06644 (SFD)P.O. BOX 1504 No. 0664 i
Building 78-105 CALLE ESTADO
Address 53^9&#x' Velasco LA QUINTA, CALIFORNIA 92253
Owner -
X=k Katzen=/Gerald Kat=wn BUILDING: TYPE CONST: - OCC: GRP. r
Mailing
Address 510 F;iw6r 14.11 Trane A.P. Number h.►f t� 4
City Zip��l�3
Tel. }
Palo Deaert: 92260 ' 9C� :� Legal Description r
Contractor Project Description 4P
-g, 1 ,l, .
Address
P, fl.. Bos 1371
`'City Zip Tel.:
La Qt t8 92253 564-3511
State Lic. City ;
& Classif: > w $ � Lic. # . Sq. Ft. No. No. Dw.
Size lg'�� Stories Units
Arch., Engr.;
,.Designer New ElAdd ❑ Alter ❑ Repair ❑ Demolition ❑
L: Address- Tel.
City Zip State
Lic. #
t LICENSED CONTRACTOR'S DECLARATION.
I hereby affirm that I am licensed under Drovisions of Chapter 9 (commencing with Section
'•700 "of Division 3 of the Business and Professions Code; and my license is -in full fyree andr 1
;effect's j �
_SIGNATURE - y- DATE '
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractors License Law for the following Q 1
reason: (Sec. 7031.5,Busm$7ess and Professions Cede:.Any city or county which requires a Y f 13
permit to construct, alter, improve; . demolish, or repair any structure, prior to its issuance also '
- requires the applicant for such permd,to file. a signed statement that hes licensed pursuant to PERMIT ' AMOUNT
the provisions of the Contractor's License taw, Chapter 9 (commencing with Section 7000) of
'?r 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 perms Plan Chk.`Dep- - -
sub)ects`Te applicant to a civil penalty of not more than five hundred dollars ($500).
Plan Chk. Bal.
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will ty . Ifs
do the work; and the structure is not intended or offered for sale. (Sec. 7044, euisness and
Professions Code: The Contrackir's License Law does not apply to an owner of property who - Const.
builds � or improves thereon and who does such work himself or through his own employees, Mech
provided that •such knprovements are not intended or offered for sale. ll, however, the building .
or improvement is sold within one year of completion, the owner -builder will have the burdenElectrical- ,
o/ proving thathe did not build or improve for the purpose of sale-) ..- . -1:123221 -
❑'l, as owner of the property, am exclusively contracting with licensed contractors to coo -Plumbing
'1'struct the project. (Sec. 7044, business -and Professions Code: The Contractor's License Law 157,
does not apply to an owner of property who builds or inproves thereon, and who contracts for S.M,I, `
•such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) A • �A
Grading -
❑ I am exempt under Sec. B. & P,C. for this reason
Driveway Enc.
20.00
Date Domer Infrastructure 1,922.38.
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of I -
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. _
',TOTAL 13.377.93 ' 3 : 1 -�"-e.
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation '
orless.) ... .
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 --i , a t ••�. `._ f c.. Y...%.'rt ii'+' - - ..
r'' Owner 1 • �
NOTICE TO APPLICANT: ff. after making_ this Certificate of Exemption you should becomes ZONE: BY:
sub)ect to the workers' Compensation provisions of the Labor code, you must forthwith Minimum Setback Distances:.
comply with such provisions or this permit shall be deemed revoked. - - '
Feont.Setback from Center,Line
-------------
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street.SetbaCk from Center Line
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:) r Side Setback from Property Line
Lender's Name , ; ` ` a 7 Y t , .- J fl S"y.
' Lender's Address
This is a building permit when property filled out, signed and validated, and is subject to FINAL DATE INSPECTOR
expiration if work thereunder is suspended for 180 days- 7..Ol J%Q9
I certify that I have read this application and state that.the above information is correct.' - Issued by:` Date - Permit'
and I agree to comply with all city and county ordinances astate laws relating to building r .
construction, 'and hereby authorize representatives orf this city to enter the -above--k '
mentioned property for inspection purposes (, - _ Validated b
Signature of applicantis )-t, . s,r y
Date'
Mailing Address �• .`a ' t " t' "' ° --Validation*
City, ;State, Zip r
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
COLL. AREA
SLAB GRADE �O
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. ®
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE 1131fg
DRAINAGE PIPING
CAR P. SO. FT. ®
GROUT
WALL SQ. FT.
SERVICE
DRINKING FOUNTAIN.
FINAL INSP.
