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05562 (SFD)' 4 4 " P.O. BOX 1504 Building 78-105 CALLE ESTADO Address 54-665 VELAMI LA QUINTA, CALIFORNIA 92253 _. SIS DeieUpm:pat Co. Address 76-924 Daffedil Dr. City Zip Tel. Palm Desert 92260 619/345.1232 Contractor Builder/Owner Address City State Lic.I City & Classif. Lic. # Arcn., tngr., Designer Address I Tel. City (Zip (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 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, 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. he is exempt therefrom, and the basis for the alleged exemption. Any vkilation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a civilpenalty of not more 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 inprove for the purpose of sale.) ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to corn 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 1 hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, ora certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company ❑ Copy is filed with the city. ❑ 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 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. It, 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 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.) 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 -of this city to enter the above- mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip No. BUILDING: TYPE CONST. OCC: GRP.; A.P. Number 774-288-003 05552 Description %t 9 BIk 28 304 I Description $rD Sq. Ft. 1600 No. 1 No. Dw. Size Stories Units New Add ❑ Alter ❑ Repair ❑ Demolition ❑ $92,497.00 PERMIT AMOUNT Plan Chk. Dep. 250.00 Plan Chk. Bal. 7-6K-336 Const. 600.00 Mech. 53.54 Electrical 115.59 Plumbing 157.56 S.M.I. 6.51 Grading 20.00. Driveway Enc. 20.00 Infrastructure 2,042.93 TOTAL REMARKS +'.—yrs •. re•. .t .. .. ...a.- . ... - ...«, - �r, .. � -t,i r.:nrr .IV YriA f Y,w.; i;•' , 'w.7�:.. T t, . ?7 Y t 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 3/28/89 Issued by: Date Validated by: Validation: Permit CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ® $ UNITS A.C. UNIT COLL. AREA SLAB GRADE YARD SPKLR SYSTEM' 2ND FL SQ. FT. @ BONDING HEATING (ROUGH) MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® ROUGH WIRING POWER OUTLET ROOF DRAINS GAR. SO. FT. ® GAS (ROUGH) METER LOOP DRAINAGE PIPING CAR P. I SO. FT. ® REINF. STEEL GAS (FINAL) WALL SQ. FT. TEMP. POLE DRINKING FOUNTAIN. URINAL SQ FT ® SERVICE ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation WATER SYSTEM FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FRAMING-5 GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED ROOFING — O `� LAUNDRYTRAY AIR HANDLING UNIT CFM i�%U�// lam" !/ 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1+/. c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac 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 & AIR COND. SOLAR SETBACK OUND PLUMB � UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. 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. FRAMING-5 FINAL INSP. ROOFING — O `� {/�' v� / lJ /✓ It�2 U / /: /� tv V( l G� i�%U�// lam" !