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06712 (SFD)4 P.O. BOX 1504 Building 78-105 CALLE ESTADO Address .53-390 Vallejo jo LA QUINTA, CALIFORNIA 92253 Owner Mailing Address pe ©. Box 59 City Zip Tel. La Quints 92253 564-j486_ Contractor No. LDING: TYPE CONST: OCC: GRP:; Number 774-083-008 Pal Description ,ject Description 06712 Sam City Zip Tel.: State Lic. City & Classif. 524325 Lic. If 1235 Sq. Ft. 11185 No. No. Dw. Arch:, Engr., Size . Stories Units Designer New ❑ Add ❑ Alter ❑ Repair ❑ 'Demolition ❑ Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I 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 1 hereby affirin that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Buseness and Professions Code: Any city or county which requires a permit to construct, after, 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 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 subjects the applicant to a 60penally of not more than rive hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Professions Code. The Conbaaor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such irprovements are not intended or offered for sale. Il, however, the building or improvement is said 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.) ❑ 1, 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 does not apply to an owner of property who builds or improves thereon, and who contracts for such prWeds with a contractors) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec S. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that 1 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. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed N 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, 1 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: ff, after making this Certificate of Exemption you should become sub)ect to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this pemut shall be deemed revoked. CONSTRUCTION LENDING AGENCY Ihereby 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 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 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 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 ,tiriated valuation $81,537 PERMIT AMOUNT Plan Chk. Dep. $250.00 Plan Chk. Bal. 4 1L9.3" Const. 5.58-5 Mech. 53-W Electrical 1013.99 Plumbing 157,50 S.M.I. 5.74 Grading 20.00 Driveway Enc. 20. Ou Infrastructure 1,334.5b TOTAL $3,1'3#. 13 REMARKS �n�t'•1��J .T : ���� f�If �T .1.�i�li�4ii7,Ytt](. i'..'� �~� 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 DATE12NSPEC�T�OR Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE t NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS A.C. UNIT COLL, AREA SLAB GRADE YARD SPKLR SYSTEM 2ND FL. SO. FT. ® BONDING HEATING (ROUGH) MOBILEHOME SVC. BAR SINK POR. SO. FT. ® SEPTI TA K ROUGH WIRING. POWER OUTLET ROOF DRAINS GAR. SO. FT. ® GAS (ROUGH) METER LOOP DRAINAGE PIPING CAR P. SD. FT. ® REINF. STEEL ` DRINKING FOUNTAIN. WALL SO. FT. GROUT WATER HEATER URINAL SO. FT. FINAL INSP. ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES LUMBER GR. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER ROOFING/-? �/Q7► GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM REMARKS: 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 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 77 ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK // 90 G I UNDERGROUND A.C. UNIT COLL, AREA SLAB GRADE /fjyj ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK a FORMS SEPTI TA K ROUGH WIRING. DUCTWORK ROCKSTORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. 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.7 _4k 4 FRAMING /_ G� �;Ze FINAL INSP. ROOFING/-? �/Q7► /%, {^► f (1 D 0 I REMARKS: VENTILATION FIRE ZONE ROOFING: FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND v 9 J PINISH.GRADING _. 