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9442 (SFD)Building Owner Ji.gneile Mailing 13 P.O. BOX 1504 �!No. 2442 a 78-105 CALLE ESTADO f LA QUINTA, CALIFORNIA 92253 Address 54--360 Martinez City Zip Tel. La Quinta 92253 564 -0793 - Contractor Address Tel.,' State Lic. City & Classif. 613'406 1 Lic. # 1858 Designer Address CityI Zip I State Lic. # LICENSED CONTRACTOR'S DECLARATION . I hereby affjm) that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Busip°ass and`Professions Code, and my license is in full force and �J effect. � �` SIGNATURE '�. .7 Cf- DATE {{ff 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, after, 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) 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). ❑ 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, Bulsness�and 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, 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 therburden . 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 contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner 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. O Certified copy is hereby furnished. - CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars (5100) valuation or less.) .--- I certify that in the performance of thg work for which this permit is issued, I shall not employ any parson imo any manner,so as to become subject tthe Workers' Compensation Laws of California. r 1 Date /� Owner.�� t iNOTICE TO APPLICANT: Il,�efterJ�along fhis�ate of Exempflon you should become t/ subject to the Workers' Comper�9adon provisions of the Labor Coder you must forthwith comply with such provisions o''this, ermft shall be deemed revoked. 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.) 'Lender's Name Lender's Address 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. I certify 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 City, State, Zip BUILDING: TYPE CONST. OCC: GRP. A.P. Number s Legal Description Block 119 Lot 11 Project Description SFS Sq. Ft. 1600 No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ 'Demolition ❑ Permit does not include any blook walls or pool r Estimated Valuation 88,862.00 . PERMIT AMOUNT Plan Chk. Dep. 250.00 Plan Chk. Bal. 251.98 Const. 590.04 Mech.. 55.5G--.' Electrical 130.00. Plumbing 135.00 S.M.I. 6.23 Grading 20.00 Driveway Enc. 20.00 Infrastructure . 1961.16 TOTAL ' 3419.87 3169.87 REMARKS _ 10_ btu ,4�.s,9,07 ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line ' Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES 140. PLUMBING FEES IST FL. SO. FT. ® $ 2ND FL. SO. FT. ® POR. SO. FT. ® GAR. SO. FT. ® CARP. SO. FT. WALL SO. FT. ® SO. 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 STORAGE TANK WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FOUND. REINF. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM REINF. STEEL 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 SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1Vi c SEWAGE DISPOSAL FINAL INSP. 6/.� SO.FT.GAR ® 3yic HOUSE SEWER ROOFING 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 5 .� �Lp ROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH P UM BONDING HEATING (ROUGH) STORAGE TANK FORMS ft EPTtC TANK 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. 6/.� FRAMING -�l FINAL INSP. ROOFING L, A /O t ` / t r REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING ,� S3r �i MESH INSULATION/SOUND Q FINISH GRADING FINAL INSPECTION- CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL :d DESERT SANDS UNIFIED SCHOOL DISTRI DT 827879 Highway 111 NOTICE: Indio, CA 92201 Document Cannot Be Duplicated (619)347-8631'.1' Date 5/7/91 Type of Permit I La Quinta No. 110577 Permit # 19442 Log # 1. Owner Name Jim Snellenberger No. 51-975, Street Villa city La Quinta zip 92253 study Ares 113 APN # Tract # Lot # square Footage 11600 `Type of Development Single Family Residence No. of units 0 Comments At the present time, the Desert Sands Unified