003524 (SFD)44-
P.O. BOX 1504 N o . 003524
Building 78-105 CALLE ESTADO
Address 53-795 Vatic''irto. LA QUINTA, CALIFORNIA 92253
Owner .. .. .... .. _ .
JrnreS Laie ' Tru$ BUILDING: TYPE CONST. - -OCC.-GRP.
Mailing
Address� � A.P. Number 774-a"�.74•� 014
City Zip Tel. y
T:q £�tt11'�n 4 �%64d Legal Description
Contractor Project Description aet 5la� -ppya± Int l I �i.nne
.. _ .. Fa t w.� l�airr.�?+ T1en 1E �-o•.snr�lra,ir+ . ✓ _
Address
Sam
. City.. _
Zip
Tel.'
State Lic.
City
& Classif.32'QZ
tic. # �,�
Sq. Ft,,
No. No. Dw.
Size
Stories Units
Arch:;Engr:, '
Designer "
New ❑ Add ❑
Alter ❑. Repair ❑ Demolition ❑
Address
Tel.
4400- Garage
City
Zip
State
21)00 ri-n p_
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. .. M�� �.� , -y ..I .
_SIGNATURE DATE
_ _
-
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
Estimated Valuation
�pf
$.Fq8
700
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
- 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
PIan.Chk. Dep..
..�','Z.���>� •�
subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ' - ' '•' -
Plan Chk. Bal
44.81
❑ I, as owner of the property, or my employees with wages as their sole compensation, will _
do tfie work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Const.....
'
Professions Code: The Contractor's License Law does not apply to an owner of property who
..
,
builds or i6proves thereon and who does such work himself or through. his own employees,
Mech.
q
it J
36AID
V it
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
Electrical -
�'
27
of proying that he did not build or improve for the purpose of sale.)
•
O I, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing
05.00
. slruct the project. (Sec. 7044, Business and Professions" Code: The Contractor's License Law
does not to who builds improves thereon, who for
S.M.I.
_- - r ,
"` "
apply an owner of property or and contracts.
• such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) -
Grading
- .50
5
—
l
:10 .00
❑ I am exempt under Sec. B. 8 P.C. for this reason
Driveway Enc.
20.100 -.
Date Owner '
Infrastructure
1,732.50-1., ,732'.50-.-
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
R
.O Copy is filed with the city. 0 Certified copy is hereby furnished.
TOTAL S2;.660.,08
CERTIFICATE OF EXEMPTION FROM--._
REMARKS
.
WORKERS' COMPENSATION INSURANCE �L
(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 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 you should become
ZONE:
BY:.
' subject to the 'Workers' Compensation provisions of the. Labor Code, you mustforthwith
comply with such provisions or this permit shall be deemed revoked.
Minimum Setback Distances: -
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY _
Side Street Setback from Center Line
hereby affirmthat 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 �-
This is'a building permit -when properly filled out, signed and validated, and is subject to
FINAL DATE
INSPECTOR
expiration if work thereunder is suspended for 180 days.
f 87
12/115/87
I certify that I have read this application and state that -the above information is'correct.
Issued by: '
12/115
Date Permit .
agree to comply with all'city and county ordinances and state laws ielating to building
`
construction, and hereby authorize representatives sof this city to enter the above-.
mentioned property for inspection purposes.
Validated by:
Signature of applicant Date
Mailing Address
Validation: _
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
U�/S
SLAB GRADE `
2ND FL. SO., FT. ®
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT. ®
GAS (ROUGH)
DRAINAGE PIPING
WALL SQ. FT. ®
OTHER APP./EQUIP.
DRINKING FOUNTAIN
SQ. FT. ®
POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER HEATER
SERVICE
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$ '
FLOOR DRAIN
MECHANICAL FEES
FRAMING
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
REMARKS:
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIRE ZONE ROOFING
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
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
LATHING
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
FINISH GRADING
GAS PIPING
PERMIT FEE
FINAL INSPECTION
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
�� _ �j
�C/'
i'ETBACK
GROUND PLUMBIN ,
UNDERGROUND
A.C. UNIT
COLL. AREA
U�/S
SLAB GRADE `
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
/e/FORMS
SEWER OR C TAN
H WIRING
DUCT WORK
ROCK STORAGE
//FOUND. REINFZ� 1 _
GAS (ROUGH)
14ETER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)IEMP.
POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$ '
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING Q
0
VENTILATION
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
M ESH,t,,/0/
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS_
GARDEN WALL FINAL
t Desert Sands Unified School District
C PUTR
NOTICE: THIS ®®CUMEN` CK OF PAYMENT
BE DU PLICATED. SCHOOL _FACILITY FEESAl
TO: City of La Quinta DATE: p7 !dl
Department of Community Development
78-105 Calle Estado
La Quinta, CA 92253
This is to c e r t i f y t h P t //LC.crdLC—
developer of3 which is
located at -5-3-63,9 -1795 , within
this District, has paid school facility f6CA imposed pursuant to the
authorit generated by government Code S c lost 53080 in the amount o
$ 3 , 660 ( 4, ice)
covering a total of 9 square feet of ( r idential or
( ) industrial/commercial development and that building permits for
this footage in this development may now be issued by yDur jurisdiction.
/O or ESERT SANDS UNIFIIP SCHOOL DISTRICT
White = Building Department • Yellow - facilities Planning • Pink - Accountirg • Gold - Developer
(10)-37
ISI
z
O
F_
U
W
U)
To
Z
O
1—
U
W
U)
U)
Y
!r
Q
W
W
X
Z
O
F-
0
W
0
v P'
COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION
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 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.
7 � i�l �4�.r . Building Department Application Log #
!
Name (Owner. Agent. Contractor. Etc.)
Marling Address •-;�
Cay
Slate
Zip Code
Telephone
'Job Property Address -'
.'Cdy o;; Community}...-=
*Legal Description of Properly.. (Lot. PM TR)
-_-_
'Assessor's Parcel No
Water Agency orr,Well
/+
r- _- --��
Use of Permit Planning Case N•
Lot Size
�- ••,r'se
a^'
SFD. MH Site Preparation Etc.
$ignalu(e-of'Apphcanl """"^' Date
'The above information must be verified from Building Application
STAFF USE — DO NOT WRITE BELOW THIS LINE
"r Initial�Date
Certification of Existing S.D. System required. ❑ Yes O -'-No, i2 7--;_i-
WOCB Clearance required. ❑ Yes ❑ o
Soils feasibility report required. ❑Yes/❑ o
f�
Special feasibility boring report required. ElYes t
t�
Detailed contour plot plans required. ❑ Yes ilr`Nol A
v y
Staff Specialist approval required. E) Yes 0 No Lot Inspection Date
Soils/boring report by Project # Date
Soils Map Page LLT I Soil Type _Approved by Date
Type of System: V
No. of Bedrooms
(1) Septic Tank
Soil Rate Required
❑ Existing ®flew ❑ Additional ❑ Replacement
Yl"
t i Gals.
(2) Leach line sq. ft.
(Bottom trench area)
Sidewall allowance
ft. rock/—Sq. Ft.
Install Lines) Ft. Long,
Fte w
. width� n. inches
r
Leach bed Sq.
F of-6otto
per running ft. �FNlA
rock below drain lines
area
Leach lines/bed-special design for slope:
(3) Pit Diameter
No. Pits
Pit BI
Seepage Pit total depth �' t A
Applicable -
N/A t=��Overburden factor
SD :5"
,,err///
1
Max. allowable depth
}/' �!`��°•� / ,yam `, /
�� l f a f 1��.:• �d ./Y ' .r-,ew: 9.. � •f,f F 6 !J �f Gi P;,:7�" ''J'dK-�-f. ,("f.�m
This application is -a r ed' denied for the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements
forth in
set Section Eft ove. A building permit is necessary for the ins�tt///allation of the above designed system
"
(1) Septic tank and sewer lines must b��50' from any wells. ftoe
(2) Leach lines must be 100' min. from any wells including expans on area t _: ¢_
(3)�
Seepage pits must be 150' min. from any wells i cluding expansion area
Signature of Health Official ` =Dale
ill
�
RECEIPT NO. 9 Issued by S$e Date 7-,? 7
d
District: ❑ Riverside OIndio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe
Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File
DOH SAN 122 (Rev 8187)
Of R
{ �. °." ' o;' ! OFFICE OF E.. LEON SPAUGY
4%t�+iS510`E8
�} s AGRICULTURAL COMMISSIONERCO
Vr, JANIES 0. WALLACE
IV
0 Q A. ASS:17A\T COMMISSIONER
WEIGHTS & MEASURES CLEMENT BENVENISTE
SEALER,
49-613 Hwy 86, 'Suite B-12
CA0,01Al 'Coachella, CA 92236
Mq Irv, t Sq619-342-8291
DATE ) ,2 - 2 1- 8 CASE NO. % 8 % RS % 2 Zl 4f
DEVELOPER'S NAME-
ADDRESS:
AME:ADDRESS: S 3 - q17 • 1�
2253
TELEPHONE: c 6 ! i) S6 V 04 y6
- 53-79.5
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•frcm plant material listed, this office must be notified
iimlediately.
.,Thank you for protecting and preserving the Coachella Valley's pest -free environment.
4CWssolker—'s Office
cc: Indio and Riverside Office
J