002340 (SFD)TA
•hf
,
P.O. BOX 1504 N Q. 002340
Building 53•-835 midaVhllej78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner _ �+
i'lrl - 1 . y'►—LS.en _�""''"l ✓ 'r'n•m
Mailing BUILDING: TYPE CONST.OCC: GRP:
Address anY "t.t 1 A.P. Number : r3 774-163-006
City Zip ITel.
Contractor I
sa
Address
. . Zip .. . Tel.-
State
el.
State Lic.
City
& Classif.
37.1587
Lic. #
Arch., Engr.,
Estimated Valuation
Designer
reason: (Sec., 7031.5,Business and Professions Code: Any city or county which requires a
demolish, its
Address
Y '.
Tel.
City
AMOUNT
Zip
State
-
Division 3 of the"Business and Professions Code, or that.he is exempt therefrom, and the basis
for the Any Section 7031.5 by 'any tapplicant for 1
Plan.Chk. Dep..
Lie. # _
alleged exemption. violation of a permit
- subjects the applicant to a civil penalty of not'more than five'hundred dollars ($500):-
A, LICENSED CONTRACTOR'S DECLARATION
I hereby affirm tat I am licensed under provisions of�Ghapter 9L(6' mmencing with Section
f Division 3 Business Professions Code,
e000)t
p�the and d y license is in full force and'
Legal Description
Project Description sim*e Farl-y M 1 '
Sq. Ft. �R 485 No. No. Dw.
Size Stories Units
New= Add ❑ Alter ❑ Repair ❑ Demolition ❑-
SIGNATURE "'" % DATE
-OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's. License "%a for the following
Estimated Valuation
76,224.00
reason: (Sec., 7031.5,Business and Professions Code: Any city or county which requires a
demolish, its
-
Y '.
permit to construct, after, improve, or repair any structur�rior to issuance also
requires the applicant for such permit to rile a signed statement di'at,he is'licensed pursuant -to
PERMIT
AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencind• with Section 7000) of
-
Division 3 of the"Business and Professions Code, or that.he is exempt therefrom, and the basis
for the Any Section 7031.5 by 'any tapplicant for 1
Plan.Chk. Dep..
alleged exemption. violation of a permit
- subjects the applicant to a civil penalty of not'more than five'hundred dollars ($500):-
Plan Chk. Bal.
$1.,2}
p_l, 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
COnSt.364.00
. Prolessions Code: The• Contractor's License Law does not,applyto an owner of property who ,
,
builds or improves thereon and who does such work himself or through his own employees,
Mech.��
provided that such improvements are not intended or offered for sale. If, however, the building
.
or improvement is sold within one year of completion, the owner -builder will have the burden
Electrical
75.319
of proving that,he did not build or improve for the purpose of sale.) _
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-.
Plumbing
- - 97.04
slruct-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
S.M.I. -
- 5.319
- such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
0.1 am exempt under Sec.. B. 8 P.C. for this reason
Driveway Enc:;
Date Owner
Infrastructure
1,143.36
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I,have a certificate of conserit,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
2,092.30 14842.30
CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS'.COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
r..-. ..,.
or less.) .. -.. - ..
I certify that in the performance of thg work for which this permit is issued, I shall not
i8:a<.....,.,.�
"14V v.#r.,.,i :.: Jt, ar-.,.,.. :,n..;. sh.•.:.-.:
employ any person in any manner so as to become 'subject 'to the Workers' Compensation
ry�
Laws of California.
A Few
Date Owner
NOTICE TO APPLICANT. If, after making this Certificate of Exemptionyou . 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 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 tb:i
expiration it 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 state laws relating to building
construction, and hereby authorize representatives -of this city to 'enter the above-
mentioned property for inspection purposes. t
Validated. by:
Signature of applicant 1- F f �^°t'!'•.✓ / Date
Mailing Address i
Validation:
City, State, Zip , a
/
A 5 4 6 0
4 29 184230 Sl
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMEING FEES
A.C. UNIT
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SO. FT. ®
CARP. 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
� L__J
NOTE: Not to be used as property tax valuation
STORAGE TANK
FLOOR DRAIN
(,SEWER OR SEPI
MECHANICAL FEES
DUCT WORK
WATER SOFTENER
I &0�15OUND. REINF. )
e
I
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
OTHER APP./EQUIP.
