0007-181 (SFD)r ar
t rocoe?— / O
Building
Owner
Titiv/ 0 4 "
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Address52• �Gf S dV- MSN-- vZo
City Zip Tel.
Lti ('a1-a.1T'f.4Z2S'-4 1 �3,6A —2$-1
Contractor
P c>Z Co fv ss -Ah, r rV Porrrc�tns
Address
5,&"
City lZip Tel.
State Lic. City
i£ Classif.-fa, — 5Q 5,15 4 Lic. A
Arch., Engr.,
Designer LSM Dgs\L-\,j
Address Tel.
CityI Zip I State I
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 1 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 're is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencutg with Section 7000) of
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for thealleged exemption. Any violation of Section 7031.5 by 'any .applicant for a permit
subjects the applicant to a civil penalty of not mole than five hundred dollars ($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 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.1 1, 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.)
I 7 I 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 sell -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
n 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 it 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, alter 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
1hereby 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 sof this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant --Date—
Mailing
ateMailing Address
City, State, Zip
WHITE = FINANCE
Ai
@tea
,P0 4 04 AAIS
APPLICATION ONLY
.DING: TYPE'CONST. OCC. GRP. 8
Number �� V' � � —0,2-s—_ Q
I Description L-c��i 1c) -1-a Loc %Z_' ``4 5 ova A, �.. V
:ct Description �0-a0� K 4- 0 M Z '
t
Sq. Ft.Z I No. No. Dw. I
Size Stories Units
New Er" Add ❑ Alter ❑ Repair ❑ Demolition ❑
A►,Yrtl;, cA-rw -cern.: AI IO/co
PERMIT
(,.� AMOUNT
Plan Chk. Dep.
t�
.Plan Chk. Bal.
-, d
Const.
Rea; Setback from Rear Prop. Line
Mech.
Side Street Setback from Center Line
Electrical
Side Setback from Property Line
Plumbing
INSPECTOR AID
S.M.I.
Date_PQr6t�p�
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Grading
'
Driveway Enc.
QUINT,
Infrastructure
TOTAL
REMARKS
ZONE:
BY:
Minimum Setback
Distances:
Front Setback from Center Line
Rea; Setback from Rear Prop. Line
r
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE
INSPECTOR AID
Issued by:
Date_PQr6t�p�
LUU
Validated by:
'
QUINT,
Validation:
YELLOW = APPLICANT
PINK = BUILDING DIVISION
Notice: -
Document Cannot Be Duplicated
Desert Sands Unified School District
47-950 Dune Palms Road
La Quinta, CA 92253
760-771-8515
CERTIFICATE OF COMPLIANCE
Date 8/17/00
No. 20898
Owner Name Augustine & Eva Paz
No. 51-455
City La Quinta
Tract #
Type of Development
Comments
Street Calle Iloilo
Lot #
Single Family Residence
APN # 770-164-022
Jurisdiction La Quinta
Zip 92253
Square Footage
Permit # 0007-181
Log #
Study Area
1421
No. of Units 1
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered
patios/walkways, residential additions under 500 square feet, detached accessory structures or replacement mobilehomes.
It has been determined the above-named owner is exempt from paying school fees at this time due to the following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of
2.05 X 1,421 or $ 2,913.05 the property listed above and that bi lding
permits and/or Certificates of Occupancy for this square footage in this proposed projectmay now:be issued
Fees Paid By CC / Valley Independent Bank / Augustine Paz ::Telephone 760-564-3023
Name on the check «�
By Dr. Doris Wilson
Superintendent s
Fee collected /exempted by Annette Barlow
Signature
Payment Received
Check No
$2,913.05
227270
40TICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified
rbove will begin to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to
:ollect them on the DistrictCs)(s') behalf, whichever is earlier.
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
n,
Requested BY
O TITLE COMPANY
XEC.ORDING REQUESTED BY:
CHICAGO TITLE COMPANY COMPANY
10069KC 207056737
lkUN OL��AXRRINS
TSDLOWND'
AGUSTIN PAZ
and EVA PAZ
52995 AVENIDA MENDOZA
LA QUINTA, CALIFORNIA 92253
M +'
S
U
PAGE
SIZE
DA
PCOR NOCOR
SMF MISC.
A
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COPY
LONG REFUND
NCHG EXAM
GRANT DEED P : - s - -
--
Oao - o/%
The undersigned grantor(s) declare(s):
Documentary transfer tax is $16.50 i
(XXX) Computed on full value of property conveyed; or
( ) Computed on full value less liens and encumbrances remaining at time of sale.
