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06744 (SFD)�f.f►t P.O. BOX 1504 No, 06744 Building 53--450 Villa LA CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Owner - . Harion L. White - BUILDING "TYPE CONST. OCC: GRP Mailing. Address 310 S. t inev St. A.P. Number 774-174-006 City Zip Tel. Escondido 92025 745-8881 Legal Description Contractor Project Description $FD Address . City Zip Tel.: .State Lic. City & Classif. Lic. # _ Sq. Ft. 1480 No. No. Dw. Arch., Engr., Size Stories Units Designer 1xvin Deaign Assoc. New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. 555 Cajon Suite D _ City Zip State 'Redlands Lic. # LICENSED CONTRACTOR'S DECLARATION I herebyy affirm that-Iam.licensed under provisions of Chapter 9 (commencing with Section 7000) of,Divirs n 3 of the Business and Professions Coded my license is in full force and effecth , - 'Q SIGNATURE DATE ✓` OWNER -BUILDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following $8�,9Vn reason: (Sect. 7031.5,BLsimess and Professions Code: Any city or county which regimes a Permit to construct, a8er, Improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to lie a signed statement that he s -tkensed pursuant to PERMIT AMOUNT the provstons 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 ti �� y • •. , for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit Plan Chk. Dep. $25040 subjects the applicant to a rid penalty of not more than rive hundred dollars ($500). ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. T J ' $ . 252.47 do the work, and the structure is not intended or offered for sale. (Sec. 7044, Busness and tt� repA Professions Code: The ContractorCOnSt. -77 Contractors License Law does not apply to an owner of property who 0.00 builds or improves thereon and who does such work himself or through his own employees, Mech. t� provided that such Improvements are not intended or offered for sale. If, however, the building .7 +JEJ or Improvements sold within one year of completion, the owner -builder will have the burden Electrical 4 \ '� \ \\' �''y' 9� of proving that he did not brill or improve for the purpose of sale.) ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 157.50 struct the projecL (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for S.M.I. 6.23 such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) �^ { 217 •0 ❑ I am exempt under Sec B. & P.C. for this reason Grading Driveway Enc. 20.00 Date owner Infrastructure 1.,875.25 WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No Company ❑ Copy is tiled with the city. ❑ Certified copy is hereby furnished. . TOTAL $3,334.45 1 14, 4/ ; CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE - (This section need not be completed if the permit is for one hundred dollars (E100)- valuation - tiA4i{S2'J $2`11 17 c� ;?.,.f};'^- ti AA or less.) 1 certify that in the performance of thg work for which this permit is issued, I shall not : —(;AI;f'f 1 f U I AL Y —4vii 4 employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. \ v r Date Owner h. N017CE TO APPLICANT: d, after making this Certificate of Exemption you should become ZONE: BY: 1' a r J subject to the Workers' Compensation provisions of the Labor Code, you must forthwith - Comply with such provsiorsorthis Permit! shall bedeemed remked. Minimum Setback Distances: Front Setback from Center. Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line Ihereby 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 Lenders Address FINAL DATE INSPECTOR 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. 12/12/89 1 certity that I have read this application and state that the above information is correct Issued by- Date Permit 1 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 CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES PLUMBING FEES IST FL SQ. FT. ® $ UNITS A.C. UNIT COLL. AREA SLAB GRADEwmQO YARD SPKLR SYSTEM E 2ND FL SQ. FT. BONDING HEATING (ROUGH) MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® / GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS FOUND. REINF. / GAS (ROUGH) DRAINAGE PIPING CAR P. I SQ. FT. METER LOOP HEATING (FINAL) WALL Sp. FT. REINF. STEEL DRINKING FOUNTAIN. SQ FT ® URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN x MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED - LAUNDRY TRAY AIR HANDLING UNIT CFM FRAMING 512,41P lg-W KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. ® c BATH TUB FIRE ZONE ROOFING: SQ. FT. ® c WATER HEATER MAX HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1+/. c SEWAGE DISPOSAL SQ.FT.GAR ® V4C 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 & AIR GOND. SOLAR SETBACK 11OUND PLUMBIN / % UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADEwmQO ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SE '4 / ROUGH WIRING. DUCTWORK ROCK STORAGE FOUND. REINF. / GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE 3 GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. T?. �� FRAMING 512,41P lg-W FINAL INSP. D ROOFING ,G �/Q� a o O py�� REMARKS: VENTILATION FIRE ZONE ROOFING: FIREPLACE SPARK ARRESTOR GAR. FIREWALL ,,/ LATHING. 