9720 (PLBG)t4
4
a"
P:O. BOX 1504 No. 9720
Building 78-144 HACIMA LA441aT'+4 &105 CALLE CALIFORNIAESTAD9 '
Address LA QUINTA, ORNIA 92253•
Owner �p
DR. EDWARD ALLRED BUILDING: TYPE CONST. SEWER ��eMp.
Mailing
Address SAME A.P. Number
City Zip F_eILA QUINTA 92253Legal Description
Contractor Project Description SEWER HOOKUP
ECONO SEFI198 SSV,
Address
P. 0 BOX 192
City Zip Tel.:
PALK DESERT 92260 346-2796
State Lic. City
8 Classif. 480-961 Lic. # 342 Sq. Ft. No. No. Dw.
Arch:; Engr., Size Stories Units
Designer New ❑ Add ❑' Alter ❑ Repair ❑ Demolition ❑
Address `Tel.
11 1 Lic. #
LICENSED,C&TRACTOR'S DECLARATION
71hereby affirm that I am liosriae8 urMe drovlalons of Chapter 9 (commencing'with.Sectlon
i � of Ivision 3 of thg ' mess and .rj#esslons:Code, and my H en Is in Jul force and
iii /. _ ��
SIQNQNRIE-:-�.�''' � ' r DATE
"r OWNER'BUILDER DECLARATION
I h afnrm that I-arn,exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Bushms and RWasslone Lode: Any city or county which requires a
permit to construct alter. improve,or -repair any structure, prior to Ifs Issuance also
regrdres ftre.appacmH for such permit to We'a signed statement that he is Ucensed pursuant to
Me prov(slomrs o/ the Contractor's License Law, Chapter 9 (commencing with Section. 7000) o/
Division 3 ol'the S w nese and Wo/essbns Cade, ou that: he Is exempt therefrom, and the basis
for Ma aAsged .xerryo. =violation o/ Sectlon 7031.5 by 'any app mt /or a pemtlt
sub(Bots'the app�Beant'to:a elvB'penalty of hot more. then rive hundred dollars �(i500). '
❑ I, as owner ofihe properly, or my employees with wages as;thelrsole compensation, wlll-
do the work and the structure.is noYlntended or oftered tor'sale. (Sec. 701, Buisnesa and
Professions Cade:. The Cantracars License Law does not apply to an owner o/ property who .
bu1Ms or` inprosee thereon and who does suoli work fihnselt or Mrough Ms own empioyees,.
provided that each irmprovenments' are •not intended or offered tom sob. d, however. the building
or dnprovernent !s sob wtMin one year o! completion, the owner buBder w!U have the burden
of proving Mat ire �d Trot brmld orirmprove torthe purpose o/ sale:)
❑ I, as'owner of the property, am exclusively contracting with licensed contractors to con-
struct the project (Sec. 7044, 9usbmess and Professbns Code: The Contractor's License Law
does not appy to an owner of property who builds or bnproves thereon, and who contracts for
such pro/eca with a corrtmctw(a) 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
workers C pensation insurance, or a ceMfl&d6TA"f. it
o�j aborCode.)
Poli�i No Como
ply is filed with the city. 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 ($100) valuation
or;lesa:) '
I certify, that in the pertorrnance of th rwork for which this permit. is issued, 1'shall not
employ any ppeerrssoon
Ito
manner so as to become subject to the Workers' Compensation
Laws of Catlfomla.
Data_ mer
NOTICE TO .APPLICANT: ll, star maAft this Certil/oate of Exemption you should become
subject to the Nhrkers' ConipensabM provisions of the Labor Code.. you must forthwith
comply wf h such provisions or this pemmlt'ahalt be deemed, revoked.
CONSTRUCTION LENDING AGENCY
Ihereby attirrothat there is a construction, lending agency for the performance of the
work'for which this permit Is issued. (Sec. 3097, Civil Code.)
Lenders. ,Name
Lenders Address
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 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..
mentl6hed`property for Inspection purposes.
Signature of applicant Date•
Mailing Address
City, State, Zip
IEstimated Valuation $12SSR $1750.00
PERMIT AMOUNT
Plan.Chk. Dep.
Plan Chk. Bal.
Const. ,�_; , $30.00
Mech.
Electrical
Plumbing
S.M.I.
Grading,
Driveway Enc.
Infrastructure
14
TOTAL
REMARKS
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: -
Vail dation:
y:Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
YARD'SPKLR SYSTEM
2ND FL. SO. FT. ®
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR SO FT ®
DUCT WORK
ROCKSTORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
METER LOOP
HEATING,(FINAL)
DRAINAGE PIPING
CAR P. I SO. FT.