( ) Unincorporated area: ( ) City of and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
BARBARA M. KROENER,
hereby GRANT(S) to
AGUSTIN PAZ and EVA PAZ, husband and wife as joint tenants
the real property in the City of LA QUINTA, County of Riverside, State of California,
described as:
Lot 10, Block 4, Unit No. 2,1 Tract Desert Club, as per map recorded in Book 20, Page(s)
6 inclusive of maps, in the office of the County Recorder of said County.
Dated June -15, 2000
R
State of California
County of _0Z ftf &.6 } S.S.
OnJUN�D, 2Lcob
before me, L)rj0A 3 W COD , N 6I -RLI pOUC,
Personally appeared
A�9AP- )\,l - k9 tF&
e (or proved to me, on.
the basis of satisfactory evidence) to be
the person( whose name () are subscribed
to the within instrument and acknowledged to
me that he/�9/they executed the same in •
his/�/their authorized capacity (iee's), and
that by his /their signature (/) on the
instrument the person(sl, or the entity upon.
behalf of which the person(d) acted, executed
the instrument.
WITNESS my han and offal sea
Signatur "C
MAIL TAX STATEMENTS TO:
BARBARA M .4K�RON
LINDA S. WGOD
Commission # 1203.20OP:
? ),lotcry Public - Cairfomia z
Orange County
lY Com n• &PtM Jon 12, 20ID3
(This area for official notarial seal)
RC DISTRICT - PLANNING REVIEW FORM
This form is to be used by CDD staff for review of single family dwellings in the RC (Cove Residential)
District, in order to determine the applicability of compatibility issues or need to.require the filing of Master
Design Guidelines by the applicant. It shall be transmitted to the Building and Safety Department as your
correction list. Please attach additional explanations as necessary.
APPLICANT PAZ CONSTRUCTION - LA QUINTA PARTNERS
SITE ADDRESS 51-455 Calle - Iloilo
APN 770 - . 164 - 022 BINNO.: CASE NO.: 2nno-27c
LEGAL: LOT 10 BLOCK 4 UNI S.C.@V.L.Q.
CHECKED BY: Greg mrcniRde1 1 DATE:
Inform the assigned Building plan checker upon your assignment to this case. The CDD Executive
Secretary maintains a log book to track a plications anj assign case numbers.
REQUIRED ITEM
Y
N
COMMENT/CORRECTION
Compatibility Review
Case logged and number assigned
Verify legal and APN information
ypFv�
Consistent with MDG on file (as applicable
QP��
MDG filing required (5 filings since 9/3/98)
Consistency with street/surrounding area:
Colors
Materials
Architecture
y
G
��
Other Requirements:
. Ua
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COUNTY OF RIVERSIDE HEALTH SERVICES AGENCY = ASSESSOR'S PARCEL NUMBER
7111
DEPARTMENT OF ENVIRONMENTAL HEALTH /
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 as indicated on the attached check list.
A non-refundable filing fee is required when the application is submitted. Check must be made payable to the County of Riverside. Approval of this applica-
tion shall remain valid for afperriiod not to exceedone year from date of payment.
LMS #
Agent, Contractor; Contact Person 4; / _ /
!�
Address /City �1 State Zip t
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Telephone �� I
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Owner/ ,(f/j��
Address - �`r /City State' 7 Zip/'
AA
Telephone
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Job Propffi. j� Addres —
City
Zip
W
Lot Size
Water Agency/Well
Use of Permit, P/P, SUP, PUP, etc.
y
Legal DescriptionCO
i
`Dwelling,YH Site Prep., etc.
Signature of- Applicant ('+ f/�
Date i' • �,
CHECK BOX IF REQUIRED
If any box is checked, this application shall be considered rejected until
❑ Detailed Contour Plot Plans Required (1 to 5 foot interval)'
the information is provided and the fee paid. Resubmittals later than 90
days after date noted below may require repayment of fees.
I
❑ Staff Specialist Lot Inspection Required
m
❑ Holding Tank Agreements Completed
Thomas Bros. Page Grid
Z
0
❑ Certification of Existing S.D. System Required
❑ Date Lot Inspection Completed: Initials
U
❑ WQCB Clearance Required
�
(Attach for DOH -SAN -007, Santa Ana Region Only)
Remarks:
❑ Soils Percolation Report Required
❑ Maintenance Booklet Provided
❑ Special Feasibility Boring Report Required
❑ Final Inspection by Department of Environmental Health is required.