URINAL
SQ. FT.
ESTIMATED CONSTRUCTION VALUATION $
-$
WATER PIPING
NOTE: Not to be used as property tax valuation
FRAMING
FLOOR DRAIN
MECHANICAL FEES
/�
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
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.
SQ. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1+/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® V4c
HOUSE SEWER
FINISH GRADING
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 /,S'/T DOUND
PLUMBI
A'
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE �O
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
WMIME SEPTIC TAN ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE 1131fg
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
-$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING 1944
/�
! "/7�
0
b
,v Y/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING -f Oryx
MESH
INSULATIONISOUND 90 /
FINISH GRADING
FINAL INSPECTION 6
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATUREa11NITIALS
GARDEN WALL FINAL
t
I
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
OF qA
SCHOOL FACILITY FEES q!
am
Ils
TO: City of La Q�%n�t o®c"�All- DATE:
s -Lr evftl rentDepartment of Commun/ O C{bYD
sem,
78-105 Calle Estado
La Quinta, CA 92253
This is to certify that /vl �1-7V U/ r (.'U11 ✓ • ,
developer of Q,w c
located at 11 I�i?n�)
this District, has paid school acili y fees imposed pursuant to the
authl.orit�, �nenQerat d by Gov r ment Code S 'ction 53080 in he amount of r
$-
f7'
(
covering a total of sq re feet of -(J() ) re 'den ial or
( ) industrial/commercial development and that building permits for
this footage in this development may now be issued by your jurisdiction.
IC�1590
for DESERT RAN -UNIFIED SCHOOL DISTRICT
White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer
(10)-37
�m� ORANGE COAST TITLE CO.
RECORDING REQUESTED B'.
i;et;ordirll'� Lir.;tlt,sic>ill,; .'
AND WHEN RECORDED MAIL THIS DEED AND UNLESS OTHERWISE SHOWN BELOW
MAIL TAX STATEMENT TO:,
Name Mark W. Katzman
Street Gerald A. Katzman
WAddress 510 Flower Hill Lane:.
cS; a Palm Desert; Ca 92260
.TO
Name
Street
Address SAME AS ABOVE
City 8
State
TITLE ORDER N0. 2 0 2 5 0 6 ESCROW N0. 3 7 18 — JC
J a CD
00$`
w
Ll
U Q
w. y S j Uj O
EDW o N V !1
4 o J '� W
N
C� _1
V.
SPACE ABOVE THIS LINE FOR RECORDER'S USE
GRANT DEED
THE UNDERSIGNED GRANTOR(S) DECLARE(S)
DOCUMENTARY TRANSFER TAX IS $ 46.20
E computed on full value of property conveyed, or
❑ computed on full value less value of liens or encumbrances remaining at time of sale.
unincorporated area
1� city of La Quinta , AND
O FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
n Leo Howard, a married man, as his sole and separate property
hereby GRANT(s) to
V Ma:rk-,-W- Katzman; -an- unmarried man AND Gerald -A4 Katzman; -a- single man,
AS.'JOINT TENANTS
the following described real property in the City of La Quinta
County of Riverside , State of California:
Lots 11 and- 12 of Block 239 -of. -Santa Carmelita at Vale La Quinta, Unit
No. 22, as shown by - Map -on file, in Book 20 -page. -24 of Maps, Records of
Riverside County, California. [apn #774-165-010 and 774-165-011]
Dated
Aug.. 19, 1989 •
STATE OF CALIFORNIA
COUNTY OF /Os /Tn96'EG��-s ISS.`
On this 3/ day of G'!/ST , in the year 19 12 ,
before me, the undersigned, a Notary Public in and for said State,
personally appeared LEcJ ctJq�y�
, personally known to me
(or proved to me on the basis of satisfactory evidence) to be the
person whose name /9 subscribed to the within
instrument, and acknowledged to me that _ he — executed it.
WITNESS my hand and official seal.
Leo Howard
W
FFICIAL SFAf,
HODO'RA E FRANK
RY PUBLIC- CALIFOi NIA
OS ANGELES COUNTYomm. expires AUG'28, 1992 h
Signaturet,
NOTARY PUBLIC IN AND FOR SAID STATE
CO -441 (REV 4/85) MAIL TAX STATEMENTS AS DIRECTED ABOVE.
