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04553 (SFD)Building Address 94-040 Diaz Owner i �T4-t�t 4 P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Wastarn Awrican Sonat Mailing Address P, 0• Bp:; 1379 City Zip Tel. La Quints 92253 564-7421 Contractor G. ravnOld>s Const. Address P. Q. BOX 807 3000Fpulm ; 1-92276 - - 343.2671 State Lic. City & Classif. 4681S7 Lic. # 1114 Arch., Engr., Designer Address Tel. CityI Zip I State I 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,Susiness 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 thathe 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 five 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, 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.) 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 of property who builds or improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the Contractor's License Law.) ❑ 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. O Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if 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, alter making this Certificate of Exemption you should became subject to the Workers' Compensation provisions or 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 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 1r) BUILDING: TYPE CONST. OCC. GRP. A.P. Number 774-201-003 Legal Description Project Description • • D • AMOUNT Plan Chk. Dep. 5250.00 Plan Chk. Bal. Sq. Ft. 1072 Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Electrical Plumbing S.M.I. w 3 Grading Driveway Enc. Estimated Valuation $99027 X 27 PERMIT AMOUNT Plan Chk. Dep. 5250.00 Plan Chk. Bal. S Const. 38.50 Mech. Electrical Plumbing S.M.I. w 3 Grading Driveway Enc. Infrastructure 1 , 0Q 2.31 TOTAL ytx�Ii.d� 1 r 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 DATEIINSPECTOR 07 26/88 Issued by: Date Permit Validated by: Validation: WHITE - FINANCE, PINK - APPLICANT, GREEN - SUILDIMG, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SO FT y $ UNITS //SETBACK! / 6 SLAB GRADE ` i �i' % ROUGH PLUMB BONDING YARD SPKLR SYSTEM 2ND FL SO FT. a FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR SO FT. of GAS (ROUGH) METER LOOP GAR SO. FT. it POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. SO FT. a GROUT WATER HEATER WALL SO. FT. @ FINAL INSP. DRINKING FOUNTAIN BOND BEAM WATER SYSTEM URINAL SO. FT. fB c$ LUMBER GR. ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTOKDISH) APPLIANCE DRYER 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, SO. FT. ® c BATH TUB SO. FT. C c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID @ 11i c SEWAGE DISPOSAL SO.FT.GAR q 3/4c 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 8 AIR COND. SOLAR -/� GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA //SETBACK! / 6 SLAB GRADE ` i �i' % ROUGH PLUMB BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. / REINF. STEEL/Q` / �7$ C, GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ c$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. OFINGREMARKS: e62 //-/o - VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR - GAR. FIREWALL LATHING,, --PW bo MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS , GARDEN WALL FINAL 71 ��"J`' 'ty.. .jr.':r. rr-S�._--"..x•� {�. -1s v:_ �.^a�..-:�. "�� '." > t'p_ :� '.s .+ � _ -.;.^^ 2 Z 0 U LU W X Z 0 U LU V) Z O U W U) COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH Assessors Parcel No. 172� —401 —0O� - ENVIRONMENTAL HEALTH SERVICES PERMIT 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 speculations as indicated on the attached checklist. 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 & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG # Agent, Contractor, Contact Person Phone Address 8 Phone nerPhone GI P.��-�zV �c'h�2«� X55 �-. 