002455 (SFD)- P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 52`-825AVenida @*A LA QUINTA, CALIFORNIA 92253
Owner
L'AIY1,,s't.X1 .
Mailing
Address �) c� J E....,
Cjty fi- ! T'} .ZIPTel.
J-40m—nmi328.6691
Contractor
Address
Sam
City.. Zip Tela .
State Lic.
& Classif.-366460
Arch., Engr.,
Designer
BUILDING: TYPE CONST. - OCC:•GRP:
A.P. Number 773--323--317
Legal Description I&,- 4
Project Description31tll�f
>r G 1493
Sq. Ft w �� No.
Size • • • Stories
No. Dw.
Units
New ❑ Add ❑ Alter ❑ Repair ❑ .Demolition ❑'
Address Tel.
City ]Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
hereby affirm thay.l.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 4'
effect . i
... ,Xi , .. ✓ f _ ter ✓
\
_
.. ..
SIGNATUREF t - _-•i^':` _ - DATE
OWNER -BUILDER DECLARATION
' I hereby affirm that I am exempt from the Contractor's -License Law for the following
. reason: .(Sec. 703(.5, Business and Professions Code: Any city'or county which requires a
permit to consiiuct, after, improve, demolish, or repair any structwe,.'prior to its issuance also
requires the applicant for such permit to file a signed statement-that•he is licensed pursuant to- '
..
Estimated Valuation
- '.s An.
.'PERMIT:
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
.
' Division 3 of the Business and Professions Code; or'thal: he 'is exempt therefrom,' arid. the basis
for the alleged exemption. Any violation of Section 7031.5 .by 'any. applicant for a permit
.. -
• .Plan Chk. Dep.
subjects the applicant to a civil penalty of not more than five hundred dollars ($500):
❑ I, as. owner of. the property, or, my employees with wages as their sole compensation, will
Plan. Chk. Bal.
Const.
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Bufsness and
Professions Code: The Contractor's License Law does not apply.to an owner. of property who.
Mach'. '
buflds� of improves thereon and who does such work himself or,fhrough'his own employees,
provided that such, Improvements are not intended or offered for sale. If,.however„the building.
'Electrical
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.) : • .
Plumbing.
❑ I, 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 -
S,M.I. -- -
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.) -
O I am exempt under Sec. B. & P.C. for this reason
Grading
Driveway Enc.
Date owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
hereby affirm that there is a construction lending agency for the performance of the
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
Lender's Name
O Copy,is filed with the city., , ❑ Certified,copy is.hereby furnished.
TOTAL
FINAL DATE
17,6 00
rp ” AMOUNT
.70.59
1 f 5 tl
14-M
,.ISS
Vii,7".71S
' k
CERTIFICATE OF EXEMPTION FROM
REMARKS.
WORKERS' COMPENSATION INSURANCE,
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
walls7�"+.,rt�r��Pp��!�
t
iy�tT� YS '
.i:'�"""a°' 1. m ISM rim a PAM UX llpaxu
orless.).. ... ,. ...
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.
' 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,Llne
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 read this application and state that the above information is correct.
Issued by:
Date 7—IA-44 Permit,
agree to comply with all city and'county ordinances and state laws relatirig.to building
E-
construction, and hereby authorize representatives -of this city to enter the above-.
mentioned property for inspection purposes.
Validated by:
Signature of applicant .t Date
_
n
Mailing Address. –_
Validation:
City, State, Zip
A5955
7 14 15-IZ91 R
' HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SO. FT. ®
CAR P. SQ. FT.
WALL SQ. FT. ®
SQ 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
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP./EQUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
`4 / <TEMP. POLE
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.
SQ. FT. ® c
BATH TUB
FINAL INSP. M 7cI
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
VENTILATION
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
r W R SEPTIIO AN
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)
`4 / <TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP. M 7cI
FRAMING
FINAL INSP. rIr Ile
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS.
GARDEN WALL FINAL
Q,(.1, --D/,. TO wr-P,o
'06�FIED
t .
-0
w BERMUDA DUNES r
RANCHO MIRAGE
INDIAN WELLS ti
PALM DESERT a
J' LA OUINTA
�p INDIO y�
Desert Sands Unified School District
82-879 HIGHWAY 111 ® INDIO, CALIFORNIA 92201-5678 6 (619) 347-8631
City of La Qui:nta
Department of Community Development
78-105 Calle Estado
La Qui-nta, CA 92253
Re: Lot 4, block 158, Tract Santa Carmelita at VAle., La Quinta
Gentlemen:
The developer of the above referenced lot
has mi.tigated its impacts 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 Supe.ri.ntende.nt
Business Services
JDB/crm
COUNTY OF RIVERSIDE, DEPARTMENT OF HEALTH
- PERMIT APPLICATION FOR A SUBSURFACE DISPOSAL SYSTEM
Applicant: Submit this form with three copies of a scaled plot plan drawn to county specifications required on the
attached check list. A non refundable filing fee of $15 is required when the application is submitted. Check must be
made payable to County of Riverside.
l � /U
Name
Mailing Address
VM Co -2,,,-- r Co if/ c-
-Z- Y u 9 G -)-I r
City,hone
State
Zip Code J TP—
C�2► .
�a�.6�
3 3s�a
'Property Address c
'City or„Community
'Legal Descriptionlof Property (Lot, Parcel Map, Tract)- y)
v
'Assessors Parcel No. ✓
Water Serving Property From /
Lot siize-
v /
�t.f 1 44, A 1./Vl-�
J–V
00
Signature of Applicant 1 / Date
'The above information must be verified from Building Application
Staff Use — Do Not Write Below This Line
Initial Date
WQCB Clearance required Yes ❑ No [11 ��'�� 1?—%V
Soils feasibility report required Yes ❑ No ❑M
Detailed boring report required Yes ❑ No
Detailed contour plot required Yes ❑ No Co
Comments:
Soils or boring report by Date
Approved by i7 �XDate
������ 001r �7� ''`'`Other ��
Soils Map Page Soil Type Tract File No. 0
Number of Bedrooms `"Septic
Tank Size (gallons)
Rate Required
Type of System
New Addition Replacement
Leach line sq. ft. of bottom area trench ;/
LeacWbed (sq.J4”. of bottom area bed)
Seepage Pit Diameter
Number of Pits
Seepage Pit Depth B.I.
Total Depth of Pit
Location �offSSystem
"tet/ ' ,e.Z�. �t'i/��•- �`�� �%� %/ "� 1�i GZ.�e.Q�
Additional Requirements4e�jf
i 0
��-f ..nt*/..T!:e A.���(I'f /l+� qf:. f%:, r"y'iT .%'+-.i .,C.?r�_.��r� .i�!',-./. ✓s'* �. ^tq,/}'�.'.iK .�+,. ,.,ems"
/A permit approved/denred for the design of a s;ubsur-face dispo �� ystem as Indicated on the accompanied plot plan
.using th-e'requirements set forth in Section B'above. A building permit is necessary for the installation of the above
designed system.
A</ (�7 A/') — /P
SignSture of Health Official i Date
Receipt No. Issued By
District: Riverside ❑ Indio,Hemet ❑ Date
DISTRIBUTION: WHITE - Office File YELLOW - Applicant PINK - Building Dept. GOLDENROD - Pending File
DOH SAN 122 (Rev 10/84)
OCA .l.