0002-463 (SFD)1 t LICENSED CONTRACTOR DECLARATION
��0' affirm under penalty of perjury that I am licensed under provisions of
'Jhapter 9 (commencing with Section 7000) of Division 3 of the Business and
ofessionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
Date "r�' �` Signature of Contractor �•�``"�� ± •��`" f
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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, Business & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
( ) I am exempt under Section B&P.C. for this reason
Date Signature of Owner
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
( ) I have and will maintain a certificate of consent to self -insure for workers'
compensation, as -..provided for by Section 3700 of the Labor Code, for the
performance of the'work for which this permit is issued.
( ) I have and will maintain workers' compensation insurance, as required by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued. My workers' compensation insurance carrier & policy no. are:
Carrier Policy No.
(This section need not be completed if the permit valuation is for $100.00 or less).
V'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, and agree that if I should become
subject to the workers' compensation provisions of Section 3700�of the Labor
Applicant
Code, I shall fQQrthwith,comply with:.those provisions. f if
Date:' f/' +�w"� 6 '�.^7 ✓'r
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify.that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property,.for inspection purpose.
Signature (Owner/Agent) Date ,'^^'"
t BUILDING PERMIT PERMIT#
DATE �lIYVALUATION LOT W02—'4 � TRACT i
1359.30 18 BLK4 TJ2
JOB SITE
APN
ADDRESS 51-3WCA.TJZ J=WW"
770-164-W7
OWNER
CONTRACTOR /DESIGNER ENGINEER
✓
A yP. O S7 U,'AEZ
OWlERi11DER
51.360 4'AIAE I IJENi
5) -360
LA (w1TS%iF.i•1. CA 92253
7..A QT,71NTA CA 922531
(760)345r9505 CW0dm
USE OF PERMIT
IEWGI.;� .PA�sHLLY 1`1VM 3 WG
: ± ;
VD -PERMIT DOES NOT IINCLUD1° BLOCKWALL5 OR P001:
• Fye r r �...,
l.+.r
TRACT CONSTRUCTJON 11,450,00 3F
IPOR.CWPATSO 2700 SF
C; RAGIUCARPORT 4'0.00 SF
5 FT. WOOD i+):14CE 200.00 )IV
UMIATED COS QF CtVITZIUCL1014
sgpw3o
FEyg r SVAufRL
CONSTRUCTION FEE 1011.000.418.000 $594.3a
PLATT CRECK 1W 101.000-439-318. $504.13
MECHANICAL FEE 1.01-000-421-000 $60.00
P-LECTRICA1, FEER 101-000-420-600 $122.99
PLUMBING PEE 101-000-419-000 $133.23
STRONO MOTION ME v RESID , 102-000-241-000 $8,9.1
0RAI) IH0 FET- 101.000.422-0100 $20,00
i7EVEL,OPER IMPACT FELT. $1,907.00
PRECISR PLAN 101.04;}0=441-345 $100,00
FEE DEPOSIT 101-000.499-31€I 4250.00
1111B-IWAL CONB'T.t2UM00 JWD PLAN CkTC
$3,410.91
LESS 'PRE-PAM1,7-&
4250,00
RECEIPT
DATE
,f -
(SATE FINALED
INSPECTOR
Final
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Footings
Underground Ducts
Forms & Footings
Main Drain
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K, to Wrap
,y —Ow $
F.A.U.
Framing
_
go—
Compressor
Insulation
.Qlp %
Vents
Fireplace P.L.
PLUMBING
Grills
Fireplace T.O.
Gas Test
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Plumbing Final
Plumbing Top Out
Exterior Lath
Drywall - Int. Lath
'Pil 01
Equipment Enclosure
Final
Final
COMMENT
'
Cron,
POOLS - SPAS
BLOCKWALL
APPROVALS
Temp. Power Pole
steel
Set Backs
Low Voltage Wiring
Fixtures
Electric Bond
Footings
Exterior Receptacles
G.F.I.