90' FINAL INSP,,EOTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL Nn - Desert Sands Unified School District CERTIFICATION OF PAYMENT OF SCHOOL FACILITY FEES a TO: City ofSI+3'a &�uI��C� DATE: Department o C 1. u d °yCDeleel4 nt 78-1.05 Calle Estado • E®t V'V®7' La Quinta, CA 92253 €(toil 1v04190 This is to gVrtifvthat I�L�-l' developer of whic is located at , within this District, has paid school cili y fees imposed pursuant to the authority g n rat b G v rnment Cod IS tion 5 80 i t e amoun of covering a of square feet of residential or o ( ) industrial/commerci 1 evelopment and that building permits for ` this footage in this development may now be issued by your jurisdiction. n(:�-u for DESERT SAN S UNIFIED SCHOOL DISTRICT White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer (10)-37 "�` ti � � . a-s-`5'^3� ``F +�" ` � � � ���... -�.,'.. �Li s:��-^ .a' u: _ .,,,_• � > ,. ,t 11 .c c""4� t•- 3W� „ i �^� �'s1�i fir. � y. vy g ' .yh .i$"..a.4 v �:.' w •t`Se ti� ._ M Z O U W U Z 0 U W O Z O 6 W COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH Assessors Parcel No. ENVIRONMENTAL HEALTH SERVICES 77y — &S75 —O 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 speculations as indicated on the attached check list. ,A non-refundable filing fee (see below) is required when the application is submitted. Check must be made payable to the County of Riverside. Approval of this application shall remain valid for a period not to exceed. one year from date of approval. VERIFY ITEMS IN SECTION A FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG # ` Agent, Contractor, ntact rson Phone Address & Phone Owner Pone Mailing Address City C &1 loll or Ae7, A State Zip Job Property Addres§ Legal.Description. Prop. (PM, Tract, Lot) % Lot Size Water Agency/Well Use of Permit P/P, CU, etc.r_ Dwelling, MH Site Prep, etc! Signature of Applicant } Date CATEGORY: r ` —REV CODE FEEt f CATEGORY: REV CODE FEE' Ir l' SUBSURFACE DISPOSAL11238° ,.. $45.00 ��'� ❑ SITE EVALUATION UPON REQUEST 7349 $42.00 ❑ MULTIPLE PARCELS WITHIN SAME Y. (NO PLOT PLAN) LAND DIVISION ❑ SEWER/SEPTIC VERIFICATION 7348 $11.00 a. 1 st 4 Parcels (Each) 1238 $45.00 (Less than 1 year) b. Each Parcel after 4 7344 $16.00 ❑ PRELIMINARY ELECTIVE - - 7352 $45.00 ❑ Rereview (2nd review same parcel) 7344 $16.00 EVALUATION (Attach DOH SAN 53) O Site Evaluation in Conjunction with ❑ HOLDING TANK 7351 $45.00 Critical Area 7346 $86.00 ❑-. ALTERNATIVE/EXPERIMENTAL 7345 $132.00 ❑ Site Evaluation Lot Less than SYSTEM 10,000 Sq. Ft. 7347 $86.00 I INITIAL, DATE Holding Tank Agreements U'S Completed ❑ Yes :❑ No Certification of Existing S.D: System Required ❑ Yes ❑ No WQCB Clearance required. (Attach Form ❑ Yes 3 No l DOH SAN 007, Santa Ana Region Only) i Soils Percolation Report Required. ❑ Yes 3 No III! } Special Feasibility Boring Report Required. O Yes No Detailed Contour Plot Plans Required (1• to 5 ft. interval) O Yes No Other ❑ Yes No Staff Specialist Lot Inspection Required ❑ Yes No Lot Inspection Date i - Soils boring report by t' n S ` Project # Date Soils Map Page Soil Type Approved by Date No. of Systems Type of System(s) No. Dwelling Units (1) Septic Tank Soil Rate Grease/Sand O Holding Tank O Existing Bedrooms, Fixture Units Greas�lntcp • O' New O Replacement rll 4 V �lr I L:)iiV ) ]a. �.,.Gal 1�1 . Gal (2) Leach Line Sq. Ft. Bottom trench Sidewall allowance Install Line(s) f ft long H wide with Leach Bed sq. ft. area 1 it rock/--Z—sq, ft per running ft. min. inches rock/below drainlines or of bottom area �t f ❑ NA Leachlines/bed special design for slope: (3) Pit Diameter No. Pits Pit Below Seepage Pit Total Depth Other: Applicable Inlet (BI) r u Max. Allowable Depth N/A Overburden factor' ❑ 5 E36 ) ►(' .h• No. 2 System , ry ,,.,REMARKS: ttin.�w" s.• 1 s n i. c� 0 VIC' , This application is APPROVED/DENIED for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated on the accompanied plot plan, using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the above -designed system. No construction is permitted in the required reserved 100% expansion area. ((1,).� Septic tank and sewer lines must be 50' minimum from any wells (2) Leach lines must be 101)' ,minimum -from any wells, including expansion area r 1 T, ec Seepage, pits must be. .1,5,0 from any wells, including expansion 1 area' Signature of Health Official Date RECEIPT NO. Issued By Date. DISTRICT:. 