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05689 (SFD)Building Address Owner P.O. BOX 1504 N o . 52-473 AV. D7[Ui'LA QUINTA8-105 CCALIFORNIA 92253 S'Y'k1 ABY . Mailing BUILDING: TYPE CONST. OCC: GRP.; Address e/o Box 1495 773--311-026 A.P. Number City Zip - Legal Description ContractorProject Description SFD ria caa SME a7LL*F.P� I ty lZip Tel. State Lic. City & Classif. B-498210 Lic. # 932 Arch., Engr., Designer Address Tel. City IZip I 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 infull force and effect. it r.t"t SIGNATURE 'DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors License Law for the following reason: (Sec. 7031.5,Business 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 file a signed statement that he is licensed pursuant to the provisions or the Contractors License Law, Chapter 9 (commencing with Section 7000) of y Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exemption. Any vioiatiun 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). O I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and Atte 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 wig have the burden of proving that he did not build or improve for the purpose of sale.) O 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 or 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 r I hereby affirm that 1 have a certificate of consent to self insure, or a,certificate of Workers Compensation Insurance, or a certified copy thereof. (Sdc. 3800, Labor Code.) Policy No Company O Copy is filed with the city. 17 Certified -copy is hereby fumished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed N the permit is for one hundred dollars ($100) vaivation 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: 11, 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 shalt 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.) Lenders Name Lenders Address This is a building permit when properly 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. 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 t ,. ZONE: BY: 't. Distances: Front Setback from Center Line Sq. Ft. 1476 Size No. Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ FINAL DATE INSPECTOR Issued by: Date 5j1/$9 Permit Validated by: Validation: Estimated Valuation $80,600.00 PERMIT AMOUNT Plan Chk. Dep. 250.00 Plan Chk. Bal. 225.30 Const. 554.00 Mech. 53.50 Electrical 108.76. Plumbing 154.30 S.M.I. 12.15 Grading 20,00 Driveway Enc. 20.00 Infrastructure >i •75 TOTAL 1 r. REMARKS - �'•�Y.:-« :"�At.l S•fr �`+ rf'�^r 1'1rr Y+ - >t: Y..V a •rV $ " 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 5j1/$9 Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ UNITS UNDERGROUND A.C. UNIT COLL. AREA YARD SPKLR SYSTEM 2ND FL SQ. FT. ROUGH PLUMB.rrr(�777. MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® FORMS GAR. SQ, FT. ® POWER OUTLET ROOF DRAINS ROUGH WIRING. DUCT WORK DRAINAGE PIPING CAR P. I SO. FT. WALL SQ. Ff. DRINKING FOUNTAIN. SO FT ® OTHER APPJEQUIP. URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation TEMP. POLE FLOOR DRAIN MECHANICAL FEES GROUT WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY 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. SQ. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® Uec 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 SETBACKUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB.rrr(�777. BONDING HEATING (ROUGH) STORAGE TANK FORMS ER OR SEPTA'�f / / ROUGH WIRING. DUCT WORK ROCK STORAGE 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. % d71 6�' FRAMING FINAL INSP. �tOOFING -ClU, �;o REMARKS: VENTILATION FIRE ZONE ROOFING: FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING fp WN MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL Desert Sands Unified School District