004303 (SFD), • } r
Building r . 53--960 Villa
' Address
Owner -
Mailing `+
Address
City ,
. z¢-.
Contracto
Ilk
�MQ I-
P.O. BOX 1504 ,
78-105 CALLE ESTADO
f,., .„ LA QU.,INTA,.,CALIFORNIA 92253
wastarn American
.,� ! ry ,
. 53--960 Villi.
Zip ..yy
Tel..,
x564 -74x1
BUILDING: -TYPE CONST. - OCC. GRP.
A.P. Number 714-174-011
Legal Description
Project Description ~►1»'.
0., BOX Baa v
City 16, .1"P92276
Tel. 3-43,-: 't l
Llc '
City'
EState
' & Classlf � L;! '4691557
Lic. #
Sq. Ft. No. ° No:Dw. }
k
'Size' "' Stories Units
Arch. Engr..
Designers„ ' k;L". 4
New ❑ Add ❑ Alter ❑ Repair ❑. Demolition ❑
Address.
Tel.
• City + { T ;.-�
Zip
State 2
�.,
Lic. #
• •,�wq : LICENSED CONTRACTOR'S DECLARATION
-
.-
I hereby affirm that I am licensed under; provisions of Chapter 9 (commencing with Section
7000) of Diiviisi)bn 3 of the Business and Professions Code, and my licen"s/e�is in full and
rforce
•.� effect r r=F" ; .,,.,w 'rf-
.A: -• % �' <. M -«.-x. ^ate f .
.. u SIGNATURE,, / _ - .. b,,. F F-1 •^DATE
✓,
OWNER -BUILDER DECLARATION ' r
Estimated Valuation
e, I hereby affirm that I am exempt from the Contractor's License Law for the following
$7 B 957 ,
-'. reason: (Sec.- 7031.5,Buslness and Professions Code: Any city or county which requires a
- - _
PERMIT '� T AMOUNT•'
permit to construct, atter, improve, demolish, or repair any structure, prior to its issuance also�*-
•r. 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
t - -
_ Division 3 of the Business and Professions Code. or that. he Is exempt therefrom, and the basis
for "the Any Section 'any for
- i• -• -
Plan Chk. Dep.
; -ralleged exemption. violation of ,7031.5 by applicant a permit,
subjects_ the applicant to a civil penalty of not more than five hundred dollars (8500). -
Plan Chk. Bal."., ..
_ ❑ I, as owner of the property, or my employees with wages as their sole compensation, will
,
Const. •
do the work; and the structure is not Intended or offered for sale. (Sec. 7044, Buisness and
.; Professions 1 Code: The, Contractor's License Law does not apply to an owner of property who
Mech. - -
builds. o/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 burdenEIBCtfICal
.
7-
of proving that he did not build or improve for the purpose of sale.)
,
Plumbing
O,I, as owner of the property, am exclusively contracting with licensed contractors to con-
•slruct 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.j, -q !5 0 _
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)'
- -
Grading .4.
O 1 am exempt under Sec. B. & P.C. for this reason
Driveway Eric.,,
t
Infrastructure' .,
Date owner
f:'t
WORKERS' COMPENSATION DECLARATION
l l 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 1
❑ Copy is filed with the city. ❑ Certifled copy is7_he4by furnished.
TOTAL
,. •
CERTIFICATE OF EXEMPTION FROM
REMARKS V
--' WORKERS' COMPENSATION INSURANCE
*action section
(This need not be completed If the permit is for one hundred dollars (8100) valuation
. or less.)
I certify that In the performance of thg work for which this permit is Issued, I shall not
•
Il &f°,.. ..�
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 Certificateof Exemption you, should become
ZONE- - '" BY:'
' subject to the Workers' Compensation provisions of the Labor Code, you must gforthwith
•gip
•`Minimum Setback Distances:,
comply with such. provisions or this permit shall be. deemed revoked.
