07517 (SFD)4
`• /ry� P.O. BOX 1504 N o . 0751.7
Building
Address
50-625 Ave. LA QUINTA, CALIFORNIA 92253
s
Owner
A & N Construction
Mailing BUILDING: TYPE CONST. OCC: GRP.
Address . PO BOX 366 A.P. Number 769 -065 -ON
City Zip Tel.
bt2! 92253 Legal Description Lot 39
Contractor Project Description Single Family DwIling
Sam
Address
P
State Lic. I City
& Classif. 487584 Lic. # 6226
Arch., Engr.,
Designer
Address Tel.
City I ZipI State
! Lic. #
LI ENSED CONTRACTOR'S DECLARATION
1 hereby affirm that I am censad under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the sin ss and Professions Co nd my license is in full force and
effect. f
d 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 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).
O 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 or property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
O 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATIDECLARATION .�
I hereby affirm that I have a certificatA of insent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certifiedcpby ereof. (Sec. 3 0,.6eeorOode��
Policy No. Company b j%
O Copy is filed with the city. O Certified c y is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of lh� work for which this permit is issued, I shall not
employ any person 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
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 uspended for 180 days.
I certify that I have read this pplication and state that the above information is correct.
I agree to comply with all ci and county ordinances and state laws relating to building
construction, and hereby au onze representlft4ves -of this city to enter the above-
mentioned property for inspec onpurpos�es.
Signature of applicant Date
Mailing Address
City, State, Zip
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback4rom Property Line
FINAL DATE INSPECTOR
Issued by: Date 4/9/'9OPermit
Validated by:
Validation:
Sq. Ft.
Size 2300
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition O
Estimated Valuation
$1331,060
PERMIT
w
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
324, IR
Const.
Mech.
53.50
Electrical
HUM
Plumbing
S.M.I.
9.1ft
Grading
Driveway Enc.
Infrastructure
2,8655,04
TOTAL
REMARKSAAk
1110194 & 4.44 It It
♦F
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback4rom Property Line
FINAL DATE INSPECTOR
Issued by: Date 4/9/'9OPermit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
A.C. UNIT
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SO. FT.
BONDING
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
SEWER OR SEPTIC TANK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF.
DRAINAGE PIPING
CAR P. SO. FT. ®
METER LOOP
HEATING (FINAL)
WALL SO. FT.
REINF. STEEL
DRINKING FOUNTAIN.
SO FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER HEATER
FLOOR DRAIN
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
LUMBER GR.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
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 ® 1% c
SEWAGE DISPOSAL
SO.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 w 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 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.1jN qo L,a
FRAMING �j FINAL INSP. lrq(�
ROOFING e b /��
:.` VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING ({,✓ �p O(/ ��%
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION ( l l
CERT. OCC.
FFNrF FINAI
/
lA, n
REMARKS:
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
Desert Sands Unified School District
• CERTIFICATION OFrPAYMENT
FACILITY FEES
. ��,� ������ V
Tp�yci f L,aQin t a DATE
Departmen ,of Community Development
78-105 Calle Estado
La Qjuinntta, CA 92253
This is to c rtify t w
developer f_
located at
this%Distr;ict-has-pa id`sc ool
aut or.t generatp4 by Governme
$ 3 cLUM 1-41
covering a total of
( ) industrial/commercial devel
this footage in this development
M
5�'9p
1 OT-
_wh-i chi s
. , _ .,,. s , ,_ --� �,i"f'hin
t
facility fees imposed pursuant -the f`
��� 0
a
White - Bu
O—W o94
pment and that building permits for
may now be issued by your jurisdiction.
2��x
� f) - eftmj�
for DESERT SAt46S UNIFIED SCHOOL DISTRICT
X702-�
,Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer
0 )-37
I
OFFICE OF
AGRICULTURAL COMMISSIONER
AND
WEIGHTS & MEASURES
CALVIN C. K/1MII4SKAS
JAMES O. WALLACE 4080 LEMON STREET, ROOM 19 Asstssoni CommhstonM
AgdeuthstotCommhslonet RIVERSIDE. CALIFORNIA 92501 CLEMENT DENVENISIE
Otreata of Wetphlt A Measures (714) 781.2561 Seoter
49613 Highway 86, Suite B12
2 Coachella, Ca. 92236 n (�
(619) 342-C8291 ()3 PC LG 0��37i� U
DATE r,
MWWPER' S NAM s A d a
ADDRESS,
1A d%
7ELEPI IONB e (
Dear Developer:
After reviewing your landscaping plans, all plant material listed is not in
violation of quarantine laws governing the Coachella Valley. If substitutions
do occur and they differ frun plant material listed, this office imst be notified
imwdiately.
