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06280 (SFD)Building Address 51--380 Jacumba Owner .7Ack tai:ate Mailing Address City Zip Contractor ress Zip 4 P.O. BOX 1504 78-105 CALLE ESTADO QUINTA, CALIFORNIA 92253 Tel. .., , Tela State Lic. City & Classif. 181233 Lic. # Arcn., tngr., Designer 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 I hereby affirm that I am exempt from the Contractors License Law for the following reason: (Sec. 7031.5,Busmess 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 rite 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 civil penalty of not more than rive hundred dollars (5500). ❑ 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, Bursness and Professions Code: The Contractor'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 improvements are not intended or offered for sale. fl, however, the building or improvement is sold within one year of completion, the owner-buider will have the burden of proving that he did not build or improve for the purpose of safe.) ❑ I, 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.) O. 1 am exempt under Sec B. & P.C. for this reason Date Owner 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. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed ff 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 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 subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions of this 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 Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration it work thereunder is suspended for 180 days. I certity that I have read this application and state that the above information is correct. 1 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 No. UILDING: TYPE CONST. OCC: GRP. .P. Number 7b9.116--006 egal Description roject Description 5FD Sq. Ft. 1600 No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation 087,408 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. $250.00 Const. $ 252.10 Mech. 585.50 Electrical 60.00 Plumbing 113.32 S.M.I. 150.5E Grading 6.16 Driveway Enc. 20.00 Infrastructure 20.00 1,928.45 TOTAL 1 13,396.03 REMARKS ..�, =r.+ r.f- r�{tirt rn...se�tt► 4Ft ', Vv r n to i. 1- .LT 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 DATE INSPECTOR 9/14/89 Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS ' ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SQ. FT. FORMS SEWER OR SEPTIC TANt 7` ROUGH WIRING 4 MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® GAS (ROUGH) METER LOOP GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CARP. SQ. FT. ® GROUT WATER HEATER SERVICE WALL SQ. FT. FINAL INSP. DRINKING FOUNTAIN SQ FT ® WATER SYSTEM URINAL ESTIMATED CONSTRUCTION VALUATION $ =$ WATER PIPING NOTE: Not to be used as property tax valuation FRAMING FLOOR DRAIN MECHANICAL FEES Ole I (� C /i � / % cw4 -,_c7 I S ( b 1 ( J O t� r� (� 0 10( WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER VENTILATION GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FIRE ZONE ROOFING LAUNDRY TRAY AIR HANDLING UNIT CFM I 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 ® 1 Vi c SEWAGE DISPOSAL SQ.FT.GAR ® V4c 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 ETBACK JROUND PLUMBIN$��t UNDERGROUND A.C. UNIT COLL. AREA OREGRADE!—_g ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANt 7` ROUGH WIRING 4 DUCT WORK ROCK STORAGE 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. % FRAMING FINAL INSP. OOFING /v - Ole I (� C /i � / % cw4 -,_c7 I S ( b 1 ( J O t� r� (� 0 10( EMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING+DAWN 1'' A9 j MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOWSSIGNATURESIINITIALS GARDEN WALL FINAL Desert Sands Unified School District CERTIFICATION OF PAYMENT OF � NOTICE: THIS DOCUMEr� �o %RA z Xwy FEES BE DUPLICATED, TO: City of La Quinta DATE: Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 This is to certify that ,ill (- �l.'�1• developer of hich is located at — within this District, has paid school facility fees imposed pursuant to the au ho it gen ra d by vern t o e Sec ioit5,00121 the mount of 16b $ ( OIXiV f covering a total of square feet of ( ) residential or ( ) industrial/commerc' evelopment and that building permits for this footage in this development may now be issued by your jurisdiction. 4foDESERT NDS UNIFIED SCHOOL DISTRICT White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer (10)-37 Cv 1�G�GhAGt/ �- c�,oFT�9�5 78 CALLE ESTADO - LA QUINTA, CALIFORNIA 9225- (619) 5 May 18, 1989 Mr. Jack 'O. Wis &Z3 x Cn; c g S cc _j .. . QC Subject: Finish Floor Elevation u= 51-380 Calle Jacumba (Lot A, Block 2, Desert Club Tract No. 2) Dear Mr. Wise; Your letter received May 1, 1989 requested a variance from the requirement of the Flood Insurance Rate Map for finish floor elevation in a A 3 zone so that you could construct the dwelling lower. At its meeting May 16, 1989 the City Council sitting as an Appeals Board, granted the variance on the basis that a) the present FIRM does not take into account the flood control facilities which have been constructed in the upper Cove and b) the Municipal Code provides that a variance may be granted if the lot is less than one-half acre contiguous to and surrounded by lots with