School District does not .collect fees on garages/carports, covered patios/walkways, residential additions under 500 square feet, detached accessory. structures or replacement mobilehomes. It has been determined the above-named owner is exempt from paying school fees at this time: due to the following reason: t . EXEMPTION NOT APPLICABLE°' This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 1.58 X 1600 or $ 2,528.00 have been pa- d to D.S.0 S.D. for the property listed above and that building permits and/or Certificate&of Occupancy for this square footage in this proposed project may now be issued. Fees Paid By Jim Snellenberger Telephone 564-0793 Name on the checkBy Richard M. Beck` Director, Facilities Planning & Development i�?� a� W Fee collected /eze pted by thleen Emmerlin Payment Receive)_ < „ ' Signat ! Collec0130 tor: Attach a�opyc_) of county or city plan check application form to district copy for. all waivers. f Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting r, =cop C"STEC�'F3 OtNG,REOUY',.A 1 i &, _ r UNION U � Y. � � , • �� .N J' ROGER', SNELLENBERG i f Street 1 5%1-35 =yy l x 1 IAddr0 AV$ItTxDA'MART.INEZ•' ..t. t � � ° �' t(i3v &, LA QVINTA, CA "92253 �„ cxo'w w" , :1i F- �' d r Fg MAI { L TAX STATEMI=NTS TO d L° r- `a } # a SAME AS ABOVE 5� cc re _.. Jy SPACE ABOVE THIS LINE FOR RECORDE',R'S USE------- `^ - 1 CAT. No. NN00578 `+� ti- - Corporation Graaf Deed TO 3021 CA ((3•-9G) THIS FORM FURNISHED BY TICOR TITLE INSURERS The un ersigned grantor(s) declare(s):�, " Docvenentary transfer tax is S 23:10 a ( computed on full value of property conveyed, or { } computed on full value less value of liens and encumbrances remaining at time of sale. (. 1 Unincorporated area: { ) City of , LA QUINTA and ' - FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, TEB, INC., a corporation organized under the laws of the State of CALIFORNIA hereby GRANTS , to ROGER SNEL,I.ENi3;ERGER, ,AIN UNMARRIED, MAN the following described real property in the CITY OF LA QUINT'A µ (i� County of R=VMSz1152 , State of California: LOT ,.71'rIN BLOCK 119 OF UNIT 12, SANTA CARM. ELXTA AT VALE LA QUX3`1T-A, AS s SHOWN � ' BY MAP ON FILE IN BOOK 18 PAGES 79 AND 60 OF M". S, RECORDS _ IN 'J"fia OFF.IC$ __lam OF THE COUN* RECORDER OF•SAID COUNTY. 1S i t� • 4 t 4y� T 1 In Witness Whereof, said 'corporation has cause&Jts corporate name and' seal to be affixed hereto and this instrument to be executed by its President.and Secretary thereunto duly authorized. ' TEE INC. A -CALIFDEMIgNR' Dau d [I UG sm t3, 145.0 By STATE OF CALIFORNIA ; ` w COUNTY OF Log . AnO1eS SS PrCsidi?nt 3 On August 20By ,1990 , befog+, Me. th"e r t , Secretary uncle rsigncd, a Nutery Public in and .foe Slid'State personally.. .y ' appeared Dean. E'V'az'35 _ wn to.me.or proxcd-to mC on the basis of sgtts —personally kno factory evidenee to be''the person who executed the within, - instrument as the Presidertt, ,sed *' Lyie S. Stran„.�.- f< * pert-sonally k°nowr� III[ IIIIIIII IlI110(ftllIII Ilftlliilrl�LiftOtlit�° ,R me or Prbvcd to mc;on the basis crf.sa'tisfacto fy widenct to.be '� ^` �.• °� ' OFFICIAL SEAL -= the person who cxocutcd.thc.withln inskru I tasthe *"� * _ K " NOR.�•fNE :, .lZOT'C . * * — °k ''N©TARyPU9LiC-CALIF.ORNlr1= Secretary of the Corporation that, executed ~ 'Z' PRINCIPA_ OFFICE° the within instrument and acknowledged to fie that such _ LOS ANGU4_ES-COUNTY Corporacion executed 'the within instrument pursuani to its ! Myi CbMMI$sion Expires May 14,.1993 e 11111lIlllllllUtittlllllllltllllllltllllllitlllflllltillllc d' ( b'y•IawS'or d reso(ution;'of its b,onrd'of directors. WITNESS Ary hand and official seal• r• x - 3V � Signatturc' t ��G-�... � r --- y - (This arca for art,cjal nota a(.,o"M ?_ f Title'Order No. Escrow or Loan No. f ' - MAIL TAX-STATEME'NTS AS qIR-ECTED ABOVE T 0..- =I,, t{ ;:�!.I73 t, ztj :3,8:, t-4.-:3 '1 1. :3,-t-4 :A : ' `D 0 :_ As. i, I 1 M'1 ,T . r T ? :� ►� LJ �- A:7ar.A s-.