-
`
r • Ftant Setback from (',enter Line
Rear Setback from Rear Prop. Line
i" f} '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.) - -.. t '- -
• • . -,
' -Side Setback from Property, Line -
Lender's Name
Lender's. Address
. FINAL DATE' INSPECTOR,i s.
This is a,building permit when properly filled out, signed and validated, and is subject to,
expiration it work thereunder is suspended for 180 days.
• I certify that 1 have read this application and state that the abo4e 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 r
' Validation: +• .
• City, .Stale, Zlp
GOLDEN.1ROD ASSESSOR S OFFICE HARD COPY -FILE `+
0 WHITE FINANCE PINK APPLICANT GREEN BUILDING,
..%�.-S �"M, .-.•� '!_,.1 •' ,_.-:.-.. 'z, Xz, .}-_..ti +�` �`t. -. 'w+., -i :.-Y.1 <..fe
-... 71ae{C J_:^'l..^: ..I„.-4. .. .r�•:dii�� ,,-.. 5:+_l -'S,:4 l r_a xT .,� �V.-.L.4 4L �'.
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO FT y $
UNITS
COLL. AREA
SLAB GRADE
ROUGH PLUMB
YARD SPKLR SYSTEM
2ND FL SO FT. a
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR SO FT. a
DUCT WORK
ROCK STORAGE
GAR SO. FT. rpt
POWER OUTLET
ROOF DRAINS
METER LOOP
HEATING (FINAL)
DRAINAGE PIPING
CAR P. SO FT.
GAS (FINAL)
WALL SO. FT. 0.7
DRINKING FOUNTAIN
GROUT
WATER HEATER
URINAL
- SO. FT. a
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE' Not to be used as property tax valuation
GRADING
cu. yd.
$ plus x$
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOYDISH)
APPLIANCE DRYER
/ A 2
IF
7
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
REMARKS:
LAUNDRYTRAY
AIR HANDLING UNIT CFM
F
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. a c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID g I'A c
SEWAGE DISPOSAL
SO.FT.GAR r JI44 c
HOUSE SEWER
MESH
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
SETBACK
GROUND PLUMBIN�
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
qq
S OR SEP A7J
ROUGH WIRING -
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
-OTHER APP.IEOUIF.
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
i
FINAL INSP.
ROOFINGON-
/ A 2
IF
7
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR'
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING.
FINAL INSPECTION
CERT. OCC.
FENCE FINAL '
INSPECTOR'S OIGNATUREVINITIALSt
GARDEN WALL FINAL
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
INOTICE: TE -11S DUPU ATE . S 00 IAC LITY FEES eW
TO: City of La Quinta DATE:
Department of Community Development
78-105 Calle Estado'
La Quinta, CA 92253
This is to certify that ()U -t. LAA11217
developer o O 3-96 d�a Sq-h'yh i
located at �,/ thin
this District, has aid s ool faci ity fees imposed pursuant to the
authority generatSq bygovernment Code Sectiost 530lQ10 in'the ampunt o
$
covering a total of square feet'of (� ) r s' enti 1 or
( ) industrial/commercial development and that building permits for
this footage in this development may now be issued by your jurisdiction.-
1-31
,� for DESERT S NDS UNIFIED SCHOOL DISTRICT
aq a� .
White - Building Department • Yellow - Facilities Planning • Pink - Accounting i Gold - Developer
0007
-
.a a ��`y�7'• 3'
P.'„ ,... ,; lei. ...9:t,: !�1 ...,. iL _,<l.,. q..a..Cr t•. :✓F IS !.#..�,•'.i'�jIC�}�ti�sry.''y `,�I'=rn,"k',,,+F:vr'�`4�. "1t;�t1J,'., ,,,�`o-''•,.af:.'7,.'Y,>' r: .4c+M"
�y "�Y�.I' 9ro� OACHELrL jA VALLEY WAT;ERYDISTRICT �n i�k:.,�1'rt'
•,61 t - Y 11 4' pR < d -q '�, h •J' ��'Cr'R ..�N
CASH REDETAILw ,
! CEIPTwT
z • 4' � 9a,..: `�'•'+ �'� - 2 ily �•u.,�Y t b 1 � tt 4 + f 3 1 i''�"r'"I � 5: �� i
.- � �' 'tlde ,•.Y -i.i4 Lv n 1 . , .. t . r 'F' �+„� r ,nfi. n..lk'toa ,ta+Y .�4ywh + 7,, �
. Reoelved From ' J %� r' Vo^Date: '. .s a 3 o...