0VA 3 MESH INSULATIONISOUND 6 O� FINISH GRADING s FINAL INSPECTION CERT. OCC_ FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS ' GARDEN WALL FINAL Building Address Owner AAA2­10"C L, W t kIT F Mailing - Address 31C) G. ST. City ZipU Tel 1E;SC0NlD1p0 Q Contractor. Address s4 - Y C� ►g- P.O. BOX 1504 APPLICATION ONLY 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 BUILDING:. TYPE CONST. OCC. GRP. A.P. Number 7 14OO(c� l I Legal. Description Project -Description 5 W /City ]ZII ,cN­ Tel:. 16Z ' State Lic_— — & Classif. Lic. # Sq. Ft. No. No. Dw. Size Stories Units Arch., Engr., _ Designer =IZ� N j�N ��OL New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. .55F; City. Zip State �V'I�I l0 S 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- ffectSIGNATURE ' SIGNATUREDATE -• OWNER -BUILDER -DECLARATION -'• - '- I hereby affirm that 1 am exempt from the Contractors License Law for the following reason: fSec. 7031.5,Bustness and Professions Code: Any city or..county which requires a EStlmated'ValuatlOh - --.— - - PERMIT-- --- - - - - - - -. - AMOUNT .. _ pemttt to construct, after, improve, demolish, or repair any. -structure, prior to its issuance also requires the'applicant for such'permf to file •a'signed statement'utat-he is-Ocensed 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 rive hundred dollars ($500). ❑ 1, 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 —Plan Chk.•...Dep.,- - - - Plan Chk. Bal. e Const. Mech.- - - -- - - - Dmfs or snpmves thereon and who does such work himself or through his own employees, _ provided that such improvements are not intended or offered for safe. Il, however, the building_., or improvement Is sold within one year of completion, the owner -builder will have the burden of that __._�_ ._ -_ ._ _ �vkrg improve for the purpose of Electrical . Plumbing �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 prope who builds or improves thereon, and who'contiacts for such projects with a contractor(s) licen pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec' ' � - B P.C. for this reason ., _ Grading. Driveway Enc. Date Ow _ Infrastructure WORKERS' COMPENSATION DECLARATION -I-hereby•affirn•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 d REMARKS 9192 t o n7�� 1 7_/14 _Lill 4 r'1 ��'Svi�Cv.� _ WORKERSCC MP NATE OF NSATION INSURAEMPTION NCE (This section • `ieed' not be corriplated if "the permit is for one hundred dollars ($100) valuation or less.) ' A certify that in the performance of the work for which this permit is issued, I shall not employ any pperson in any manner so as to become subject to the Workers' Compensation laws of California: - - VA 4 (i CASH i TOTAL i 275.00 - Owner N077CE TO APPLICANT:h, after making this Cerifficate of Exemption you should become subject to the Workers" Compensation provisions of the Labor Code, you must forthwith • comply with such provisions or this pemrftshaft bedeemed revoked. - ZONE: BY: ._.. Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line Thereby 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 Lender's 'Name ` Lenders Address FINAL DATE Issued by: Validated by: INSPECTOR Date Permit ' 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.K I certity 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 - Validation: ' City, State, Zip - BUILDING DIVISION CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES. ,, ` NO.- PLUMBING FEES. 1ST FL. SQ. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SQ. FT. FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® GAS (ROUGH) METER LOOP GAR. SQ. FT. ® POWER OUTLET ROOFQDRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. SQ. FT. ® GROUT WATER HEATER WALL - - SQ. FT, ® - . DRINKING FOUNTAIN BOND BEAM WATER SYSTEM URINAL SQ. FT. ® 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(AUTO)(DISH) APPLIANCE DRYER VENTILATION GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FIRE ZONE ROOFING LAUNDRY TRAY AIR HANDLING UNIT CFM FIREPLACE 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. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac 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 & 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./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. 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 SIGNATURES/INITIALS GARDEN WALL FINAL Desert Sands Unified School District CERTIFICATION OF PAYMENT OF SCHOOL FACILITY FEES CANNOT THIS DOC �iC?� bQ'ieb tf La�Q,u� n t�° ��Ea�a FED, DATE: Department o ommunity Development 78-105 Calle Estado La Quinta, CA .92253 .This is to'certify that C-0; developer of 0 1 }� which is located at within -this District, has paid school facility fees imposed pursuant to the authori't a er(t d by G vernment Cod Secti n 530 0 in thea ou t of ,� w $ 44 JQ6 �OZ7 coveting a total of square feet of (residential or ( )"industrial/commercial development and that build in ) permits for this footage in this development may now be issued by your jurisdiction. for DESERT SAND UNIFIED SCHOOL DISTRICT White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer (10)-37 V (�y)Q9 Ile -7 RECEIPT NO. ! V Off/ Issued By A�ejtl�__ Date /A2 �Indi DISTRICT: ❑ Riverside, Eo 0 Hemet q Perris ❑ Rancho Calif. ❑ Blythe DOH -SAN -122 (Rev. 7/89) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records COUNTY OF RIVERSIDE ENVIRONMENTAL -1Assessm14— --cc(. HEALTH SERVICES DIVISION PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM Appllcante Submit this form with four copies of a scaled plot plan (1-20 scale) drawn to County speculations as indicated on the attached check list 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. Q A VERIFY ITEMS IN SECTION A FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG # --V7W Z Z PhINN one Agent Contractor, Contact Person 24�9 Address & Firm C— ftl ^\C— U Owner Phone L• If Mailing Add 3t0 � UioVCsT-. City L f po State 04- Zip J0 Property Address MAY Legal D ription Prop. (PM, Tract, Lot,%cZwp 1,9 �. �: - , Lot Size 1 titer A e �yhlNelI Use of Permit P/P, CU, etc A _ V-,* Other cs l) KA (,LTir / Dwellin a Prep, etc. F Signature of Applicant- Date CATEGORY:. REV CODE FE CATEGORY: REV CODE FEE C�] SUBSURFACE DISPOSAL 1238 a!7 _ ❑ .SITE EVALUATION UPON REQUEST 7349 $ 43.00 m ❑ MULTIPLE PARCELS WITHIN SAME ' (NO PLOT PLAN) LAND DIVISION ❑ SEWER/SEPTIC VERIFICATION 7348• $ 17.00 Z a. 1 st 4 Parcels (Each) 1238 $ 57.00 i, (Less than 1 year) b. Each Parcel after 4 7344 $ 24.00 ❑ PRELIMINARY ELECTIVE 7352 $ 23.00 W ❑ Rereview (2nd review same parcel) 7344 $ 24.00 EVALUATION (Attach DOH SAN 53) Ing ❑ Site Evaluation in Conjunction with "_­� . Critical Area. ❑ HOLDING TANK 7351 $ 47.00 7346 $111.00`N'a ❑ ALTERNATIVE/EXPERIMENTAL 7345 $222.00 A. ❑ Site Evaluation Lot Less than SYSTEM 10,000 Sq. Ft. 7347 $ 87.00 NITIALL� / DATE Holding Tank Agreements Completed ❑ Yes fL. f J y"� VNO'� Certification of,Existing S.D. System Required ❑ Yes of Clearance required. (Attach Form ❑ Yes�NoWQCB DOH SAN 007, Santa Ana Region Only) Soils PercoUdion Report Required. ❑ Yes Special Feasibility Boring Report Required. ❑ Yes d] Detailed Contour Plot Plans Required (1 to 5 ft. interval) ❑ `Yes ZN�Other ❑ Yes yNo Staff Specialist Lot Inspection Required- ❑ Yes Lot Inspection Date Soils boring report by ProjectDate / r.'Soils Map Page Scr Type . G(G Approved by Date U Z No. of Systema T of System(s) �� No. Dwelling Unhs i (1) Septic Tank Soil Rate Greaser," !! Ing Tank ❑ Existing Bed V f ff 197"New ❑ Replaoenwe,t A��1 �4�`tt 444-,2 Gel a G/ �! UJ In 2) Leach Line Sq. FL Sidewall allowance Irv" s) K long ff wide with Leach Bed sq. tL trench area _ ft aq. fl per running ft. min. rode below draMlinea or `sof bolt -aree (®SNA Leachlines/bed special design for slope: (3) Pit Diameter No. Pits Pit Below Seepage Pit Total Depth CKtter: / Applicable /I • Inlet (BI) (TD) W. W _ N/A t� Overburden factor `" �([ / Max. All cable Depth ¢ /i�Ar�� No. 2 System REMARKS: 74 d i This application is+t{kFPROVED EKf1ED for the category checked in -SECTION B above, regarding the design of a subsurface disposal system as indicated on the accompa .— o Ian, using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the Z above -designed system. No construction is permitted in the required reserved 100% expansion real 0 (1 Septic tank and sewer lines must be 50' minimum from any wellsIto r () Leach lines must be 100' minimum"from any wells, including expansion area W (3 Seepage pits musZbe 50' minimum from any wells, including expansion area /�U)%pSi nature of Health Offic:al!`f��t pate / �J �d / - - (�y)Q9 Ile -7 RECEIPT NO. ! V Off/ Issued By A�ejtl�__ Date /A2 �Indi DISTRICT: ❑ Riverside, Eo 0 Hemet q Perris ❑ Rancho Calif. ❑ Blythe DOH -SAN -122 (Rev. 7/89) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records