04782 (SFD)1
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P.O. BOX 1504
BuildingnT 78-105 CALLE ESTADO
Address 79;-775Nestward No DriV®LA OUINTA, CALIFORNIA 92253
Owner
'ftatern American Construction
Mailing BUILDING: TYPE CONST. OCC. GRP.
Address P. 0. rox 1379 617-111-'002
A.P. Number
City Zip Tel.
Lit Quintal 92253 564-7411 Legal Description
Contractor Project Description
P.oynod as Construction
Address
Sale
City Zip Tel.
State Lic. City
& Classif. Lic. #Sq. Ft. No. No. Dw.
Size 2390
Stories Units
Arch., Engr.,
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
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) t. of Division 3 of the Business and Professions Code, and my license is in full force and
effec
SIGNATURE DATE
OWNER -BUILDER DECLARATION Estimated Valuation
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 S125,861
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also AMOUNT
requires the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT
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 Plan Chk. Dep. c
subjects the applicant to a civil penalty of not more than five hundred dollars ($500). Plan Chk. Bal. Y . ti V
❑ I, as owner of the property, or my employees with wages as their sole compensation, will 4
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 13 . J5
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, Mech. 10 . -,�
provided that such Improvements are not intended or offered for sale. If, however, the building r tf��
or improvement is sold within one year of completion, the owner -builder will have the burden Electrical .�i uj • UU
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- Plumbing 8 . 79
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 S.M.I. dU . fit)
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading 111. 00
❑ 1 am exempt under Sec. B. & P.C. for this reason
Driveway Enc. .!3`U
Date Owner Infrastructure
Primo -Tined l izard
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 Zy 4 8. U3 u .!;;i
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of the work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become ZONE: BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked.
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.) Side Setback from Property Line
Lenders Name
Lender's Address FINAL DATE INSPECTOR
This is a building permit when properly filled out, signed and validated, and is subject to 11/7/38
expiration it work thereunder is suspended for 180 days.
1 certify that I have read this application and state that the above information Is correct. Issued by: Date Permit
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-
mentioned property for inspection purposes. Validated by:
Signature of applicant Date
Mailing Address Validation:
City, State, Zip
WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUM84NG FEES
IST FL SO Fl rp S
UNITS
SLAB GRADE
.77 ROUGH PLUMB
BONDING
YARD SPKLR SYSTEM y
2ND FL SO FT. 8
FORMS
SEWER OR
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR SO FT. a
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR SO. FT. Qt
TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. SO FT. 0
FINAL INSP.
WALL SO. FT. a
WATER SYSTEM
FINAL INSP.
DRINKING FOUNTAIN
GRADING
cu.yd.
plus x$
-$
URINAL
SO. FT. Ia
/ OOFING
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((/ l 7!/— �j{ �j /7—
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ESTIMATED CONSTRUCTION VALUATION S
REMARKS:
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(AUTOXDISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
SPARK ARRESTOR,
LAUNDRYTRAY
AIR HANDLING UNIT CFM
GAR. FIREWALL
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
el FINISH GRADING
SO. FT. c
WATER HEATER
MAX. HEATER OUTPUT. B.T.U.
SO. FT. RESID 1 V. c
SEWAGE DISPOSAL
SO.FT.GAR (g 3/� c
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
SETBACK
ND PLUMBIN
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
.77 ROUGH PLUMB
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP. '
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
�7
FINAL INSP. v
$
GRADING
cu.yd.
plus x$
-$
LUMBER GR.
RAMING—�
/ OOFING
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((/ l 7!/— �j{ �j /7—
J !/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR,
GAR. FIREWALL
LATHING ��vv'7j
MF H
ULATIONISOUND
✓✓✓ ��1
el FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
NOTICE' THIS DOCUmrs-wOOF
FEES VA
BE DUPLICATED,
TO: City of La Quinta DATE: �r3
Department of Community Development
78-105 Calle Estado
La Quinta, CA 92253
This is to certify that LV'/L L -G c LO . .
developer of ich is
located at — ithin
this District, has paid school facility fees imposed pursuant o the
author it generate by Gov rnment Code Section 53080 in he amount f
$ ( �G�i /
covering a total of %% 3 square feet of ) residential or
( ) industrial/comtt(ercial development and that bui ding permits for
this footage in this development may now be issued by your jurisdiction.
C�
o DESERT SANDS•UNIFIED SCHOOL DISTRICT
White - Building Department 0 Yellow - Facilities Planning 0 Pink - Accounting 0 Gold - Developer
04
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COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH Assessors Parcel No.