/ REMARKS: VENTILATION FIRE ZONE ROOFING ' FIREPLACE SPARK ARRESTOR GAR. FIREWALL YWGTHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTIOfJ(� �,� ,' -04 CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES11INIT1ALS GARDEN WALL FINAL Desert Sands Unified School District CERTIFICATION OF PAYMENT OF INOTICE: THIS DOCUP. � 141 %0M1��VV I Fees BE DUPLICATED, TO: City of La Quinta DATE: Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 This is to developer of located at this District, authority generatoA by Gov rnment de Secti n 53080 in the amount of covering a total of ® /square feet oO/( ) rdgidential or ( ) industrial/commercial development and that building permits for this footage in this development may now be issued by your jurisdiction. - "�f7 1;� — for DESERT SANDS•UNI ED SCHr L DISTRICT certify that A e/V which is twithin has paid school facility fees imp -sed pursuant to the White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer (10)-37 —.:�.: • t ^^x"S. S'•='rii�i'�';'S` -} :�:�,%FTIg: ^�b%�o�f�;�tr��, e i bT��iy ��ykc' r-. �,:i-c.�,<:Y '�.'� "i„ �-� F , .y RECEIPT NO. Issued By T' D e DISTRICT: ❑ Riverside, Vlndi6 ❑ Hemet Q Perris ❑• Rancho Calif. D Blythe , DOH SAN 122 (Rev. 5/88) DISTRIBUTION: t 'WHITE - Office file YELLOW Appiicant4 PINK - Bldg. Dept GOLDENROD - Plans/Records 10 COUNTY OF RIVERSIDE "DEPARTMENT OF HEALTH '' " j �/ �J Asammm Pumel No. / — Ar3 ENVIRONMENTAL HEALTH SERVICES i 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 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. f Q VERIFY ITEMS IN SECTION A FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG ar Z QV7 Aor, fact Pe Phone Address & Phone ' U ' P li Address 9 2 Sts6 J Z� JA � Lot) , Legal D ription Prop.P���Grl a. O - Lot Size ter /Well Use of Permit P/P, CU, et q ell$ a Prep, etc. � Signature of Applicant G Date CATEGORY: • ." " REV CODE E CATEGORY: REV CODE FEE ©/SUBSURFACE DISPOSAL. 1238 $45.00 ❑ SITE EVALUATION UPON REQUEST }, 7349 $42.00• ❑ MULTIPLE PARCELS WITHIN SAME (NO PLOT PLAN) Z LAND DIVISION' ❑ SEWER/SEPTIC VERIFICATION" 7348 $11.00 O a. 1 at 4 Parcels (Each) 1238. $45:00 • (Less than 1 year) H b. Each Parcel after 4 7344 $16.00 ❑ PRELIMINARY ELECTIVE 7352 $45.00 W ❑ Rereview (2nd review same parcel) 7344 $16.00 • EVALUATION (Attach DOH SAN 53) In ❑ Site Evaluation in Conjunction with', O HOLDING TANK 7351 $45.00 Critical Area 7346 $86.00 ❑ ALTERNATIVE/EXPERIMENITAL 7345 $13200 ❑ Site Evaluation Lot Less than SYSTEM 10,000 Sq. Ft. 7347 .$86.00 DATfE� C7 3" Holding Tank Agreements Completed ❑ Yes o� ✓k-- 7"",f Certification of Existing.S.D. System Required ❑ Yes No, ( i WOCB Clearance required. (Attach Form ❑ Yes. DOH SAN 007, Sante Ana Region Only) N �No Sella Percolatlon Report Required. ❑ Yes Special Feasibility Boring Report Required. ❑ Yes Detailed Contour Pktt Plans Required (1 to 5 fL interval) ❑ Yes 13 If Other ❑ Yes ;No' Staff Specialist Lot Inspection Required q YesLot Inspection Date Soils boring report by Project # Date Soils Map Page / Soft Type Approved by f � Date U No. of Systema TYA of Syatem(s) No. Dwelling Units/ (1) Septic Tank Soil Rats Grease/Send O Ing,Tank OO Repl®P Existing Bedrooms 61xta►e 1Nts ei eIntcp � 3 M&I-AWS,Gal V W14 V/041Gal F _ wNR Leach Una Sq. Ft '� Sidewali allowance Install IN Line(s) R. long ft wide with -leach Bed eq. n trench area it rock/ sq. It. min. rnohes dralnlines or O y„area � per running ft ! •• o ," L.eachlines/bed special design for slope: (3) Pit Diameter No. Pits Pit Below Seepage Pit Jotel Depth Other. Apple�� 479' L�1 6 + Inlet (BI) Max. Allowaf3le Depth N/A L�- Overburden facto // No. -2 System N/ 4 REMARKS: 4 ,/?