APPLIANCE DRYER
GAS (FINAL)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
j� GROUT
E
LAUNDRY TRAY
SERVICE
AIR HANDLING UNIT CFM
KITCHEN SINK
WATER SYSTEM
ABSORPTION SYSTEM. B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
LUMBER GR.
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
FINAL INSP.
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
VENTILATION
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
FIREPLACE
SO.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
GAR. FIREWALL
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUM
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
q—GROUND PLUMBING'
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE ��
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
( FORMS
(,SEWER OR SEPI
OD ROUGH WIRING
DUCT WORK
ROCK STORAGE
I &0�15OUND. REINF. )
e
I
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
i REINF. STEEL
GAS (FINAL)
TEMP. POLE
j� GROUT
E
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
THING
MESH
INSULATIONISOUND
FINISH GRADING
{/WEINAL INSPECTION
fVt� a
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
'0,�FIEp
o o
= ° Desert Sands.Unihed School District
H 8ERMUDA DUNES r
RANCHO MIRAGE 82-879 HIGHWAY 111 INDIO, CALIFORNIA 92201-5678 • (619) 347-8631
INDIAN WELLS a
PALM DESERT
,PLA OUINTA
",OINDIO y�
City of La Quinta
Department of Community Development
M-105 Calle Estado
La Quinta, CA 92253
Re: 53-836 Vallejo, La Quinta, CA
Gentlemen
The developer of the above referenced lot .
has mitigated its impacts on our overcrowded-sch'ools by payment
of the amount'of $628 per unit to be applied to the cost of"
district educational facilities made necessary by°such new
de ve 1 o pme n t.
Sincerely,
. �.
John D. Brooks
Assistant Superintendent
Business Services
JDB/crm
a
M
c
E_
C
Pl
V
P:
Cr
x
f�
a
X
W
a
U
RECEIPT N0. issued by Late
District: Riverside C ] Indio G I'" Hemet C ] PerrisC ] Rancho Calif. [ ] BlytheC ]
Distribution: WHITE -Office file YELLOW -Applicant PINK -Bldg. Dept. GOLDENROD -Pending File
DOH SAN 122 (Rev. 2/86)
'pr rah 74
1!L L -v)
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
$30 is required when the application is submitted. Check must be made payable to the
County of Riverside
Building Department Application Log #
14 a
Name (Owner, Agent, Contractor, Etc.)
7
Mailing Address
_(i L/
Cit
State,
CL
Zip Code Telephone
ILI
*Job P Opefty Address
*.City, -or Community-
`Legal Description of, Prpty. (Lot, PM, TR)
*Assessor's Parcel N'$.
Water Agency
Use of Permit
Lot Size 9
_QdZ1 XR0
SFD, MH Site Prep Etc.
1��
Planning Case # ! ; �- �t
6 f�
� X 1 0V
AIL -
Signature of Appl=icant Date 1
*The above information must be verified from Building Application
STAFF USE - DO NOT WRITE BELOW THIS LINE
Initial Date
Certification of Existing S.D. System regd. Yes C ] No C``] �� .--,ids ?
WQCB Clearance reqd. Yes C ] No C�7
Soils feasibility report reqd. Yes[ ] No VI"
Detailed boring report reqd. Yes[ ] No G--]
Detailed contour plot plans reqd. Yes[ ] No F-11
Staff Specialist approval regd. Yes[ ] No[-"] Lot Inspection Date
Soils/boring report by Proj. # Date
l
Soils Map Page'' Soil Type, Approved by Date y�
Type of System:
No. of Bedrooms (1) Septic Tank
Soil Rate Required
Existing New Addition Replacement
+ r
Gals.
C ] U--]' C ]
(2) Leach line sq. ft.
Sidewall allowance
Install Line(s)
Leach bed
(Bott�m�trench area)
�T-t., mock/� Sq. Ft.
Ft. Long-.�` Ft. wide
S' =Ft `of
Sq_
per running=ft.
with Min:inch( as rock
a _
bottom
N/A [ ]
below drain lines
area
Leach lines/bed-specia7design
3) PitDiameter
No.
