003131 (SFD)1
\' P.O. BOX 1504 No.- 003131,
Building 78-105 CALLE ESTADO
Address' 54-555 AvptniAA V,911f0n LA QUINTA, CALIFORNIA 92253
Owner
0"Noll BUILDING: TYPE CONST. OCC: GRP.
Mailing
Address � � Aw**n4clot j*l^, n A.P. Number
City Zip w Tel.
Legal Description
Contractor Project Description SinpXe Famfly Wl ellA44ti:
,wpm^? �,iisRox
.Address
City Zip Tela t
State Lic. ' ' City
& Classif. Lic. # Sq. Ft.� No. %� .� Io9Dw?
Size Stories Units L"
Arch., Engr., _. __ .. ..
Designer New QM, Add ❑ Alter ❑ Repair ❑ Demolition ❑ '
Address Tel. 1321 of Wood Pence
City Zip State X528 Sq. ft. garage
.. . Lic: #
LICENSEDCONTRACTOR'S DECLARATION 0 $ • 2�D
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
70 OO) of Division 3 of the Business and Professions Code, and'my'license'is in full force and
effect..
SIGNATURE DATE _
OWNER -BUILDER DECLARATION ' ' Estimated Valuation h9
I 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 AMOUNT
requires the applicant for such permit to file a signed statement that he is•11censed pursuant to PERMIT . • -,.
the provisions o/ the Contractor's License, Law, . Chapter 9 (commencing with Section .7000). o/ ' a
Division 3 of the Businessand Protession9-- 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.'0 3
subjects the applicant to a civil penalty ofnot 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.
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 ...�R .,
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
of proving that he.did not build or Improve /or the purpose of sale.) 7A . •s
1
O I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing
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 improvesthereon, and who contracts for . S.M.I..
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) -
0. I am exempt under Sec. Grading ?n -nn
B. 8 P.C. for this reason -
Driveway Enc. i>n.fit)
Date ty- C- Iovvner. ; 4 • • •- � �' f -A i(f 77 Infrastructure 14011 7wa
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 A7_ '1.77 At .,823_77
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed i/ 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 rFf r, 1n� A^- ._Aa A.V, ONO _ l'.' i
employ any person -in any manner so as to become subject to the Workers' Compensation Y
Laws of California. S.L�' lEi.'ift 1 _3t3I(yt:
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 ,Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked.
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 Ll.ne
Lender's Name
Lender's Address FINAL DATE INSPECTOR
This is a building permit'wherrproperly 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 61sT /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. Validated by:
Signature of applicant —Date—
Mailing.
ateMailing Address Validation:
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. $
UNITS
doLAB GRADE
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
POR. SQ. FT. @
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. @
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT. @
GAS (ROUGH)
DRAINAGE PIPING
WALL SQ. FT. @
OTHER APP./EQUIP.
DRINKING FOUNTAIN
SQ. FT. @
EMP. POLE O— -�
��ll��SERVICE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
INALcu.
$
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
INAL INSP�Q� L
O
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
VENTILATION
KITCHEN SINK
ABSORPTION SYSTEM. B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. @ c
BATH TUB
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID @ 1114 c
SEWAGE DISPOSAL
SQ.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
PLUMBIN v
UNDERGROUND
A.C. UNIT
COLL. AREA
doLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK "+
FORMS
SEWER OR SE 1 A
ROUGH WIRING
DUCT WORK
ROCK STORAGE
OUND. REINF. `0
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)
EMP. POLE O— -�
��ll��SERVICE
GROUT
WATER HEATER
[L�1NAL INSbZ.G9_�
BOND BEAM
WATER SYSTEM
INALcu.
$
GRADING
d y .
plus x$
_$
LUMBER GR.
FRAMING
INAL INSP�Q� L
O
gG�OOFIING G/
-V ` �71�1,5�
/
REMARKS:
VENTILATION
FIRE
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND l /t7
FINISH GRADING
.r
/INAL INSPECTION-?.
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES)INITIALS.
GARDEN WALL FINAL
f' t
• Desert'Sands Unified School District
CERTIFICATION OF PAYMENT `
OF
SCHOOL FACILITY FEES (tom
TO: City of La Quinta DATE:
Department of Community Development
78-105 Calle Estado _
La Quinta, CA 92253 NOTICE: THIS DOCUMENT CANNOT
BE DUPLICATED.
This is to certify tha
developer of which is
located at within'
this District, has paid sch000 facility fees imposed pursuant to the
autho 'ty'generart d by overnment Code Section 5308 �n the amoun -
$�� ( J ' ,
covering a total of— 19132, square feet of ( rgid ntial or
( ) industrial/commercial development and that building permits for
this footage in this development may now be issued by your jurisdiction.
four ESERT SANDS UNI IED SCHOOL DISTRICT
White - Building Department • Yellow - Facilities Planning • Pink -, Accounting • Gold - Developer
(10)-37
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COUNTYPERMITIVISION
NMENTAL HEALTH SERVICES DSYSTEM
AOPPLICATION OR A SF RIVERSIDE, OUBSURFACE 7Y—d,f1—(1/ r
SEWAGE DISPOSAL f
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.)
