002982 (SFD)r
Building
Address 73-805 VtStwiwd 5D Wive
Owner
a3.tt3 tri »g.
Mailing
Address 789 Pudl Xings
City Zip Tel.
Daim. m o CA 92260
Contractor
ress
City (Zip
State Lic.
& Classif.
Arch.; Engr:,
Designer
Address
City
Lic. #
Tel
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA; CALIFORNIA 92253
BUILDING: -TYPE CONST. -OCC: GRP.-
A.P. Number
34-464. _ Legal Description lot 4• IYact.
21090.
Project Description�1t3,��?
Sq.•Ft.No. No. Dw.
Size . Wig..2031.*.. Stories Units
I New ❑ Add ❑ Alter ❑ Repair ❑ :• 'Demolition ❑
.. . .
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
_.
hereby affirm that I am licensed under Provisions of Chapter 9 (commencing with Section
70 OO) of Division 3 of the Business and Professions. Code, and my license is in full force and
effect. .. -.
_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 Coder Any city or county ,which requires a
*to
!�2
permit construct, alter, impiove, demolish, or repair any structure, prior to tits issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
PERMIT
-
AMOUNT '
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 30f the Business and Professions Code; oc: that. he is exempt therefrom, and the basis
for the Any Section 7031.5 by 'any for
- Plan. Chk. Dep.
alleged exemption. violation of applicant a permit
subjects the applicant to a civil penalty of not more than five hundred dollars'(8500).
Plan Chk. Bal.
��
O 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
Const.
l
. Professions Code: The Contractor's License Law does not. apply to an owner.of property who
- F.7s
builds or improves thereon and who does such work himself or through his own employees;
Mech.
y9 [}Hq
dskpt)
provided thal'such improvements are not intended or -offered for sale. It, however, the building
or improvement is sold within one year of completion, the owner -builder will have the burden
Electrical
wit
-
&
of proving that, he did not build or improve for the, purpose of sale.) - - , - .
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing
00
struct the project. (Sec. 7044, Business and Professions'Code: The Contractor's License Law
__.U7.-
does not apply 'to an owner or property who builds or improves thereon, and who contracts for
S.M.I.-
"* "
such projects with a contractor(s) licensed pursuant to the Contractor's License Law:)
Grading
❑ I am exempt under Sec.. B. 8 P.C. for this reason
Driveway Enc.
20
'i` ,, ., fi
Date � " Owner
Infrastructure
1. 68
a s
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.
TOTAL
�j�� p- /�
5' 2.846.65 2.596 a.05
CERTIFICATE OF EXEMPTION FROM .. -
REMARKS,
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred 'dollars ($100) valuation
f _
/2/At
7—.p P_(i [./ Z.440 /f1W IZAU,01.-e
or less.) - -
I certify that in the performance of thg work for which this permit is issued, i shall not
—��L.
O N '/�'L"I�G L Ty 76i Z04% "
-employ any person in any manner so as to become•subject,to the Workers' Compensation
f
Laws of California.
' Date Owner
NOTICE TO APPLICANT: If, after making this Ceitificate of Exemption you -should become
ZONE:
BY: -
subject lo' the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
Minimum Setback Distances: - -
Front Setback from Center Line
Rear Setback from Rear Prop. Line
I CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
I hereby affirm that there is a construction lending agency for the performance of the
r work for which this permit is issued. (Sec. 3097, Civil Code.)
Side Setback from Property Line
Lender's Name
Lender's Address
-signed
FINAL DATE
INSPECTOR
This is a building permit when properly filled out; and validated, andds subject to '
expiration if work thereunder is suspended for 180 days.
I certify -that I have
3/10/87
read this application and state that the above information is.correct.
Issued by:
Date Permit
agree to comply with'all'city and county ordinances and slate 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
B)491
3 l0 59665 it
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING F EES
IST FL. SQ: FT. @ $
2ND FL. SQ. FT.
POR. SO. FT. @
GAR. SO. FT. @
CARP. SO. FT.
WALL SQ. FT. @
SQ FT @
ESTIMATED CONSTRUCTION VALUATION $
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
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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.
SO. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
%�
*t' 1
�' 6"~,� _
i
SQ.FT.GAR @ 3/ac
HOUSE SEWER
VENTILATION
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
7// SETBACK
' 9�
OUND PLUMBING
'
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
WER OR SEPT[Xi�
ROUGH WIRING
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.
ROOFING
%�
*t' 1
�' 6"~,� _
i
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
OF
SCHOOL FACILITY FEES
(CD'
TO: City of La Qtfinta DATE Z.?
