05172 (SFD)Building 54-925 Valle'o
Afifi J
T4-4 4 4 Q"
P.O. BOX 1504 N EBRIP9*144
78-105 CALLE ESTADO "AN ADEQUATEVI SIP01 DL
LA QUINTA, CALIFORNIA 92253
IS p
F jig ON THE JOB -SITE DURING
.1D it
BUILDING:"TYPE C tqST. 5 OF CONSTRUCTION
-OCC'. GRP.-
A.P.,.Number 774-301-019
Coachella Valley Land
Address 247 E.
City
Palm Sprin
Contractor
Tahquitz Way 02
1ZiD Tel.
92262 1 - 12-2-t-1020
Legal Description_
Project Description
� - � p � . ,
S.F.D.
city Zip Tel:
State Lic. City
& Classif. 387934 Lic. # 895, Sq. Ft. 1409 No. No. Dw.
Arch., Engr., Size Stories Units
Designer New I-] Add 0 Alter El Repair 0 -Demolition 0
Address Tel.
C..,xrapp- 4301
City Zip State
I I Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7=ol Division 3 of the Business and Professions Code, and my license is in full force and
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5.8usi7ess and Professions Code: Any city of 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 Me a signed statement that he is licensed pursuant to
the provisions of the C"itractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Buskiess and Professions Code. or that. he is exempt therefrom, and the basis
for the alleged exemption. Any viotatkin of Section 7031.5 by 'any applicant for a permit
subjects the applicaritto a civil penally of not more than rive hundred dollars ($500).
0 1, 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 Contradoes 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 kriprovements are not intended or offered for sale. It. however, the building
or In7provemant is sold wffldn one year of conwietion, the owner -builder will have the burden
of proving that he did net build or improve for the purpose of sale.)
0 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 projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
0 1 am exempt under Sec -B. & P.C. for this reason
Date -owner
WORKERS' COMPENSATION DECLARATION
Worklehereby affirm that I have a certificate of consent to self -insure, or a certificate of
r's Compensation Insurance, or a certified copy thereof. (Sec. 3800. Labor Code.)
Policy N - Company -
0 Copy is filed with the city. .0 Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS7 COMPENSATION INSURANCE
(This section need not be complIaled ff the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thp 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 H, after making this Certificate of Exemption you should become
sufject to the Wbrkefs' Compensation' promsdons of the Labor Code, you must forthwith
comply with such Provisions Or thia permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
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.)
Lender's Name --
Lenders Add
This is a buildin is subject to
f � permit when properly filled out, signed and validated, and
expiration I work t ereunder is suspended for 180 days.
I Cer tity that I 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
fil X 1701
Estimatea Valuation
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Eric.
Infrastructure
TOTAL
AMOUNT
6 FA 0 5
7A 17
q An,
REMARKS
905*i. V P64NIV!
Aw 4,iNw.f � " -- - �
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Lin
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
-Side Setback from Property Line
FINAL DATE . INSPECTOR
-issued by: Date 12/29/ 8 ermit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FIL SO. Fr. @ $
UNITS
A.C. UNIT
COLL. AREA
YARD SPKLR SYSTEM
2ND FIL SO. FT. @
BONDING
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. @
SEWER OR SEPTIC TANK
ROUGH WIRING
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. @
FOUND. REINF.
GAS(ROUGH)
METER LOOP
DRAINAGE PIPING
CARP. SO. FT. @
REINF. STEEL
GAS (FINAL)
TEMP. POLE
DRINKING FOUNTAIN.
WALL SO. FT. @
GROUT
WATER HEATER
URINAL
SQ. FT. @
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
BOND BEAM
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
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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.
SO. FT. @ c
BATH TUB
SQ. Fr. @ c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 1% c
SEWAGE DISPOSAL
SQ.FT.GAR @ V4c
HOUSE SEWER
MESH
GAS PIPING I
PERMIT FEE
PERMIT FEE I
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.FEE
CONST. FEE ELECT.FEE
SMIFEE 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)
STORAGETANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCKSTORAGE
FOUND. REINF.
GAS(ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
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
0 7-0 4-, vt -1p P -g' ;I
REMARKS:
VENTILATION
FIRE ZONE ROOFING'
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
KtAbATHING -7 -q?-1
MESH
QLKINsuLA-noNisoUND,j— jLt
FINISH GRADING
Z/(F'INAL INSPECTION
CERT. OCC.
FENCE FINAL
1INSPECTOR'S SIGNATURESKNI`TIALS
GARDEN WALL FINAL
Desert Sands. Unified School District
CERTIFICATION OF PAY*MENT
OF
SCHOOL FACILITY FEES
1,� 4
27
UMLrI.
