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9585 (SFD)Bu•Iding Ad.lrPcc 78-625 Ultimo Owner A & H Builders Ma6ling Address P. 0. Brix 366 City Zip La Quinta 92253 Contractor t A & M Builders Address P.O. BOX 1504 N Q S 9585 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST. OCC: GRP. el. 564-4832 cam Cit_+ 1 Zip Tel.: State Lic. City & Classif. Lic. # Arch., Engr., Designer Address Tel. City Zip : " State L' ic.4, LICENSED CONTRACTOR'S DECLARATION I h=reby affirm that l am licensed under provisions of Chapter 9,(e6mmencing with Section TIXA) of Division 3 of'the Business and Professions+Code, a d my license is in full force and SIGr4:1TURE DATE OWNER -BUILDER DECLARATION hereby affirm that I am exempt from the Contractors License Law forthe following reason: (Sec. 7031.5;Business and Professions Code: Any city or county which iequires a Permit to construct, alter, improve; demolish, or repair any structure, prior to its issuance also. requires the applicant for such permit to the 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 Cie 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.(E500). - - ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do tte 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 build-- 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. t, however, the building or improvement is sold within one year of completion, the owner -builder wit have the burden of paving that he did not build or improve for the purpose of sale.) ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to corp 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 dhereon, and who contracts for such•projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. 8 P.C. for this 'reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm'that I have a certificate of consent to self -insure, or a certificate of Wor.er'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. CERTIFICATE OF EXEMPTION FROM. , WORKERS' COMPENSATION INSURANCE (This: section need not be completed if the permit- is for one hundred dollars (E 100) valuation or leas.) I! certify that in the performance of thp.work for which this permit is issued, I shall not emp.oy any person in any manner so as to become subject to the Workers' Compensation Lawn of California Date _Owner NOTCE 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 comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Ihereby affirm that there is a construction lending agency for the performance of the work -or which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address TF.is is a building permit when properly filled out, signed and validated, and is subject to expir tion if work thereunder Is suspended for 180 days. I certify that 1 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 consvuction, and hereby authorize representatives -of this city to enter the above-. mentioned property for Inspection purposes. Signature of applicant Date Maili'eg Address City, State, Zip A.P. Number 769-060-002 Legal Description 'Lot 6 Project Description SM Sq. Ft. 2265 No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Permit does not include block walls or pool (Estimated Valuation 123.650 r PERMIT Plan Chir:"Dep. 250.00 Plan Chk. Bal. Const. Mech. ' Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure Arts in Publi. TOTAL 4691. AMOUNT 366.43 723.50 62.00 155.98 173.50 12.50 20.00 20.00 2743.88 59.13 4341.92 REMARKS S/'e i13]�l�t.'I��'f �1��4�#Itr�� .:x. ��•tii�, y� �� ZONE: BY: Minimum Setback Distances: Front Setback from Center Line - r Rear Setback from Rear Prop. Line ` Side Street Setback from Center Line Side Setback from Properti,Line FINAL DATE INSPECTOR Issued by: Date APermit Validated by: Validation: SETBACK GROUND PLUMBINGS UNDERGROUND CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEE IST FL. SO. FT. ® $ 2ND FL. SQ. FT. POR. SQ. FT. ® GAR. SO. FT. ® CAR P. SQ. FT. WALL SQ. FT. SO FT ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN, URINAL WATER PIPING NOTE: Not to be used as property tax valuation FORMS FLOOR DRAIN ROUGH WIRING. MECHANICAL FEES ROCK STORAGE WATER SOFTENER GAS (ROUGH) VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) REINF. STEE - APPLIANCE DRYER TEMP. POLE GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED WATER HEATER LAUNDRYTRAY FINAL INSP. AIR HANDLING UNIT CFM BOND BEAM KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' FINAL INSP. COMPRESSOR HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER. B.T.U. SQ. FT. ® c BATH TUB FIRE ZONE ROOFING SO. FT. ®c IWATER HEATER FIREPLACE/1 MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11A c SEWAGE DISPOSAL SQ.FT.GAR ® 3Vic HOUSE SEWER GAR. FIREWALL GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PLCK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE / PLUMBING _ ELECTRICAL HEATING & AIR COND. SOLAR' SETBACK GROUND PLUMBINGS UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ZA j ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING. DUCT WORK ROCK STORAGE FOUND. REIN GAS (ROUGH) METER L60P HEATING (FINAL) OTHER APPJEQUIP. REINF. STEE - GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ 17- plus x$ =$ LUMBER GR. FINAL INSP. FRAMING Z FINAL INSP. ROOFING l VENTILATION REMARKS: FIRE ZONE ROOFING FIREPLACE/1 SPARK ARRESTOR GAR. FIREWALL RING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL DESERT SANDS UNIFIED SCHOOL DISTRICT 82-879 Highway 111 NOTICE: Indio, CA 92201 Document Cannot Be Duplicated (619) 347-8631 Date 5/22/91 No. 110618 Owner Name Type of Permit A & M Builders No. 78-625 Street Ultimo city La Quinta zip 92253 La Quinta Permit # Log # Study Area APN # 769-060-002 1 Tract # Lot # © Square Footage 122,65 Type of Development Single Family Residence No. of units Comments 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 1.58 X ® or $ 3,578.70 have been paid to D.S.0 S.D. for the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued. Fees Paid By A & M Construction Name on the check Richard M. Beck Director, Facilities Planning & Development Telephone 564-4832 Fee collected /eempted by Shelley D. Bennett - • ` `- " Payment Received Signature Check No. 1056 Collector: Attach a copy of county or city plan check application form to distract cope for all waivers. Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting '7— RECEIPT NO. Issued By gki/0 Date DISTRICT: 0 Riverside, audio'- 0 Hemet C7 Perris 11 Rancho Calif. 0 Blythe DOH -SAN -122 (Rev. 3/90) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records Avea*M ftraw NO. COUNTY •OF RIVERSIDE DEPARTMENT OF HEALTH' . - . I 1 ENVIRONMENTAL SERVICES. DIVISION Z 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 speclatlons,as Indicated an the attached check IIaL A non-refundable filing fee (sea below) is required when the application Is submitted. Check must be made payable to, the County pt fiCef' rc 8_ [ e Approvaliof this application shall remain valid for a period not to exceed one year from date of approval.. VERIFY ITEMS 4N&ECTION A FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT: APPLICATION LOG Z A—qet(�)ntractor Contad)- n ;Z,4-�-�4 - xS Phone Add ss & Firm Ac!! X - e<Co " - , Owner UJI (1) Phone— Mailing Address City ce 1*n57W State 1 e- Zip >2<3 JobP2� rty,,d4res%.,,, 78e Legal Description Prop. (PM. Tract, Lot) 4(Z Lot Size Water Agency/Well Use of Permit P/P, CU, etc. Other Dwelling H She Prep, etc. az, Signature of Applicant Date CATEGORY: REV CODE FEE CATEGORY: REV CODE.' • FEE 1R( SUBSURFACE DISPOSAL 1238 - 0 SITE EVALUATION UPON REQUEST 7349 $ 43.00 74 0 MULTIPLE PARCELS WITHIN SAME (NO PLOT PLAN). LAND,DMS40N 0 SEWER/SEPTIC,VERIFICATION 7348 $ 17.00 Z 0a 1 at 4 Parcels (Each) 1238 $ 57.00 (Less than 1 year) — b. Each Parcel after 4 7344 $ 24.00 0 PRELIMINARY ELECTIVE 7352. $ 23.00 LU0 "Rereview (2nd review same parcel) 7344 $ 24.00 EVALUATION (Attach DOH SAN 53) U) 0 Site Evaluation in Conjunction with 0 HOLDING TANK 7351 $,47..00 Critical Area 7346 $111.00 0 ALTERNATIVE/EXPERIMENTAL 7345, $222.00 0 Site Evaluation Lot Less than SYSTEM 10,000 Sq. Ft. 7347 $ 87.00 INITIAL 'DATE Holding Tank Agreements Completed 0 Yes No 1.44 A AMY � Certification of Existing S.D. System Required 0 Yes No WOCB Clearance required. (Attach Form 0 yes No DOH SAN 007, Santa Ana Region Only) Soils Percolation Report Required. 0 yes No Special Feasibility Boring Report Required. 