� �%���:���%"`h��-a'�!r GZI�:� /1,{J•�-3.. d ,�fi�'4 t� a'l. � - Q This application <PP"�PR0 ED .WM for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated on the accompanied plot plan, using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the Z above -designed system. No construction is permitted in the required reserved 100% expansion area. 10, Septic tank and sewer lines must be 50' minimum from any wells f'��, J w g (2 Leach lines must be 100' minimum from any wells, including exI ansio a G �i 3 Seepage be from' ,:At pits must 150' minimum any wells, ,including expans' -Signature n a ear of Heatth'Official 4"4 4�4�e RECEIPT NO. Issued By T' D e DISTRICT: ❑ Riverside, Vlndi6 ❑ Hemet Q Perris ❑• Rancho Calif. D Blythe , DOH SAN 122 (Rev. 5/88) DISTRIBUTION: t 'WHITE - Office file YELLOW Appiicant4 PINK - Bldg. Dept GOLDENROD - Plans/Records 10 ui I II.E or A6RICUL 1 MAL c;OMMISSIO"L-1t AND WI:It,i I I S .�i MEASURES 49-613 Ilwy IIG, Hulte 11—I2 'Cvnclfellti, CA 922JG 619-362-0291 E. LE014 SPAtiGY co•.nn:;irr.tn ZANIES u WAIXAC CLEMENI BF.`VENISIE SLAW cAsc m. 1� 8 G/�3 - ofao1s I)EVCLIC)M i' 5 [IN -1E1 AUUIIESS t '1'rLL1'I tUIJC War UeveloperI — � (o S /4 -✓e ,� � � a lie joys Co � !�- � ler w � %� Alter teviewilly your lalalscUillIKI 111011r), Illi`Isle"tllatV711eyllsICdsubstit-utlolls vivll�tivn vl quarantine lir•�s tjovemI119 th_ do occur and they c11[[er .[11-111 plant mlteLlal listed, tills v[[ice must be Ilotilied itlu>edlately . '1'llank you 1vr �,totectLly and 1Ir,esewlliy llie Cvdchella Valley's rest-[>:ee envlrvin�ent. Jlgricul tutallcctm�t ss tier s ul [ tce cct llldlo and Rivetside UtOce ,,r ....�.�,-. ,r .•. -. a.� �. f..-�.-.s {. +rr .=�. ,. �.-. ,.r-. .. . ..�._. vl.��•�jtb..ii. s'3 Buena Engineers, Inc. y 79-811 Country Club Drive, Suite 4 Bermuda Dunes, CA 92201 • (619) 345-1588 / 328-9131 M Client Name Client Address All "'Client Phone 1 9 ` r �x_ DATE T JOB NO. FIELD TESTING REFERENCE CURVE MOISTURE DRY , PROJECT MAXIMUM OPTIMUM TEST 1�uJ, (jo(usro LOCATION NUMBER ( u QJIvl ELEVATION CONTENT CONTRACTOR DRY DRY OWNER WEATHER 1' TEMP. o at AM G(CU d % ° at PM PRESENT AT SITE DENSITY CONTENT ,ou s c ' % r peg �u..,�;� .(0 I tr CLIENT REPRESENTATIVE SIGNATURE 5.304 a FIELD REPORT I TECHNICIANS SIGNATURE ` T FIELD TESTING REFERENCE CURVE MOISTURE DRY , MAXIMUM MAXIMUM OPTIMUM TEST TEST LOCATION LOT NUMBER NO. ELEVATION CONTENT DENSITY DRY DRY MOISTURE 1' % IbsJCu. ft. DENSITY DENSITY CONTENT ,ou s % Ibs./cu. h. % 1 peg �u..,�;� .(0 S,o �, rt 61(-G $,v r , I i- �-. ti REMARKS: J c�-1eNP Po div j,,j CA l fote.'r vP wAP k COOLOK 1 ���� •2, �r.st�, ���,�,�, ,�. P,r�S ..o� �O 5o ro�<< S�E�<�o ~. 2; �a al -au Wnr a `rsk- e t {� 1 o ; tucc lrt� 'r-, (45{rc _plad'rt x Q N v Skf',. G ., b+ 4t!-� Wo 0t0 e- C Ctd < QF Gr C4 f I tr CLIENT REPRESENTATIVE SIGNATURE 5.304 a FIELD REPORT I TECHNICIANS SIGNATURE `