(This area for.official notarial seal)
?a`s+y$o�,is ^:*aX,+nit+e",��*�?�"1►��':►iwiv�`i+sri�+''��lr':h+�x �7i �`+�'
COACHELLA VALLEY WATER DISTRICT
CASH RECEIPT DETAIL
No `3�1d'1
Received From: J—' -A -r -Z W&A t-1 vv`i-.AI%- le -W`
Date:
0 L D l cJ'�] i2 �L �.
Address: 510
/
rel/V. r��
Tc^
L�
y�
l
Tract
Account No. `SLot(s)
�G AS CO
G.A. Code
Service Address
❑ Meter(s)
$
❑ Service(s)
❑ Backflow(s)
❑ House Lateral (s)
❑ Detector Check(s)
❑ Meter Surcharge04,
anitationCapacity Charge
y�
1"'
❑ W.S.B.F.C.
❑ Temporary Construction Meter
❑ Turn on Charge
❑ Uncollected Account - Name
❑ Inspection Fee - Tract -
Fee -
❑ Plan Check Fees Water I Sewer -
Tract -
❑ Bond Payment - A.D. - Bond
Assmt.
❑ Customer Deposit
1
❑ Other
TOTAL S �"
Remarks: CL/LO'H+../Z
/
$
Armn- Nq-
❑Copy to:
'� �
3r`T .,:
!
baa
Water Service _
Cashier•
CVM- 438 (11/89)
Cash'..
Check.
Money
Order
®ATELAND CONSTRUCTION CO.
50-305 Highway 111 • Coachella, CA • 92263 • (619) 398-5544
AUGUST 15, 1990
CITY OF LA QUINTA
BUILDING DEPT.
P.O. BOX-1504-
LA
OX-1504LA QUINTA, CAo 92253.
ATTENTION. TOM HARTUNG
WE RECENTLY ABANDONED A'. SEPTIC SYSTEM AT 5.�194i) : V_EL,A.SC®
BY PUMPING THE • UNUSED EXISTING GALLON SEPT I C TANk*,:
AND DEMOLISHING THE. FIRST TWO TO THREE FOOT OF CONCRETE
LEACH'F'IT AND BAt FILLING THE EXCAVATIONS.''
THE REMOVED TANk' 'WAS INCORPORATED . I N A SYSTEM INSTALLED AT
52-7-10 MADEROa
IF THERE ARE ANY F=URTHER QUESTIONS, DO NOT HESITATE TO
CALL.
S'I NCERELY ,
,y.
A. MC NEIL
DATELAND CION T.
4
AUG 1350
Grading • Paving • Pipelines • Septic Systems • Grease Traps • Drywells
y�K�l �-rSpr' � �,y3"",�i ;�._ a r�,�d�1 � � t,. �•�y,� s �`s.�` S r �t: t �s,'xx'• �'~4�,?' e ''�',.
a`{'�`"•"' `' s7+'4 1 i+..�. �Y�.' `xvi.. :�' • �e"yk "' - ;�i+�'`/ +',y�`..:a��"}�" �j"`•�'�" "�',
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COUNTY OF RIVERSIDE ENVIRONMENTAL """011111 Paroi1NO.
' -. HEALTH SERVICES DIVISION t +
;ry
APERMIT 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 speculations as indicated on the attached check list
A non-refundable filing fee (see below) is required when the application is submitted. Check must be made payable to the County of
Riverside. Approval of this application shall remain valid for a period -not to exceed one year from date of approval.
i
VERIFY ITEMS IN SECTION A FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG #
Agent. Contractor, Contact Person
m U \ h 2�vt ca-,�J
Phone
--7 1
Address & Firm
1 4:W f r= .�. n�. �� .� Ce ,-� :s
Owner
Phone
Mailing Address
o (-a.:,, r,
City
State ,
C_4\
Zip
°%)LCc7
Jot(F4r6AayfAddrbss
v•e G 0,eC.0T
Legal Description Prop. (PM, Tract, Lot)
r Z /� Lo c,re' 2 3 S
Lot Size
Water Agency e1
Use of Permit P/P, CU, etc. C>�&l
Other
SU
G U
Dwelling H bite' Prep,
etc:
Signature of Applicant
} Date
CATEGORY: a REV CODE,WE
$ 57.0
CATEGORY:. REV CODE FEE
O' SUBSURFACE DISPOSAL 1238 _ _
❑ SITE EVALUATION UPON REQUEST 7349 $ 43.00
❑ .MULTIPLE PARCELS WITHIN SAME'
(NO PLOT PLAN)
LAND DIVISION
❑ SEWER/SEPTIC VERIFICATION 7348• $ 17.00
a ;1 at 4 Parcels (Each) 1238 • $ 57.00
(Less than 1 year)
b. Each Parcel after 4 `` 7344 $ 24.00
❑ PRELIMINARY. ELECTIVE 7352 .. $ 23.00
❑ Rereview (2nd review same parcel) " 7344 $ '24.00
EVALUATION (Attach DOH SAN 53)
❑ Site Evaluation in Conjunction with rj ",
❑ HOLDING TANK 7351 _$ 47.00
Critical Area 7346 $111.00
❑ ALTERNATIVE/EXPERIMENTAL 7345 $222.00
❑ Site Evaluation Lot Less than
. SYSTEM -
10,000 Sq: Ft _! '7347 $ 87.00 .