Thank you for protecting and preserviiilg the Coachella Valley's pest -free envirotment.
'
Agr&Zultural Canni.ss Toner s Off ice
cai Indio and Riverside Office
a
r
1;S
% 1
II
T H E C I l- 1' 0 F
La'-�
Tell Calm N. ad'
May 8, 1992
Riverside County Assessor's Office
46-209 Oasis Street, Room #406
Indio, CA 92201
To Whom It May Concern:
The address of the structure located on A.P.N. #769-065-004, lot
39, in La Quinta has been corrected from 50-625 Avenida Tujunga, to
50-625 Calle Guaymas. Please note this change.
Thank you.
BUILDING AND SAFETY DEPARTMENT
-6h�t4
Tom Hartung
Building and Safety Director
TH:es
cc: A & M Construction
Imperial Irrigation District
LTRTH.10
Cite of La Quinta
Posr Office Box 1504 ♦ 78-105 Calle Esrado
La Quima, California 92253
Phone (619) 564-2246, Fax (619) 564-5617
Deva: S Pwouaon. Mark Paimer Des,Oo 619-340 0::2
urs �u mu!
"TAX T=f1l . .
mA & MM COnSU140t
red
P.O.. Box 566
f&La Quinta
"Ca 92253
9;740
ivv w� r,lt�w
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CM
ll
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W
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rva3797-JC I
SPACE ABOVE THIS LINE FOR RECORDER'S USE
'# GRANT DEED
THE UNDERSIGNED GRANTOR(S) DECLARE(S)
DOCUMENTARY TRANSFER TAX IS $
X3 computed on full value.,
of property conveyed, or
O computed on full value less value of liens or encumbrances remaining at time of sale.
0 unincorporated=area
` X3 city of La Quints , AND
P6R A VALUABLE CONSIDERATION, receipt of.which is hereby af. nQwledged,_
o'Howard, a married man as his sole and separate property
hereby GRANT(s) to _
& M Construction, A California Partnership
� r.
the following described real property in the City of La Quinta
County of Riverside , State of California:
is 33, 34t 35, '39, 42, 43r-44, 45f. -l-13,-115, 131, '135, 138 -of DESERT
UB,TRACT UNIT-NO.5, as shown by -Map on file -in Book 21 Pages 61 and 62
Maps, Records of Riverside County, California.
in
— - - ---�� Al ' --
'ri DOW Ja>n. • 4 f 19 9 0
{ Leo Howard
STATE OF WFORNIA
.COUNTY OF �S N �s Lc s SS.
yOn V* day of J'R a u &&±� in the year 19 90 ,
before me, the undersigned, a Notary Public in and for said State,
personally appeared Leo "/0W' zz
,
personally known to me
,`.(or proved to me on the basis of satisfactory evidence) to be the
^person whose name— is subscribed to the within
1 4 vArument, and acknowledged to me that — he _ executed it.
i 41
WITWSS my hand and official seal.
§ignatur
NOTARY PUBLIC IN AND FOR SAID STATE
OFFICIAL SPAT,
RHODORA E FRANK
a NOTARY PUBLIC - CALIFORNIA
LOS ANGELES COUNTY
My comm. expires AUG 18, 3991
(7 t area br otflclel notadal eaal)
(REV 4415) MAIL TAX STATEMENTS AS VIRECTED ABOVE.
E
a
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
Indio, CA 92201
TO:
Date: 9 D
This is to certifat Q tok C ,
developer of NTwhich is
located at - AZA - .S <-n -
f
with It school district,is required to Vyschool facility fees
pursuant to the authority generated by Government Code Section/.5 080. The
amount of fees due for thei."above referenced pr 'ect i $J
covering total applicable /square footage of square feet,
which is subject to final verification at time payment is presented.
CC)
rC�a3a0►�
Desert Sands Unified School District
CERTIFICATION QF6wPAYKENT
O
s� a0A ACILITY FEES f
OC
Q
�q�fa�Qa DATE:
W Departure of Community Development a,
78-105 Calle Estado
La Quinta, CA 92253
This is to c rtify A
developer of ;,''which, ig►; orf
located at '��hi0 x• r;
this District, has paid sc ool facility fee: itApose .`6 `-,iq nk''t the 1.;�' , ,•.