De artment=of,Communit Develo men - �
P Y t P
78-105 Calle Estado
La .Quinta', CA 92253
This is to ,certify that
developer of which, is
located a.t79-_ wi¢hin
this District, has paid school facility,;fees imposed pursuant to the
authoritXogenerated by Government Code Sect101 530A0 in the amount of
e44,
AAoNA
covering a total of A 0 :5/' V square: feet of..( residential or.
(- ) industrial/commercial,development and.•that building-permits for
this footage in this development may now be issued by your jurisdiction.
for DESERT SANDS,UNIFIED SCHOOL DISTRICT
White Building Department • Yellow-'Facilities Planning • Pink - Accounting • -Gold Devviloper
c�. baa
1 O)-37
'� ;r`i� jwro:� IC,i:`fl tw-'4�'.,, y, .c r, i .i ar; .'v ,�f,.rv'�. 1g�� `]�r= i!�'�'�'f-•:J"� fi►w 'S` �' �,t
COUNTY OF RIVERS.iDE, ENVIRONMENTAL HEALTH SERVICES DIVISION
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 specifications required on the attached check list.
A non-refundable filing fee of $37 is required when the application is submitted. Check must be made payable to the County of Riverside.
Building Department Application Log #
qNme (Owner, Agent, Contractor, Etc.) y ty 17-S-069
MailinngAddress „yd
CityState
Zip Code
Telephone 9
Job Property Address
° a
7 1- AC16 \J
c ; •emrounitya
Legal Description of
of ProFerty. (Lot, PyM�, TR)) i`
0City
0,
'Assessor's Parcel No.
-
Water Agency orAXelh f
. _ 1, •sem
rV x� - .
Use of Permit'" 0%•��of1 tanning Case #
Lot Size
�i
➢i*
ipt�9�id lN..tlrFd\
t c•�
SFD, MH Site Preparation Etc. `i
On
04
j2
Signature of Applicant '*y Date 1
m The above information must be verified from Building A'pp'lication .
STAFF USE — DO NOT WRITE BELOW THIS LINE
nittiiial Date
Certification of Existing S.D. System required. ❑Yes ❑'No' riff/ _�2 - r, 41-
WQCB Clearance required. ❑ Yes O Nor
00;1 x
Soils feasibility report required. ElYes 1�2 /Nor
Detailed boring report required. ❑ YesL�( . o
Detailed contour plot plans required. ❑ Yes. Z,No
Staff Specialist approval required. El Yes �Z No Lot I nspection 'Date
Soils/boring report by. /`� Project # Date
Soils Map Page�/>i /c1 Soil Type F Gi Approved by!r� Date aK1 '
r if t - 1 .. ✓ �n..r ij ,
Type of System:
No. of Bedrooms?
4�� 3Boi71r�1
(1) Septic Tank
�
Soil Rate Required '
❑. Existing. ®Nf ew El Additional Replacement
`
=d "7t t�t/u.Arlr4ii
(2), eachline sq.. ft.
trench
Sidewall allowance 1
ft. Sq. Ft.
Install Line(s) Ft. _ong,
inches
Leach bed Sq.
FtN'of bottom
(Botto ,, area)
rock/
Ft"wide with min.
per running ft. ❑„ 1A'
rock below drain line~--
area""
Leach: lines/ bed -special design for slope:
Applicable
(3) Pit Diameter
No: Pits
Pit BI
Seepage: Pit total depth
..r
N/A-1toef Overburden factor
.,�; ,
Max. allcWable depth
If
��..��_.1✓` _.. i -OCC.., ...r .... /'�i✓f'S1"'�� xo�d Ca ✓$+!d t,.tA.wr�ct.�.....-
f /J
�� �.�
.C�Y..Ll. �' � _Y : •>�:.«• -£ .�..!''Z�ed9.:.� .... .�/� G%2 ..SAF" ' .-d%� W �/�F
v i oil ` .
-?F`...f�'-C�./-I.�X ILiC✓I'./�+/1J•../9rt�. �!� �/C/Y•�FK� �'^'/./CR'i.�iiV.._f/ LrT/ C✓ `✓�%fIY' (w��tK// A �%YZK...
This applicationEi p ov d denied:for the design of a subsurface disposal system as indicated on the accompaned plot plan using the requirements
set forth in Section B above. A. building permit is necessary for the installation of the above -designed system.