5d7-71111 Mailing Address Yd - 6on 13-1 City �A State Zip Job Property Address Legal Description Prop. (PM, Tract, Lot) viNi�, 60� 5Z253 1 Gmt Ztf-22 $L►t ass' Jnf�( �ti LotSize Water Agency/Well Use of Permit P/P, CU, etc. Other ` �� 3 luo Dwelling, MH Site Prep, etc. / f— I `-� r V Signature of Applicant Date CATEGORY: REV CODE FEE _ CATEGORY: REV CODE FEE SUBSURFACE DISPOSAL 1238 $45.00 ❑ SITE EVALUATION UPON REQUEST 7349 $42.00 ❑ MULTIPLE PARCELS WITHIN SAME (NO PLOT PLAN) LAND DIVISION ❑ SEWER/SEPTIC VERIFICATION 7348 $11.00 a. 1 st 4 Parcels (Each) 1238 $45.00 (Less than 1 year) 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 7,346 $86.00 ❑ ALTERNATIVE/EXPERIMENTAL 7345 $132.00 ❑ Site Evaluation Lot Less than SYSTEM 10,000 Sq. Ft. 7347 $86.00 I INTI DATE Holding Tank Agreements Completed ❑ Yes p Noj' Certification of Existing S.D. System Required ❑ Yes No WQCB Clearance required. (Attach Form ❑ Yes No DOH SAN 007, Santa Ana Region Only) Soils Percolation Report Required. ❑ Yes No Special Feasibility Boring Report Required. ❑ Yes No Detailed Contour Plot Plans Required (1 to 5 ft. interval) ❑ Yes No Other ❑ Yes No Staff Specialist Lot Inspection Required ❑ Yes No Lot Inspection Date Soils boring report by' U?�% �� Project_ Date 11 Soils Map Page Soil Type Approved by Date�''"`� No. of Systems Type of System(s) No. Dwelling Units (1) Septic Tank Soil Rate Grease/Sand ❑ Holding Tank ❑ Existing Bedrooms, Fixture Units Grease Intcp cr1 Q Kew ❑ Replacement 3 S D tin. (TV) v JA f r+) Gal I (2) Leach Line Sq. Ft. Sidewall allowance Install Lines) fL ft wide with Leach Bed sq. ft. Bottom trench area fL rock/sq. fL min. inches rock bel drainlines or of bottom – per running ft. Leachlines/bed special design for slope: (3) Pit Diameter No. Pits Pit Below Seepage Pit Total Depth Other: Applicable / Inlet (BI) = (,%) Max. Allowabfle Depth N/A Overburden factor ❑ 5 6 j r . No. 2 System REMARKS: _ v o - d This applicatioVAs APPROVEDMENIED for the category checked In SECTION B above, regarding the design of a subsurface disposal system as indicated on the actor(+ ame o plan, using the requirements set forth in SECTION - C above. A building permit is necessary for the installation of the above -designed system. No construction is permitted in the required reserved 100% expansion area. fi)L Septic tank and sewer lines must be 50' minimum from any wells 2) Leach lines must be1'ml .mum from any wells, including expansion area Seepage pits 150' minimum from any ells, includin expansion area Signature of Health • ictal ` Date RECEIPTNOA W AIssued By— Date DISTRICT: ❑ Riverside, ❑ Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe K DOH SAN 122 (Rev. 5/88) DISTRIBUTION: ;$ WHITE - Officefile YELLOW -Applicant PINK - Bldg. Dept. GOLDENROD - Plans/Records .i=. T4ht I - �iGGiit/ L M 4IL 6ejt�/ l� P.O. Box 1504 APPLICATION ONLY Building 54-040 Avenida Diaz, La uinta &105 CALLS CALIFORNIAESTAD9 Address Q LA QUINTA, ORNIA 92253 Owner `fi C '" WESTERN AMERICAN CONSTRUCTION COMPANY BUILDING: TYPE CONST. OCC. GRP. Mailing Address P 0 Box 1379 � of 011a A.P. Number 4o— ' o a City Zip Tel. La.Quinta 92253 619-564-7411 Contractor G Reynolds Construction P O Box 807 City -Luvu k'�.1lT1tS y,c,c rr� State Lic. City & Classif. B1 468157 Lic. # 1114 Arch., Engr., Designer Address I Tel. CityI Zip I State # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that) am licensed under provisions of Chapter 9 (commencing with Section 7000) of Dlvislon 3 of the Buslness;—nd Professions Code, and my license is in full force and effect. ok E3�1 //tit3 S GNATU .f" f .f' F" - DATE OWNER -BUILDER DECLARATION 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, atter, improve, demolish, or repair any structure, prior to its Issuance also requires the applicant for such permit to rile 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 live hundred dollars.($500). ❑ 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 Improvem s sold within one year of completion, the owner -builder will have the burden of proving lhi did not build or improve for the purpose of sale.) O 1, es 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 no*apply to an owner of property -who builds or Onproves thereon, and who contracts for such projects with a contractors) licensed pursuant to the Contractor's License Law.) ❑ 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 ' O Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed If the permit Is for one hundred dollars ($100) valuation or less.) I certify that in the performance of lhp 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 Ihereby affirm that there is a construction lending agency for the