�p VA I 1ply(
Mailing Address
or illa-1-
City a
r%( I f.rk
State
<<<.
Zip.Code Telephone
G I-�tih( l� ��t
'Job Property Address
<�ity (3ornmujnitya,
�7
Legal Description of Property. (Lot, PM, TR) Cp
�
Lst� • (./�.C!(Cea�G
-�/n t' c.t. r , -
� �. J '!1f %( ��i� .�Ti' ,�,1�� f -�
'Assessor's Parcel No.
ryVateFAgendy�onWell—/
Use of Permit�7., 8f V��Gf� �(� 4-e;planning Case #
Lot Size
~1 //��i
/fitt '' ,,
SFD, MH Site Preparation
Etc.
Signature of Appfcant Date
'The
above information must be verified from Building Application
STAFF USE — DO NOT WRITE BELOW THIS LINE
Initial Date G
Certification of Existing S.D. System required. ❑ Yes LJ No,`�s
WQCB Clearance required. t ❑ Yes�16 , )
Soils feasibility report required. ❑ Yes ,D' No
%e al ed bonng report Tequired. El Yes (] No f
Detailed contour plot plans required. El Yes �"0
Staff Specialist approval required. 1:1 Yes U No Lot Inspection Date
Soils/boring report by / n . l Project # Date
Soils Map Page IAt�t`�q Soil Type CC Approved by ��l�cj�
Date !,f�
Type of System: v /
❑ Existing ❑,New ❑ Additional ❑ Replacementrn�(
No. of Bedrooms
(1) Septic Tank
Gals.,d
Soil Rate Required
(2) Leac'line sq. ft.
Sidewall allowance
InstalLine(s) Ft. Long,
Leac bed Sq.
(Bottom tPe ch area)
ft. rock/ Sq. Ft.
Ft. wide -wit. min. inches
Ft. of bottom"—
per running ft. ON AO
rock below drain lines-
area
Leach lines/bed-special design for slope:
Applicable /
(3) Pit Diameter
No. Pits
Pit BI
1
Seepage Pit total depth_
N/A � Overburden factor.�.
�, [6'
J
Max. allowable depth
This application is ap roved denied 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 permit is necessary for the installation of the above` -designed system.
OSeptic tank and sewer lines must be 50' from any wells `�/Q{ .t�t� S w^ rlJzj f
(2) Leach lines must be 100' min. from any wells including expapslon area
(3) Seepage pits must be 150' min. from any including
�wJells expansion area_ po
>-� . ! ♦ /C rl s-..�..r fie' 7 / r.. !�_ra � .�*.-.4 . �'' f.!Jl .P`'rf"
/IAf
Signature of Health Official
RECEIPT NO. 7 TY Issued by -54. Date 5� : -24 -
7
District: ❑ Riverside ®'Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe
Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File
DOH -SAN -122 (Rev. 6/86)
2V
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7
�,yq Y•9/ � .1
UrrICE Of
/AGRICULTURAL CO,'1 1ISSIONER
4180 LEMO`1 STREET, 800:.1 19
(iIVERSIDF. CALIFORNIA 92501
(714) 787.2561
46-209 Oasis Street, Room 14
Indio, CA ' .92201
*_ (619) 342-'8291
E. LEON SPAUGY
COMMISSIOW.R
JAMES 0. WALLACE
ASSISMST COMMISSIONER
Dear Developer/Landscaper:
Thank you for inquiring with the Agricultural Comnilocal quarantine laws, ssioner's Office regarding
g
Any diseases or insects associated with the plants/landscaping material presented
on your landscaping plans do not pose a threat to the Coachella Valley Citrus,
Date, Grape, Vegetable, or Field Crop industry.., We therefore approve your
landscaping plans.
If however, any substitutions of plants/landscaping materials within your plans
occurs between now and the actual planting date, you must contact this office
within 48 hours before delivery into the Coachella Valley; 'Also, -the substituted
plants/landscaping material must be for inspection upon arrival. Any sub-
stituted landscaping material found infected/infested with quarantine pests will
.be inaediately treated or shipped out of the Coachella Valley at the discretion
of the Agricultural Cccmissioner's Office,
Under penalty of perjur}�, ' I. the undersigned ,;ill cc'
>,ply with the above
Authorized Agent:
a
Signatur
Permit Number(s) 97 RS' A C_Z -7
Developer �_ /, Q:
"d d r
AGRUCC!LTL-iUL C0` 1fjStiIO--T � I S . p
r �
-. _. ,-, t1.: Late
Authority cites: Agricultural Code; SectiOils 6301, 6461, 64.2, 64.6'1 6501, 6521-
6524
cc: 2 Pion Cl�cc;:, I::dio Office, Riverside Office