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002646 (SFD)4 �. T4 hf P.O. BOX 1504 No. 002646 Building 78-105 CALLE ESTADO Address 52`9GO Atie330a Vallejo LA QUINTA, CALIFORNIA 92253 Owner 'Worn BUILDING: TYPE CONST. - OCC: GRP. Mailing Address 3.3_255 Date PB AA,P. Number 773-324-011 CityZip Tel. 16 °C C.it 234 . Legal. Description ContractorProject Description siz*l . f3f ily C o3.�M �ai Address City Zip Tel.' Siert£ State Lic. City MG 1493 & Classif. 157580 Lic. # 765 sq. Ft. - (M 492 No. No. Dw. Arch., Engr., Size Y.xxe �Z.r Stones Units Designer New Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State _ Lic. # LICENSED CONTRACTOR'S DECLARATION y I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division Sof the Business and -Professions Code, and my license is in full force and effect} SI,r <r. .v JJt✓ xis, ry irY 1� GNATURE '" '�'.`" i' DATE i ' v OWNER -BUILDER DECLARATION " I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation reason:. (Sec. • 7031.5, Business and Professions Code: Any city_ or county which requires a $ '801 1.00 permit to construct, alter, improve, demolish, or repair any structure, prior.to its issuance also AMOUNT requires the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT. A Me provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) or •2` 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 Plan Chk. Dep. 250.00. - subjects the applicant to a civil penalty or 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. 52.26 do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and ConSt.'• Professions Code: The Contractor's License Law does not apply to an owner of property who [ • 00 builds or improves thereon and who does such work himself or through his own employees, Mech. .y� provided that such improvements are not Intended or offered for sale. If, however, -the building 36.50 or improvement Is sold within one year of completion, the owner -builder willhavethe burden Electrical '� ' of proving that he did not build or, Improve for the purpose or sale.) •A ❑-1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 93.00struct the project. (Sec. 7044, Business -and Professions Code: The Contractor's License Law does not apply to an owner or property who builds or"improves thereon, and, who contracts for S.M..I. - - S.Ij such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - Grading 32.00 ❑ I am exempt under Seca B. 8 P.C. for this reason Driveway Enc. 20.00 Date owner Infrastructure 3.:2.86 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 ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished-. TOTAL 1.54." 1.904.99 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 thg 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 or Exemption you should become ZONE: BY: - subject to the Workers' Compensation provisions of -the Labor Code, you mustforthwith 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 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.) 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 Permit I agree to comply with all city,and county ordinances and stale laws relating to building construction, and hereby authorize representatives of this city to enter the above- mentioned property for inspection purposes. , Validated by: Signature of applicant.. t.. a+.F ..-+ .4 Date _ Mailing Address - '*'1 Validation: City, State, Zip V A6530 10 16 4, 4.°9 CK HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES , NO. PLUMBING FEES IST FL. SO. FT. ® $ 2ND FL. SQ. FT. POR. SQ. FT. ® GAR. SQ. FT. ® CAR P. I 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 ROUGH PLUMB. FLOOR DRAIN MECHANICAL FEES HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER DUCT WORK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GAS (ROUGH) LAUNDRYTRAY AIR HANDLING UNIT CFM HEATING (FINAL) 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 BOND BEAM SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL LUMBER GR. SQ.FT.GAR ® V4c HOUSE SEWER ROOFING VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING / t 7 MESH 244 NSULATION/SOUND ,tl FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL 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 2 y GC% GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRAD ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS (� E R PTIC T� ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. ! ( GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. 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 VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING / t 7 MESH 244 NSULATION/SOUND ,tl FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL ^ � C� � � G� � � t � ) � G�j ®C REMARKS: INSPECTOW5 SIGNATURE511NITIAL5. GARDEN WALL FINAL - _ k1fIE0 S O —0 Desert Sands Unified SAool District r BERMUDA DUNES RANCHO MIRAGE o 82-879 HIGHWAY 111 • INDIO. CALIFORNIA 92201-5678 • (619) 347-8631 INDIAN WELLS'October 14, 1986 PALM DESERT a P LA OUINTA' '�p - INDIO ti City of La Quinta Department of Community Development. 78-105 Calle Estado La Quinta, CA. 92253, Re: Lot 16, Block 15.9, Santa-Carmelita at Vale, La Quinta, CA Unit 16, Avenida,Vallejo Gentlemen: The developer of the above referenced project has mitigated. its impacts on our overcrowded schools by payment of the amount of $628 per unit. This amount is. .to be applied to the cost of additional district educational facilities made - necessary by suchnew development. Sincerely, J, John D. Brooks Assistant Superintendent Business Services Z O H U W U) T Z O F— U w 1) U) Y Q w Ir X Z O U LL1 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,$30—IS required when the application is submitted. Check must be made payable to the County of Riverside. 7 / ,11 I ( Building Department Application Log # Name (Owner, Agent, Contractor, Etc.) Mailing Address j r� j i— �S •1! l �� � �7L. �+-� City r �2—)e-��� L- I?i State C'a Zip Code 7.)- L/ Telephone 3��- /001" Job Property Address ! ��. City pd Gmrmmmmi"Legal �� C� v 1107, Description of Property. (Lot, PM, TR) � ��'�/ /3 )bT 4 (JA,, -T- i(, . 'Assessor's Parcel No. ,J Water Agency orWell- CC V �(/ �J ''''►., i;e� /j _ _ /) /1 _ Use of Perm"'A iU�it! ,t7 /,,fanning Case # Lot Size if 4 SFD. MH Site Preparation Etc. S'F4 5'0 >( f t Signature of Applicant„- Date r - 'The above information must be verified from Building Application STAFF USE — DO NOT WRITE BELOW THIS LINE inititi�al Date p/ Certification of Existing S.D. System required. 1:1 Yes D o �=, / '0(n — WOCB Clearance required. ❑ Yes 2� No Soils feasibility report required. El Yes LiJ No Detailed boring report required. ❑ Yes IJ NO, Detailed contour plot plans required. ❑ Yes ©No Staff Specialist approval required. ❑ Yes �2-No Lot Inspection Date— Soils/boring report by. F Project # Date Soils Map Page % Soil Type�u_S„`—Approved by / �/ �� Date Type of System: No. of Bedrooms (1) Septic Tank Soil Rate Required ❑ Existing ©rNew ❑ Additional ❑ Replacement f'1^ - l Gals. (2) -Leach line sift, (Bottom trench area) Sidew_ all allowance ft -rock/ Sq. Ft. Install Line(s)Ft. Long, Ft..wi Leach!b�ed Sq. bottorp, ee win._ inches Ft. ofof per running ft. ❑ N/ rock below drain lines` area Leach lines/bed-special design for slope: Applicabfl=:�— (3) Pit Diameter No. Pits Pit BI Seepage Pit total depth r N/A__ Overburden factor �(( r Max. allowable depth e r.. This application is,approvvd/ enied 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 permitriss necessary for the installation of the above -designed system. , r� Al �1)1Septic tank and sewer lines must be 50' from any wells ' 4, 1("Ak "litf.^vr - f �� 4 -mom (2) Leach lines must be 100' min. from any wells including expansI"''o''nI /3) Seepage pits must be 150; min. from any wells including expansion area-/ /p Z"' Signature of Health Official - Date RECEIPT NO.y 7 �-+ _ C! Issued by_ �K^- Date -713 /2ta _ District: ❑ Riverside ❑'Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File DOH SAN 122 (Rev. 2/86) KIC Inhh