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING
APPROVALS
Gas Test
Electric Final
Waste Lines
Water Piping
Heater Final
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
i 7 ^1 1 _
Notice
Final
COMMENT
'
Cron,
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Notice
��,r:,4,-b�f�'S, _.. %,...�,?e..A.+:ir:�r�1+,.-4� _ �yrc. ,y/„�w.,:�..�.,��„r�. .,�. �,,�,l�,,rs�,,la�i"t,•�;�-*.+:�ci
xBuilding F
Address
Owner
pa
Mailing t
Address
City Zip
Contracto/r�
ltna,(1E'Y
Address
T4ht 4 4 "
P.O. BOX 1504 APPLICATION ONLY
i Lii 78-495 CALLE TAMPICO
ii...WLAQUINTA:2CALIFORNIA 92253
State Lic.I City
& Classif. Lic. ft
Arch., Engr.,
Designer
Address I Tel.
City (Zip ( State 1
Lic. # I
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 Busirress and PIJJdf�ssions Bode, and my license is in full force and
" effect. /✓/� ♦ L �_ r✓� /��i�.
X SLGNATURE'•1%�Py' W/!!l1/.11ilr/! //' 7_ DATE
1r OWhER-BUILDER DECLARATION
Ihereby 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
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 thealleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
I: 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 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. If, however, the building
or improvement is sold 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.)
1'1 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.)
i 7 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
f7 Copy is filed with the city. O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed 0 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: If, 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 or 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 certify 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
Mailing Add
City, State,
WHITE = FINANCE
LDING: TYPE"CONST. OCC. GRP
P. Number_ 74 ` i L q , QQJ
Legal Description
Project Description
<1 ! �.
`Sq. Ft.
Size $�
No.t
Stories 1
��Ot . Dw.
Units nn(li,
New ❑ Add ❑
Alter ❑
Re De 00
lu
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
s0, od
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
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
Issued by: Date Permit
Validated by:
Validation:
YELLOW = APPLICANT PINK = BUILDING DIVISION
Notice:
Document Cannot Be Duplicated
Date 4/17/00
Desert Sands Unified' School District
47-950 Dune Palms Road
La Quinta, CA 92253
760-771-8515
CERTIFICATE OF COMPLIANCE
No. 20298 Jurisdiction
Owner NameAlfredo Alvidrez
No. 51-360 Street Calle Hueneme
City La Quinta Zip 92253
APN # 770-164-007
La Quinta
Permit # 0002-463
Log #
Study Area
Tract # BLK4 U2 Lot # 18 Square Footage 1450
Type of Development' Single Family Residence No. of Units 1
Comments
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered
patios/walkways, residential additions under 500 square feet, detached accessory structures or replacement mobilehomes. It
has been determined the above-named owner is exempt from paying school fees at this time due to the following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of
2.05 X 1,450 or $ 2,972.50 the property listed above and that building
permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued
Fees Paid By CC/1 st Bank/Alfredo Alvidrez' "
Telephone 760-345-9505
Name on the check
,
By Dr. Doris Wilson
Superintendent ` *-
,� L�
Fee collected /exempted by Mary Ann L. Boda Payment Received,f' t $2,972.50
Check No. 54242
Signature
NOTICE: Pursuant of Assemb"ill 3081 (CHAP 548, STATS. 1998) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified
above will begin to run from the data on which the building or installation permit for this project is essued or on which they are paid to the District(s) or to another public entity authorized to
collect them on the Dlstrict('s)(s') behalf, whichever is earlier.
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building DeptJApplicant Copy - Applicant/Receipt Copy - Accounting
I
"7
�ierording Requested By
�. drdpr�1 Awic^o:i Tli=.3 hiaili--- Vtitii{18i1y
Escrow A0. 10-15761
C1 Loan No.
WHEN RECORDED MAIL TO:
Mr. and Mrs. Alfredo Alvidrez, Jr.
s. L
; a
a as 8 aIN
>f
SPACE ABOVE UNE FOR RECORDER'S
MAIL TAX STATEMENTS TO: DOCUMENTARY TRANSFER TAX 0A..� . .