0 Riverside,. X Indio- ❑ -Hemet ❑• Perris ❑ Rancho Calif. ❑ Blythe DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE • Office file YELLOW - Applicant PINK - Bldg. Dept. GOLDENROD - Plans/Records i American Engineering Laboratories, Inc. 58945 Business Center Dr., Unit A Yucca Valley, CA 92284 le Telephone (619) 228-1754 4 FAX (619) 365-6908 �.�. San Diego • Corona • Modesto • Yucca Valley Apple Valley January 2, 1990 Acct. No. 31098-C To: General Contract Management P.O. Box 59 La. Quinti, CA 92253. Subject: In Place Density Testing Single Family Residence .53-390 Avenida Vallejo La Quinta, California Attn: Michael Bangerter On January 2, 1990, a representative of this company visited the above referenced project and performed in place density tests. The results of our testing indicate that the embankment placed as compacted fill was compacted to at least 90 percent of maximum density at the locations tested. The maximum density was determined per ASTM Test Method D1557 and the field density tests were performed in.accordance with ASTM D2922. Please call this office if you have any questions. regarding the above referenced project. Sincerely, PM , CAN ENC NEERING LABORATORIES, INC Pau R �oersti, Branc anager/ a ca Valley PRH/bf a �i' i I 3 Prat R3 E -)' A "N n 7940 Arjons Dr.. Suite A !0 350 S. i\4aPte St., Unit K O 515 Ga!axy 4% -'Sy 510945 Business Center Dr., Unit A Sen Diego. CA 921 26 Carona.. CA 91720 ivlodasto, CA 9=356 r�, Yucca Valley, CA 92284 (Ei9) i 5-37�0 (7141 272-44230 (__^vS) 570 i3 (619)223-1754 CLIE:7T: ?ROJcCT: DATE: _ 1. D. NO.: Q \.I_ C� .'�: 1 DJ J�O' Zl t";�1 \li r. U \LL PROJECT NO.: 3 10 : i 3 c7- -' ;R•1• =:U Clic T i.i i~ i i' -z LT) C ✓iVI ACS 1 I J:.d ) Iw•v . 1 _ TEST I = _v..,.TiCY CP -cs' •� ti! .. ,_.''� \l \ �� t�\ 1� � �,, y L\ '., i '� � _ ... l� �% �, •:\ i i'J i•V � •�j - ,.• I ! i 0.' -im ' _ ='_-D i ,,te... t.> 11.1Ura n'?=AC=riT �• i t ;AOISTU:.� M0: rU _-. _ ° __:TY �cNs!"! I =! ATPlE I R (•' I CQ!.!?ACTION I .=-OUIRE-D I I. 7=5T _ � I AT. -0N CP -=_T I ' - 1 - i t I 1 I OP TI:A U`A = =L0 I MQI STURE I _._ . C_N siTY MA XI.NI UM I DAY DENSITY i PE ENT I R=I.i, 'JE COY,PA CTION . FIELD C?TI:AUM I .- =!0 I "AX;'MUM P -RC =:1T PEACcNT �.D ! rA OISTU P.E I �:O!STC=E i ..:- 7=N SITY ORY D=.451TY „TI'!E i i L. CQMP. C. I -PT .:L. c_0 � MA".lSn:d I ?=RC=:.7 7ERC E.4T -. c.. -?.i I s: ` •C�r'�-T t,J 1 _ MO:�i:l :?= .A01;; -: U,RC = { - _=NS;TY ( ORY J=NSIT'f C01.t?. T=.,i _ I LOC..?IC.v O I �. G _•,• ! _ FI>_LO�• ! I -MSX1`•!U:A PF::v=NT I -=°CFNT ._ .. •,7t� MQIsTURE STUE 0_ _=NSI'iY ., n. _=iI S!TY ?=!E I ... _. CO. I?. I. V \�•l I = = I Col.!P.�cTio:: ! =C L; IR I in J 1 1_ C I 1\ 1 ! I .} v I Cl; J I vS S T S� I ! f ! I TES _ ! I ..00A7:0.4 OP --ST I ' - 1 - i t I 1 - OP TI:A U`A = =L0 I MQI STURE I _._ . C_N siTY MA XI.NI UM I DAY DENSITY i PE ENT I R=I.i, 'JE COY,PA CTION . FIELD C?TI:AUM I .- =!0 I "AX;'MUM P -RC =:1T PEACcNT I .R=M 4;:..< S: rA OISTU P.E I �:O!STC=E i ..:- 7=N SITY ORY D=.451TY „TI'!E i i L. CQMP. C. i Comp. 'I0N _ i.'IR=O TEST LOCA7;CN OF -=ST ' Pi ELO MO;STURE OP TI:A U`A = =L0 I MQI STURE I _._ . C_N siTY MA XI.NI UM I DAY DENSITY i PE ENT I R=I.i, 'JE COY,PA CTION E. I ;;.LAC . CO.4MP . RE O u::l E0 I A E M =..K S: I( I GC�1FRtaL. Cv��RRc� �v�t�1�GFM�U 53 .3 0 Av Z'J 'D Lf -3O Amcm-n � � [ =mrszonm Lac .58945 ouiinc= Ccnrer Or Unic A Yuca Vailev. C.-\ 92`34 T• 4191 _!:1..--L P\U t lv Amcm-n � � [ =mrszonm Lac .58945 ouiinc= Ccnrer Or Unic A Yuca Vailev. C.-\ 92`34 T• 4191 _!:1..--L 0 Tit� pi Ed (Quinta jluitbin�- anb $afjot�r �ibi�siun 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 the various ordinances of the City regulating building construction or use. For the following: BUILDING ADDRESS 53-390 Avenida Vallejo Use Classificotion S F D Bldg. Permit No. 06712 Group R3 Type Construction VN Fire Zone Use Zone SR Owner of Building Char j acq Inc. Address P • 0 • Box 59 City La Quinta, CA 92253 BY.'Mark Harold Dote: December 17, 1990 ildi r4 0fTitrQT1—wvw'%Pw POST IN A CONSPICUOUS PLACE