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003327 (BLCK)P.O. BOX 1504 No. 003327 Building 78-105 CALLE ESTADO Address 78-680 AV-01DA Lki0 M LA QUINTA, CALIFORNIA 92253 Owner LUC ANOm"oun Mailing Address 8 City Zip Tel .. LA QU A .... 92253 - 564-3763 Contractor .. OIRUM EM Address City Zip BUILDING: TYPE CONST: OCC.:GRP. A.P. Number Legal Description Project Description Z$'3 feet ®f .e$3iu' link fe—nee^ State Li.c. City & Classif. Lic. # Sq. Ft, No. No. Dw. —,Size Stories - Units '•Arch:; Engr.; Designer. New ❑. Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. ^ ;.... _ City Zip State .Lic. # . LICENSED CONTRACTOR'S. DECLARATION, 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 Estimated Valuation _ I hereby affirm that.) 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 he is licensed pursuant to - PERMIT '- ' - AMOUNT— the provisions of the Contractor's License Law, Chapter 9 (commencing. with Section 7000) -of o ,r • ': Division 3 of the Business'and.Professions Code, or that. he Isexempttherefrom; and the basis for the Any Section 7031.5 by. 'any 'applicant for _. Plan._Chk. Dep. - -{ • .. ' alleged exemption. violation of a%permit • subjects the applicant to a civil penalty o/not more'lhan.five hundred dollars ($500). "•" Chk. Bad. ❑ I, as owner.oI the. property, or my employees. with wages as theirsole compensation, will _•Plan -" do the work, and the structure is not intended or offeredfor sale. (Sec. 7044, Buisness and Const. T n C� Professions Code: The .Contractor's License Law does not apply to an owner,of property who 40.00 builds -or improves thereon and who does such work himself or through his own employees, 'Meeh..• . ., 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. Electrical of proving•that he did not build or improve for the purpose of sale:) ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing. • - .. • • 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- S.M.I: such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - -. ❑.I am exempt under Sec.. B. &P.C. for-thisreasonreason'- - Driveway Enc. Date owner Infrastructure WORKERS' COMPENSATION DECLARATION ' I hereby'affirmahat 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 ❑ Copy is filed with the city.. ❑ Certified copy is hereby furnished. TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS'. COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred 'dollars ($100)- valuation - - or less. . _ I certify that in the performance of the work for which this permit is issued, I shall not -• , k1 .t`$y1 ''+� '�' �.;;•. employ 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 ZONE: BY:, ' ' subject' to 'the Workers' Compensation provisions of the Labor Code,' you must'- forthwith' comply with such provisions or this permit shall be deemed revoked. _Minimum Setback Distances: ' Front Setback from Center Line Rear Setback from Rear Prop.. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line- 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.)' .. Side Setback from Property Line Lender's Name Lender's Address FINAL DATE- INSPECTOR 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 Perrnit read thisapplication and state that the above information is correct. 'and ISSUed.by: Date ,811 `187. . I agree to comply with all city county ordinances and state laws relating to building construction, and hereby authorize representatives -of ' this city to enter' the above•. mentioned property for inspection purposas. Validated by: Signature of applicant Date - Mailing Address Validation: City, State, Zip " HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ UNITS SLAB GRADE 2ND FL. SO. FT. BONDING YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS• CAR P. SO. FT. GAS (ROUGH) DRAINAGE PIPING WALL SO. FT. OTHER APP.IEOUIP. DRINKING FOUNTAIN SO 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 WASH ER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM DEC 17 198? 