002795 (SFD)Building :.,3_395 -�i°3sC'
Address
Owner
Taft cistr�.
Mailing
Address -74_,990 w.� ww, mt D
CityJZip Tel
Pal
Contractor
�„�. ;fit tYvrral��iv�
Address... .
sam
City Zip Tel
P.O. BOX 1504. No.
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number 774-0921
)864 Legal.Description 8
Project, Description - Simla fa—VY abellim '
State Lic.M
& Classif: .354141
City
C. #
MC 1464
Sq. Ft. ,
Size
fence 200
No. No. Dw.
~
StoriesUnits
Arch.; Engr.,
Designer
rum
New Q; A00
Alter ❑ Repair ❑ .' Demolition O
Address
Tel.
City
Zip
State
Lic. #
~
4LICENSED•CONTRACTOR'S DECLARATION
hereby affirm that I am licensed under,piovisions of Chapter 9 (commencing with Section
7000) of Division,3Yof the Business-enndP 'rofessions Code, and my licenss'ls in full force and
.. . effect. lf.f•lrt:Jt.'.f.. • ,(i'i .µ� <7- f./•.tom• -
-�
SIGNATURE / / J' 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, alter, 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) or
' 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 We civil penalty of not more than five hundred dollars ($500).
. ❑ I, as owner of the property, or my, employees with wages as their sole compensation, will
do•tfie work, and the structure is not -intended or offered for sale. (Sec. 7044, Buisness and
• Professions• Code: The Contractor's License Law does not.apply to•an owner property -who
builds or improves thereon and -who does such work- himself or through his own employees,
provided that such improvements are not intended or 'offered for sale. If, however,, the building
or Improvement is. sold within one year of completion, the owner -builder will have - the burden
of proving that he did not build or improve for the purpose of sale.) - -
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law•
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractors) licensed pursuant to the Contractor's License Law.)
.0 I. am exempt under Sec.- B. 8 P.C. for this reason
Estimated Valuation
�}, A /�
�fF>4G�a'�€/
PERMIT -
•• - "
AMOUNT
-
Plan Chk. Dep..
-
: •.
Plan Chk. BBL
• 71
Const.
-370.U0
Mech.
EleCtflCdl`. "
%� 62
Plumbing
ry� �t p�
103.y� 0
S.M.I.
5•.50
Grading
Driveway Enc..
Date owner
Infrastructure
1r1.4$.61
WORKERS' COMPENSATION DECLARATION
hereby affirm that I have a certificate of consent tb'self•insure, or a' certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor.Code.)
-
' Policy No.Company
0 Copy is filed with the city. , O Certified copy is hereby furnished.
TOTAL
2,0941.44 11544.44
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS
(This section need not be completed if the permit is for one hundred dollars -(S 100) valuation
ofless.) . ... .
1 certify that in the performance of thg work for which this permit.is issued, I shall not'
employ any person in any manner sous to become subject -to the Workers' Compensation'
Laws of California.
'
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate or • 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.
ZONE: BY:,
Minimum Setback Distances: -
Front Setback from. Center Line
Rear Setback from Rear Prop. Line
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.)
Side Street Setback from Center Line
Side Setback from Property Line
Lender's Name
Address
FINAL DATE
Issued by:
Validated by:
INSPECTOR
Date 12 -29 -Kermit
-Lender's
This iv building'permit when properly filled out,'signed and validated, and issubject 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.
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., //�/ fes(;
Signature of applicant �f�f -fi(/ ;. •r %' 9' Date
Mailing Address !'
Validation:
City, State, Zip f
A 7 0 4 8.
12. 31. _.1&44,44 fl._
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SQ. FT. ®
SQ. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
'
YARD SPKLR SYSTEIA
BAR SINK
I ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
UGH PLUMBG —
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GAS (ROUGH)
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
BOND BEAM
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR @ 3/ac
HOUSE SEWER
MING L —20-
!/FRA&/
FINAL INSP.
��
GAS PIPING.