NTCERTIFICATION OF PAYMENT +fit. THIS DOCU�*�ENT CANNOTBE DUPLICAT-E-CHOOL FACILITY FEES TO: City of La Quinta Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 DATE: as CPO I L qJ 42 This is to ertify that (1T/r developer of hich is located at — , within this District, has paid school fac' ity fees imposed pursuant to the authorit ge e a ed by overnment ode S ctiot 53 8 n the a ount o $ -Ojf)k k16r covering a total of square feet o re dential or ( ) industrial/commercial development and that building permits for this footage in this development may now be issued by your jurisdiction. /A i Tvp.-,4 a Oomzq ti � fo DESERT S f DS UNIFIED SCHOOL DISTRICT White - Building Department • Yellow - Facilities Planning • Pink - Accounting 0 Gold - Developer 0007 r"/ i�k '":1,. sj-�: 4 • Y' � �,1.�.1'S.�Yi. �5'2i4 h 5y%':.Z-„=.vL• y�' i�`."ik ♦ r ����. r '�.^l� ,�. 'r�` �f � . a.� i+; y' 9 . � �.;i V� �-'S� j { _,�: �R.' ..; .. .� .—}. •.tet ♦f }, F. yw w, 1 14 Q Z 0 W M Z O U W to U 2 0 U W C0 COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH Anes+or's Parcel No. ENVIRONMENTAL HEALTH SERVICES 1-773 — 311 — ©a (O PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM 1 Applicant: Submit this form with four copies of a scaled plot plan (1-20 scale) drawn to County speculations as indicated on the attached check list A non-refundable filing fee (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 8 SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG'* Agent re 0, n D • owner Malll � ✓ 11- �R ,>O ✓JL7 C to /Zjp _ ,� j..j Job P d Legal Description (PM, Tract /' U J /I/ r�C.__.• T YG Lot Size (Wate*AgencyAtelP U]s'e�of Perm P CU, etc. Q ��"- Other Dwellin Site rep, etc. „1dH d Signature of Applicant F .date ' CATEGORY: REV CODE FEE CATEGORY: REV CODE FEE 01, SUBSURFACE DISPOSAL 1238 $45. ❑ SITE EVALUATION UPON REQUEST 7349 $42.00 ❑ MULTIPLE PARCELS WITHIN SAME (NO PLOT PLAN) LAND DIVISION ❑ SEWER/SEPTIC VERIFICATION 7348 $11.00 a. 1 at 4 Parcels (Each) 1238 $45.00 (Less than 1 year) I b. Each Parcel after 4 7344 $16:00 ❑ PRELIMINARY ELECTIVE 7352 $45.00 ❑ Rereview (2nd review same parcel) 7344 $16.00 EVALUATION (Attach DOH SAN 53) ❑ Site Evaluation in Conjunction with ❑ HOLDING TANK 7351 $45.00 Critical Area 7346 $86.00 ❑ ALTERNATIVE/EXPERIMENTAL 7345 $13200 ❑ Site Evaluation`Lot Less than SYSTEM 10,000 Sq. Ft. 7347 $86.00 1��>� Holding Tank Agreements Completed ❑ Yes z N Certification of Existing S.D. System Required ❑ Yes ) WOCS Clearance required. (Attach Form ❑ Yes 0, No DOH SAN 007, Santa Ana Region Only) Sills Percolation Report Required. ❑ Yes b No Special Feasibility Boring Report Required. ❑ Yes )3 NO Detailed Contour Plot Plans Required (1 to 5 it interval) ❑ Yes Other ❑ Yes Staff Specialist Lot Inspection Required ❑ Yes No Lot Inspection Date Sills boring report by Date f/���/P,,rojject Soils Map Page 0 ( ! Son Type Approved by/&A-- Data No. of Systems Type/of Systems) U Tank ❑ Existing No. Dwelling Units �) Bedroorm (1) Septic Tank Soil Rate .� Oreaee/Send Uolding re4in-it§ (ifease Irncp ❑"New ❑ Replacement 60,7 �' /q„� ,, vv �` l/ l .3 / Ga, %k(2LLeLine Sq. Ft Sidewali allowance Instal - e(s) UnR ft long wide with `Leach Bed sq, ft Boltach trench area g „ sq. R min. inches below dntlnlu{es or, Off'o�r l°ecee per running ft Cia!IW4 Leachlines/bed special design for slope: (3) Pit Diameter No. Pita Pit Below Seepage �� Total Depth Applicable % r Inlet (BI) �j N/A Overburden factor 6 / [L Max. Allowable Depth No. 2 System NIA - REMARKS: �p F' :�G. !