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. SO. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL GAR. FIREWALL SO.FT.GAR ® 3/ac HOUSE SEWER LATHING 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 GROUND PLUMBING 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 APP.IEOUIP. 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 FINAL INSP. ROOFING et DEC 17 198? REMARKS:. VENTILATION F1RE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS. GARDEN WALL FINAL d�flE� 2 ! O N BERMUDA DUNES r RANCHO MIRAGE INDIAN WELLScc rn PALM DESERT ,P LA OUINTA �a JIQ INDIO y� Desert Sands Unified School District 82.879 HIGHWAY 1 1 1 0 INDID. CALIFORNIA 92201-5678 0 (619) 347-8631 October 7, 1986 City of La Quinta Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 Re: Parcel 769143-008 Gentlemen: The developer of the above referenced parcel has mitigated i:ts tmpacts.on our overcrowded schools by payment of the amount of $628 per unit to be applied to the cost of district educational faci'li.ties made necessary by such new development. Sincerely, John D. Brooks Assistant Superintendent Business Services JDB/crm 20 Z O PZ U UU U) co Z O 1— U LU U) rn V tr Q 2 U-1 cr X 1 Z O H U W U) 4 e� COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM I Applicant: Submit this form with four copies of a scaled plot plan (1-20 scale) drawn to County specifications required on the attached check list. A non-refundable filing fee of $37 is required when the application is submitted. Check must be made payable to the County of Riverside. 4 ' ' Building Department Application Log # Name (Owner, Agent, Contractor, Etc.) Mailing Address S-4 C/ C'ty State Zip Code IIU4J Telephone x.14{,3 J Al 'Job Property Address A-jF. 1ATo-,It f14 (A QW 170 "*CCitty�oor°Community (. �► Q�,.� i9 'Legal Description of Property. (Lot, PM;,TR) LX IS') ocSeAX GI4� 'Assessor's Parcel No. Water Agency dt'Well- % Use o` Permit annipg Case p Lot Size 3 ��`1 �+ � 3..r.. l qo, �" .. SFD, Iv1H Site Preparation Etc. / \ fuA Signatu, re"of Applicant f Dat VThe above information must be verified from Building Application STAFF USE — DO NOT WRITE BELOW THIS LINE i �/ / Initial Date f Certification of Existing S.D. System required. ❑ Yes L2J" No /. f 7 b i WQCB Clearance required. ❑ Yes ® No ❑ © No Soils feasibility report required. Yes ❑ ©No { Detailed boring report required. Yes No { Detailed contour plot plans required. ❑ Yes [7 Staff Specialist approval required. ❑ Yes ©No Lot Inspection Date Soils/boring report by Project # Date G� Soils Map Pagel / 9 Soil Type i Approved by /t%� �-. Date f! Type of System: No. of Bedrooms (1) Septic Tank Soil Rate Required ❑ Existing ❑IsNew ❑ Additional ❑ Replacement Gals. (2) Leach line sq. ft. h Sidewall allowance ft. Ft. Instal6. � Line(s) Ft. Long, ✓ Y Leach bed Sq. of''bottom (Bottom„t encs area) rock/ Sq. ft. 14oN7A Ft. Wide wit, min. inches below drain lines Ft. per running rock area Leach lines/bed-special design for slope: (3) Pit Diameter No. Pits Pit B1; Seepage Pit total depth Ake; r Applicable N/A Overburden factor 10�5 I �A7 Max. allowable depth } . 4r) ' 'p + .Qf r.^ 'rrt it .a est f 7.r - ; - l El I'Z � (r`a moo• ,?! / .. r �/A This application is,a0 ro ev d denied�for the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements set forth in Section B above. A building permit is necessary for the insta lation of the above -designed system,_. L (1) Septic tank and sewer lines must be 50' from any wells 111Iv4 +'� `r- (2) Leach lines must be 100' min. from any wells including expansion area (3) Seepage pits must be 150' min.. from any wells including expansion area'1 / Signature of'Health Official's t �..�t,/'' . /� �(, .�--'t %'� /(: %� Date �-�� " a0 RECEIPT NO. 06 Y,--2 by � Date —4� .� w a District: ❑ Riverside ©-Alndio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File DOH -SAN -122 (Rev. 6/86)