07524 (SFD)P.O. BOX 1504 No. 07524,
Building 78-105 CALLE ESTADO
Address 77.211 Sonora LA QUINTA, CALIFORNIA 92253
Owner
Tom ftnffw
Mailing
Address
City Zip
Contractor -
0W1*1"
• Address
City- ZIp
State`Lic
BUILDING: TYPE CONST. OCC: GRP..-
A.P.
RP. -A.P. Number M-241-007
Tel.
Legal Description_ Lat x
Project Description Single Family DwIling -r
T
Tela
& CIassif.. • I Lic #
BArch., Engr.,
Designer
Address, Tel.
City'.•- `. Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I herebyy 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
requjres,the applicant for such permit to file a signed statement that he is licensed pursuant to
the provisions or the Contractor's License Law, 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 permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
❑ 1,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 or 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.)
0 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.)
❑ Tam exempt under Sec. B. & P.C. for this reason
Date Owner��
Y_ s
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
O Copy is filed with the city. ❑ Certified copy is hereby furnished.
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 thg work for which this permit is issued, 1 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
subject to the Workers' Compensation provisions of the Labor Code, 'you must forthwith
complywith 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 _
Lenders 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 -
men
tioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City,State, Zip
REMARKS
Sq. Ft.
Size 14W— -.
No. No. Dw. • •' ,'
Stories -Units 1'%
New ❑ Add El -
Alter ❑ Repair ❑ • '''Demolition ❑
ZONE:
BY:
Minimum Setback
Distances:
Front Setback from Center Line
Estimated Valuation
$N.
's
PERMIT
AMOUNT
Plan Chk. Dep.{�s�o
Side Setback from Property Line
Plan Chk: Bal.
174.73
Const.
57f .5I}
Mech.
Validated by:
Electrical '•
ZJ,�j®
Plumbing3j•Q�
S.M.I.
; 6.02
Grading
IM400
Driveway Enc.
0400
Infrastructure
135752.05
r
TOTAL
$3.074.69
REMARKS
I t :4, 6"�4Ii7Ai 4 i. U-74 to I
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
INSPEEC,�OFj9q
jj
Issued by:
Date �� JJPermit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADEy �2 7
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ, FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SQ. FT.
OTHER APPJEQUIP.
DRINKING FOUNTAIN
SQ FT ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR ' SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IKITCHEN 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
SPARK ARRESTOR
SQ. FT. ®c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1 Vi c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ic
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 Z 9,
c9c1fY[) PLUMBIN
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADEy �2 7
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
EPTIC 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 S h to 7-11,
FINAL INSP.
ROOFING y 2i/ QO
7
Z 0 111"el
/ 6!//�" i`LA
(((
f /
G
B ►l/7
6 n�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING f � fQ Af
MESH
INSULATIONISOUND
FINISH GRADING
I`� !01
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIAL
GARDEN WALL FINAL
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
OF ((A
SCHOOL FACILITY FEES CA
1v®t Ice 01N
TO: City o�LRa Quflnta�;�LR DATE: ' O
Department o?dr0l6rtim�v r etve 'pmgnn®t
78-105 Calle Estado i07,
La Quinta, CA 92253
This is to certif t M U ,
developer of �� which is
located at within
this District, has paid school facility fees imposed pursuant to the
$u hori�g--e(te by Government Cod Sec n 53080 in enaj nt of J�
�i 7 1
covering a total of -4 L square -Re 1 02
feet of ( ) resi nti 1 or f?
( ) industrial/commercial development and that building permits for R
this footage in this development may now be issued by your jurisdiction.
- 6wpttt, D_ eaA�,a)
C� 2 for DESERT SA •UNIFIED SCHOOL DISTRICT
White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer
(10)-37
'at.:r+t,•:r�r:.rr-�';+t�tux�•;•.ry�':r.ar-�•s•.h:tlk;
COUNTY OF RIVERSIDE ENVIRONMENTAL Atnes.on P"°'I Mo.