Pit
Seepage Pit total depthfor
slope: App=1-i,cablepeg'
_ 6' [J-
Pits
BIN/A
Overburden fac
%
Max. allowable depth
i
This application is approved/bdenied for the design of a subsurface disposal s --stem 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 �° /I�,,, y � ''-��'
�sio `'area,,,
(2),Leach lines must be 100' min. from any wells including exp
/
;-`�, ,
L°Seepage pits must 150' min. from any wells including expansion area
�be
Signature of Health Official y Date
RECEIPT N0. issued by Late
District: Riverside C ] Indio G I'" Hemet C ] PerrisC ] Rancho Calif. [ ] BlytheC ]
Distribution: WHITE -Office file YELLOW -Applicant PINK -Bldg. Dept. GOLDENROD -Pending File
DOH SAN 122 (Rev. 2/86)
'pr rah 74
1!L L -v)
COMPLIANCE CHECKLIST FOR LOWRISE RESIDENTIAL
BUILDINGS
FORM 2
(EXCEPT HOTELS AND MOTELS)
DATE '04/04/86
OWNER CARBON C. DUBBS
PROJECT, SINGLE RESIDENCE
~PREPARED AND DOCUMENTED BY.RICHARD R HAPSBURG
'
CLIMATE ZONE -15,
BUILDING SHELL
MEASURE POINTS
*TOTAL'FLOOR AREA
.1424 FT2
1. SLAB ON. GROUND PERIMETER 154 FT; DEPTH
0 .IN.
R- 0 -4.
2. RAISED FLOOR R- VALUE
R- 0 0.
3. CEILING INSULATION OR CONSTRUCTION ASSEMBLY,
R -VALUE
R-. 38 C
ATTIC, PCT. OF ROOF OVER CONDITIONED SPACE
100-%
1424-FT2 4
4. WALL INSULATION OR CONSTRUCTION ASSEMBLY,
R -VALUE
R- 1.1
GLAZING TOTAL X FLOOR AREA SINGLE DOUBLE
_
TRIPLE
5.•NORTH-FACING 2.3% 0-FT2
33-FT2
0-FT2 0
6. EAST --FACING .4%. 0-FT2
6-FT2
0=FT2 4
7. SOUTH -FACING 4.4X 0-FT2
62-FT2
0-FT2 -c.'
8. WEST --FACING 2% 0-FT2
28-FT2
0-FT2 4
9. SKYLIGHT---- OX 0-FT2
0-FT2
10. -SHADING COEFFECIENT (EXCLUDE OVERHANG)
A. EAST...
.58 -SC
0
B. SOUTH..
.58 -SC
-3
C. WEST...
.58 -SC
-3
D. NORTH..
.58 -SC
01
E. SKYLIGHT
O -SC
of
11. HORIZONTAL SOUTH OVERHANG LENGTH
1.5 -FT
-1
12. MOVABLE INSULATION, V. FLOOR AREA
OX
0l
13. INFILTRATION (INDICATE STANDARD -MEDIUM -TIGHT)
MEDIUM -1'
14. THERMAL MASS
'
EXTERIOR WALL THERMAL MASS
AREA, HEAT CAPACITY, R -VALUE 0-FT2,
0-HC,R-
0 0
INTERIOR THERMAL MASS
AREA, HEAT CAPACITY, R -VALUE 238-FT2,
8-HC,R-
.32 6
H.V.A.C: SYSTEM**
15. GAS FURNACE WITHOUT'REFRIGERATION COOLING
O -SE- 0
(SEASONAL EFFICIENCY)
16. HEAT PUMP (ENERGY, EFFICIENCY RATIO
9 -EER 7
17. GAS FURNACE WITH REFRIGERATION COOLING
- SEASONAL EFFICIENCY (SE), SEASONAL ENERGY
EFFICIENCY RATIO (SEER) O -SE
0 -SEER, 0
18. ACTIVE SOLAR (NET SOLAR FRACTION'X)
0 -%NSF 0
19. ZONALLY CONTROLLED ELECTRIC RESISTANCE (YES/N0)
NO 0
DOMESTIC WATER HEATING**
20. SOLAR WITH GAS BACKUP (NET SOLAR FRACTION
X)
O -NSF% 0
21. OTHER WATER HEATING (DESCRIBE TYPE)
HEAT PUMP 0
POINT SYSTEM COMPLIANCE TOTAL
+5
(MUST BE -GREATER OR EQUAL TO 0 TO COMPLY WITH
AB163)
* CHECKLIST 'ITEMS NOT A POINT SYSTEM MEASURE.