performance of the work for ,ch 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 if work thereunder is suspended for 180 days. I car ity 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 ~ BUILDING DIVISI�> Description Lot 21 &.22, Blk 255, SCVQLQ, Unit24 t Description Single Familv Dwelling Sq. Ft. 1, 872 No. No. Dw. Size Stories Units New]M Add ❑ Alter ❑ Repair ❑ 'Demolition ❑ itimated Valuation PERMIT AMOUNT Plan Chk. Dep. o J Plan Chk. Bal. Const. '� g Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure v 3 71 c94 TOTAL _7 a_ op REMARKS AnNi i%') in i KIQ diS3—t 7—Ztli 4 () W CASH i WTAL i 2'15,00 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: CONSTRUCTION ESTIMATE GROUND PLUMBING NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® 9;,c='(0 $ 2ND FL. SQ. FT. POR. SQ. FT. ® GAR. 0 SQ. FT. ® 6 '�VAp!iZOD CAR P. SQ. FT. WALL 67 SQ. FT. ® Z T- SO. FT. ESTIMATED CONSTRUCTION VALUATION $ 7m V UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used as property tax valuation STORAGE TANK FORMS FLOOR DRAIN MECHANICAL FEES DUCT WORK ROCK STORAGE WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD METER LOOP SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (FINAL) TEMP. POLE GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GROUT WATER HEATER LAUNDRY TRAY AIR HANDLING UNIT CFM BOND BEAM KITCHEN SINK ABSORPTION SYSTEM. B.T.U. GRADING Cu. yd. $ -Plus-x$-=$ TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP FINAL INSP. POLE,TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY ROOFING AMPERES SERV ENT SHOWER BOILER B.T.U. REMARKS: SQ. FT. ® c BATH TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER GAR. FIREWALL GAS PIPING PERMIT FEE LATHING 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 GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IWIP. 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 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL Akk Fr� �MMONWEALTH (AND TmE co. 0. EOaw Iio. 10-4348 yLeen No. I ININ RECORDED MAIL TO. M110mm AIRRICA1f CONSTRUCTION CO. iqr Ir. 0. Box 1779 to Write, CA 92231 ' 0,0 d U Wift '4. MAIL TAX STATEMENTS TO: APR 774- SAMS AS ABOVE -003-0, 004-1, 005-2, 006ii,0807-4 DOCU ENTA" TRAN " TAX S . Ca•Mouwd ae M tta•dd.r.eae ar e.tw b is". y ter—m; OR ...... Ca-%Wnd en M ear.a.raaoe er..t.ra Isar two w a.av-*— rwW Nry M drn. el rw GRANT DEED FOR A VALUABLE CONSIDERATION• receipt of which if hereby acknowledfied, JOSEPH MUDRY and MARY MUDRY, Co -Trustees of the MUDRY REVOCABLE INTERVIVOS TRUST, u/d/t October 24, 1986 hereby GRANTM) to WESTERN AMERICAN CONSTRUCTION CO., a California corporation the real property in the City of La Quinta County of Riverside State of California, described as Lot" 18, 19, 20, 21 and 22 of Block 255 of SANTA CARMELITA AT VALE'LA QUINTA, UNIT NO. 24, as per map recorded in Book 19, page 44 of Map", in the office of the County Recorder of said County. Oated_—.November .l8, 1987 STATE CW . COUNTVr__._. lu �.rora W a. und.ratpnoa • Notaty kN ane I� a.a suw. o«• pareonally known to rMe for prO ad to me on the W... pl ..00 .Ad~ to be she p..".1 whose NmM.1 W— wW n—d to the .Mw, a.M.1e 1 .M .r..n.1....daM bins th.t herahe/they...Mad 9. "Me =.r WRNESS .ra aak�W/1e..I. , . �4pntwa_.._ .-N ... ......-._-- AAIL TAX STATE m--' 66W ►U1RY IfU ,, T[uis" OFFICI0.1. SF.�L IERI OIXON EQ tOTAtry eflai.K •CAWOR.M 141 aerw asst •f +119 II. IM6 fTkN .r.. la. eMNwt no1rIM W) 1002 (6/82) MENTS AS DIRECTED ABOVE Of R� ? A ••°` o; 1'� OF FICE OF E. LEON SPAUGY p AGRICULTURAL COINIMISSIONER COMMISONER J s JAMES 'WALLACE0 0 I �b A•NU ASSIS;A` t f,1.)N?115S10%ER St .'�) '" WEIGHTS& MEASURES BENVENISTE SEALER }' 49-613 Ilwy 86, Suite B-12 r u1 .fi9, 'Coachella, CA 92236 4 8q 619-342-8291 DATE ,> S CASE N0. Z� Ste DEVELOPER'S NAME: C.1J f Z s� R -A_ ADDRESS: TELEPHONE: ( 1 Dear Developers After reviewing your landscaping plans, all plant material listed is not in violation of quarantine laws governing the Coachella Valley. If substitutions do occur and they differ from plant material listed, this office must be notified immediately. Thank you for protecting and preserving the Coachella Valley's pest -free environment. Agricultural Camii.ssioner's Office ccs Indio and Riverside Office lcr 3