au t or't ge erat by Governme t Code se f'ot► A 080''n"t mount of`�' ' I'
$
'
covering a total of square--.,
eet
( ) industrial/commercial development and -that bu1, �0g perMiis or-tv
this footage in this development may now bg:,issued by youx jyrisdiC iA�#
r =t
3� for DESERT $A S UNIFIED SCHOOL'. pISTR!T
hue -Buil ing Department • Ye,.ow - aalities Planning Pink Accounting Gold - Develop
�1-37•
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Ips
UO.S'2C
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COUNTY OF RIVERSIDE ENVIRONMENTAL Aaiiia`aOr' Paraw Na
HEALTH SERVICES DIVISION
PERMIT APPLICATION FOR A SUBSURFAC WAGE DISPOSAL SYSTEM
Applicant: Submit this form with four copies of a scaled'plot (1-20 scale) drawn to County speculations as Indicated on the attached check IISL
Anon -refundable filing fee (see below); en the application Is submitted. Check must be made payable to the County of
Inns `
`}Rtverslde."Approval of this application §ball re ;valid for a period not to exceed one year from date of approval.
VERIFY ITEMS IN SECTION A FROM BUILDING & SAFE PLICATION BUILDING DEPARTMENT APPLICATION LOG #
— Agent, Coit
P Z
Address 8 Firm
�j y`�
Owner ^
Phone
Mailing Address
City d /hv r
to
Z6 Z
17
Job
Legal Description Prop. M. Tract Lot)
CLX—
Lot Size�{ /�(lp jl
Agency
A
Use of Permit P/P, CU, etc:' v a6/
Other
1✓l ���
voter
V S O
G
r
k
Dwelling, Site Prep, etc.
Signature of Applicant
Date
CATEGORY: REV CODE FEE
CATEGORY: REV CODE FEE
SUBSURFACE DISPOSAL 1238 57.00
❑ SITE EVALUATION UPON REQUEST 7349 $ 43.00
❑ MULTIPLE PARCELS WITHIN SAME
(NO PLOT PLAN)
LAND DIVISION
❑ SEWER/SEPTIC VERIFICATION 7348 $ 17.00
a gist 4 Parcels (Each) 1238 $ 57.00
(Less than 1 year)
b. Each Parcel after 4 7344 $ 24.00
❑ PRELIMINARY ELECTIVE 7352 $ 23.00
❑ Rerevlew (2nd review same parcel) 7344 $ 24.00
EVALUATION (Attach DOH SAN 53)
❑ She Evaluation in Conjunctiomwlth.•,
❑ 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
/ INITIAL DATE
Holding Tank Agreements Completed ❑ Yes G ZZ f' �/ - -ZCertification
of Existing S.D. System Required ❑ Yes
WOCB Clearance required. (Attach Form ❑ Yes o /
DOH SAN 007, Santa Ana Region Only)
Solis Percolation Report Required. ❑ Yes
Special Feasibility Boring Report Required. ❑ Yes tai
Detailed Contour Piot Plans Required (1 to 5 fL interval) ❑ Yes C /
Ottter ❑ Yes
/Nd�
Staff Specialist Lot Inspection Required ❑ Yes 0 No
Lot Inspection Date
Solis boring report by Project Date
/� c7 C
Soils Map Page Sol Type C.'T r A Approved by t �•�" Dade
No. of Syeleme
Tylt of System(.)
No. Dwelling Units (1) (1) Septic Tank
Soil Rale
roaee/Sand
❑�ding Tank ❑O Rept
Bedrooms
li\
30, 94
/,
rl• y
s/LGel
N�
Gr
(g t i . Ft.
Sq
Sidewall allowance
Install Lines) ft long a wide with
Leach Bed sq. ft
trench area
It. nxtic/ sq. iL
min. I as rock below drainlines or
per running It.
47+• NA
Leachlines/bed special design for slope:
Applicable
(3) Pit Diameter
No. PAs
Pit Balo N
W 413111
Seepage Pit Total Depth
(TD) uA 1
�pri5 f
1
+
N/A J of Overbrxden lector
6
Max. Allowable Depth
/ 0
1
No. 2 System
REMARKS:
��f/^ 1,y
r, 7r`.
This application 'iA APPROVED M for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated
on the accompan using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the
above -designed system. No construction is permitted in the required reserved 100% expansion area.
(1) Septic tank and sewer lines must be 50' minimum from any wells/ /U -r �,p,Q�p `y' L�Q`y`'
Leach lines must be 100' minimum from any wells, including expansion ea
Seepage pits must be 150' minimum from any wells, including expansion area
��-r �< ��, 3 90
Signature of Health Official -� to
RECEIPT NO. ? Issued By Int Date 3 3u - 9v
DISTRICT: ❑ Riverside,[II= Jp.® ❑ Hemet q Perris ❑ Rancho Cati . ❑ Blythe
DOH -SAN -122 (Rev. 7/89) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records
k.