003037 (SFD)T4&f 0
4 4a"
Building 52-545 AvouMa Villa
Address
Rick 1'obnaton
Mailing
Address P. ID. p ,���
City Zlp ITEII.
ntractor
Address
jZip
P.O. BOX 1504
78.105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
State Llc. I City
& Classif. 393169 Lic. # 202
Arch., Engr.,
Designer
Address Tel.
City I Zip I State
_ LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (Commencing with Section
7000) of Dlvls)on13 of the Busln9ssan61PPr9fesslons Code, and my license Is in full force and
effect. >,>�.,; -,I -V r��� �.n �—%.= - 7
SIGNATURE DA E
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Buslness and Professions Code: Any city or county which requires e
permit to construct, alter, Improve, demolish, or repair any structure, prior to Its Issuance also
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
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 five hundred dollars ($500).
Q 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
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 the burden
of proving that he did not build or Improve for the purpose of sale.)
O 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.)
❑ 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. ❑ Certified copy Is hereby furnished,
CERTIFICATE OF EXEMPTION FROM
WORKERS'COMPENSATIONINSURANCE
(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 the work for which this permit Is Issued, I shall not
employ anyparson in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of 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.
CONSTRUCTION LENDING AGENCY
Ihereby affirm that there Is a construction lending agency for the performance of the
work for which this permit is Issued. (Sec. 3087, 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 appl
Meiling Address.
City, State, Zip.
HARD COPY
No. 00303T
ILDING: TYPE CONST. OCC. GRP.
P. Number 773••AMA- 114
Legal Description
Project Description Si>Z;zla X29
Sq. Ft. MC 1650 No. No. Dw.
Size C.atr AMI Stories 1f Units
New;L Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation $89,988.10
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mach.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
AMOUNT
593,.04
403.00
33.00
81.62
105.00
6.7.7
7A.AA
20.00
1325.39
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 4/ %87 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. @ $
2ND FL. SO. FT. @
POR. SO. FT. @
GAR. SO. FT. @
CAR P. 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
STORAGE TANK
FLOOR DRAIN
MECHANICAL FEES
DUCT WORK
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
REINF. STEEL
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM,
FINAL INSP.
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. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/. c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ec
HOUSE SEWER
SPARK ARRESTOR
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 3
G OU LUMBI G UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTVT?N"�I ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. /n/ iJ7
GAS (ROUGH) METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL
GAS (FINAL) TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
'F/AL INSP.
FINAL INSP.
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
7
//FRAMING
�( "ROOFINGG�,� / ��� /_
/ '711��
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
&! SULATION/SOUN
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 �Al
TO: City of La Quinta DATE:
Department of Community Development
78-105 Calle Estado
La Quinta, CA 92253
This is to certify tha
developer of which is
located at 16--L- within
this District, has paid school facility fees imposed pu suant to the
authorityenerated by Gove nment Code Sec ion 5308 in the am unt of
covering a total of'� square feet o ( 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 UNIF ED SCHOOL DISTRICT
White - Building Department • Yellow - Facilities Planni g • Pink - Accounting • Gold - Developer
&J % O �l (10)-37
0
Z
O
H
U
W
C0
DO
Z
O
H
U
W
07
V
W
Q
W
W
X
Z
O
U
W
rn
� '11111111111V
COUNTY OF RIVZRSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION//
/ 73 —
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 mace payable to the County of Riverside.
Building Department Application Log #
Name (Owner, Agent, Contractor, Etc.)
Mailing Address
W111( 1;� 4 ° t/" b1 e% ' S r I
- (• ' zl,- -y 3 r�
City
State
Zip Code
Telephone
�6/�• _; /
i
fir''
%el , ; 3
e, ;
Job Property Address
`City or ommunity
'Legal Description of Property. (Lot, PM, TR)
�rr.rr,/..r ii✓f
�/"i N �% N
!< �/ • �i��ir �. rr,A li %►. 1, ., - ..�,
'Assessor's Parcel No.
