9598 (PLBG)1�
Tit,, 4
t-
P.O. BOX 1504
No. 9598
Building 79-105 CALLE ESTADO
HACIENDA LA QUINTA,.CALIFORNIA 92253
Address 78-27b
Owner .1
DON SEYFEBTD BUILDING: TYPE CONST. HOOKUP OCC: GRP.
Mailing'
Aouress t, SA14E
City Zip Tel.
LA QUIIfTA, G 92253 1
Address. _. I
P 0 BOX 192
State Lic.City
& Classif, 460981 Lic. # 342
Arch:, Engr.,
Designer
Address Tel.
Zip(State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm 4hat-bam Iic_pnBeil nder _W.1V1slons of Chapter 9 (commencing with Section
7000)'of Division 3 ofAhe Buaineffis and Profeifeions Code, and my license is In full force and
effect z C-.,, -/-.' �.
OWNER -BUILDER DECLARATION
I, hereby affirm that 1 am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,131ushess,and Professions Code:- Any city or county whAdh requires a ..;
'Permit to conatrrrct after, Improve, demolish,- or repair eny structure, prior to Its- Issuance also -
requlres the applicant for such peMrrh to file a'slgned statement that he la licensed pursuant to
Me'provfslana of the Contractor's L k ansa Law, Chapter 9 (commencing with Section 7000) .9f;
Drvlaion 3 of me Busfiess and:;Prolesalons Cotle, or that. he is exempt therefrom, and the basis
for the a0eged exeritptlon: Aijy,idola0on of Section '7031.5 by Any applicant for a perml
duty ctathe appBcant to a c1W penalty ofnct more than Ove hundred dollars ($500).
0;1; as ownerof-the property, or my employees with wages as their_sole compensation, will
do the wank, and .the structure Is not. intended or offered for sale. (Sec. 7044; Butanes and '
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or 6nprovesthereon and who does such work himself 'or .through his own employees,
provided Met' such improvements;are.not Intended or offered for safe: 9,. however, ,the buWft
q• arprovenrent 'is sold within one .year of completion, the owner -builder will have the burden
of proving fleatAe did not build or'knprove for. the purpose of sale.)
❑, I, as owner of the property, am exclusively:contracting wlth.licensedreontractors to coo-' ,
struct the project. (Sec. 7041, Business and Profssslons Code: The Contractors License Law
does: not, appy -to an. owner of property, who builds or Improves -thereon, and wfp_ contracts for
such pr%Wft wfth a.carxraator(s) licensed pursuant to the Contractor's Ucenss'Law.)
O lam exempt:under Sec B. & P.C.; for this,reason
Date Owner
WORKERS''COMPENSATION DECLARATION
1 h�erreebbyy aSffiirrma that I have a certificate,
,00fcconsent too},s(eelff-iin�ssurre,, orr aprcertificate of
Wo Poll rlc (: 1 1 tlgp,lAsu pa or a
Earadd �'Y 8 L LM O< •� )
❑ Copy Is filed with,the,city. ❑ Certified copy Is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATIONINSURANCE
(This seclbn need not be completed If:the permit Is for one,hundred, dollars (S100); vahratbn
or
II certify that in the performance of the work for which this•permit Is -issued, Cattell not
employ any ppeerson In any manner so as to become subject to the WoAters'.Compensation
Laws of CaNfemia.
Date Owner
NOTICE TO .APPLICANT: lf, after making this Certificate of Exemption you abourd •became
sugiecr to 011e Itkrrrrers' Compensation provisions of the Labor Code, you must lbrfhw/m
comply
with such provisions or this permit shall be dawned 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. '3097, Civil Code:)
Lender's Name
Lender's Addreae
This is a building permit when properly filled out, signed,and validated, and is,subjectto
expiration If work thereunder Is suspended for.180.days.
1 certify thaCl have read this appllcation'and state that the above, information Is correct.
I agree to,compty with all city; and county ordinances; andstate 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
1. Number
Description
1 Description SEWER HOOKUP
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add O Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT' AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.:
Electrical
Plumbing$30.00'
S.M.I.
Grading,
Driveway Enc:
Infrastructure
TOTAL $30-00
REMARKS
li ll'r4;vrri3.<
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
IST FL SO. FT. ® E
UNITS
COLL AREA
2ND FL. SO. FT.
YARD SPKLR:SYSTEM
POR SO FT. ®
MOBILEHOMESVC.
BAR SINK
GAR. SO. FT.,@
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
DUCTWORK
DRAINAGE PIPING
WALL SO. FT.
DRINKING FOUNTAIN.
SO FT ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION S
WATER PIPING
NOTE:, Not to be used as property tax valuatlon '
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 xE
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 ® I'A c
SEWAGE DISPOSAL
SO.FT.GAR ® lAc
HOUSE SEWER
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
UGH WIRING.
qj!FOUND.
DUCTWORK
ROCK STORAGE
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 xE
=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 r
CERT. OCC -
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS.
,
GARDEN WALL FINAL
ESTABLISHED. IN 1,918 AS A PUBLIC AGENCY
COACHELLA VALLEY WATER DISTRICT
POST OFFICE BOX'1058 • COACHELLA, CALIFORNIA 92236 • TELEPHONE (619),398-2651
DIRECTORS OFFICERS
RAYMOND R: RUMMONDS, PRESIDENT LOWELL O. WEEKS, GENERAL MANAGER -CHIEF ENGINEER.
TELLIS'CODEKAS', VICE PRESIDENT BERNARDINE SUTTON, SECRETARY
JOHN P. POWELL KEITH:M.AINSWORTH, ASSIST ANT GENERAL MANAGERIAUDITOR
PAUL W. NICHOLSi REDWINEANDSHERRILL.ATTORNEYS
THEODORE J, FISH January 2'7, 1986'.
File: 0:721.1
V'Name V
VAddVf
VSa1V
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 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 following 'items. must. be
completed:
1. The owners of record of theproperty must 'compl'ete the enclosed application
for ,service card; and ,return it to the District in the enclosed envelope.
'. The physicalconnection 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 ofthe connecting pipeline.
A monthly sewer charge which is currently $11,.00 is collected to pay for
treatment of the wastewater generated from your. home.
TRUE CONSERVATION
USE WATER WISELY
VNameV -2--January 27, 1,9.86
1-f you have any questions or require additional information,. please call
Jim Zimmerman at (619) 398-26515;.
Yours very truly,
Lowell 0. Weeks
General Manager -Chief Engineer
AU:lmf
Enclosures /2 /as