HEALTH SERVICES DIVISION
P9RMITJAP,�PUCATIO_N FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM
'Appllcant:.
Submitt�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 refuidable filing fee (see below) is required when the application is submitted. Check must be made payable to the County of
diI Riverside. Approval of this application shall remain valid for a period not to exceed one year from date of approval.
.VERIFY ITEMS IN SECTION A FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG #
Agent, Contractor, Contact Person
Phone
Address & Firm
Owner .
T Dv�'
Phone
SG�f-991
Mailing Address
3oX 8a4 4A uiAj-rA
City
,104
State
ZipJob
5.3
Property Address
coymerof
Legal Description Prop. (PM, Tract, Lot)
0 cGi�M
a Pro -
,Cod" - RX K Q flk
Lot Size
Water Agency/Well
Use of Permit P/P, CU, etc. (� f7� ���
Other
5-0. ('
C • v� w D
Dwelling, H Site Prep, etc.
' Date
nature of Applicant
CATEGORY: REV CODE FEE
CATEGORY: REV CODE FEE
'j SUBSURFACE DISPOSAL 1238 $ 57.00
❑ SITE EVALUATION UPON REQUEST 7349 $ 43.00
❑ MULTIPLE PARCELS WITHIN SAME
(NO PLOT PLAN)
LAND DIVISION
❑ SEWER/SEPTIC VERIFICATION 7348 $ 17.00
a. 1st 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
❑ HOLDING TANK 7351 $ 47.00
Critical Area 7348 $111.00
❑' ALTERNATIVE/EXPERIMENTAL 7345 $222.00 _
❑ She Evaluation Lot Less than
SYSTEM
10,000 Sq. Ft. 7347 $ 87.00
INITIAL DATE
Holding Tank Agreements Completed ❑ Yes No
Certification of Existing S.D. System Required ❑ Yes No
WQCB Clearance required. (Attach Form ❑ Yes No
DOH SAN 007, Santa Ana Region Only)
Sails Percolation Report Required. ❑ Yes No
Special Feasibility Boring Report Required. ❑ Yes No
Detailed Contour Plot Pians Required (1 to 5 ft interval) ❑ Yes No
Other ❑ Yes No
Staff Specialist Lot Inspection Required ❑ Yes No
Lot Inspection Date
t
Soils boring report by t la e Project Date
Soils Map Page..Soll Type Approved by - ( � • Date
No. of Systems
Type of Systems)
Dwelling Units
(1)
Soil RBedrooms,
Grease/Sand
I
❑ Holding Tank O❑ R
LNo.
Fixture Units�a%te
/SJeptk�]Tank
�VOV�F�rIU!%
Grows
ll(
Gal
(2) Leach Line Sq. Ft
Sidewall albkranee'"'��
ZO
Install Lines) R long It wide with
Leach Bed aq. fL
Bottom trench area
rock/ fL
min. inches rock below drafnlines or
ora area
per running It.
❑ NA
Leachlines/bed special design for slope:
(3) Pit Diameter
No. Pits
Pit Below
Seepage Ph Total Depth
Other:
Applicable
Inlet (BI)
(TD) fl
N/A _X— Overburden factor
❑ 51 6
1
I
Max. Allowably Depth
�U
No.2 System
REMARKS:
This application isCPPROVED ENIED for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicatec
on the accompan 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.
'!Septic tank and sewer lines must be 50' minimum from any wells
( ! e,Leach lines must be 100' minimum from any wells, including expansion area
3) Seepage pits must be 150' minimum from any wells, includin expansion area
Signature of"Heafth Official De—
RECEIPT NO. �" Issued By 1 G Date
DISTRICT: ❑ Riverside, ❑ Indio ❑ Hemet q Perris ❑ Rancho Calif. ❑ Blythe
DOH -SAN -122 (Rev. 7/89) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records
2
OFFICE OF
AGRICULTURAL COMMISSIONER
1 0 ` • ..
