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003160 (SFD)P.O. BOX 1504 Building 78-105 CALLE ESTADO Address 51-960 Avenida V121010 LA QUINTA, CALIFORNIA 92253 Owner ])ata D' Amicm Mailing. Address . Pa. 0e Box 1773 City Zip Tel. 92202. Contractor Aririroee BUILDING: TYPE'CONST. OCC: GRP., A.P. Number 773=172-011 398-0106 Legal Description a Project Description $Lng e V -` y Dwelling " City.. .Zip. .. .. Tel:: . Tt�rma3 9227.4 399 . . .-5521 State Lir. Citv & Classif:- B : '. 211280 c # Li. 553 Sq. Ft. 12004 .. N too. Size ., .. .. -Arch., Engr., _ . _ Designer New O,, Add ❑ Alter ❑, Address Tel. Grading Driveway Enc. City Zip State Lic: # • , F , LICENSED CONTRACTOR'S DECLARATION ; I hereby affirm+that I am licensed under provisionstof Chapter 9 (commencing with'Section 7000) of Di�vii6lo�li, 3 of the Bp�iness'•and Professiyoon--l(s,Code, and my license is in'full force and •t�effect . /sem#; ".ds..'y-&- ( fS.! %t "�rzn' - ;IGNATURE DATE Y 4 ' ' OWNER -BUILDER DECLARATION 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, 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 the provisions of the Contractor's License, Law, Chapter 9 (commencing with Section 7000) of ' 'Division 3 0/ the Business•and Professions Code, 'or'fhaL he is exempt therefrom;:and thePbasis /or the alleged exemption. Any violation o/ Section' 7031:5 by any applicant for a . ermit subjects the applicant to a civil penalty of not more than five hundred dollars°($500). .. Estimated Valuation - k` •-' z..- •'PERMIT Plan Chk.. De . G 6,J p L25�a No. Dw: Units Repair ❑-. -Demolition ❑:. ❑ I, as owner of the property, or my employees with wages as their sole compensation,.wiII : 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 of improves thereon and who does such 'work himself or through his' own employees, provided that' such improvements are not intended or offered- for sale. 1/, ;however, -the building .or improvement is sold within one year of completion, -the owner -builder will have the burden o/ proving.that,he did not build or improve. for the. purpose o/ sale.) ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- strucl -the project. (Sec.- 7044; Business and Professions Coder 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.) - ❑.l am exempt under Sec. B. ti: P.C. for this reason Plan Chk. Bal.._ CohSt. ` ' .' Mech. "Electrical . Plumbing S.M.I. -• Grading Driveway Enc. Date owner Infrastructure 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 s !* 1 : O1 C0py.is.filed with the city. . O. 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 the 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. Dale Owner NOTICE TO APPLICANT., .If, . after making this Certificate o% 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 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 r 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 HARD COPY TOTAL AMOUNT .137.00 30..C: .. 991.27 REMARKS et-, r,' n r � . w . "fff AL i � `.2,405.45 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 - Issued.by: Date -61161A7 . Permit Validated by: Validation: 14 CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PJ.UMBING FEES IST FL. SQ. FT. ® $ UNITS LAB GRADE r 2ND FL. SQ. FT. BONDING YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. (ROUGH) DRAINAGE PIPING WALL SQ. FT. OTHER APP.IEQUIP. 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 WASH ER(AUTO)(DISH) APPLIANCE DRYER 2!�INAL INSP./o �- GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM �� KITCHEN 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 SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.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 GROUND PLUMB NG UNDERGROUND A.C. UNIT COLL. AREA LAB GRADE r OUGH PLUMB. ' _` BONDING HEATING (ROUGH) STORAGE TANK RMS � VoLO �L4SEWER OR SE7G-TPIO�Q ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEQUIP. REINF. STEEL '' //GAS VeAS (FINAL) _! , �S� TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. 2!�INAL INSP./o �- e/�FRAMING / �INAL INSP/0— _ r$ AII``L{�OOFING 7_d I-)- /_ i 1 IO t Y:ti�/L A jA / L (� - /� 7 i; IAOU9 GP�A`j ' o P7 �� REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH . I ISULATION/SOUND INISH GRADING INAL INSPECTIO CERT. OCC. FENCE FINAL INSPECTOR'S SIG NATO RES/INITIALS, GARDEN WALL FINAL Desert Sands Unified School District •. CERTIFICATION OF PAYMENT , a. OF f i. ' iSCHOOL FACILITY FEES ({ TO: City of ta, Quinta r DATE: Department•,of Community Development,. 78-105 Calle Estado- La Quinta' `CA 92253,' n'. •���� r Y I ' This is to_certify. that . ✓��� 1� G developer of ie which is located at p ,� ,` within this District, has paid school facilit fees imposed pqrsL4nt to the i authority genera�tped by Governme t, Code ' ectiolt 53 8.0 in a amount of 7' covering a total of et of (//f residential ,or ( ) industrial/commercial development and that building permits ,for this -footage in this development may now be issued by your -jurisdiction. ' for DESERT SANDS UNIFIEJb SCHOOL DISTRICT White.