003621 (SFD)r.
IOU
4
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 54-045 Juarez LA QUINTA, CALIFORNIA 92253
Western American Construction
Mailing
Address P. A. BOX 1379
City Zip Tel.
La Ouinta 92253 564-7411
Contractor
ress
City � Zip Tel.
1040 Palms 92276 343-2671
State Lic. City
& Classif. 469157 Lic. #
Arch., Engr.,
Designer
Address Tel.
City I
Zip _ I
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 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 (8500).
❑ 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 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. ❑ 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 (8100) 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 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
.Ir4 �
No. 003621.
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number 774 -*265-'016
Legal Description
Project Description Sinal,e Favai.ly Dweliina
/ V_;,
Sq. Ft. No. No. Dw.
Size - Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Pc#n1 } not a mart of this ve mit
Estimated Valuation
$101 7 r a
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal. Sf` 32.82
Const. St1 5b
Mech.
Electrical
Plumbing
S.M.I. 6�
Grading
Driveway Enc.
Infrastructure
TOTAL tzeat7rr
REMARKS
'1'r t rt.'r� � It'Ifii , �.t•.
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
2/16/8
Issued by: Date Permit
Validated by:
Validati
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FtESa
IST FL. SO. FT. ® $
ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO, FT, ®
CAR P. SO. FT.
WALL SO. FT. ®
Sp 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)
I WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
l
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
KITCHEN SINK
ABSORPTION SYSTEM. B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
ISHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
BOND BEAM
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR ® 3/ac
HOUSE SEWER
FINAL INSP.
ROOFING
VENTILATION
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 P M IN
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 3
�
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SE TIC/T
ROUGH WIRING
DUCT WORK
ROCKSTORAGE
FOUND. REINF.
l
(ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POL&7C�c3 �9
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP. /
FRAMING
FINAL INSP.
ROOFING
VENTILATION
A
v
l/•
REMARKS:
FIRE ZONE, ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING k/ y ��/
MESH
/z INSULATION/SOUNCL
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS,
GARDEN WALL FINAL
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
OF y�
SCHOOL FACILITY FEES, LA
NV-110EY 'TV -46 u 0UMENi CANNOT DATE-
Depa r e•n��mgrLy
�evelopment
78-10 Ca a Es ado
La Quinta, CA 92253
This is to certify that C*07JX -1
developer of which is
located at - aAP_A_ within
this District, has pai schoo facility fees imposed pursuan' to the
authority generated by Government C de Section 530 0 in the amo nt of
covering a total of square feet of ( ) r side tial or
( ) industrial/commer.cial development and that building permits for
this footage in this development may be issued by your jurisdiction.
for ESERT SANDS UNIFIED SCHOOL DISTRICT
White -Building Department • Yellow -Facilities Planning • Pink - Accounting • Gold - Developer
(10)-37
V)
Order No.
Escrow No. 10-4320
Loan No.
WHEN RECORDED MAIL TO:
ESTERN AMERICAN CONSTRUCTION CO.
5-656 Via Serena
Indian Wells, CA 92210
MAIL TAX STATEMENTS TO:
SAME AS ABOVE
ID
OFFICIAL SELL.
JANIS L GEIB
NOTARY PUBLIC - CALIFORNIA
•
PRINCIPAL OFFICE IN
LAKE COUNTY
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SPACE ABOVE THIS LINE FOR RECORDER'S USE
DOCUMENTARY TRANSFER TAX $.....37 :95_•,,,•..••
X... Computed 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 of Declarant or Agent determining tax — Firm Name
GRANT DEED
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, ROBERT W. MINTIE and ROSEMARIE S.
MINTIE, his wife, as Joint Tenants, as to an undivided one-third interest; JAMES LEWIS MINTIE
and ELIZABETH F. MINTIE, his wife, as Joint Tenants, as to an undivided one-third interest, and
KEVIN JAMES MINTIE, a single man, as to an undivided one-third interest
hereby GRANT(S) to
WESTERN AMERICAN CONSTRUCTION CO., a California corporation
the real property in the City of La Quinta
County of Riverside State of California, described as
r
PARCEL 1: Lot 4 and the Northerly 25 feet of Lot 5, Block 275 of
SANTA CARMELITA AT VALE LA QUINTA, UNIT 25, as per map recorded in
Book 19, pages 50 and 51 of Maps, in the office of the County Recorder
--- . -vf-said County;. ---
PARCEL 2: Lot 6 and the Southerly 25 feet of Lot 5, Block 275 of
SANTA CARMELITA AT VALE LA QUINTA, UNIT 25, as per map recorded in
Book 19, pages 50 and 51 of Maps, in the office of the County Recorder
of said County.
Dated October 30, 1987
STATE OF CALIFORNIA . I
COUNTY OF Lake Iss
I
nn November 11, 1987
before me, the undersigned, a Notary Public in and for said State, per-
sonally appeared JAMES LEWIS MINTIE
AND ELIZABETH F. MINTIE
r
Rej,qjQRq&KtfX�Tkkkproved to me on the basis of satisfactory
evidence) to be the person(s) whose name(s) is/are subscribed to the
within instrument and acknowledged to me that he/she hey ecuted
the sam
e.
WITNESS y hand and official seal.
W. MINTIE
••IE S MINTIE
Signature (This area for official notarial seal)
1002 (6/82)
MAIL TAX STATEMENTS AS DIRECTED ABOVE
OFFICIAL SELL.