BARB AS ABOVE x ConWed an the consideratwn a value o1 property Conveyed. OR
Computed on the consttleralren of value less'kons v exumbranws
P remaumg at rows of sate.
,
t
twe ant a rtonu:g tat vm amu
GRANT DEED
FOR A VALUABLE CONSIDERATION. receipt of which is hereby acknowledged.
^1 ROBERT NELSON TUVELL and MARILYN JEAN TUVELL, Husband and Wife as Joint Tenants
1
hereby GRANT(S) to .
INN ALFREDO ALVIDRE$, JR, and TINA ALVIDRE2, Husband and Wife as Joint Tenants
the real property In the City of La Quinta
County Of Riverside State Of Caubm18. d9SCribed as
Lot IS in Block 9 of DESERT CLUB TRACT, UNIT NO. 2, as per
rasp recorded in Bock 20 pages 6 of Maps, in Lhe office of
the County Recorder of said County.
DatedMarch 1, 1993
STATE OF CALIFORNIA }
)ss
COUNTY OF Riverside i
On March 2, 1993 before me.
She undermigned
parsonallyappeared Robert Nelson Tuvell and
Marilyn Jean Tuvell
personally known to me (or Waved to me on the bears of get,staolory
Qndentallo be Iha penm(s) whose namels) a(E*ubscfoed 10lhewdisn
instrument and acknow)edged to me that harsh Ihp otOpllad the same
N Iasllre(Aht/aulhOnred ca0aritylies). slid that by hi9lnst660sgna•
Ne(sl rut the mstrumem the person) or the entry upon berotf of which
RB porson(s) acted. executed lho msbumonl
WITNESS my_n official sea+
s4naturo "log
MAII .rally—fl*r,, 11f:
ROBERT NELSON TUVELL
� O
M3il1:ILYVJEdtil TUVELL
U•
saw 5 r"�;.avy
s NoforyPtrDtic•Carorno
MV612ME COUNM
gg
Mr rc l° i
1
.)k—
. Rrss mea for ottav notmw Sam
Q "r:• )";' '"i A
1"111., 1002 (1/9t)
Z
RECORDING REQUESTED BY:
AND WHEN RECORDED MAIL TO:
NAME FAlf.redo -Alvidrez
STREET
ADDRESS
CITY
STATE
ZIP L J
04/27/1999 08:00A Fee:6 00 v
Page 1 of 1
Recorded in Official Records
County of Riverside
Gary L. Orso
Assessor, County Clerk & Recorder
11111111111111111111111111111111111111111111111111111111
M
$
I U
PAGE
SIZE
DA
PCO
NOCOR
SMF
MISC.
A
R
L 11
COPY
I LONG
REFUND
NCNG
EXAM
� rFl O� .
GRANT DEED Tiie u, Icier signed Grantor( deciare(s) that the DOCUMENTARY
TRANSFER TAX IS: $ County, $ Cit
ASSESSOR'S PARCEL NO: ?70/ (oyQ0 7 )_ computed on the full value of the interest of proper
TITLE ORDER NO:
L*Y91asiz[e]
conveyed, or
computed on the full value less the value of liens CI
encumbrances remaining thereon at the time of sale
OR transfer is exempt from tax for the following reason:
TRA: 020-016 inter family transfer (name change)
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
Grantor/Seller Alfredo Alvidrez Jr. and Tina Alvidrez, Husband and Wife as
Joint Tenants
hereby GRANT(S) to
Grantee/Buyer Deana Alvidrez, a single woman
all that real property situated in the City of La Quinta
County of Riverside
(name of city or unincorporated area)
,State of Californi?• dnerrihad P.5 -
Lot 18 in Block 4 of Desert Club Tract, Unit No. 2, as per map recorded
in Book 20, uaae 6 of Maps, in the Office of the County Recorder of
said County.
gated _—F e_b,_-4-5-,
STATE OF CA ORNIA, )
COUNTY OF I ) ss
On before me
personally appeared
personally known to me (or proved to me on the
basis of satisfactor evidence) to be the
Person(s) whose namek 4/subscribed to the
within in trument, and ackno ledged to me t t
he>e tey exeCut the same in +iis,4�ef• their
authorizbtiJcapacit (les and that by-hic/hef beei��
signatur issl on the in the
the perso s or tFie
entity up?Sn behalf of which the person acted,
executed the instrument.