GAS (FINAL)
WALL SO. FT. 0
DRINKING FOUNTAIN,
SO. FT. ®
URINAL
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
ROOFING
GARBAGE DISPOSAL
FURNACE UNIT WALL, FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B,T;U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEWPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SO. FT. ® c
BATH TUB
SPARK ARRESTOR
SO. FT. ® c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SO. FT: RESID ® 114 c
SEWAGE DISPOSAL
LATHING
SO.FT.GAR ® 3Ac
HOUSE SEWER
GASPIPING
PERMIT.FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.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 TAN
4q ROUGH WIRING.
DUCT WORK
ROCKSTORAGE
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:
j plus xS
=S
'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 C R
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINfTIALS
GARDEN WALL FINAL
<<r
ATER
'D/STRICT
ESTABLISHED IN 1918 AS A PUBLIC AGENCY
COACHELLA VALLEY WATER
DISTRICT ---
POST OFFICE,BOX=1058 • COACHELLA, CALIFORNIA 92236 a TELEPHONE (619):398.2651
DIRECTORSOFFICERS
RAYMOND R. RUMMONDS, PRESIDENT' LOWELLO.,WEEKS.GENERALMANAGER-CHIEF ENGINEER
TELLIS CODEKAS;.VICE PRESIDENT BERNARDINESUTTON;SECRETARY
JOHN P., POWELL KEITH H. AINSWORTH; ASSISTANT GENERAL MANAGERIAUDITOR
PAUL W. NICHOLS REDWINE AND SHERRILL. ATTORNEYS
THEODORE J. FISH January 27, 19.86
File;: 0721.1
VNameV
VAddV (9�
VSalV
Subject: Sanitation Service f.or.,Avila,;Drive, Hacienda.
La Quinta, Guijarro Place, La Quinta, California
The tract in whichyour home is located.was constructed with a dry sewer system.
This system was installed in anticipation of the extension of community trunk,.
sewers:. In October '1,985 connection to the community trunk sewer 'was made.,
thereby activating the sewer system,within your tract.
The developer of your -tract, recognizing that the sewer system was, not usable,
installed septic tanks for .the purpose of providing wastewater treatment until
the sewer system could be activated. Now.that`your sewer system is -in service
you may desire to connect to it..
In order to obtain sewer service to your property the followingitems must be
ccmpleted,:
1. The owners of record of the property must complete the enclosed application
for service. card and return it, to the District in the enclosed envelope.
^. The physical, connection. of your home to the community sewer, may be made by
a plumber or sewer contractor -of your choice.,- The contractor or plumber must
secure a building permit from the .City of'
prior
Quinta and notify the District
prior to.installation of the connecting pipeline.
A monthly sewer charge which is: currently $1-146 is collected to pay for
treatment of the wastewater generated from your home.
TRUE CONSERVATION
USE WATER WISELY
t
:eA&
DET -1, BHT, 1 -18th CAVALRY
BLDG'16, AFRC
LOS ALMMOs, CA 907.20-5002
Unit Heading
SUBJECT: Order to Military Duty
Date
1. The following named individual Is . ordered to perform military duty, for the period and
purpose Indicated:
spe. Joseph Loveland _
Grade Name
P.O. Box 278 Thousand Palms,Ca.. 92276-0278 _
Address,
2. Type., locatlon, and dates of military duty:
XXX Inactive duty training
*See note below
Annual training
(e.g,., ;s,urnmer camp)
Full-time training duty
(e;.g., active service school)
State emergency active duty
Other (explain)
FROM:. 28 June 1900 Hrs. _
Date and Time
'TO: 30 June 91 1700Hrs.
Date -and Time
LOCATION: .Bldg. 16 AFRC Los Alamitos
Los Alamitos,. Calif. 90720
*Inactive duty training- Includes weekend drills, tr'al'ning performed on a weekday .In lieu of a
weekend; 'additi'onal flying training periods; etc., for which paid, military ,leave Is not normall.�
authorized'.
3. The above—named California t' ation,al Guard member hereby requests a leave of .absence from
his/her employment, p:ursuant-to Title 3$, Unl:ted States Code, Section 2024: and Cal;ifornla Military
and Veterans Code, Section 395:
CAL ARNG. Form 350-3 jJin 81) All previous editions are .absolete
G
VVameV -2- January 27, 1986
If you have anyquestions or require additional information, please call
Jim. Zimmerman at (61;9) 39'8-2651.
AU:lmf
Enclosures/2/as
Yours very truly,
Lowell 0. Weeks,
General Manager -Chief Engineer