JANIS L GEIB
NOTARY PUBLIC - CALIFORNIA
•
PRINCIPAL OFFICE IN
LAKE COUNTY
1M i aaunilld" E* krn 21.11110
Signature (This area for official notarial seal)
1002 (6/82)
MAIL TAX STATEMENTS AS DIRECTED ABOVE
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COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION
PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM 77Y —,z.261' G'/
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 $40 is required when the application is submitted. Check must be made payable to the, County of Riverside.
,}
/11.�7r Al ��Bk elw ZZVf% (.lC/'/O/t% �/ Building Department Application Log #
Name (Owner. Agent. Contractor. Etc.)
Madi'ng Address
P. 0 .' Raze / 3 7 -
City
49 r,� �
State
C�lk -
Zip Code
9,sUs3
Telephone
s'4V-7 Yll
'Job Property Address
.oc,Eorn�ugity,
fru,,
'Legal Description of Property. (Lot. PM. TR) ��++
l.c2
.6 R+
spys'.71- �:fa
'Assessor's Parcel NoWater
Agency o Wethk
;Q,
Use of Permit, /r�/i �XJ/Lt// AZPla4,A, Case a
Lot
^''/�7 ��j/-
-26 " 01x
� �
7 X n
•
J
'f
SFD. MH site Preparation Etc.
—_�-—�—�
V
Signature of Applicant 1,'�,A Date "
'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. ❑ Yes eLl Nom
WOCB Clearance required. ❑ Yeso/ f I
Soils feasibility report required. ElYes ��No"
.Special feasibility boring report required. ❑ Yes No"` I
Detailed contour plot plans required. ❑ Yes No,
Staff Specialist approval required. ❑ YesNo Lot Inspection Date
Soils/boring report by Project # Date
Soils Map Page ` ^1 Soil Typei C Approved by .!�, ✓��-- Date2 -.1-1 Pli
if
Type of System:
❑ Existing ® New ❑ Additional ❑ Replacement
No. of Bedrooms
40 R wia 3 -44711
46 '
(1) Septic Tank
00 Gals.
Soil Rate Required
(2) -Leach line sq. ft.
(Bottoh-.t ench area)
Sidewall allowance
ft. Sq. Ft.
k
Install Lines) Ft. Long,
tr 1
Leach bed Sq.
rock/
❑Mr?Y/A
Ft: wide l minmin. inches
�
Ft. of b�ottoMI
per running ft.
rock below drain lines
area
Leach lines/bed-special design for slope:
(3) Pit Diameter
No. Pits
Pit BI
Seepage Pit total depth
Applicable ---
N/A 4r!� Overburden factor
!'
/1
la?/
Max. allowable depth �U
e�„u7.�`` 'C�_..,e..�_ .. .. ./� . li�:.x.s-�.s.�....-__ ��•r:,r9'f ,d-•C.�rc.A .,--�.� �� .a�� .� ,a.,�f!�-
.r..�+i�.fy� �� .�' �y 1:��`cr..� ,.6jGG�..�i1✓a�...� A�,i _ rte- G'4f?•'t.J`s�O
�.� .dc%G' C / ,/•,�.:dr ,l//�iJJ�y� ' c:G:in. - ,G1cS,r+Y.� 4�rJ•7" y�/da�"�.//r=te ((Pf'��'re'
This apphcahon is a prover 7 ntetl or the ' estgn of a subsurface Id s�sal syst-ftem a/s ffidicate oEf n the aceorYipanie pro plan u�ngft equirements
seI forth in Section B above. A buildln g permit is necessary for }he"installation of thls'above-designed system.
(1 Septic tank and sewer lines must b�50' from any wells q /0.172
. Y1 n.•*, ;�. :f= , ,�g,,G%
Leach lines
(2) must be 100' min. from any wells including expanslro�m area
63 pits must be 1/5,0', min. from any wells including expansion area ft4
/Seepage
�`"r;'"���_..•,� /C Gtatd�-<-.,c. �lj.� ���t - $'�r i3 � Gt�.(-.�'� ���. "`✓�''�
'��. /v.l
f,r
.�
Signature of Hearth Olhaal' V�� ••�^ - f� /r/^�. ,� ...Date "7/ /� .
RECEIPT NO.Issued.-by Date
District: ❑ Riverside .2I d ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe
Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File
DOH SAN 122 (Rev 8187)
91
Of f ICE OF
AGRICULTURAL C0ti1MISSIONER
AND
WEIGHTS & MEASURES
49-613 Ilwy 86, Suite B-12
'Coachel.1a, CA 92236
619-342-8291
E. LEON SPAUGY
COMM15 10`•EA
JAMES 0 WALLACE
A5S:StA\f COM-7-115SWAP.
CLENIUNJ BE`VENISTE
SCALER
DATE 2— 7— 8 2 CASE NO. R SB 4.5 6 2 D y 9
ADDRESS: Q , -1377
of" 4:4 2 z S 3
TELEPHONE:
:
Dear Developer:
c619i sty- 7
s
19Y.5-
4
ys
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 frau plant material listed, this office nest be notified
imediately.
Thank you for protecting and preserving the Coachella Valley's pest -free environment.
Agricultural Calmissioner'Office
cc: Indio and Riverside Office