WITNESS my hand and official seal.
1401, 7
=_RTina AlViCrez,
A11SHA L BARNES
Commission # 1191952
Notary Pubfic - Cortomiq
�M Riverside County
tY
My Comm. Erp7m Aug Z 2002
(This area for official notary seal)
MAIL TAX
STATEMENTS TO:!)Ef-NA Alvidrez -
NAME ADDRESS CITY, STATE & ZIP
I-sIOD-S' 'area THIS FORM FURNISHED COURTESY OF ORANGE COAST TITLE COMPANIES
1
�s
5
PLEASE COMPLETE THIS INFOn&%Ar10N
RECORDING REOUESTEO Dv
AND WHEN RECORDED MAIL rO
Mr'edv AIS-►drem
'
TRA: Oa O
DTT: -lb-
GRAlY'IDEED
This Grant Deed needs to be re-recorded because the assessor's parcel number was
written with my social security number. It has now been changed to the actual
Parcel number 7701540072.
ID®a tsa 0000-003430
01/r.G/2o6v 68:90A F"6:9.00
Paya 1 of 2
Recorded In Offlclal Records
County of Rlverslde
Gary L. Oreo
Assa90or, County Clerk 8 Recorder
. IIIIIIIIIIIIIIIIIIIIIIIIaIIIIIiJIIIIIIIiIIIIIIIIIIIIIJI
M I I v/^11//GE .IJ[ I DA I ncow rnt n yY i M:C
—_.
I a I L I C., I IONC I w(r�p rlClee I [awy
cz
HUS
/ I I - Thank you,
> f Deana Alvidrez
T)
E C O S
U SE DNLY�
THIS PAGE ADDED TO PROVIDE ADEQUATE SPACE FOR RECORDING INFORMATION
63.00 Additional Recording Fee Applies)
ly ^
1RDING REQUESTED BY
i
i
AND WHEN RECORDED MAIL TO
+� NAME rAlfredo Alvidrez
STREET
ADDRESS
m
CITY
STATE
ZIP L
J
DOC N MSSS31-1"76038
04/27/1999 08:00A Fee:6.00
Page t of t
Recorded in Official Records
County of Riverside
Gary L. Orso
Rssessor, County Clerk d Recorder
M s I u PAGE I .12E x05 1 NOC O7 ,Ne I AI:C
—4 ~
� i I
A i R i L I COPi 1'0-c wuw E71M
GRANT DEED I `A 03,DTi.e urldel SlynZo Granton oeclarelsl trial the DOCUMENTARY
TRANSFER TAX IS: S County. S Cit —
ASSESSOR'S PARCEL NO: 77f7/ tps/00�2 computed on the full value of the interest of proper I�AG�
conveyed. or
TITLE ORDER NO _ computed on the full value less the value of liens o - -
ESCROW NO encumbrances remaining thereon at the time of sale
OR transfer Is exempt from tax for the following reason:
TRA 020-016 inter family transfer (name chan•je)
FOR A VALUABLE CONSIDERATION. receipt of which Is hereby acknowledged.
Grantor'SellerAlfredo Alvidrez Jr. and Tina Alvidrez, Husband and Wife as
Joint Tenants
hereby GRANTISI to
Grantee/Buyer Deana Alvidrez, a single woman
all that real property situated In the City of La Quinta
(name of city or unincorporated areal
i.ouncy oi7 Rivorside State of Cagiwr0L, deSCribed a5 -
Lot 18 in Block 4 of Desert Club Tract, Unit No. 2, as per map recorded
in Book 20, uaae 6 of Maps, in the Office of the County Recorder of
said County.