existing structures constructed below the base flood level. The Municipal Code requires that I advise you that the structure will be permitted to be built with a lowest floor elevation below the regulatory flood elevation and that the cost of flood insurance will be commensurate with the increased risk resulting from the reduced lowest floor elevation. Please be further advised that a copy of this letter will be recorded in the office of the Riverside County Recorder in such a manner that it will appear in the chain of title of the affected parcel of land. Ver truly yours, Fr nk yno ds, Director of Public Works/City Engineer FR/sh r7r` M` V -0 - MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253 STATE OF CALIFORNIA 180673 vss. COUNTY OF u U e('s l6d4' On this day of in the year 19—(L'-7, before me, the undersigned, a Notary Public in 6d for said State, personally appeared FR-an K. QL4 n O personally known to me OFFICIAL SEAL (or proved to me on the basis of satisfactory evidence) to be the person_ whose name_ SAUNDRA L. JUHOIA AS subscribed to the within instrument, and acknowledged to me that _he_ NOTARY PUBLIC • CALIFORNIA executed it. RIVERSIDE COUNTY 11*1 Comm. Expires Dec. 18. 1992 WITNESS my hand and offic al al. Notary Public in d for said State. ACKNOWLEDGMENT—General—Wolcotts Form 233CA—Rev. 5.82 ©1982 WOLCOTTS, INC. (price class 8-2) ��''ti"'"�,1 �-uF�•ik�=.s �;;R"`s.•+•Ts=:�:...._`�•Kc�''�-�n�: >-s_";^`''� `�iyar�''�I"S+r7;fZi� `.�'wr+�FrF��* tom'-��:t�;-'�•�,,�?R;��•�a^.-' COUNTY OF RIVERSIDE DEPARTGIENT OF HEALTH Assessors Parcel No. ENVIRONMENTAL HEALTJJ SERVICES PERMIT APPLICATION FOR A SUPS. V FACE SEWAGE 61SPOSAL SYSTEM Applicant: Submit this form with four coniss-of a scaled plot plan (1-20 scale) drawn to County speculations as indicated on the attached check list. A nar-refuniabl� Aft tete (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, ContQ r, Contact onFtp�e�1 Address & Pn� � �• '221 owner V i'AJ� V V 1 4Ine< -y City Stye Zip I Jpb Property Holding Tank Agreements Completed Certification of Existing S.D. System Required WQCB Clearance required. (Attach Form DOH SAN 007, Santa Ana Region Only) Soils Percolation Report Required. Special Feasibility Boring Report Required. Detailed Contour Plot Plans Required (1 to 5 ft. interval) Other Staff Specialist Lot Inspection Required LI De ri tion Pro . (P Tract, 1 A17M Other Date CATEGORY: REV CODE SITE EVALUATION UPON REQUEST 7349 (NO PLOT PLAN) ❑ SEWER/SEPTIC VERIFICATION (Less than 1 year) ❑ PRELIMINARY ELECTIVE EVALUATION (Attach DOH SAN 53) ❑ HOLDING TANK ❑ ALTERNATIVE/EXPERIMENTAL SYSTEM ❑ Yes ❑ Yes ++ �KoNo ❑ Yes IJO ❑ Yes N ❑ Yes ❑ Yes !20;001"" ❑ Yes ❑ Yes y Lot Inspection Date FEE $42.00 7348 $11.00 7352 $45.00 7351 $45.00 7345 $132.00 /DATE Leachlines/bed special design for slope: (3) Pit Diameter No. Pits Pit Beth' SeegagetP' Total Depth her: Applicable N/A 4"isf�••(1�EEi�yIU! � � ❑ 5 �" EJ./i Max. Allowable Depth ,�......��Overburden factor � (J No. 2 System / t REMARKS: This applicationAPPROVED -for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated �. on the accompame using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the 1O ahove-designed system. No construction is permitted in the required reserved 100% exp nsion area. F (1) '.Septic tank and sewer lines must be 50' minimum from any wells��(7� ± W Lead, lines must be 100'. minimum from any wells, including expansion ea 3 Seepage pits must be 1 minimum from any wel including expansi ar N 10 + Signature of Health Official � nar. V.—," P 4 / /'w. RECEIPT•NO. Issued By Date e ^ DISTRICT: ❑ Riverside, &I dio ❑ Hemet 0 Perris ❑ Rancho Calif. ❑ Blythe DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file rYELLOW - Applicant PINK -,Bldg. Dept. GOLDENROD - Plans/Records Soils boring report by # Date Soils Map Page �f Soil Type _ S ��i //�'r'ojeectt Approved by /'�'_4 — Date U Z No. of Systems Ype of System(s) H�o No. Dwelling Units (1) Septic Tank Soil Rate z refa /land 0 ❑❑ ding Tank ❑ Existing L�New Bedrooms, ftftwitimilsom G ntcp ❑ Replacement U ly v v Galall W (2)each Line Sq. Ft. eo trench area Sidewall allowance ft rock/ sq. ft. I Line(s) min. inc I, ft. long ft wide with L h Bed sq. ft. , c of boo ea ebw drainlines or per running ft. Leachlines/bed special design for slope: (3) Pit Diameter No. Pits Pit Beth' SeegagetP' Total Depth her: Applicable N/A 4"isf�••(1�EEi�yIU! � � ❑ 5 �" EJ./i Max. Allowable Depth ,�......��Overburden factor � (J No. 2 System / t REMARKS: This applicationAPPROVED -for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated �. on the accompame using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the 1O ahove-designed system. No construction is permitted in the required reserved 100% exp nsion area. F (1) '.Septic tank and sewer lines must be 50' minimum from any wells��(7� ± W Lead, lines must be 100'. minimum from any wells, including expansion ea 3 Seepage pits must be 1 minimum from any wel including expansi ar N 10 + Signature of Health Official � nar. V.—," P 4 / /'w. RECEIPT•NO. Issued By Date e ^ DISTRICT: ❑ Riverside, &I dio ❑ Hemet 0 Perris ❑ Rancho Calif. ❑ Blythe DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file rYELLOW - Applicant PINK -,Bldg. Dept. GOLDENROD - Plans/Records