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06073 (SFD)4 P.O. BOX 1504 No. 46073 Building 78-105 CALLE ESTADO Address 53-3343 Navarro LA QUINTA, CALIFORNIA 92253 Owner ?Iii81tt Tribble , BUILDING: TYPE CONST. OCC: GRP. Mailing Address 80-1655 Ave 43 A.P. Number 774-095— City Zip Tel. Indio 3'201 347,-9755 Legal Description Lot. 17 Block 215 Contractor Project Description �••�• Address $ate City Zip State Lic. & Classif. 484957 B-1 Arch., Engr., Designer Lic. If 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 7(lOp) of Division:3 of the Business and Professions, Code; and my license is:in full force and effect..ld*ramie%'4, 401 Is SIGNATURE a DATE OWNER -BUILDER DECLARATION I hereby affirTn that I am exempt from the Contractors License Law for the following reason: (Sec. 7031.5,8usuress and Protessims Code: Any city or cowry which requires a Permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to Me 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. hes 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 crud penally of not more than five hundred dogars ($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 no 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 -budder wig have the burden of proving that he did not build ori prove 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 ori proves thereon, and who contracts for such projects with a contractors) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec_ a_ & 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 Workers Compensation Insurance, or a certified copythereof.,(Sec: 3800, Labor Code.) Policy No. Company !,i 2 1, or ❑ Copy is filed with the city. ❑ Certified copy is hereby fumished. 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. It, after making this Cerwkate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or thfs permit shag 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.) - Lenders Name Lenders Address This is a building permit when property 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 Sq. Ft. 1441. No. No. Dw. Size Stories Units New Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation 85,204:.00 PERMIT AMOUNT Plan Chk. Dep. 250,00 Plan Chk. Bal. 239.83 Const. 576.50 Mech. 47.00 Electrical 109.02 Plumbing 154,•5€ S.M.I. 6.02 Grading 20.00 Driveway Enc. 20..'m Infrastructure 1878.84 TOTAL REMARKS 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 7-7-89 Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. @ $ 2ND FL. SO. FT. POR. SO. FT. @ GAR. SO. FT. @ CAR P. I SO. FT. WALL SO. 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 ROUGH PLUMB. FLOOR DRAIN MECHANICAL FEES HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER DUCT WORK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GAS (ROUGH) 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 SHOWER 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/. c SEWAGE DISPOSAL LUMBER GR. SO.FT.GAR @ 3/ac HOUSE SEWER FRAMING ®s IT 47 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 -� /L/—ley I ROUND PLUMBINt�S UNDERGROUND A.C. UNIT COLL. AREA LAB GRADE ��a / ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS AKEWER OR SE ii ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ -$ LUMBER GR. FINAL INSP., 7/ 0 zi FRAMING ®s IT 47 FINAL INSP. ROOFING / C� t {L /i (J V C UT _ lLv �'�� / 6 / ^ d`� q�✓i lJ � vA REMARKS: VENTILATION FIRE ZONE ROOFING ' FIREP4A CE SPARK ARRESTOR GAR. FIREWALL /� ffLATHINCy�/)-,-,j5 MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL t Desert Sands Unified School District pp CERTIFICATION OF PAYMENT NOTIC> o 7-t�tl��6�. + __OILITY FEES DOS NN 'r TO: City of La Quinta DATE: Department of Community Development U U 78-105 Calle Estado La Quinta, CA 92253 This is to certify that 1,4 1' developer of whdch is located at— Q O)OAi thin this District, has paid school facility fees imposed pursuant to the authority genera d by Gov rnment C de Section 308 i the ano t of co e�/ ring a total of square square feet of (4) residential or ( ) industrial/commercial development and that building permits for this footage in this development may now be issued by your jurisdiction. I e 441 ifi I I a- a @ e for DESERT S NDS•UNIFIED SCHOOL DISTRICT White - Building Department • Yellow - Facilities Planning • Pin Accounting • Gold - Developer s�7 gol. 0 h.� y-��\ r }"" �'?: _"�.}s}.. ri % ¢ � �•�.' � W{�'°���^� ��iia ~ �i - V 6P���� f a' :..a�i,�.«n,�<�'9"" � �'`�'t i S ` '�'�'' "i�'�''�"y p"�-i7's`'4 ' �. -.-� Y , FtECEIPT,NO v ""°�Issued. By/�' 1 i h Date DISTRICT ' ❑ Riverside, i❑ Ind10 ❑ Hemet 4 Perris , ❑ , Rancho Calif ?i�..❑.'Blythe }' y DOH SAN 122 (Rev. 5/88) ,, DISTRIBUTION , WHfTE Office ftle ,:' YELLOW Applicant PINK - Bldg. GOLDENROD.f Plans/Records y .3 9 P !I i .. � i/ j i •a.''/ i ,mss Parcel COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH_ QrAmeamfe�' ddtf ENVIRONMENTAL HEALTH SERVICES ; ... 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 speculationsas Indicated on the attached check list' i A non-refundable filing fee (see below) is required when the application is submitted. Check must be made payable to the CounWof Riverside. Approval of this application shall remain•valid for a period not to exceed one year from date of'approval. ; t Q VERIFY ITEMS IN SECTION A FROM BUILDING 8 SAFETY APPLICATION BUILDING DEPARTmE. WuAPPUCATION'LOG4, Z 0 Agent,.Contractor, Contact Person !r �.� 1 1, Phone 3;s'' 12).5eU %lddress.B Phone U , e fafJs7r<;�: or✓ ui Owner l r - Phone , — / 7 Q � Mailing Address 4.1i' � o i' �• �fC' a ? _' , !City- State Zip Job Property Address "nf vgRRo Legal Description Prop, (PM T!acC C �^ a,a/ s� '�`%D flv�/v r? L.77'/ 9 Lot Sizet,6r A /Well Use of PerrnR P/P, CU, etc. Vic, Ciru, Pj Other X /0 . /fi. J / Dwelling MHI .50 SX a Prep, etc. Signature of Applicant, Data CATEGORY: REV CODE FEE :' CATEGORY: �" REV CODE FEE ©SUBSURFACE DISPOSAL. 1238 $45.00 b SITE EVALUATION UPON REQUEST 7349 $42.00 m ❑ MULTIPLE PARCELS WITHIN SAME ;y (NO PLOT PLAN) Z LAND DIVISION 17 SEWER/SEPTIC VERIFICATION 7348 $11.00 O a. 1 at 4 Parcels (Each) 1238 $45.00 ' . (Less than 1 year) U b. Each Parcel after 4 - 7344 $16.00 •. ❑ PRELIMINARY ELECTIVE 7352 : - $45.00 Ul ❑ Rereview (2nd review same parcel) 7344 $16.00 EVALUATION (Attach DOH SAN 53) ❑ Site Evaluation in Conjunction with ❑ HOLDING TANK 7351 $45.00: . Crkk:al Area 7346 $86.00 ❑ ALTERNATIVE/EXPERIMENTAL .7345 $13200 ❑ Site Evaluation Loi Cess than SYSTEM 10,000 Sq. Ft. 7347 $86.00, ,INITIAL ,. DATE Holding Tank Agreements Completed ❑ Yes inN e IfJ 1�� �n • .. Certification of Existing S.D. System Required ❑ Yes 15IN61e" f WQCB Clearance required. (Attach Form- ❑ Yes ET No DOH SAN 007, Santa Ana Region Only) Soils Percolation Report Required. - 4 ❑ :Yes Special Feasibility Boring Report Required. ❑ Yes EI % Detailed Contour Plot Plans Required (1 to -5 ft'inteiyal). ❑ Yes•, • No Other - ❑ Yes 1, No .a Staff Specialist Lot Inspection Required ❑ Yes l7 No i Cat I Date. on v.