STATE OF CA ORNIA 155
COUNTY OF qW.S
On before m_eJ J
personally appeared / fTI FGI(-) 'glMir•QZ Sr.
moi- I I tmC1 Iliri ✓f'_
personally known to me for proved to me on the
basis of satlsfactor evidence) to be the
person(s) whose name ss .a r�`A subscribed to the
within In trument. and ackno ledged to me t t
t ey execut the same .r.
authonz capac t Iles and that by ~-, s -ho: el
slgnatur IS on the In rument the pe s Or e
entity up n the
of which the perso(S acted.
executed the Instrument
WITNESS my hand and official seal
ty
. �usl•u t_ sn.izva
Commission M 1191952
NotcoyPubfiC-C-oGicrtliQ
Rlvasido County
My CC:rm.fxpLns Aug 22002
r -
Signature Io;PI ni . �J�IThls area for official notary seal)
VIAIL TAX
STATEMENTS TODEPti•Fl AI✓,&e z
NAME ADDRESS CITY' STATE & ZIP
< -: . THIS FORM FURNISHED COURTESY OF ORANGE COAST TITLE CONAPANIES
COACHELLA
DISTRICT
RECEIPT DETAIL
CASH
Received From: Date
Address: _.
Account No �-
f �Lot(s) is
Tract -t. -��� U4
Service Address -25 10 �.' C 1.�.\ i k Zvi-we, G.A. Code
❑ Meter(s) $
❑ Service(s)
❑ Backflow(s)
❑ House Lateral (s)
❑ Detector Check(s)
❑ Meter Surcharge
(2,"S'anitation Capacity Charge
❑ W.S.B.F.C.
❑ Temporary Construction Meter
❑ Turn on Charge
❑ Uncollected Account - Name
❑ InspectionFee- Tract -
Fee -
❑ Plan Check Fees Water I Sewer -
r
Tract -
❑ Bond Payment - A.D. - Bond
Assmt.
❑ Customer Deposit
❑ Other
r TOTAL $
Remarks:
l
Q'Copy to:
CashWater Service
L • J
Check r) �/,
Money ` 7 Cashier
r ��
Ord e CVWD-438(11189)
I
' ASSESSOR'S PARCEL NUMBER
_ ER
C9UNTY OF RIVERSIDE HEALTH SERVICES AGENCY SSSS _ PARCEL
70
D&ARTMENT OF ENVIRONMENTAL HEALTH
VERMIT 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 as indicated on the attached check list.
A non-refundable filing fee is required when the application is submitted. Check must be made payable to Ilia County of Riverside. Approval of this applica-
ddllnot to exceed one year from date of payment.
tion shall remain valid for a period
'#� iT f/ [ A
LMS L. t 1XN�
Agent, Contractor, Contact Person t
/1 G�
Address City State Zip
;
Owner
Address city i State Zip
Telephone
ZO
Job Property Address
51-36 U C'A [ 44
�ty Cif
t4 Qu,.'Wt
Zip
s 3
0
U
Lot Size
��`.� //;
'Water Agen ell
��, sCc�t �/<<Py
Use of Permit, P/P, SUP, PUP, etc.
D�WAo6i:/,��r c4�cf
Legal Description S. )
107 1J)dt6rx Y, DFr��r(�u3 T�ca��
'owel�ingl HzSlteY?i8, etc. p� t
�_ 117/! C
'
Signature of Applical�]l r�rr.•,!/ w{�2 - lam- � `
Date
�
CHECKBOX IF REQUIRED
If any box is checked, this application shall be considered rejected until
❑ Detailed Contour Plot Plans Required (1 to 5 foot interval)
the information is provided and the fee paid. Resubmittals later than 90
days after date noted below may require repayment of fees.