TO: City of La Quinta
Department of.Community Development
78-105 Calle Estado:
La Quinta, CA 92253
t A
..This is to certify that
developei of which is
loca ted at within
TIA
this Distric:t, has paid school facility fees imposed'pursuant to the
authority generat y &Gver/nent �ode Section �5308� the amount of
-- 11
"S
1 ofj
covering a total of 4uarA.feet of residential or
'Industrial/commercial developmen,t that building permits for
this footage in this development may ow e y your, juris iction.
v
I r �ES*EhT,_SMlDS LAIFIED S C.HOOL. DISTRICT
AW4
White Building Department 0 Yellow Facilities Planning 0 Pink Accounting Gold Developer
(10)-37,
W X11, !
cm-rr%cL1CA1-ru Assessors Parcel No.
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ENVIRONMENTAL HEALTH SERVICES
PERMIT APPLICATION FOR -A SUBSURFACE SEWAGE DISPOSAL SYSTEM
Applicant: Submit th - is form with four copies of a scaled plot plan (11 -20 scale)'drawn.to County speculations as indicited'on the attached check lisL
A nonr4fundabie filing fee (see below) is required when the application is submitted. Check must be made payalbli to the County ot
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 AppucAmON 13UILDING DEPARTMENT APPLICATION LOG'#
Agent Contractor, CbntEict-Person
Phone
Address & Phone
5 7* A 19 0 It rf 0 4)
Owner
Phone
Mailing Address
I -e- go f- Ar v A AJ P
A* 7 15 -t-,q 14 Z41
city
Siste
Zip
Job Property Address
C66al Description Prop. (PM, Tract Vot)
IF 7,41AI SPA -0
I CAI—
f
6-YfZ5' t/ogiceio(
4or 9 AC X .31, de
Lot Size
Water Agency/Well
Use of Permh P/P, CU, etc.
Other
d V 04 r4014-
D(S ra fc,�
Dwelling, MH Site Prep, etc.
Ilate
Signature of Applicant
CATEGORY: REV CODE FEE
CATEGORY: REV CODE FEE
SUBSURFACE DISPOSAL 1238/ 5"
0 SITE EVALUATION UPON REOUEST 7349- t42.00
• MULTIPLE PARCELS WITHIN SAME
(NO PLOT PLAN)
LAND DIVISION
0 SEWER/SEPTIC VERIFICATION 7348 $11.00
a. 1 at 4 Pamela (Each) 1238 $45.00
(Lew than 1 yew)
b. Each Parcel after 4 7344 $16:00
0 PRELIMINARY ELECTIVE M52 �45.00
• Rereview (2nd review same parcel) 7344 $16.00
EVALUATION (Attach DOH SAN 53),
• S4te Evaluation in Conjunction with
0 HOLDING TANK 7351 $45.00
Critical Area 7346 $86.00
0 ALTERNATIVE/EXPERIMENTAL .7346 $132.00
• Site Evaluation Lot Less than
SYSTEM
10,000 Sq. Ft. 7347 $86.00.
INIM, AL TE
Holding Tank Agreements Completed 0 yes NO
Certification of Existing S.D. Sy"m Required 0 Yes No
WQCB Clearance required. (Attach Form 0 Yes No v
DOH SAN 007, Santa Ana Region Only)
Soils Percolation Report Required. 0 Yes No
Special Feasibility Boring Report Required. 0 yes No
Detalled Contour Plot Plans Required (1 to 5 Ill. interval) 11 Yes No
Other 0 Yes No
Staff Specialist Lot Inspection Required 0 Yes No
Lot Inspection Date
Soils boring report by' Proiect 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
I' I
Q Holding Tank 0 Existing
PKN&w Replacement
Bedrooms, Fixture Uni
its,
I I
I
G r/.
p(se Intp
S �AO,X.
,
_,
_Gal
(2) Leach Une Sq
Bottom trench 4t
Sidewall al
Instail — Une(s) wide with
�dndnfihries
Leach Bed'sq. It.
7 -
It. rc sq. It.
—per WQng _tL
min. inches rock or
of bottdm area
0 NA
Leachlines/bed special desig for slope:
(3) Ph Diameter
No. Pits
Pit Below
Inlet
Seepage Ph Total Depth
Other.
7L7
Applicable Yfator-
\Y
(BI)
N/A — Overburl�
0 5 0 \6
Max. AJlowable Depth
No. 2 System
REMARKS: ob -,Z,�ksa v _S k C X CA Y4 C,
O'k V\
This application is 4g=PROV_E_D�DENIED for the category checked in SECTION B above, regarding the design of a subsurface disposal system, as indicated
on the accompan ' ied 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.