INITIAL/% DATE_�C�
Holding Tank Agreements Co_ mpleted ❑Yes r`T" No ariul�
CertHication of Existing S.D. System Required _ ❑Yes Ca0tV� E
WOCB Clearance Form
required. (Attach ❑ Yes P No
DCH SAN 007, Santa Ana Region Only) -
Sills Percolation Report Required. n ❑Yes O'/
Special Feasibilfty Boring Report Required. ❑ Yes 0' No
1
Detailed Contour Plot Plans Required (lrto 5 R interval) 11 Yes a, N 1
Other "' C1Yes 01 No", ' 1
Staff SpeclW st Lot Inspection Required. ' 1'wr ❑ Yes O'/No
Lot Inspection Date
Soils boring report by Prr�oj�.ec't�/ Date
! Q �j
Soils Map Page '� �� ! Sot1 Type ` ��- Approved -1 �7•i f / '� 'O
_ byC - Dffie/ /
No. of Systems
Type of Syetem(s) .L
No. Dwelling Units f�
(1) Septic Tank
Soff Rate
\Grease/Send
tp- t�&ding Tank, ❑ Existing
New O Replaoertwrrt
Bedrooms F�I�ct re•l7rilta
G'regeeJ
-
/fin^ Aux
Lf/E�t
U /
I `x
.
Gal
7 J
-Gal
`(2 Leach Line Sq. Ft
Bdttom trench
Sidewall allowance
d
Instalb— Line(s) R long ft wide rv�Ut/
Leach Bed sq. k
area
_ It rock/ sq. R
per running It.
min. ,►c below drainlines or
om area
Leachfines/bed special design for slope:
Applicable/
(3) Pit Diameter
/
No. Pits
Pit Below
Inlet (BI)
Seepage Pit Total Depth
(TD)
Other:
Max. Allowable Depth
�,�
s — -
I� /
N/A Overburden factor
S�
No. 2 SystemI`t
REMARKS: !' � �'1 C• /?rr ) t
/ ..
7
This applicatio As --APPROVED ENIE-D for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated
on the accompan' p t p n, using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the
above -designed system._ No construction, is permitted in the required reserved 100% expansion area.1'
Septic tank and sewerlines must be 50' minimum from any weliscq/0 7
E0 Leach lines must be 100' minimum from any wells, including ezpans' area.
-^ (3 Seepage must be 1501 from !c^l 0c,
pits minimum any wells, including expansion, area
�� �4�Date
Signature of Health Official , �
RECEIPT NO. f ""� Issued By �1�[�c/� Date
DISTRICT: ❑ Riverside, J_1Indio ° `- ❑ Hemet q Perris ❑ Rancho Calif. ❑ Blythe
DOH -SAN -122 (Rev. 7/89) DISTRIBUTION: WHITE - Office file YELLOW Applicant PINK . Bldg. Dept GOLDENROD - Plans/Records
rwy
h.Ti -7
-
I
Ti of 1a uin a i+
uttbtn stub �SdfPt3titkoitun I w 1
This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building !� i
-
.: 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: I !�
I
!53-940 Avenida Velasco I! '
BUILDING ADDRESS !
!
SFD06644 1
'i Use Classification Bldg. Permit No.
Group R3 Type Construction VN Fre Zone Use Zone SR
Katzman 53-940 Avenida Velasco
i, Owner of Building Address kP
La Quinta, CA 92253
City e G
y; Mark Harold
Date; 6-6-90
of
Ili 11U it
POST IN A CONSPICUOUS PLACE
...rte■. ._ . �-�_---- - -----_� _ _.,-. _ , ., ...,.., .. __ _ z..�..���.,,. _.. _.-_ . .. �_.._���.a_:.,«.-=-..ate_-� . �....._.�..d.�r.... -�..- .-..._,,,.-..a..,......._ _�---