❑ Staff Specialist Lot Inspection Required
ca
❑ Holding Tank Agreements Completed
Thomas Bros. Page Grid
Z
O
❑ Certification of Existing S.D. System Required
❑ Date Lot Inspection Completed: Initials
(~j
❑ WQCB Clearance Required
LU
(Attach for DOH -SAN -007, Santa Ana Region Only)
Remarks:
❑ Soils Percolation Report Required
❑ Maintenance Booklet Provided
❑ Special Feasibility Boring Report Required
❑ Final Inspection by Department of Environmental Health is required.
❑ Rereview Required Initials Date
Please call 24 hours PRIOR to inspection.
C/42 / Soils Percolation Boring Report by Uc/Project # Date
Soils Map Page Soil Type Approved By Date
No of Systems
Type o�Systerl
Fiotding Tank ❑ Replacement
No. Dwelling Ul / IJety
Bedrooms, Fixtere.Units
(t) Septic Tank
?•
Soil Rate
Grease/Sand
Greased tcp/Lint Trap
LWNew Addition
Existing
3� �^ "< 3ar�
1
10049 Gal.
'f. Q A,)
ll ` Gal.
r a ^
•
Sq. Ft.
blottom Area
Total Linear
Ft
Sidewall Allowance
'
Leach Bed sq. ft. of
Bottom Area
•
� rock/ sq. ft. running ft.
Inlet Tested Depth ❑ NA
-""Depth
wi
Install Lines) ft. long ft. wide with
min. l c es;rock below drainlines or
•U
\\\
Proposed Bottom Tested
Z
Leach lines/bed special design for slope:
(3) Pit Diameter
No. Pits
Pit Below Inlet (BI)
Seepage Pit
Maximum
Other:
O
Applicable
Total Depth
Allowable
Depth
LU
N/A Overbu%rden%ctor
3%
D
/
TD !
,
i�
I
Well Review Approved: Date: Well Drilling Permit #
' SIGNATURE
a
Grading Plan Approved: Date:
SIGNATUREN
Sewer Verification!Approved: .r Date:
t
Plan Check Only Approved: Date:
'w��
REMARKS: �� :�Wd�l. //'sLC.T�/ fr G���C �/�01 CITY Gly( 2v✓1 /:Cu/t,✓ QG�:
4 u ,. /
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This application is APPROVED/D„ NIED}for� 4fhercategoryxc4ocked:inzSECT-IOWB
v
FOR OFFICE USE ONLY
above; regarding the design of a subsurface disposal system as indicated on the
acompanied plot plan, using the requirements set forth in SECTION C above. A build-
inp4permit is necessary for the installation the No
�^' 3 %/��� tI
Revenue 7 r Fee
of above -designed system. con•
Is In
code $b71
structlon permitted the required reserved 100% expansion area.
(1) Septic Tank must be�AO minimum from any wells:/6F,46—'/-�`6—
Q
Check # /
-r12 .tr! / 4 4VA 4
1
res
/#,r" ~ �V - O %
(2) Leach lines must be 100' minimum from any wells, including expansion area.
V
Date Initial /!
Z
(3 Sewer lines must be 50' minimum from any wells.
�� 7-71-_
Of7
O
(4) Seepage pits must be 15V minimum from any wells, including expansion area.
Signature of Health Official
� .� /� ~ OI✓
Date
t
ti
DEH -SAN -122 (Rev 9/98) usiriouvon: vvm I t—Unice hila; YtLLUW—Appllcal PINK—mag. Uepi.; WLUtNHUL—Flans/Records
1
oF xPQ�ry
78-495 CALLE TAMPICO
LA QUINTA, CA 92253
(760) 777-7075
APPLICATION
FLOOD PLAIN DEVELOPMENT PERMIT
BUILDING SITE LOCATION T 18 'ic
D5rWr
FLOOD ZONE "AO" - DEPTH 1
COMMUNITY- PANEL NUMBER
51-3(Qo ve ew`e'I"2��UNI�2
0607090005B
Lrk
Map Revised: 8/19/1991
APPLICANT INFORMATION SECTION
APPLICANT NAME
be'anex yL
APPLICANT
ADDRESS
'
DAYTIME TELEPHONE NO.