- ,L`”.•
i
" Address:
4ccount No., �+?►�l,Z<� ' `fr �rY s 1 .d LOt(s)'. ? 8 c ti i CR
Tract —+.
'ervice Address ,`^'�
G A. ,Qode,
0 Mete (i) 'M.. w t q.7 'i ..,'�.Y"�". au a uM , or 41
M1, i�rt Y. � • �r f.� .
3 ServloB(s)
7 :BackflOW()i. r L 1 I
7 House Laterals) . c jar,:. r +
7 Detector'Ch°eck(s)a� 5 � P J � "
�. ''?v,.�){,y.vr 1iL.`kT,1`.6 is W!'44'v C•,"!F A'tt r, r7•.gc„..•.,d Yo-...: ..f f ?µi - i
Wterj�Surcharge �x > ".
tt?' 's.�!`Wx'A•a"q'3 je . < , „t —IjFull
.a -
f 9 Sanitation Capacity Charce' ` % ••.,--��5 � r r _ � ,�(`�l +n� per• t�V
��''Wi(.4� r. r a 3 y r �, _'9 iCw�"A •A C
XyxWy ntt 4 of t x i a r rE aq
s,
J Temporary Construction Mater "
� 4iV 3 ",`r' ^tv t f,, r t / X u F'.- N Ar 4 n..
J 1 urn on,Charge u w e k L 4� u 4 r 2� a;.k n
0
7 Uncollected Acco ni Name' ti y r ' °Ew
InspectiohFee Tract- + . " , �s<
_ r
Fee
'1 ] Plan .Check Fees: Water/Sewer— ' �` a r s + go;
Tracy »
] PondPayment - A.D.' gond r " * `
v' s tF
Assmt.
] Customer Deposit
'Other
� 1
►> r
TAL
r
Remarks: ^'�� Ci 1Ct to a J L� \ \,).V_
ti j
)COPY to:
:ash
-Heck 4J&✓°°� ; A ° �y� a 7 ,ri + - c- ti WaterSBrvlCe `
;r i ' �,. 'ion 1- •-
' ViOney r S �" �' s• t r�
�rtler 4: { w Cashier
as..- t �• ' ' it a Y' �' bf "(' CWVD -4 11/89). S
• • � :mac ! .�_" ,* .�T G",.' ia•�' �� � V � . i.
k
Kms'
Jr -•
i
Z
O
H
U
W
cn
Te
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4O
L
COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION
—17Y—
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.
r.
A non-refundable filing fee of $40 is required when the application is submitted. Check must be made payable to the County of Riverside.
Building Department Application Log #
Name (Owner. Agent. Contractor. Etc.)
Mailing Address
Pei, C1
cues -"rte,
13 7
City)
bN QutN
States
�./-����"
Zip Code
�'1 z 7—s—'Job
Telephore
v
Property Address- ,j' _ /� ' U1�
"Not
'Cd r.,Cor0homay
'Legal Description M Property. (Lot. PM. TR)
' +
� U I r� �•
�`�`i � 7' IMC . , � � 0 �'+,+{ [.Qk3� / m t�,�.Gv��'
' Assessor's Parcel No
Waler A enc ,6or Well
�t'� �l�� ,�./ - %�
use PermiDJI .� Al 11k -- •=fin'- Pla ning Case M
Lot Size
�+f7
/ 7� — ! Y -0(/
�` J
�{
of
SFD. MH Sne Preparation Et� <"'sfli
t�
JQ 'X 10C
/le-
Signature of Applicant _ '°" Date
- 'The above information must be verdied from Building Application
STAFF USE — 00 NOT WRITE BELOW THIS LINE
Initial Date
�. err'" • f^; //J
Certification of Existing S.D. System required. , ❑ Yesp,�/
WOCB Clearance required. ❑ Yes � No i
Soils feasibility report required. ❑ Yes ®
T!