'
** ATTACH DOCUMENTATION FOR•EFFICIENCIES AND NET
SOLAR FRACTIONS.
COMPLIANCE CHECKLIST FOR LOW RISE RESIDENTIAL BUILDINGS
(EXCEPT HOTELS AND MOTELS)
DATE 04/04/86
OWNER CARBON C. DUBBS
PROJECT SINGLE RESIDENCE
PREPARED AND DOCUMENTED BY RICHARD R HAPSBURG
CLIMATE ZONE 15
BUILDING SHELL
*TOTAL FLOOR AREA
1. SLAB ON GROUND PERIMETER 154 FT;:DEPTH 0 IN.
2. RAISED FLOOR R- VALUE
3. CEILING INSULATION OR CONSTRUCTION ASSEMBLY, R -VALUE
ATTIC, PCT. OF ROOF OVER CONDITIONED SPACE 100-X
4. WALL INSULATION OR CONSTRUCTION ASSEMBLY; R -VALUE
GLAZING TOTAL X FLOOR
AREA
SINGLE
DOUBLE
5.
NORTH -FACING
2.3X
0-FT2
33-FT2
6.
EAST --FACING
.47.
0-FT2
6-FT2
7.
SOUTH -FACING
4.4X
0-FT2
62-FT2
S.
WEST --FACING
27.
0-FT2
28-FT2
9.
SKYLIGHT--
OX
0-FT2
0-FT2
10.
SHADING COEFFECIENT
(EXCLUDE
OVERHANG)
A."EAST...
.58 -SC -
B. SOUTH..
.58 -SC
C. WEST...
.58 -SC
D. NORTH..
.58 -SC
E. SKYLIGHT
0 -SC
11.
HORIZONTAL SOUTH
OVERHANG LENGTH
1.5 -FT
12.
MOVABLE INSULATION,
X FLOOR
AREA
OX
MEASURE
1424
FT2
R-
0
R--
• 0
R-
38
1424;FT2
R -
+5
TRIPLE -
0-FT2
0-FT2
0-FT2
0-FT2
13. INFILTRATION (INDICATE STANDARD -MEDIUM -TIGHT) MEDIUM
14. THERMAL MASS
EXTERIOR WALL THERMAL MASS
AREA, HEAT CAPACITY, R -VALUE 0-FT2, O-HC,R-
INTERIOR THERMAL MASS
AREA, HEAT CAPACITY, R -VALUE 238-FT2-, 8-HC,R-
H.V.A.C. SYSTEM**
15. GAS FURNACE WITHOUT REFRIGERATION COOLING
(SEASONAL EFFICIENCY).
16. HEAT PUMP (ENERGY EFFICIENCY RATIO
17. GAS FURNACE WITH REFRIGERATION COOLING
SEASONAL EFFICIENCY (SE), SEASONAL ENERGY
EFFICIENCY RATIO (SEER) 0 -SE
18. ACTIVE SOLAR (NET SOLAR FRACTION X)
19. ZONALLY CONTROLLED ELECTRIC RESISTANCE (YES/NO)
DOMESTIC WATER HEATING**.
20. SOLAR WITH GAS BACKUP (NET SOLAR FRACTION X)
21. OTHER WATER HEATING (DESCRIBE TYPE)
POINT SYSTEM COMPLIANCE TOTAL
(MUST BE GREATER OR EQUAL TO 0 TO COMPLY WITH AB163)
* CHECKLIST ITEMS NOT A POINT SYSTEM MEASURE.
FORM 2
POINTS
0 0
.32 6
0 -SE 0
9 -EER 7
0 -SEER
0
0-XNSF
0
NO
0
0-NSFX
0
'HEAT PUMP
0
+5
** ATTACH DOCUMENTATION FOR EFFICIENCIES AND NET SOLAR FRACTIONS.