/y_G2 c ;6ezX,1-4 .r.i ✓.i r r This application isrAPPROVED Ei for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated on the accompan ed pTusing 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, (1) •Septic tank and sewer lines must be 50' minimum from any wells ,4 / 0 Leach lines must be 100' minimum from any wells, including expansionres 1 (3) ,Seepage pits must be 150' minimum fro ni w�ellls, including expansion area e/o Signature of Health Officia • c > - RECEIPT NO. -5-109� Issued By 5le. D e V DISTRICT: ❑ Riverside,Indio ❑ Hemet q Perris ❑ Rancho Calif. ❑ Blythe DOH'SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Pians/Records b3 VA crJ� Fitch Engineers Inc. May 23, 1989 Mason Enterprises RECEi vED ,SUN 1 1989 CITY OF LA QUINTA PLANNING & DEVELOPMENT DEPT. SUBJECT: Report of In -Place Tests- 52 965 Avenida Diaz La Quinta, Ca. Gentlemen: In accordance with your request, this report has been prepared to present the results of the in-place tests performed on the fill material at the subject site by Fitch Engineers, Inc. These tests were performed on May 22, 1989. AVAILABLE PLANS To assist in determining the locations and elevations of our field density tests and to define the general extent of the site grading for this phase of work, we were provided with a grading plan by Fitch Engineers Inc. FIELD TESTING Field density tests were performed by a representative of Fitch Engineers Inc. upon completion of site grading. The density tests were taken according to A.S.T.M. Test 1556-74 and the location and results of those tests are shown on the attached plates. The locations and elevations of the in-situ tests were determined in accordance with their importance and the accuracy and proximity of the survey control provided by Fitch Engineers Inc. representatives. Unless otherwise noted, their locations and elevations were determined by pacing and hand level methods and should be considered accurate only to the degree implied by the CIVIL ENGINEERING — PLANNING — SURVEYING — DESIGN P.O. BOX 4551 PALM DESERT, CA 92261 (619) 345-7667 .1 -2- method used. LABORATORY TESTS A maximum dry density determination was performed on a representa- tive sample of the soils used in the compacted fills, according to A.S.T.M. Test 1557-78, Method A. This method specifies that a four (4) inch diameter cylindrical mold of 1/30 cubic foot volume be used and that the soil tested be placed in five (5) equal layers with each layer compacted by twenty-five (25) blows of a 10 pound hammer with a 18 inch drop. The results of these tests as pre- sented on Plate No. 1 were used in.conjunction with the field density tests to determine the percent of relative compaction of the compacted fill. This, report- covers only the work performed on May 22, 1989. Our opinions, presented herein are based on our observations and the relative compaction tests results. Due to possible variations in the uniformity of compacted fills, we only warrant that our work was performed in accordance with the currently accepted standards of practice and in such a manner as to have reasonable certainty that the mass grading complies with the job requirements. No other warranty, express or implied is given or intended. If you should have any questions after reviewing this report, please do not hesitate to contact this office. This opportunity to be of professional service is sincerely appreciated. Respectfully submitted, PITCH ENGINEERS INC. WM. H. FITCH R.C.E. 12571 SOIL TYP_l #1= 108.3 lbs. cu./ I t. @ 13.9% Mo' ture SOIL TYPII #2126.I 1 s . cu . . @a Il .7°Z M6343turE Plate No.l JOB NAME 52 965 Avenida Diaz, La Quinta, Ca. .JOB NO iT NO. DATE ELEVATION OR LOCATION DEP111 OF LEST MOISTURE 'J. DRY DEN. lbs /cu .I i. SOIL TYPE REL. CO '!. 1 5/22/89 See Sketch 1' 8.7 98.6 108.3 91.0 •2 " " -0.5' 7.5 103:7 108.3 95.8 3 " " . F.G. 9.9 115.6 126.1 91.7 SOIL TYP_l #1= 108.3 lbs. cu./ I t. @ 13.9% Mo' ture SOIL TYPII #2126.I 1 s . cu . . @a Il .7°Z M6343turE Plate No.l r O O E DENSITY TEST - 52 965 Avenida Diaz La Quinta, Ca. By G. Krause DATE 5/22/89 JOB NO. NTS Plate No.2