Special feasibility boring report required. El Yes ?o/ 1� A
Detailed contour plot plans required. ❑ Yes p No 1 �—
Staff Specialist approval required. ❑ Yes No Lot Inspection Date
Soils/boring report by Project # Date
r
Soils Map Page ' c r Soil Type(.,, 64 G Approved by r Datet, 0 -
Af
.4 _..
Type of System:
No. of Bedrooms
(1) Septic Tank
Soil Rate Required
❑ Existing [9'6ew ❑ Additional ❑ Replacement
3If' 4r <.
AM Gals.
l /✓ ju
(2) Leach line sq. ft.
trrx�
Sidewall allowance
ft. Sq. Ft.
Install Line(s) Ft. Long,
Ft. wth.,inches
Le Wbed Sq.
Ft�o``bottttom�
(Bottb. ench area)
\\
rock/—Sq.
running ft. ®"N/A
wide In.
rock below,drain lines �'
per s
areal
area--
Leach lines/bed-special design for slope:
Applicable
(3) Pit Diameter
No.,Pits
Pit BI /
I
Seepage Pit total depth ' V/
N/A 4. - O factor-
N ®"'
�
Max. allowable depth
burden actor
4
q ,J
e / /y///�-72
G,.: ti F/' ( .. i /: Com. . H• .I�'f.' .-IL�� /`^ r/ ( G% Yf
wI `"++ �X +SLI✓
lY/IiV
� ! 2..s,�' ..Q-x,i,-t. , _6 r�' A_ .Jt�.G?Te�F`l� /<1,�,.-'•�>�, C��6n.e .» �,., /JA.irf/r
1���-
This application i prove enied for the design of a subsurface disposal system as indicated on the accompanied 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, rom any wells �V1
(2) Leach lines must be 100' min. from any wells including expansio; area
03 .Seepage pits must be 150', min. from any wells including expansion area„/S-
"�' ,
Signature of Health OfficialD to
RECEIPT N0. '1 // Issued by �c"" Date �D O
District: ❑ Riverside p Incl o ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe
Distribution: (WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File
DOH SAN 122 (Rev 8187)
11
UQ ;trR.. V� (At lr. E OF E. LEON SPAUGY
• rte-- �r AGRIC.UL I URAL COMMISSIONLIt
/�,Itl ZANIES O WALLACE
/ \I V V 'r ASSiSUfvI ') 1'.IItt10\EP.
o -.._l3 •
ry Wl.IG1Its Fi h1CASUftL. S CLEN'IEN1 13ENVENISIE
SLAUR
49=613 Ilwy 86, Suite 11-12
`. .,e.,,��•f'• Conthelln, CA 922J6
Mq► 9 1 v� 619-342-8291
DNF Z .? CASE M..
DEVELOPER'S I MEt
ADDMSS z
--
Dear Developer:
After reviewirhg your landscapi.rhg plaits, all plarht material listed is not
violation of yuarantine laws governing the COMIlella Valley.. lf. substitutions
do occur and they differ [roil plant n4aterial listed, tills oEfice tllust be notified
imhhediately.
Ti►ank you for prvtectiji' and 'theserv.ing -tile Coachella Valley's Fest-free envirotmhent.
1lgriculturW Cactm . oner's Office
ccs Indio and Riverside VE[i.ce