK and JOYCE F. TRESTIK, as Trustees of .the TRESTIK TRUST established
under the DONALD A. TRESTIK and JOYCE F. TRESTIK TRUST DECLARATION, June 24, 1985"and
as Community Property
hereby GRANT(S) to WESTERN AMERICAN CONSTRUCTION CO., a. California corporation. p�
the real property in the City of La Quinta
\ County of. Riverside State of California,: described as .:
�. Lot 16'1n Block 240 of SANTA CARMELITA AT VALE LA QUINTA, UNIT 230
as per map Recorded in Book 20, page 25 of Maps, in the office of
the County Recorder of, said County...
Dated November 16, 1987
1
STATE OF CALIFORNIA isa
COUNTY OF LOS �YAJ L F t_K ST )
On 4iOV61WAIP, �2Al ME
before me, the undersIgned, a Notary Public in and for said State, per.
sonallyappeared_-7)O/JR i D A l T1��ST 1 K
Or FICIAL. SEAL
10ANNA IAM7-z DANIELS
pereonally known to me (or proved to me on the basis of eati6factory
NOTARY PUBLIC - CALIFORNIA
evidence) to be the person(s) whose name(e) ie/are subscribed to the \+r 1`a� ' LOS ANGELES COUN'N
within instrument and acknowledged to me that he/she/they executed " ' i+ly comm. expires MAR 1, 1988
! the Game.
- WITNESS my hand and official seal.
(Yhis area for officiai notarial seal)
Signature, _•°��+ r.ai h"LC.'VL'
A..4 A 6i Tw v frw-rf • •. w- n-.-.---- -. .-..-....-
b _ _ �� *� r.:.3o;��� , �•- - .�,i -,s� .:..,�l.+r- *-s�''�•..= �'°s;-. Rs a.;�+ tF: �'.��' a •r
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9
COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH Assessors Parcel No.
ENVIRONMENTAL HEALTH SERVICES '77Y - 273 - o,! o I Z
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, Contac erson
Phone
Address 8 Phone
rOV
Owner
W ryft- cam, -z.*, -I-
Phone
--Aill
ailing Address
PO 13? 1 k0u,A4,cA. 9ZZS3
C'
tv
to
Zip
-7Z?:-,-3S
Job Property Address
Legal Description Prop. (PM, Tract, Lot)
"JI
y -7c, DtoZ
&.14 26Z. Loo a4viI uA,42y
Lot Size
Water Agency/Well
Use of Permit P/P, CU, etc.
Other
wellin H Site Prep, etc.
I
rr
li
Signature of Applicant
If Date
CATEGORY: REV CODE FEE
CATEGORY: REV CODE FEE
SUBSURFACE DISPOSAL 1238 $45.00
❑ 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
INITIAL DATE
Holding Tank Agreements Completed ❑ Yes No M dz
Certification of Existing S.D. System Required ❑ Yes I I No
WQCB Clearance required. (Attach Form ❑ Yes 11 No
DOH SAN 007, Santa Ana Region Only)
Soils Percolation Report Required. ❑ Yes I I No
Special Feasibility Boring Report Required. ❑ Yes No
Detailed Contour Plot Plans Required (1 to 5 ft. interval) ❑ Yes No
Other ❑ Yes No
Staff Specialist Lot Inspection Required ❑ Yes No
' Lot Inspection Date
Soils boring report by' Project Date
Soils Map Page Soil Type �v /
Approved by 17 /_ Date
,
No. of Systems
Type of System(s)Ilin
pda� g Units
(1) Septic Tank
Soil Rate
Grease/Sand
d ti e
❑ tpding Tank ❑ Existing
ew ❑ Replacement
edmoms, fixture Units
Grease Intcp
�'-
-Gal
(2) Leach Line Sq. Ft.
Sidewall allowance
Install Line(s) ft long ft wide with
Leach Bed sq. It.
Bottom trench area
fL rock/sq. ft
min. inches rock belo • nn mr�l' es or
of bottom aces
per running ft. /"
SNA
—
/.
Leachlines/bed special design for slope:
(3) Pit Diameter
No. Pits
Pit Below
Seepage Pit Total Depth
Other:
Applicable
NC
Inlet (eq
/ $
N/A Overburden factor
❑ 5
p
/ Z/
Max. Allowable Depth
,
No. 2 System
REMARKS: 2-m�f "f*� ��
f , %< y4C fti Iasi I/
This application is PPROV D{9Ei�IED 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
above -designed system. No construction is permitted in the required reserved 100% expansion area.
\L'1� Septic tank and sewer lines must be 50' minimum from any wells
(2) Leach lines must be 100' minimum from any wells, including expansion area
Q3� Seepage pits must be 150' minimum from any wells, including expansion area
Signature of Health Official.✓� �' < Date
— '�� q7 Issued By ��.5
RECEIPT NO: Date 2
DISTRICT: ❑ Riverside, ❑ Indio ❑ Hemet. O Perris ❑ Rancho Calif. 0'. Blythe
DOH SAN'122 (Rev 5/88)• , DISTRIBUTION WHITE Office file YELLOW -•Applicant PINK Bldg Dept. GOLDENROD - Plans/Records
OFFICE OF E. LEON SPAUGY
�Q AGRICULTURAL COMMISSIONER COMw5:10`Ea
J s LOAFS 0 WALLACE
C . F AN A55t5tANf fp?4MISSIWIEP.
t .� CLEMENT BENVEINISFE
"l�=� WEIGHTS & MEASURES -SEALER
�:. 49-613 Ilwy 86, Suite B-12
,.•'' Coachella, CA 92236
Mq r 9 gq� 619-342-8291
DATE s— CASE NO.
DEVELOPER'S NAME:(�Jt�`6xl*L{ �
ADDRESS:'
DDRESSa 2C
01 til TA
TEL,EPNONE:
Dear Developer:
After reviewing your landscaping plans, all plant material listed is not in
violation of quarantine laws governing the Coachella Valley. If substitutions
do occur and they differ fran plant material listed, this office must be notified
irat ediately.
Thank you for protecting and preserving the Coachella Valley's pest -free environment.
Agricultural Cannissioner's Office
cc: Indio and Riverside Office
�5- r- y7® A-vo. -JuAre-A z—