❑ Rereview Required Initials Date
Please call 24 hours PRIOR to inspection.
C/42 / Soils Percolation Boring Report by Uc/Project # Date
Soils Map Page Soil Type Approved By Date
No of Systems
T pe of System(s)
Holding Tank ❑ Replacement
No. Dwelling Units
Bedrooms, Fixture Units
(1) Septic Tank
Soil Rate
Grease/Sand
Grease Intcp/Lint Trap
I
New ❑ Addition
Existing
/
/��s9r! "
r)Gal.
/
/ •Q
Gal.
,�%�i►
Sq %Ft.
Bottom Area
Total Linear
Ft.
Sidewall Allowance
\
Leach Bed sq. ft. of
Bottom Area
ft. rock/ sq. ft. running ft.
Install �Line(s) ft. long ft. wide with
ti
Inlet Tested Depth ❑ NA
min. in—ch., rock below drainlines or
Proposed Bottom Tested Depth
Z
Leach lines/bed special design for slope:
(3) Pit Diameter
No. Pits
Pit Below Inlet (BI)
Seepage Pit
Maximum
Other:
O
H
Applicable
Total Depth
Allowable
Depth
LU
N/A Overburden Factor
❑ 5' ® 6
/
TD
Well Review Approved: ( rd (' : k / t`1 / Date:. -A t_ k! / • /1 4 Well Drilling Permit #
• SIGNATURE /
Grading Plan Approved:�// Date:
SIGNATURE `I �r106-
Sewer Verification Approved: O� i /.�7 �"r• F•C` R Date: %
. _r
Plan Check Only Approved: V`T ���/ //'/1,�T�f Date: 13 (77i �;iJ �% (►tYL1� /%%s fti��%"(../�`1S f� 7� ' rn
REMARKS: /Y�/../�:w / .!� lri �.��` fn 7 .oc fYr /'/5 17 1X II
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"'A �Y✓r / �� .xis �� r�� ,/mac ✓ �.rJ 11� �%/� ti� /
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This application i APPROVED/DENIED for the category checked in SECTION B
FOR OFFICE USE ONLY
above, regarding the design of a subsurface disposal system as indicated on the
�, ,�. (• t 7 ��
acompanied plot plan, using the requirements set forth in SECTION C above. A build-
Ing is for
permit necessary the installation of the above -designed system. No con •
structlon Is permitted In the required reserved 1009' expansion area.
Revenue code�Fee $
(1) Septic Tank must be 100' minimum from any wells.
❑ Check #� 2 '
(2) Leach lines must be'100' minimum from any wells, including expansion area.
Date ��� �� " Initial
Z
O
(3) Sewer lines must be 50' minimum from any wells.j
(4) Seepage must be 150 minimum from in ding
yTiyt
V�'�'O'%
pits any wells, expansion area.
%,,,/ r9 ii'`9 ^ t'/G�JrL! li�'•a''^f"-�/'•✓%r �rv« .+i
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Signature'of`H,ealth Official
10'2-6 0)
Date
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LOA
"COUNTY OF RIVERSIDE HEALTH SERVICES AGENCY ASSESSOR'S PARCEL NUMBER
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DEPARTMENT OF ENVIRONMENTAL HEALTH '
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 as indicated on the attached check list.
A non-refundable filing fee is required when the application is submitted. Check must be made payable to the County of Riverside. Approval of this applica-
tion shall remain valid for a period not to exceed one year from date of payment.
LMS '#^f_ '; y 67f 1A 0 tW1A , ,4
Agent, Contractor, Contact Person
Address City State Zip
4zzs
Telephone
52-9efs' by 4ts�r.�nc�zs 1� �.
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Owner _
Address City State Zip
Telephone
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Job Property Address
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City
Lte. f
Zip
LU
Lot Size
t ,
Water Agency/Well
r�lE.t# .
AR
Use of Permit, P/P, SUP, PUP etc. c
�- ---, �"I�rEELt.racwlwr67,4,4CLos
Legal Description
% 4
8 lvc.
�L
- Dw�ll ng, )`iQ it6 f=rep�+et ! y Z f / If !
:50y, 100
A� Lt '
.+'e i rC7
e�s� ar j e -t a SAV i rJ tr 'L
Signature of Applicant P 04f jCf044N'v - U 4
V Date
t!