- Building Department • Yello_W - Facilities Planning • Pin_ k - Accounting .• Gold - Developer (10)-37. a ^ -a c 81 $; a� WHEN RECORDED MAIL TO: CQ U. S C, C� Daniel E. D' Amino o � g _ o v o �.g 39-400 F1na Way w Q W o o m` C Cathedral City. CA 92234LU°° a Z > . •• ' " tr < , qs ESCROW NUMBER: 782 ORDER NUMBER: 1741869; SPACE ABOVE THIS LINE FOR RECORDER'S USE MAIL TAX STATEMENTS TO: Daniel E. DOCUMENTARY TRANSFER TAX $............. D' Amico •6•:6fi....................... 39-400 Elna Way •••••. CoMputed on the consideration or value of property conveyed; OR .. Computed on the consideration or value less liens or encumbrances Cathedral City, CA 92234 remaining at time of sale. Signature of Declarnt or Agent determining tax — Flrm Name A.P.N. 773-172-011 GRANT DEED FOR A VALUABLE CONSIDERATION,' receipt of which is hereby acknowledged, CLARKE WILLIAM MOORE, A SINGLE MAN hereby GRANT(S) to DANIEL E. D'AMIOO and Glenda M. D'Amico Husband and Wife as Joint Tenants the real property in the City of 4UINTA County of Riverside LOT 14 OF BLOCK 60, OF SANTA .State of California, described as IN THE OOUNTY OF RIVERSIDE. STATE OF CALIFORN��AS PEAMAP E DR D IN BOOK 18, PAGW 63 OF MAPS, IN THE OFFICE OF THE AUNTY REOORDERRDED OF SAID COUNTY. _ .... .. _. _ r u..?,. - � ;:'a �C`D 4t` rt �1',... 3 +s�� "it�.�: � �'�, �»:� � £�,,.'. t - � .,r�..+hiw.�u•��. �,'2.r _ J STATE OF CALI IA 1 COUNTY OF_- §�� BERNARDINO 1ss 1- On NOVEM13R 4, 19R6 before me, the undersigned, a Notary Public in and for said State, per- sonally appeared CLARKE WILLIAM MOORE -------------------------------- p7i"3UXlibp3nld to me (or proved to me on the basis of satisfactory evidence) to be the person.(s) whose name(s) is/ft subscribed to the within Instrument and acknowledged to me that he/Xt*Xxy executed the same. WITNESS my hand and of ici seal. Signature Clarke William Moore LISA NICKEL NOTARY PUBLIC s � SAN BERNARDINO COUNTY CALIFORNIA �^MvCn-1ni_sion Expires September 18, 199( fThis area for official notarial seal) FORM NO. GD 400 (1/83) MAIL TAX STATEMENTS AS DIRECTED ABOVE D Z O H U W CO .87 Z O H U LU rn Y tr Q 2 W U Z O 1= U W U) + COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION 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 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. Building Department Application Log # Name (Owner,'Agent, Contractor, Etc.) Mailing Address ' 0, 6oy / 7 7.3 City /VP/0 State C,4L F Zip Code 7e -J220 Telephone Job Property Address �� AYE.' 1.fcity or"Com`mu �+ iN 7' Legal Description of Property. (Lot, PM, TR) L©T-/4, �� �0 5,�; �I� �RG-1 'Assessor's Parcel No. Water Agency-orJWell%l g� _ //.,.�y. { _ �R Use of Permit C/rt7_/�[I y�-Plavg-Case # Lot Size ' U 3-6 x SFD, MH Site Preparation /00 Etc" -Jr Signature of Applicant Date .The above information must be verified from Building Application STAFF USE — DO NOT WRITE BELOW THIS LINE Initial) Date �.o��✓ Certification of Existing S.D. System required. ❑ Yes Z Nr WQCB Clearance required. ❑ Yes ZZ� Ne'� C-)% Soils feasibility report required. Yesi Nom Detailed boring report required. ❑ Yes El No Detailed contour plot plans required. ❑ Yes alNo• ++ Staff Specialist approval required. ❑ Yes El No Lot Inspection Date Soils/boring report by ,// - Project # Date- ate Soils Map Page //�"+'! C / 7 Soil Type(- /T✓+ Approved by � �✓l Date - d Soils A Type of System: V No. of Bedrooms (1) Septic Tank Soil Rate Required 'Ile ❑ Existing 1"New El Additional El Replacement j'K0. <- A v Gals. (2)*Leach line sq. ft. , trench Sidewall allowance ft. Sq. Ft. Install -_ Line(s)—Ft. Long, Ft wde�w'tlth inches � Leach bedr Sqs. Ft. bottom, (Botto area) rock/ 19,1111A 19,1111Aper min. of running ft. rock below drain lines area Leach lines/bed-special design for slope: A/ (3) Pit Diameter No. Pits r% Pit BI Seepage Pit total depth 4 f N/A Overburden factor pplicable s ©6� -f— / Max. allowable depth � _ a /7 This application i . prmsovved enied for the design of a subsurface disposal'-§ystem as indicated on the accompanied plot plan using the requirements set forth in Section B above. A building permit is necessary for the installation of the above -designed system. (1)' Septic tank and sewer lines must be 50' from any wells 11 / 0 A -`y' � J_/ - ,,/, �.�; , (2) Leach lines must be 100' min. from .any wells including expansion area (3) Seepage pits must be 15/0: min. from any wells including expan�sion�area� �O ICA 4411Signature of Health Official ! i Date M t!� RECEIPT NO. _:i 3r/ / Issued, by 'rDate , District: ❑ Riverside P'I d ❑Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe Distribution: WHITE—Office file YELLOW—Applicant PINK'—' -Bldg. Dept. GOLDENROD—Pending File DOH -SAN -122 (Rev. 6/86)