INSTRUCTIONS
1. A Flood Plain Development Permit is required by LQMC Section 8.11.040(A). The Applicant should complete the
Applicant Information portion of this application and submit. it to the Engineering Department along with the
required documentation noted hereon at the same time the Precise Grading Plan is submitted to the Building and
Safety Department for plan checking.
2. Documentation required for STEP" 1OF 2 APPROVAL prior to receiving clearance. for Building Permit issuance
+ Copy of the proposed Precise Grading Plan for review and approval containing all information required by
the checklist shown on the back of this application.
3. Documentation required for STEP 2 OF 2 APPROVAL prior to receiving Flood Plain Development Permit approval.
Note, this approval occurs after forms for the lowest habitable floor are set and before the Building & Safety
Department authorizes foundation construction.
• Submit a completed FEMA "Elevation Certificate" form to the Engineering Department.
• Submit 95% relative density soils compaction certification to the Engineering Department.
STEP 1 OF 2 APPROVAL
STEP 2 OF 2 APPROVAL "
The Precise Grading Plan submitted for this application has been "
All requirements have been satisfied. This Flood Plain
reviewed and found to contain all data required to"satisfy the
Development Permit is approved.
requirements of LQMC 8.11 The proposed dwelling is eligible to
receive a building permit upon satisfying all other Building &
Safety Department requirements. "
• ,/x7-00
AUTHORIZED SIGNATURE DATE
AUTHORIZED SIGNATURE DATE
La Quinta Engineering Department
La Quinta Engineering Department
F090 REV -1 11/99
CHECKLIST
FOR
PRECISE GRADING PLANS
IN "AO" FLOOD ZONE
1. Prepare Precise Grading Plan in accordance with Checklist for Precise Plans
and the following additional items.
2. All elevations shall employ the NGVD-29 convention.
3. Show and label elevation of "Highest Adjacent Grade" next to the building
footprint. This refers to the highest existing natural grade next to the
proposed building prior to constructing the elevated the building pad.
4. Show and, label the "Highest Existing Elevation on Lot'
5. Show and label the "Lowest Habitable Finished Floor Elevation". Note, this
elevation shall be at least ONE FOOT higher than the "Highest Adjacent
Grade" elevation.
6. The following grading note shall appear on the plan:
All fill material placed under the structure shall be compacted to
ninety-five percent (95%) relative density.
F090A 10/99
Fitch Engineers Inc.
M4y'121 2000.
�/&
City of La Quinta
78'495 Calle,Tampico
La Quinta, Ca. 92253
SUBJECT: 51 360 -Calle Hueneme,_La._.Quinta_,__C
Gentlemen:
I -hereby certify this day that the finished floor
elevation on the above referred to lot is set at 101.6. The
approved.grading plan established the elevation at 101.5. -
Respectfully,
WM. H. PITCH
R.C.E. 12571
O QROFESS/o�,9`
�p,RVEY
No. 12571 y
FNG I N,E�� �@
�F
CAO���
CIVIL ENGINEERING — PLANNING — SURVEYING — DESIGN
P.O. BOX 4551 PALM DESERT, CA 92261
(760)- 345-7667
Certificate of Occupancy
City of La Quinta
Building and Safety Department
This Certificate issued pursuant to the requirements of Section 109 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: 51-360 CALLE HUENEME
Use Classification: SFD
Occupancy Group: R 3 Type of Construction: VN
Owner of Building: ALFREDO ALVIDREZ
Building Official
Bldg. Permit No.: 0002-463
Land Use Zone: RL
Address: 51-360 CALLS HUENEME
City: LA QUINTA, CA 92253
By: STEVE TRAXEL
Date: 05-17-01
POST IN A CONSPICUOUS PLACE