AND
WEIGHTS &MEASURES
CALVIN C. KAMINSKAS
JAMES O. WALLACE 4080 LEMON STREET, ROOM 19. A9051onl commissioner
`• Agrlculhsrol Commissioner RIVERSIDE, CALIFORNIA 92501 CLEMENT BENVENISTE
j Di,sctor of Wetphls A Meosmes 11114) 781.2565°alar
49613 highway 86, Suite B12
Coachella, Ca. 92236
(619) 342-8291
CASE NO. A C L(-, b q ()S 9 6N.
Q
DEVELOPER'S NAME s S' U. til T-6 W +J C_�
ADDRESSI �"4
Cly
TELEPHONE, ((,l �) SSG -49-1-2
': tf
Dear Developers
After reviewing your landscaping plans, all plant material listed is not in
.violation of quarantine-laws governing the Coachella Valley. If substitutions
i. do occur and they differ fran plant material listed, this office must be notified
imwdiately.
`i. ':.Thank you for protecting and preserving the Coachella Valley's pest-free environment.
'r
Xi-r—icultbikail Ccinnissioner's Office
` ac I Indio and Riverside Office
i
f Y c
p i
,. • 5
t
} X78-105 CALLE ESTADO - LA QUINTA, CALIFORNIA '92253 - (6 19) 564-2246
FAX - (619) 564-561
June 28, 1991
To Whom It May Concern:':- `
The structure located at 77=211 Calle Sonora'w-11'be located in a
"B ,flood°zoneer the revised F.I.R:�M:
P "(panels' 060709, 005, A and
0010-A) for'La Quinta. This change will `be effective- August 13,
1991., The property is'currently designated as zone AO (,depth two
- (2) feet) .
If you have any questions, feel free to contact me.
Sincerely,
B G AN �6AFET,Y '
Tom• Hartung
Director of Building and Safety"
TH/es - -
LTRTH30
r
d r
MAILING ADDRESS P.O. BOX 1504 = LA' QUINTA;• CALIFORNIA 92253
"oo (r
CITY OF LA QUINTA
PLANNING AND DEVELOPMENT DEPARTMENT
APPLICATION FOR SETBACK ADJUSTMENT
SECTION 9.188, L.Q.M.C.
APPLICANT: Submit this form with three•copies of a scaled site plan,
draw u ely depict the nature of the request. A nonrefundable
fee f $100 is equired when the Application is submitted. Check must
be ma a ya le to the "City of La Quinta".
If the Applicant is not the owner of the property, a letter must -'be.
submitted by the owner authorizing the Applicantto execute.this.:
document in his behalf. _
-----------------------------------------=-�------------------- --
Please Print or Type
Applicant's Name T� �,f,P �., Date
Mailing Address VoX Phone S-60-11'97 7
City /,t, &::U. State d^4- Zip.7-
Owner's Name
Mailing Address TaMe, �+�''Sh�•�b
City s,9„4e- State Zip's
treet Address of Property 1-1 -711 �or1oN
Legal Description of Property (may be attached): Tract
Lot # 7 /J1x 4e0 Tract Name 6f0Q,t0-V#k1 v -V Alp, yp4r
Assessor's Parcel Number
Adjustment requested 2 QA/ io' S6T/fpcEL. t° r
Reason for request. �l.�v.�no, ls• -A ilw t-groeve& a,,
JUSTIFICATION: No request for a Setback Adjustment shall be granted
unless it is determined that the adjustment is consistent with the
intent and purpose of this•Ordinance; that there are special
circumstances applicable to the property., including such factors as -
size, shape, topography, location or surroundings that justify the
approval of the adjustment of the setback requirement, and that.the
adjustment will be not detrimental to the health, safety, and general
welfare of the community or be detrimental to property in the vicinity
of the parcel.for which the adjustment is requested.
--------------- --------------------------------------------------------
-S&A '10 - 01 Gj STAFF USE ONLY
Case: No.: 9 59
Related Case(s) N/
Assigned to:
BJ/FORM.122
Existing Zoning:
518iTLi-9010
W CASH OTAi10).00
S /1
Date of Decision:
File Closed: