03912 (SFD)Building
I T4ht 4 4 Q"
53—OSS Navarro
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Owner
Wastern Am ician cssmtruction Cc
Mailing
Address P. 0, Box 1379
City Zip fel.
Lt Quinta 92253 564 -!?411
Contractor
Address
14 Q,iintQ Zlp 92353 Tel 443-r2671
State Lic. City
& Classif. 469157 Lic. # 11,1 Sq. Ft. .1500
Arch., ESize
ngr.,
Designer
Address Tel.
BUILDING: TYPE CONST. DCC. GRP.
A.P. Number 774-174-01.9
174-01.9
Legal Description
Project Description Singe rmmily Dwelling
CityI 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.
_SIGNATUREDATE.;'
OWNER -BUILDER DECLARATION f' ! `.� A.
I herebyaffirm 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 or 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 or 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. It, 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
O Copy is filed with the city. O 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 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= 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 slate 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
No.
Stories "
New ❑ Add ❑ Alter ❑
uation
PERMIT
Plan Chk. Dep. 62,50400
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL,;•ra
No. Dw.
Units
Repair ❑ Demolition ❑
AMOUNT
36A
784!
105.(
SA
2 0 A
20A
Ir876A
REMARKS
•,r. .-.+.r.x t •s ^ex wet ++t •.n a �
ZONE:
BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setbac< from Center Line
Side Setback from Property Line
FINAL DATE
-INSPECTOR
Issued by:
Date Permit
Validated by:
Validation:
WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO Fl (p S
UNITS
SLAB GRADE
2ND FL SO FT. C
UGH PLUM g BONDING
YARD SPKLR SYSTEM
POR SO FT. a
MOBILEHOME SVC.
BAR SINK
GARSO. FT. a
POWER OUTLET
ROOF DRAINS
FOUND. REINF.
DRAINAGE PIPING
CAR P. SO FT. iC
OTHER APP.IEOUIP.
REINF. STEEL
WALL SO. FT. /a
GAS (FINAL) TEMP. POLE
DRINKING FOUNTAIN
SO. FT. (a
GROUT
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
=$
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTOXDISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
REMARKS:
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 @ t'A c
SEWAGE DISPOSAL
SO.FT.GAR g 3/.c
HOUSE SEWER
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 03'` UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
UGH PLUM g BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
/
SEWER OR SEPTIC TANK UGH WIRIN2
JJJ
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.
$ plus xE
=$
LUMBER GR.
FINAL INSP.
FRAMING '
'
FINAL INSP.
ROOFING
1
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
,
GAR. FIREWALL
I,n%
LATHING1, / fi
MESH
INSULATIONISOUND
FINISH GRADING
a�(FINALINSPECTION
CERT. OCC.
FENCE FINAL
-
INSPECTOR'S SIGNATURESlINITIALS
GARDEN WALL FINAL
Desert Sands Unified School District
(3
�• _ OTT�lEd G`1.3
1MMENi CA/^NNOT
(C4SCHOOL FACII�JJC"TE®e
.
TO: City of La Quinta DATE:
,7/ye -41
Department of Community Development
78-105 Calle Estado-
La Quinta, CA 92253
This is to ert.ify that
developer of which Iis
located at _ Q2ea.///� within
this District, has pai school f ility fees imposed pursuant to the
authority generated by Government Code S ct' 53 80 in the amoun of
$
covering a total of square feet of ( ) residential or
( ) industrial/commercial- development and that building permits for
this footage in this development may now issued by yojr jurisdiction.
V2r
f DE RT SANDS UNIFI D SCHOOL DISTRICT
White - Building Department • Yellow - Facilities Planning 0 Pink -'Accounting • Gold - Developer
(10)-37
RECORDING ' LIESTEG OY O U c
OtIANGE COAST TITLE CO. a Y ; °�i °`
r
cc 74. ce-
AND WHEN RECORDED MAIL THIS DEED AND. UNLESS LL U > Q r4 O O ro W .Q
OTHERWISE SHOWN BELOW. Mr. t' rP,1� RTATEMENTS TO: O g0 1 r_ VV Z
U- ,00 D C
W u; W: `� T in
NAMEI— : , co Q Uy �l .O m — C W
WESTERN AMERICAN CONSTRUCTI CO.lU t Z $ > .► �. _
STaccr E ~
ASTR[aa 75-656 Via'Serena U Cr °� 0 a �- J.?
Ill O � � U. v JI B
Indian Wells, CA 92210 v
Cm. 3-
STAT[I I
Title Order No ............................. Escrow No. -.-10-4313
'chis space for Recorder's use
Grant Teed
THE UNDERSIGNED GRANTOR(s) DECLARE(s)
DOCUMENTARY TRANSFER TAX is $ 9.3
❑ unincorporated areaCity of -c?-
Parcel No. 774-174-010
[3Ccomputed on full value of property conveyed; or
' ❑ computed on full value less value of liens or encumbrances remaining at time of sale, and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
EARL D_SHOEMAKER and GERALDINE SHOEMAKER, Husband .and Wife as Joint Tenants
hereby GRANT(S)to WESTERN AMERICAN CONSTRUCTIONS COMPANY, A California Corporation
a � '
the following described real prolierty in the City of La Ouinta
�U. county of Riverside , state of California:
Lot 15 in Block 250 of SANTA CARMELITA AT VALE LA QUINTA. Unit 23,
as per map, recorded in Book 20 page.25 of Maps, in the office of
the County Recorder of said County."
j r
Dated - October 22,` 1987
-i STATE OF MXNFaXXU South Carolina EARL D. SHOEP4A
COUNTY OF.; Georgetown } SS.'
i - On this 3rd day November
ay of in the year
Me, the unt4e.^:3ned, a notar. PnS:ia i�. GERALDINE SHOEMAKER
'and, for said°County and State, personally appeared
'EARL D.. 'SHOEMAKER and
GERALDINE SHOEMAKER
j
personally known to rre (or proved to me on the basis of satisfactory a
evidence) to be the person s " whose name
7�r
are subscribed to the within instrument and rJ� o °
acknowledged that they - '
executed the
same:
Signature �t%/4� L�':1` ci QC~ r*�
Name (Typed or Printed)
'Notary_ Public in and for said County and State f� �J. (_.� FOR NOTARY SEAL OR STAMP..
MAIL TAX STATEMENTS TO PARTY SHOWN ON FOLLOWING LINE; IF NO PARTY SO SHOWN, MAIL AS DIRECTED ABOVE
Name Street Address City State
11D1 - "" .
CHICAGO TITLE INSURANCE
COMPANY
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WESTERN REGIONAL HEADQUARTERS
3280 E. FOOTHILL BOULEVARD
PASADENA, CALIFORNIA 91107
(818) 793-7710
RIVERSIDE (714) 784-2484
SAN BERNARDINO (714) 884.0148
ORANGE COUNTY (714) 541-8381
SAN DIEGO (819) 232-8921
'1"#t.' � ."7G�. :,Y.+, 1�'i7.%7:s'¢��.�'Ai'ltlr�tia`�,+7�'`►�.Y9''r�y'gft i�a•A �,� rp��,.. ,. •^y v, i;. `'i•-s..k�ix'-s d:" �;k. ' TP+h��`+i+f,� �.t+� .�.{•.'r ,��:.''.G+y"'�'N✓�{`
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COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION
PERMIT APPLICATION FOR A. SUBSURFACE SEWAGE DISPOSAL SYSTEM
ti
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 S40 is required when the application is submitted. Check must be made payable to the County of Riverside.
Building Department Application Log #,
. Name (Owner. Agent. Contractor. Etc.) -
�e.5-�A'h/ %
Mailing Address '
�c� Qax 13 79
�� �e�-�s�
City
Zip Code.
Telephone
ei
'.Job Property Address �G, _ /G
'Crty-or. eru'tnty ..
'Legal Description of Property. (Lot. PM. 7R)
o
�7 �ilc $I iii
•Assessor's Parcel No
y titer Agency VJeU
�3�}���Gu
��CCC��
`
Use of Perrrut/J(.!/G�u W (.G��IC P,tanning Case n
Lot Size
/1
mrd �V
�•�OO
SFD. MH Site Preparation. El S/ iJ
_.
Signature of Applicant - Date -
:The above information must be verified from Building Application - -
STAFF USE — DO NOT WRITE BELOW THIS LINE
nitial Date
Certification of Existing S.D. System required. ❑ Yes'
_ 1" '" --i'
WOCB Clearance required. ❑ Yes.
Soils feasibility report required. ❑ Yes
Special feasibility .boring report required. ❑ Yes
Detailed contour plot plans required. ❑ Yes
Staff Specialist approval required. ❑ Yes Lot Inspection Date
Soils/boring report by -/ Project # Date
Soils Map Page o / Soil Type 0 CApproved by � Date
Type of System:
No: of Bedrooms
(1) Septic Tank
Soil Rate Required
_
❑ Existing -Ce - ew ❑ Additional ❑ Replacement
w�j(•
%p Gals
t -
(2) L ch line sq: ft.
Sidewall allowance
Install Lines) Ft Long,
Leach bed Seq.
(Bottom ch area)
ff. rock/ Sq. Ft..
FL wide wi fTm inches
. Ft., of bottom
,/
per running ft. C�dNT
rock below drain lines
area
Leach lines/bed-special design for slope:
Applicable—
(3) Pit Diameter.
No. Pits
Pit BI
Seepage 'it total depth ��"L/4?
� factor
...
%
Max. allowable depth
N/A . Overburden
.�
This application .pprove red+fot the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements
set fo. in Section .B a"�bo : A building permit r necessary for, the installation of the above -designed system.
I0,� Septic. tank and sewer lines must be150'. from any wells,/ 10
(2 Leach lines must be 100' min ~ from any Wells including exp" nsio .area G�tL
(3) See age° its must :be 150' min from any. Wells including expansion area /v-f�¢rP,c c�
Signature;of ryealth_On c al ,
RECEIP•T;NO 3 T 0 � Issued by Sl� �a Cate
District ❑•Riverside Indio ❑ Hemet El' 'tPerns . ❑ Rancho Calif. ,: ❑r Blythe
Distribution: WHITE—Office file , . YELLOW—Applicant PINK—Bldg. Dept. _ GOLDEN ROD= Pending Rife,
DOH SAN 122 (Rev 8187) ,
eA.1o(
!;Z3
i
1
'0 Of Fl(_E OF E. ;LEON SPAUCY
AGRICULTURAL CO.•IMISSIONER ;co��S:�o`ea .
)A� ES 0 WALLACE
Q C - A V V ASS;°7A\i fO�1 �1�SSIU�EP.
CLD-IE`+T BENVENISTE
WEIGH
I I S £� "ME��SU(ZES SEALER
_ _
-�,,•��- 49 613 Ilwy 86, Suite 13 12 •
4(.f''� Coachella, CA 92236'
q r 9, 16q 619-342-8291
DATE 8 g CASE NO. 1� 99 S 0 M6
DEVELOPER' S. NAME :
ADDRESS : 1317 9
TELEPIIONE- i d!q) 5 4Y— 7 911
s
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 plait material listed, this office must be notified
imnediately. .
Thank you for protecting and preserving the Coachella Valley's pest -free environrrent.
t Agricultural Ccumissis n i s Office..
cc: Indio and Riverside Office