(1 Septic tank and sewer lines must be,50' from any, wells d to ems, c(.� • . ui Ge. � %�r�� �'r f �• 1
12Leach lines must be 1001 min. from any wells including expansion area
"(3) Seepage pits must be 150' miin/n from any wells includiinng.,eexxpa�n}sion area-/ /p
_ � o
Signature of -Health Official ` "' I { f� lJl,? ,y �� ' Dater (/ +� ^•, r.i,� C
RECEIPT NO �7' a ` Issued by— _/-&t Date 4 2 �2
District: • O Riverside ®'I�dio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe
Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending =ile
DOH -SAN -122 (Rev. 6/86)
N
-G6T,It�
I .A
L.1
RU''-ORDING REQUESTED BY
a Ln CT
$�
_�
3� o _
N AND WHEN RECORDED MAIL THIS DEED AND, UNLESS Ow N c v Z a
_ y OTHERWISE SHOWN BELOW, MAIL TAX STATEMENTS TO: W
NAMES �.. .� a �_ a - ~ COi
CD
Mr. and Mrs. Keith Palmer IW V -� tel (L a
STREET J .�
ADDRESS 73-089 Buck Springs 'Dr. g _
CITY, Palm -Desert, Ca. 92260 I .`
STAT
ZiaE - J
Title Order. No ................ ... Escrow No ........
This space for Recorder's use
l
Corporation , Grant Deed.. F7
ThIE UNDERSIGNED CRANTOR(s) DECLAAE(s)
DOCUMENTARY TRANSFER. TAX is ?7.50 _ --
unincorporated area ❑ City of
Parcel No 617-111-004.-5
computed on full value of property conveyed, or
❑ computed on full value less .value of liens or encumbrances 'remaining at time of sale, and
'FOR A VALUABLE CONSIDERATION, receipt of which is herebv.'acknowl edged,
Bank of America National'Trust and Savings Association;
A National Banking Association organized under,the laws.of the United States
x�c of America D11MherebyGRANT(S) to Keith C. Palmer and Anna B.. Palmer,.
husband and wife as joint tenants
N the following described real property in the
N County. of Riverside ,State of California:
N
Lot 4 of Tract 2190 as per map recorded in Book 41, Pages 55, 56 and 57 of Maps,
Official Records of Riverside County, California
Dated April 13,• 19.83
Bank of America National Trust -and
STATE .OF CALIFORNIA )
Savings Association:
COUNTY OF Los Angeles } 'SS.
On April 26., 1981 ).
before me,
BY,
the undersigned, a Notary Public in and for said County and State,
i t ice— rest en
BY,
personally appeared Jack Bennett
known to me to be the A •'V . President, and R : E . , South
AssisEint Secretary
Y
known to me to be
Assistant Secretary of the corporation that executed the
within Instrument, aiid acknowledged to me that such .corporation
O=AFAL'
°executed the within instrument pursuant to'its by-laws or a resolu-
��
_ `f. Ntion
of its board'of direc rs.
o 'NOTARIFORNIALOTYMy
co29, 1983
Signature
Name ( Typed or Printed)
Notary Public in and for said County and State
.( Space above for official notarial seal.) -
fAIL TAX STATEMENTS 'I -O PARTY SHOWN ON FOLLOWING LINE;
IF NO PARTY SO SIiOWN, MAIL AS DIRECTED ABOVE
Name Street Address
2462
City & State
`
78-105 CALLE ESTADO - LA QUINTA,.CALIFORNIA 92253- 1619► 564-2246
March 25, 1987 ;
Mr: Keith Palmer
73-.089 Buck Springs Drive '
Palm Desert, CA 92260
SUBJECT: Collection of Fees forlthe-Coachella Valleys Fringe-Toed
Lizard
Dear Mr. Palmer:
Our records indicate that a single family home was approved:for you
at the following address:
79-805-Westward'Ho Drive
La Quinta, CA
This location is within what is established, as-the Coachella Valley ,
Fringe-Toed Lizard habitat fee area. A"fee, in the amount of $600.00
per acre,(or portion thereof) is collected from Any new development
within the fee area. The amount of this fee, for your property is
$110.19. _
This fee should have been calculated into the building permit `costs;
your'''..'
was inadvertently overlooked during review of your
residence., we apologize for`any inconvenience this nay cause you,
and appreciate your remittance of the.above amount at-;your earliest
convenience., Please make your,.check payable.to,.the Citytof La Quinta.
Again, thank you for your cooperation. i
Very truly yours,'
MURRELL CRUMP
PLANNING•DIRECTOR
Wallace H. Nesbit
Assistant Planner
'WHN:bja F
cc: File,•79-805 Westward Ho Drive
MAILING ADDRESS - P.O. -BOX 1504 LA QUINTA,' CALIFORNIA 92253