�:� a�"' r.p,y$,g; p=s v .,� ,. r•yry-„G,.gvm`FyL"i+e%Y'i�SL[i�i�8`r'�,t'7,R�°}TRi3�f"'�'f°•'� COUNTY OF RIVERSIDE DEPARTMENT' OF HEALTH+ Af0`�0" P"O'I N''` ENVIRONMENTAL SERVICES 7 — DIVISION a0 3, PERMIT APPLICATION FOR A:SUBSURFACE SEWAGE DISPOSAL SYSTEM: Applkant: Submit this form.with four copies of•a scaled plot plan 0 20:scale) drawn to County speculations as indicated on the attached check Ilst when r application de payable below) emain reitl App � to the Couritj! of LOWEA Riverside o application to exceeeed date of "I, Tree valid ouired ver oWl tis period f cone fromheck f i0l:4o VERIFY ITEM,S/(IN.SECTION A FROM BUILDING SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG # _ � r °* AWContractor, ContA1109s6n Phone Address & FirmV Owner •'S1VLfA6 /_- Al jr:(I 15k Phone Mailing Address Lr>• (,jiAId.Nk yoras /n E City �?v ' State 614 Zip Job Property AddresokO,//1J/,, - 6u � ! /y4� Legal Description ?rop.•(PM, Tract, Lot) Lo-- //- - S _ 10 40 Lot Size Water Agency 1 Use of Peril P/P, CU, etc o�0 �itiw7 r� Other /� X J/ .- . ..�v wellies Dwelling MH Srt rep etc. --- - Signature,_.%lpplicant Date ' CATEGORY:" - REV CODE FEE CATEGORY: REV CODE, FEE SUBSURFACE DISPOSAL 1238 UO ' ❑ SITE EVALUATION UPON REQUEST 7349 $ '43.00 ❑ MULTIPLE PARCELS WITHIN SAME (XJ (NO PLOT PLAN) LAND DIVISION ❑ SEWER/SEPTIC VERIFICATION 7348 $ .17.00 a. 1 at 4 Parcels (Each) 1238 $ 57.00 (Less than 1 year) b. Each Pwcel after 4 7344 $ 24.00 ❑ PRELIMINARY ELECTIVE 7352 ,. $. 23.00 ❑ Rereview (2nd review same parcel) 7344 $ 24.00 EVALUATION (Attach DOH SAN 53) ❑ She Evaluation in Conjunction with ❑ HOLDING TANK 7351 $ 47:00 Critical Area 7348 $111.00 ❑ ALTERNATIVE/EXPERIMENTAL 7345 $222.00 . ❑ Site Evaluation Lot Less than SYSTEM .10,000 Sq. Ft. 7347 $ 87.00 INITI/AL, DATE Holding Tank Agreements Completed ❑ Yes A N Nr '' oacp -17 Certification of Existing S.D. System Required ❑ Yes NoO' 1 WQCB.Clearance required. (Attach Form ❑ Yes PI!C DOH SAN 007, Santa Ana Region Only) Solis Percolation Report Required. ❑ Yes Nod`,,,���...••• Special Feasibility Boring Report Required. ❑ Yes, f Detailed Contour Plot Plana Required It. (1 to 5 interval) ❑ Yes ET OB►er ❑Yes Staff Specialist Lot Inspection Required ❑ Yea No Lot Inspection late Solis boring report by Project >t Date Soils Map Page Soil TYPe!' Approved by �'`° Date No. of Systems Type of Systems) ❑ Holding Tank ❑ Existing No. Dwelling Units Bedrooms, f1ir ureunhar (1) Septic Tank Soil Rate Greaee/Send rese Intop �Vl, ❑ Replacement J lo,"a AOR -Gal ' (2)l Line Sq. Ft Bottom trench area Sidewali allowance R rocW sq. R Irstalldna. _ une(s) It. kxig _ to wide with beech Bed s% ft.. '5'boltorn per running It min. inches•- below drelnlines or area Leachlines/Ded special design for slope: (3) Pit Diameter ` No. Pits Pit BelowD Inlet (BI)! Seepage Fit Tota Depth (T) «bd j Other '"^,•,+ �, Applicable , a> s s • � F Max. A Depth N/A Overburiden factor /) mn ati � . No. 2 System REMARKS: l/ � I�+�rL+�►� %r's-,.: �',•�Jn�/,.rl��✓"Y�'� �i �/9'�/,113 /� /1t �-►1�"i-- t,�«•°t,'....,_ _„ .f%i'�.Q ��. �.c..L'1� � ..trj,�G2./�.r� .�.%tra/�rr,�'. e.°GI' !•k1..e�•-�,�� r. This application isrAPPROVED/D NIED for the category checked in SECTION B above, regarding the design of a sibsurtace disposal system as indicated on the accompanied` p using the requirements set-orth„in-SECTIONzG-above. AA-buildinpermit is necessary for the installation of ;the above -designed system. No const ion is permitted' in the required reserved 100% expansion area. (1 Septic tank and sewer lines must be 50' minimum from any wells A2 Leach lines must be 100' minimum from any wells, including expansion rea �•�.� %.uf '. (3)Seepage pits must be 150' minimum from any wells, including expansion ar �✓� ✓►`a Signature of Health Official ?,11-& /C DaterQ ^. r? RECEIPT NO. rk`' Issued By �'-�titl �_ Date '. �e ' p �/ DISTRICT: ❑ Riverside, ©' Indio 'PO Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe DOH -SAN -122 (Rev. 3/90) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records '