Water Agency ar.-Wellf
r`C
Lot Size
e of Permit-)!-t��✓��� - planning Case N
i`fr
ISUISD,MH Site Preparation Etc.
.�
/
Signature of Applicant Date
'The above information must be verified from Building Application
STAFF USE — DO NOT WRITE BELOW THIS LINE
Initial Date
Certification of Existing S.D. System required. ❑ Yes 121Noo� J-44
WQCB Clearance required. ❑ Yes 60-
oSoils
Soilsfeasibility report required. ❑ Yes /Z�No
Detailed boring report required. ❑ Yes 3 No
Detailed contour plot plans required. ❑ Yes ❑ No
Staff Specialist approval required. ❑ Yes �'No Lot Inspection Date
Soils/boring report by Project # Date
// /?
Soils Map Page iira/ Soil Type l C Approved by ' ` ( Date
/1
Type of System: "
No. of Bedrooms
(1) Septic Tank
Soil Rate Required
❑ Existing B'New ❑ Additional ❑ Replacement
) rY a_e,
r/� Gals.
Y t r%��• fir, f
(2) teach line sq. ft.
Sidewall allowance
Instal Lines) Ft. Long,
r
Leach bed Sq.
(Boli trench area)
ft. rock/ Sq. Ft.
Fte.uu h min. inches
Ft. of'bottom
per running ft. CSN/A
rock below drain lines
area
Leach lines/bed-special design for slope:
(3) Pit Diameter
No. Pits
Pit BI
SeepaDe Pit total depth
Applicable
N/AOverburden factor
Cl -.5 ®-6
!
Max. allowable depth `r ti
This application is.approved%d&h ed,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' from any wells / " �,f / • , -G; s' o , f /; %' • . r.t� {� ' .•C,
(2) Leach lines must be 100' min. from any wells including expansion area
e(5) -)Seepage pits must be 150' min. from any wells including expansion area / 1r ri 1 - ti*' re
Signature of Health Official ; i Date
RECEIPT NO. / �-6, n Issued by
Date .5 // 'F-1
District: ❑ Riverside 0••16dio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe
Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pendirg File
DOH -SAN -122 (Rev. 6/86)
7
I
✓r
• 0GR1CU1-TL1R(i\rlLl_ CO'"" .'lk.',�; r=
(ilk US!i%. C NL1!'U;,'I'T', � 2� , 11
(71i) .57.2--061
46-209 Oasis SLrect, Foo- 14
Indio, CA 92201
(619) 32-8291
Dear Developer/Landscaper:
Thank you for inquiring with the Agricultural CoMissioner's Office regarding
local quarantine laws.
Any diseases or insects associated with the plants/landscaping eaterial presented
cn your landscaping plans do not pose a threat to the Coachella Valley Citrus,
Date, Grape, Vegetable, or Field Crop industry. 6;e therefore approve your
landscaping plans.
If however, any substitutions of plants/landscaping materials within your plans
occurs between now and the actual planting date, you must contact this office
within 48 hours before delivery into the Coachella Valley. Also, the substituted
Plants/landscaping material dust be held for inspection upon arrival. Any sub-
stituted landscaping material found infected/infested with quarantine pests will
be i-,-Lrediately treated or shipped out of the Coachella Valley 'at the discretion
of the Agricultural Coc-issioner's Office,
Under penalty of perjury, 1 -the undersigned will comply with the above,
Authorized Agent:
j/
Sigrat�—� ��•-=
Permit Number (s)_ %i g7RS OVA a
--
Date
-� reg eloper �,• �- dress
AGRICULTt'R`",L CO`•.ISSIC`:=3' S6 y- -2 22 8
flutt:orit} cited: Agricultural Code; Sections 6301, 6461, 6462, 64-64, 6501, 6521-
6524
cc: 2 Plan C ec,:, Indio Office,
Riverside Office