9595 (PLBG)Building
• 9��
Q'
P.O. BOX 1504
78-25-2 HACIENDA LA QUINTACCALIFORNIA 92253
N IGHTERGAL E
Address SANTE
City Zip Tel.
LA QUINTA,C® 92253 1347-
ECONO SEVER SERVICES
&Classif. 460981 ILic.# 342
Arch:, Engr.,
Designer
Address Tei.
City( Zip ( State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that l'am licensed under'orovisions of Chapter 9 (commencing with Section
71100) of Division 3 of the Businees and.ProfessWp Code, and my license Is in full force and
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SIGNATURE - ti. s A-' °• m 1 ' .. f / DATE
OWNEWBUILDER,DECLARATION
I hereby afflrin'that 1 am exempt from the Contractors -License. Law for the following
reason: (Sec. 7031.5,Buabress and Professions Code: Any city or county which requbes a
permit to construct, after. Improve, demolish, or repair any structure, prior to its issuance also
reWrea the applicant for such permit to 8le a signed statement that he Is licensed- pursuant to
the. provisions of the. Contractor's License Law, Chapter :9 (commencing with Section 7000) of
Divlalon 3 of the Business and Proteselons Cade, or that. he is exempt therehorim, and the basis
for the alleged exemption. Any _ vkiWon of Section 7031.5 by -any applicant for a permit
subjects the.ap 1._ fo a _ penally of not more then five hundred,doears,(5500).
❑ 1, ae owner of the property,;or,my, employees with wages:as their sole compensation, will
do the work, and the structure'la not Intended or offered for. site. (Sec. 7044, Suisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or 9 roves thereon end who does such work hlmsetf- or through his own employees,
provided that such kTprovementa .are not Intended or offered for sale. N, however: the bugdAfg
or Improvement is- sold within Me year of completion, dme owner-bulider win have: the burden
of proving that he dki.not build or kVmve for, the puryose of:sals.) -
O I, as owner of the property, am exciusively contracting' with licensed contractors to coo-
struct the project. (See. 7044,, Business and Professions Code: The Contractor's License Law
does not apply to an, owner of property -who bullds_or Improves thereon, and who contracts for
such projects will; a contractWa) Boensed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATIONDECLARATION
I hereby affirm that 1 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.fumished.
CRRTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed If the permit is for one hundred dollar ($100) vaboon
or less.)
I,certify that In the performance of`thp.work for which this permit le Issued, I shall not
employ any pe reon in manner so as to bene'st�blect V thg,lQ Trs' Compensation
Law4baWifor�iimjl ng $�4 STAON iFN.ti..
Date Owner
NOTICE TO ,APPLICANT: H, after nudit this CeRili ate . of Exemption you should become
suh/sct to the Workers' 'CmrpensEUM provisons of the Labor Code, you must forthwith
compty with such provisions or this pemml shag be deemed. revoked.
CONSTRUCTION LENDING AGENCY
1hereby_afirm that there is a construction, lending agency for the performance of the
work for which this permit Is Issued. (Sec. 3087, Civil Code.)
Lenders 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 certltythat.l have read this application and state'that the above Information Is correct,
I agree to comply with all city and county ordinanees.and.state law_ s relating to building
construction, and hereby authorize representatives -of, this city to enter the above•.
mentioned property for insDectlon purposes:
Signature of applicant Data
Meiling Address
City, State, Zlp
No. 9595
IBUILDING: TYPE CONST. HOOKUP OCC: GRP.-
A.P.. Number.
Legal Description
Project Description SEVER HOOKUP
Sq. Ft. No. No._Dw.
Size. Stories Units
rNew ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
i
Estimated Valuation
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Ball.
Const..".
Mech. -
Electrical
Plumbing $ 30.00
S.W.
Grading
Driveway Enc:
Infrastructure
TOTAL $30.00
REMARKS
=' I
`�i1Ett,�.����
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
NO. PLUMBING FEES,
1ST FL. SO. FT. ® $
UNITS
COLL, AREA
2ND FL. SO. FT.,®
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO -FT. 0
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT. ®
DUCT WORK
DRAINAGE PIPING
WALL SO. FT.
DRINKING FOUNTAIN.
SO. FT. ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
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(AUTOXDISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.,
= plus xS
LAUNDRY TRAY
AIR HANDLING UNIT CFM
A 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.
SQ. FT. ® c
BATH TUB
SO. FT. c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® t+A c
SEWAGE DISPOSAL.
SO.FT.GAR ® 3Ac
HOUSE SEWER
SPARK ARRESTOR
GAS PIPING
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 TANK
OUGH 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 xS
=S
LUMBER GR.
A 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 SIGNATURFSIINITIALS
GARDEN WALL FINAL
rte'
M*ATEq
ESTABLISHED IN 191'8 AS A PUBLIC -AGENCY`
COACHELLA VALLEY WATER DISTRICT
POST OFFICE BOX 1058 • COACHELLA, CALIFORNIA,92236 • TELEPHONE (619) 39&2651
DIRECTORS OFFICERS
RAYMOND R. RUMMONDS;,PRESIDENT LOWELL0.WEEKS, GENERAL MANAGER=CHIEF ENGINEER .
TELLIS CODEKAS, VICE PRESIDENT BERNARDINE SUTTON, SECRETARY
JOHN P. POWELL KEITH M:AINSWORTH. ASSISTANT GENERAL MANAGERIAUDITOR
PAUL W: NICHOLS REDWINE AND SHERRILL ATTORNEYS'
THEODORE.J. FISH January 27,, 1986
File: 072-1.11per
V''NameV
VAd diT
VSalV
Subject: 'Sanitation Service.for. Avila Drive., Hacienda
La Quinta, Guijarro Place, La Quinta, California
The tract in which your -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 1985 connection to the community trunk sewer was made,
thereby activating the sewer'sys'tem 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 following items must be
completed::
1. The owners of, record of the. property must complete the enclosed application
for service card and re urn.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 La Quinta and notify the District
prior to installation of the connecting pipeline.
A monthly sewer charge which is currently $11.GO is collected to pay for
treatment of the was generated from your home.
TRUE CONSERVATION
USE WATER WISELY
f
;; °r.il,
v
MameV -27-- January 27, 19,86
If you have, any questions or require additional information., please call
Jim Zimmerman at (619) 398-2651.
AU: lmf.
Enclosures/2/as
Yours very truly,
Lowell 0., Weeks
General Manager -Chief. Engineer