0 yes No • Detailed Contour Plot Plans Required (1 to 5 ft interval) 0 Yes No Other 0 Yes No Staff Specialist Lot Inspection Required 0 Yes No Lot Inspection Date Soils boring report by Project Dots Soils Map • Page Sol Type Alop"NOd by I&V14— Da I le VIC? Z 0 No. Of Systems Type of Sys"s)(1) 0 Holding Tank 0 Existing I Septic Tank Soil Rate Grease Grease U New 0 Replacernt" /Opo Gal '/,�& / W U) (2) Leach Line Sq.. t Sickwall alb wane I WWI tL I P4k Leech Bed Bottom trent ft rock/— sq. ft. Min. Inches rock drekhlines or Of area per running ft. Leachlines/bed special design for slope: (3) Ph Diameter N . o. Pits Ph Below (TD) Seepage P11;btal Depth Other. Applicable Inlet (BI) V V Max. Allowable Depth N/A 71_1�r Overburden factor (9 6 It L10 No. 2 System REMARKS: 0 This application QPPRO�VE APPROVED for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated Z 1��l is pi on the accompan plan, using the requirements set forth in SECTION C above. A building permit is necessary for the.,installati'on of. the Z above -designed system. No construction is permitted in the required reserved 100% expansion area. 0 Septic tank and sewer lines must be *50' minimum from any wells Leach lines must be 100' minimum from any wells, including expansion area Seepage pits must be 150' minimum from any wells, including expansion area U) Signature of Health Official&�A:A&4m� Date) 7/1 %A// RECEIPT NO. Issued By gki/0 Date DISTRICT: 0 Riverside, audio'- 0 Hemet C7 Perris 11 Rancho Calif. 0 Blythe DOH -SAN -122 (Rev. 3/90) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records N A T E p .lam, 4D/STRIC" ESTABLISHED IN 1918 AS A PUBLIC AGENCY COACHELLAVALLEY WATER DISTRICT POST OFFICE BOX 1058 • COACHELLA, CALIFORNIA 92236 • TELEPHONE (619) 398.2651 DIRECTORS RAYMOND R. RUMMONDS, PRESIDENT TELLIS CODEKAS, VICE PRESIDENT JOHN P. POWELL PAUL W. NICHOLS THEODORE J. FISH VNameV VAddV VSa1V January 27, 1986 F, 1 OFFICERS LOWELL O. WEEKS. GENERAL MANAGER—CHIEF ENGINEER BERNARDINE SUTTON, SECRETARY KEITH H. AINSWORTH• ASSISTANT GENERAL MANAGER/AUDITOR REDWINE AND SHERRILL, ATTORNEYS ' a File:- 0721.1 7/1A<--�� Subject: Sanitation Service for Avila Drive, Hacienda La Quinta,•Guijarro Place, La Quinta, California The tract in which your home is located was constructed with a dry'sewer system. This system was installed in,anticipation of the extension of community trunk sewers. In October 1985 connection to the community trunk sewer was made, thereby activating the sewer system within your tract. The developer of your tract, recognizing that the'sewer system was not usable, installed septic tanks for.the purpose of providing wastewater treatment until the sewer .system could.be activated. Now that your sewer system is in service you may desire to connect to it. In`order to obtain sewer service to your property the following items must be completed: 1. The owners of record of the'property must complete the enclosed application for service card and return it to the District in the enclosed envelope. ^: The p.hysical connection of your home to the community sewer may be made by a plumber or sewer contractor of your choice. The contractor or plumber must secure a building permit from the City of La Quinta and notify the District prior to installation of the connecting pipeline. A monthly sewer charge which is currently $11.00 is collected to pay for treatment of the wastewater generated from your home. TRUE CONSERVATION USE WATER WISELY VNameV -2- Januar 27 1986 If you have any questions or require additional information, please call Jim Zimmerman at (619) 398-2651. Yours very truly, Lowell 0. Weeks General Manager -Chief Engineer AU:lmf Enclosures/2/as 4* Ak it Pff .1 lizky'vt Ti -of 14a Wuinta luitbin anb �$afeN t t n This Certificate issued pursuant to the requirements of Section 306 'of the Uniform Building Code certifying that. at the time of issuance this structure was in compliance with 1hevaridus ordinances of the City regulating building construction or use. Pot the folld-wing:' - BUILDING ADDRESS 78-625 Ultimo Use classification SFD Bldg. Permit No. 9585- .F - Use zone SR Group R3 Type Construction VN !re'Zorie Owner of Building Tom SpAtes P. 0. Box 366'. Address City La QUinta, CA 92253 Lonnie*. bay September, i941 A T IN A WW8*ICU0U§. I " X, A .