10) Septic tank and sewer lines must be 50' minimum from any wells
(2) Leach lines must be 100' minimum from any wells, including expansion area
(31_ -.>Seepage %s 1 0 �tAao, k, -OP,
Pits must inclkA)ng expansion area C�' I\^ -
wells,
�_\, "k - C &
2:t L,.�, I L.) 0
Signature of Health Off icialK� Date -
RECEIPT NO. Issued By Date LJ
DISTRICT: 0 Riverside, Indio 0 Hemet 0 Perris 0 Rancho Calif. 0 Blythe
DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file YELLOW - Applicani PINK - Bldg. Dept. GOLDENROD- Plans/Records
01 F ICE OF E.LEOMSPAOGY.
0 AGRICULTURAL COMMISSIONER )AMES 9 WALLACE
ANP
CLEMENT BENVENISTE
V ITS:& MEASURES SEALER
WEIGI
49-6t3 Ilwy 86, Suite 0 -12 -
'Coachella, CA 92236
Af4 q �619-342-Mt
CASE NO.
DATE
DEVELJDPERIS-NAMEs.-� C OA1 :5 7- 19 tj a- 2" 1 '0
jj-;V
ADDRESS: X L) 7'.
?
z z C_ Z__
2- .-�Z.
TELEPI IONE: .
Dear Developeri.
After reviewin your landscapilig plalls, all plant noteriallisted is.not in
9 ns
violation of quaranitime law's governij.19 the Coachella Valley. If substitutio,
ice must 136. notified
do occur and they differ frun plant material listed, this off
Initediately..
you for prOtectij d -ervijig the Coachella Yalley' s pest -free. envimment.
Thank ig an pres
Agricultural, Comnisigictier,s. office
cci Indlo and.Riverside of f ice
jo
Fri.
0
A Off ICE OF E. LEON SPAUGY
AGRICUU[URAL COMMISSIONER NIES WALLACE
M,
AND
0 NT - VENISTE
CLEME. - BEN
WEIGHTS MEASURES
SEALER'
U
49-613.11wy 86, Suite B-12
'Coachella, CA 92236,
4f -z:1 I
4 Ir Sq 619.-342-8291
CASE N3., G1
E
DbTWPER'S 19 a C 0A1 .5 r1Q 0 a 1,,$ 0*
ADDRESS.s X4 T 0 -r,4,Oi Q Ll I 'r
<7
/A) Ge- Z C. Z---
TELEPHONEs Z '2 -/'c Z-0
Dear Developers.
andscaping platS, all Plant fmterial listed is not.in
-After reviewing your Ic
violation of quarantime laws governing the Coachella Valley. - �f substitutions
do occur 'and they differ frun plant noterial listed, this office must be notified
Imte.diately.
-free environment.
e
Thank you for -protecting and preserving the Coachelld Vall y's per
71�g_ricultural Cannisgifter's office
-cm Indio and -Riverside Office
S 9 VALLEJO .4 a 4
7.7 1/ /9
Z 3
ar
Buena Engineers, Inc.
79-811 Country Club Drive, Suite 4
Bermuda. Dunes, CA 92201 - (619) 345-1588 / 328-9131
Client
Client Addres
Client Phone
DATE
JOB NO.
PROJECT
A C.0
Ur, (e 10
LOCATION
MOISTURE
CONTRACTOR
MAXIMUM
OWNER
WEATHER
TEMP. 0 at AM
0 at PM
PRESENT AT SITE
LOT:
NUMBER
NO.:
A CLIENT REPRESENTATIVE SIGNATURE
14*10-3 3 9
FIELD REPORT
TECHNICIANS SIGNATURE
FIELD TESTING
REFERENCE CURVE
MOISTURE
DRY
MAXIMUM
MAXIMUM
OPTIMUM
TEST
TEST LOCATION
LOT:
NUMBER
NO.:
ELEVATION
CONTENT
DENSITY
DRY
DRY '
MOISTURE
%
lbsiCu. ft.
DENSITY
DENsr6e
CONTENT
Dw p 0.,
%
lbsicu. ft.
%
o ieA 4
U
Sk �C�
4(
Col" Tpr'�-f-'
R
Zc" i U 14 p e- �1- U 3 o s -s L),,, K
9 ap k) k r� S' VIA ak� C k '�L PC
v
A CLIENT REPRESENTATIVE SIGNATURE
14*10-3 3 9
FIELD REPORT
TECHNICIANS SIGNATURE