� Solis boring report by' + Project '# Date . Soile Map Page Type C Fit r Apprweij by C./i:.i/!C_ —X2 $oil Data . U Z No. of Systems *. Type of Systema) O , Ing Tank ❑Existing No. Dwelling Unit>,+ .. BedroomslXttlrerUhits (1) Septic Tank Soil Rate Grease/Sand Grease Intop 1V�c�'e,. 0 o R eptaoenrent: �30��,• >�:�. !�-+ l�'� �`J _J 2 Line Ft l ),!:each Sq. m Sidewall allowenoe Install - �%' �" �"' !~R r tine(s)'^ 1t long• wide with _ 'Leach Bed eq it Bottoms° trench area " ' R rocW; r°` sq ft mrn. inches below drainlines or b. per runninj ' Y � Leachlines/bed special design for slope: (3) Pit Diameter ; No. Pita Pit Below:.. See Pit Total Depth ' Applicable N/A —Overburden factor Inlet (BI ) ` Mak, Allowable Depth No. 2 Systeme/PT REMARKS- ' ��0 l"?z' ' �.�lF'�.�? moi/.'% � `,.. •^/�.�. ; ,>✓ e�--:.-w- t^ - ••�- :,,� �fd 01/r, A -. ✓��( �����..CJ`•': -✓'Lt,rt...,:,ct�,.:-_ r�.:��,Pif :, x t"'•sa_ f'+1:-.-� 1 !�•�7 .// cw d�:>+.� �1'//..C.�•F� f�.}' � /�_,^.,,Jri; This application is'APP O D/D - � IED for.category checked in SECTION B above, regarding the design�of a subsurface disposal system as indicated on, the accompanied plot p using the requirements .set forth irNSECTIOR C `above. A: building permit is necessary for the installation 'of the �Y above-designed•system." No construction is,permitted m`the,required reserved 100% expansion•area. E 1)Septic tank and sewer lines must be 50.' minimum from any wells J `I'�"� Leach lines must be; 100', minimum, from any, wells, including expansion ar ,must Seepage pits be,;150 minimum from any wells, including expansiomarea F r �: Vs `!+-�s L� 9( ^•-C�fJ + nature of,,HeaRhOtficial�'v FtECEIPT,NO v ""°�Issued. By/�' 1 i h Date DISTRICT ' ❑ Riverside, i❑ Ind10 ❑ Hemet 4 Perris , ❑ , Rancho Calif ?i�..❑.'Blythe }' y DOH SAN 122 (Rev. 5/88) ,, DISTRIBUTION , WHfTE Office ftle ,:' YELLOW Applicant PINK - Bldg. GOLDENROD.f Plans/Records y .3 9 P !I i .. � i/ j i •a.''/ i ,mss .E. IE014 51'nI,C;Y t 'vI R..� .. IItIIt.E.UF . co •nn;�w`�n , A �Fea>;►rat� �'� �r nvlll�U� I URAL (;U�It`11551UtdElt )AMOv �:nunc:F. AN GLUME' I CF.NVEhISIE o M �V1:1�;1 IJ S li tr ASU11L5 st,�Cn n r' 49-w] Ilwy 'IIG� Ilulte 11-IZ .: Cotrcl�ell.n� CA 9ZZ36- S 1-4rp�...i69 Mr rAsc I N.` 3 • nuumss rru�Emics Lear Ueveloperi Alter rev y our latt�lscttl►i:ncj Itlan till Itlaltt Iiylerlal listed is . violat un cif: yuatttililate ltr+ws'nittlanlelliyhv�lelrl 1 listed, lllls.11leo[[.lce Inusl: he IwtlEieJ do occur t.1 tltey,ral[[er [t� Lt J` �tesetvllly the (vaclieIla,Valley�s L'esl-[gee etivirottit nt. '1•hmik you Lor ptuaect y ult1 s J1grctal tutal C t� sslvlterl UL [ lce ` cco Indio al td Itivetside UtIke LA Qv tti� +i PIP, �� MUM `Buena Engineers, Inc. • 79-811 Country Club Drive !iU e 4/' . Bermuda Dunes, CA 92201-• (619) 345-_1588/328-9131 Client Name Client Address 4 •" ` i 1 4 Client Phone ' z DATE .y TEST LOCATION �{{ � Rro og. pc"4 JOB NO. ELEVATION FIELD TESTING �GS7- MOISTURE CONTENT % . DRY DENSITY Ibs./Cu. h.. MAXIMUM DRY DENSITY PROJECT',` OPTIMUM MOISTURE CONTENT % 3t0 /rock Nauccrc) LOCATION CONTRACTOR �o OWNER � WEATHER TEMP. oat AM c / I (`6� 0 a PM PRESENT AT SITE TEST NUMBER TEST LOCATION �{{ � Rro og. pc"4 LOT NO. ELEVATION FIELD TESTING REFERENCE CURVE MOISTURE CONTENT % . DRY DENSITY Ibs./Cu. h.. MAXIMUM DRY DENSITY MAXIMUMS DRY • • DENSITY lbs./cu":h. OPTIMUM MOISTURE CONTENT % .o �o ►ii:'�i jqt s REMARK {� uw�� �A' 1Mcrc 1 • e - FIELD REPORT A. CLIENT REPRESENTATIVE SIGNATURE TECHNICIANS SIGNATURE n �,h