//70
^
CHECK BOX -IE -REQUIRED _
If any box is-checc- ed, this application shall be considered rejected until
❑ Detailed Contour Plot Plans Required (1 to 5 foot interval)
the information is provided and the fee paid. Resubmittals later than 90
days after date noted below may require repayment of fees.
❑ Staff Specialist Lot Inspection Required
ca
❑ Holding Tank Agreements Completed
r
Z
Thomas Bros. Page Grid
0
❑ Certification of Existing S.D. System Required
U❑
WQCB Clearance Required
❑ Date Lot Inspection Completed: Initials
LU
(Attach for DOH -SAN -007, Santa Ana Region Only)
Remarks:
❑ Maintenance Booklet Provided
❑ Soils Percolation Report Required
❑ Special Feasibility Boring Report Required
❑ Rereview Required Initials Date
❑ Final Inspection by Department of Environmental Health is required.
Please call 24 hours PRIOR to inspection.
C/42 / Soils Percolation Boring Report by Lic/Project # Date
/ L /j
Soils Map Page Wit/ t+"/.d7i
Soil Types Approved By Date
r
r r
No of Systems
T pe of System(s)
Iding Tank ❑ Replacement
No. Dwelling Units(0414>
Bedrooms FixturesUnits—
(1) Septic Tank
Soil Rate
Grease/Sand
Grease Int p6Lint Trap
'��`H,
t ❑ Addition
Existing
9
9 171A ? S��&
/
l000Gal.
•Q 3� �
\
IVY
1'�+X
Gal.
Sq. Ft.
Bottom Area
\ft.
Total Linear
Ft.
Sidewall Allowance
rock/ sq. ft. running ft.
Install \LiAe(s� ft. long ft. wide with
Leach Bed sq. ft. of
Bottom Area
\\
Inlet Tested Depth ❑ NA
min. inches rock below drainlines or
U
Proposed Bottom Tested Depth
Z
Leach lines/bed special design for slope:
(3) Pit Diameter
No. Pits
Pit Below Inlet (BI)
Seepage Pit
Maximum
Other:
0
P
`*Total
Applicable\,
�..,
,
j
Depth
f
Allowable
Depth
LU
N/A Overburden actor
Q�5 R 6'
TV
TD Y3
3,
Well Review Approved: SIGNATURE Date: Well Drilling Permit #
Grading Plan Approved: Date:
"GNATURE
Sewer Verification Approved: Date:
Plan Check Only Approved: —Date:
REMARKS:I&WIVW
u IA ��/! / �!,'? air. �., Lv /tom :" cif do !Jt /2.�-►A i
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This applicationi,sFAPP�/DENIED for the.categoryrchecked-in-SEC.T.ION B
FOR OFFICE USE ONLY
above, regarding the design a subsurface disposal system as indicated on the
acompanied plot plan, using the requirements set forth in SECTION C above. A build-
ing
��/^
permit is necessary for the installation of the above -designed system, do con•
structlon la In th(e\
Revenue code Fee S
nermltted renulred reserved 1009 etcnana on area
Sf1 , y
Septic Tank must beminimum from any wellsa /ft +� —^'" /
*heck#
(,,/10 444 .-1
(2) .Leach lines must be 100' minimum from any wells, including expansion area.
e
Date �Z - [ T W Initial 1Wd P% VQ..
Z(3)
Sewer lines must be 50' minimum from any wells.
0
(4) Seepage pits must be 150' minimum from any wells, including expansion area.
,...rr
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Signature of Health Official f
Date
DEH-SAN-122
DEH -SAN -122 (Rev 9/98) UlstrlDutlon: WHI I E—OttlCe, File; YELLOW—Applicant; PINK—Bldg. Dept.; GOLDENROL—Plans/Records
Fes. ..
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-4-
Certificate of Occupancy
City of La Quinta
Building and Safety Department
This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code,
certifying that, at the time of issuance, this structure was in compliance with the various ordinances
of the City regulating building construction or use. For the following.
BUILDING ADDRESS:
Use Classification: SFD
Occupancy Group: R 3
51-455CALLE ILOILO
Type of Construction:
Owner of Building: AUGUSTINE & EVA PAZ
Building Official
Bldg. Permit No.: 0007-181
Land Use Zone: RL
Address: 52-995 AVENIDA MENDOZA
City: LA QUINTA, CA 92253
By: STEVE TRAXEL
Date: 11-22-00
POST IN A CONSPICUOUS PLACE