PERMIT FEE
� L�-ZL ` / 5�. �
4 ��
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
S ACK
OUND PLUMBING '
UNDERGROUND
A.C. UNIT
COLL. AREA
S GRADE / /kR
UGH PLUMBG —
BONDING
HEATING (ROUGH)
STORAGE TANK
F RMS 3�/
EWE O
OUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
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. �,;�7,gw
MING L —20-
!/FRA&/
FINAL INSP.
��
a-16tOOFING�` GvaI��L/ /r�a
1' 0 K i K /�/O
� L�-ZL ` / 5�. �
4 ��
REMARKS:
VENTILATION���
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
�INSULATIONISOUND �� �2•�
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS.
GARDEN WALL FINAL
��f1Ep
C Desert Sands ' Unified School District
y BERMUDA DUNES r "
RANCHO MIRAGE 82-879 HIGHWAY 111 • INDIO. CALIFORNIA 92201.5678 •-16191 347-8631
INDIAN WELLS ti
,PALM DESERT a December30, 1986
% LA OUINTA
'Jp INDIO 1�
* City of La Quints
Department of Community Development
7.8-105 Calle Estado
La Quinta, CA 92253
Re: 53-395 & 53-425 Villa and 54-825 & 54-845 Rubio, La Quinta, CA.
(4 units)
Gentlemen:
The developer of the above referenced project has
mitigated its impacts on our overcrowded schools by
payment of the amount of,$628 per unit. This amount is
to be applied to the.cost'of additional district
educational facilities made*.necessary by -such new
development.
Sincerely, -
John.D. Brooks
Assistant Supe 'ntendeat
Business Se es
By:
Richard M. Beck
Facilities Planner
JDB/vmm
* This certification of payment of developer fees is valid
for issuance of building permits'only until and including'
December 31, 1986.
X
C.QUNTY OF RIVERSIDE, 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.
A
Building Department Application Log #
Name (Owner, Agent, Contractor, Etc.)
Mailing Address
ap
Ile 4, "1
City
State i
Zip Code
T91ephone
t
615
Job Property Address
City or Community
Legal Description of Property. (Lot, PM, TR)
0/1
*Assessor's Parcel No.
Water Agency or Well T .
Lot Size
Use of Permit Planning Case #
77V 3— _0,� I
SFD, MH Site Preparation Etc.
Signature of Applicant Date
-The above information must be verified from Bulldliig Application
STAFF USE DO NOT WRITE BELOW THIS LINE
Initial Date
Certification of Existing S.D: System required. El Yes No
WQCB Clearance required. No
Soils feasibility report .required. 'E] Yes„Ep No
Detailed boring report required. El 'Yes ED No -
Detailed contour plot plans required. ED Yes 11) NO
Staff Specialist approval required. ❑ Yes* 1h No Lot Inspection Date
Soils/boring report by Project # Date
Soils Map PageSoil Type _c— Approved by •/0fDate
Type of System:
No. of Bedrooms
(1) Septic Tank
Soil Rate Required
0 Existing '[9,New 1:1 Additional 0 Replacement
Z, A
Gals.
4
(2) Leach Ii6e sq. ft.
Sidewall allowance
Install— Lines) Ft. Long,
Leach bed Sq.
(Bottom trench area)
ft. rock/------:— Sq. Ft
Ft. wide with min. inches
Ft. of bottom
per. running, ft.” .0 N/A
rock below drain,lirC6s
area
Leach lin(§§/bed-special design for!slope:
(3) Pit•Diameter
No. Pits
Pit BI
Seepage -Pit total depth
Applicable
N/A_ Overburden factor
E) 51 216
'.Max. allowable depth
4.
This application is approved/denied for the design of a subsurface disposal system as indicated on the accompanied plot plan using the, requiremeints
set forth in Section B above. A building permit is necessary for the installation of the above -designed system.
rm Septic tank and sewer lines must be 50' from any wells
(2) Leach lines must be 100' min. from any wells including expansion area
(Q) Seepage pits must be 150' min.from dny wells including expansion area
Signature of Health Official Date
IN C,
RECEIPT NO. Issued by " P Date—
District:' El Riverside 2 Indio 0 Hemet El Perris 11 Rancho Calif. D Blythe
Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD— Pending File
DOH -SAN -122 (Rev. 6/86)