ENVIRONMENTAL HEALTH SERVICES G�%
I
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, Co tact Person
Phone
A dress & Ph ne `
-. r,
V-46-7 f I
v• 1 1
Owner
W� A
Phone
zic- 7 I,
Mailing Add ss
Ro . t 1
City L
�Sttatte
Property�A�d�dgress
Legal Description Prop. (PM, Tract, Lot)
tN T y
6^i-
G�Zip
12.25
7Job
{j
/ — �7� UA*kWyt/1 `O
•&� F ~fC+.cll` Zi clt)
Lot Size
titer Agency eI0
Use of Permit P/P, CU, etc. Ca Q L! a A/.*
Other
/
q+
D,wellirig, M Site Prep, etc. b /U
..... -----
Signature of Applicant
Date
CATEGORY: REV CODE FEE CATEGORY: v REV CODE FEE
19 -SUBSURFACE DISPOSAL 1238 50Q ❑ SITE EVALUATION UPON REQUEST 7349 $42.00
V
❑ MULTIPLE PARCELS WITHIN SAME (NO PLOT PLAN)
LAND DIVISION I ❑ SEWER/SEPTIC VERIFICATION 7348 $11.00
a. 1 st 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 It 7351 $45.00
Critical Area 7346 $86.00 ❑ ALTERNATIVE/EXPERIMENTAL 7345 $132.00
❑ Site Evaluation Lot Less than SYSTEM
10,000 Sq. Ft. 7347 $86.00
i
INITIALS DATE
Holding Tank Agreements Completed ❑ Yes �t� Q
Certification Existing S.D. System Required
of ❑ Yes CONO r
WOCB Clearance required. (Attach Form ❑ Yes No
DOH SAN 007, Santa Ana Region Only)
Soils Percolation Report Required. ❑ Yes y No
Special Feasibility Boring Report Required. ❑ Yes
Detailed Contour Plot Plans Required (1 to 5 ft. interval) ❑ Yes 0
Other ❑ Yes ❑ 0 7`
i
Staff Specialist Lot Inspection Required ❑ Yes No
Lot Inspection Date
-'Soils boring report by Project # Date
C /
Soils Map Page � f Soil TypeApproved by/ 4--' Date f 9 -02e•_
No. of Systems
T of Systems)
❑ Holding Tank ❑ Existing
No. Dwelling Units (/)
Bedrooms, Fixtar0M-,gtts*.
(1) Septic Tank
Soil Rate
Grease/Sand
'%rea Intcp
'r]olew ❑ Replacement
/� M 3 44(red 4
V Q
a
Gal
Gal
(2) Leach Line Sq. Ft.
Sidewall allowance
Ihstall Line(s) ft long ft wide with
:tLeLach Bed sq. ft
ottom trench area
ft. rock/ sq. R - "
\ �"c:.
min. inches roc •beb. drainlines or
o bm area
per running ft.
m�Tl%►
Leachlines/bed special design for slope:
(3) Pit Diameter
No. Pits
Pit Below
Seepage Pit Total Depth
i /
Other:
Applicablle
Inlet (BI)
/
Max. Allowable Depth
N/Ay Overburden factor
-" 1/-
p� Q
el
/
0,
No..2 System.
41
REMARKS:
��2t;C%Li.A•Q .. !�� C%SLC - h� m �� i .�i�Lt/}1�.�-e-�
J
� ��•6ild �iSJ'ii"C
.� � .�..t�, rt) ,si*7- ,4�AP/.��i
,�r
�O �G� .mss .I ,/ �►,.. ?.r p�� �'Yi ��,�' t.�
This application isPRJ'O�D�7DENIED4for t etego�ecked in�SECTIOI�B above, a ardmg the design of a su��Tf" a� isposal system as indicated
on the accompamedeplot plan, using toe requirements set ford/in SECTION C Zove. 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 /0 T (I
( Leach lines must be 100' minimum from any wells, including expansion/ are S i
3) Seepage pits mustbe 150' minimum from any wells,.in luding expansj(on Aea
Signature of Health Official - - Dae
RECEIPT NO. T a Issued By Date �� ' jKS
DISTRICT: y❑ Riverside, 0 / Indio ❑ Hemet ❑ 'Perris V ❑ Rancho Calif. ❑ Blythe
DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office fila YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records
r. .
A,q%.w ens 97
DATE
DEVELOPER'S IWIEt
OIIWE OF
AGIIICUL i URAL_ COMMISSIONER
AND
WI:IGI I I'S b.. MEASURES
49-613 Ilwy 06, Sulte 11-12
-Conchel.ln, CA 92236
619-342-0291
ADDItESSi A-0.
-00
TELL"PI►ONE: 02) s 6
Dear Developers
E. LEON SPAUGY
JAMES 0 WALLACE
ASSIVANE ! T•1 •USSW`CR
CLEMENT BUNWENISIE
SLAM
CASE Iu. IMF
yz rii
7 9, 77 s' !^/-ti
Q.,IAI • 6�4
After reviewing your landscaphig plans, all plant material listed is trot
violation of yuararttine laws govetni.ng the Coicl►ella Valley. If substitutions
do occur and they differ frcin plant nviterial listed, tills office must be notified
iimr-diately. .
Thank you for prvtectillg and pteservitty the Coachella Valley's pest -free envirotnnent.
Agriculiural CamEi s' t is U[ E ice
ccs Indio and Itiverside Office
L