08620 (SFD)Building
Address 52-830 RaMWA
Owner
Mailing
Address
c&ty/ 4
P.O. BOX 1504 / N o .
78-105 CALLE ESTADOt(
LA QUINTA, CALIFORNIA 92253
0. Wilkinson JBUILDING: TYPE CONST. OCC: GRP,
City i�hitti zlp of
Contractor
HwCier Dewlopwmt Inc.
Address
77720 Cbe rokee
ity lZip Tela
State Lie.I City
& Classif. _ _ Lie. #
Arch., Engr., I
Designer R..G_ 3EsnAt� .
Address Tel.
City IZip I Stae
Ljct# I
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect. i
SIGNATURE -f` DATE
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 thathe 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.)
0 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' 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 thg 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: It, 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 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 applicant Date
Mailing Address
City, State, Zip
A.P. Number
Legal Description
Project Description Awn
Sq. Ft.
Size
New ❑
No.
Stori
s • 1
No. Dw.
w
Add ❑ Alter ❑ Repair ❑ Demolition ❑
stimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
2511M
Plan Chk. Bal.
b
Const.
512,4110
Mech.
55. SO
Electrical
0
Plumbing
163,50
S.M.I.
aS
Grading
90,00
Driveway Enc.
20,00
Infrastructure
TOTAL
4 i
REMARKS
irr'9�Yi) .Y �
wi i ti ff.. .W vry • a .. . e,
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:
T
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE A&
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
STORAGE TANK
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
DUCT WORK
ROCK STORAGE
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER APP./EQUIP.
DRAINAGE PIPING
CAR P. SQ. FT.
TEMP. POLE
WALL SQ. FT. @
GROUT
DRINKING FOUNTAIN
SO FT. ®
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
=$
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
I
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ®c
BATH TUB
GAR. FIREWALL
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Vi c
SEWAGE DISPOSAL
MESH
INSULATION/SOUNDi2Z rv�
SQ.Fi.GAR ® 3/ic
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 ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUM131
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE A&
01 ROUGHP U B.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SE ER
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
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.
FRAMING a
FINAL INSP.
ROOFING/ ?/6 9�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING +I)WIV l ml ql
MESH
INSULATION/SOUNDi2Z rv�
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
Building
Address
Address
T-v4t 4 4 Qum&
P.O. BOX 1504 APPLICATION ONLY
78105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
State Lic.I City
-7> n
& Classif. it 1 '1 ' Lic. #
Arch., Engr
Designer i
Tel.
State
Lic. #
D CONTRACTOR'S DEC RATION
I hereby affil hat a licensed under DrovI ns of apter 9 (commencing with Section
7000) of Divisi Business and ProfesW e, and my licence is in full force and
effect. w ' //
OWNER•BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Wsiness and Professions Lode: Any dty or county which requires a
pemrt to construct. ater, improve, demolish. or repair any structure, prior to Its Issuance also
regcrbas the applicant for such permit to fie a signed statement Mat he is licensed pursuant to
Me provisions of the Carmbactors License Law, Chapter 9 (comirnencirg with Section 7000) of
Division 3 of the B simess and Professions Code, or Mat. he is exempt therefrom, and the basis
for the aieged exemption. Any violation of Section 7037.5 by 'any applicant for a permit
subjects the applicant to a crW penaNy of not more Man five hundred dollars ($500).
❑ 1, 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
Prolesmns Code: The Contractor's License Law does not apply to an owner of property who
builds or k proves Meson and who does such work himself or through his own employees,
provided Mat such krprovernents are not intended or offered for safe. ff, however, Me building
or irprovement is sold wittn one year of completion, the owner -builder will have the burden
of proving Mat he did not buid or improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct
onstruct the project. (See. 7044, Business and Professions Code: The Contractors License Law
does not apply to an owner of property who buil is or hniaroves thereon, and who contracts for
such projects with a contractor(s) licensed Me Contractor's License Lew.)
O 1 am exempt under Sec B. & P.C. for this reason
c
Date owner
WORKERS COMPENSATION DECLARATION
1 hereby affirm that I have a certificate of consent to self -insure, or a certificate of
workers 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' COMPENSATION INSURANCE
(rims section need not beeonpleted for one hundred dollars ($100) valuation
or Less.)
1 certify that in the pert of 6 work for which a Is issued,,Ushall not
employ any person in any man o to become subject orkers' Compensation
laws of California
Date Owner
NOTICE TO APPLICANT. 9, altar makiV this Certificate of Exemption you should become
suilject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this pemW 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.)
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-
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Add
City, State, Zip
ILDING: TYPE CONST. OCC. GRP.
Number
Description
Description
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT AMOUNT
an Chk. Dep. o� r
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
.rastructure
U'
TOTAL O
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:
Validation:
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 10/1/90 1 Type of Permit I La Quinta
No. 10176 Permit #
Owner Name William O. Wilkinson Log #
No. street See Below
city La Quinta zip 92253
Study Area
APN N I I Tract # I Lot li Square Footage 112,448
Type of Development I Single Family Residence INo. of units
Comments r%1 _Rd_9; R_nmirP7. .rid -19.n R.rnhin 9;9._9.Rll MPnfln2a M _R -M
At the present time, the Desert Sands Unified School District does not collect fees on
garages/carports, covered patios/walkways, residential additions under 500 square feet,
detached accessory structures or replacement mobilehomes. It has been determined
the above-named owner is exempt from paying school fees at this time due to the
following reason:
EXEMPTION NOT APPLICABLE
Ibis certifies that school facility fees imposed pursuant to Government Code 53080
in the amount of 1.58 x F1-254-48-1 ors 19,667.84 have been paid to D.&U.&D. for
the property listed above and that building permits and/or Certificates of Occupancy for
this square footage in this proposed project may now be issued.
Fees Paid By
William O. Wilkinson
Name on the check
Richard M. Beck
Director, Facilities Planning & Development
Fee collected /exempted by Shelley D. Bennett
Signature-
i , , U d4��
Telephone
. 'J , ' `
Payr' ent ,F.o.fsi!ved
CFieck No. 019694
Collector: Attach a copyof County or City plan check application form to >hictlict copy.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
51
I
r
Name
Street
Address
City &
State L
r
Name
Street
Address
City &
State L
1:2-007A3
RECORDING REQUESTED BY
-U*d LWI KYLE CU MANY
AND WHEN RECORDED MAIL TO
WILLIAM 0. WILKINSON
38344 Poppett Canyon
Palm Desert, Calif 92260
NAT -30 (5-87)
MAIL TAX STATEMENTS TO
same as above
sE
s _
W 2
e
IL~{$ m
gal L
J
NO COR FILED
SPACE ABOVE THIS LINE FOR RECORDER'S USE
Individual Grant Deed
The undersigned grantor(s) declare(s):
Documentary transfer tax is $
aa ( �Kf computed on full value of property conveyed, or
( ) computed on full value less value of liens and enc mbrances remaining at time of sale.
( ) Unincorporated area: (.+J City of d"'Ou7w , and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
Edward E. Roseman. and Pearl E. Roseman , trustees of the Roseman family trust
dated 3-22-84
hereby GRANT(S) to John L. Hart, an unmarried man as to an undivided one half interest
and William 0. Wilkinson and Barbara L. Wilkinson, husband and wife as joint tenants,
as to an undivided one half interest, as tenants in common
the following described real property in the
County of Riverside , State of California:
Lot 23 Block 160 Santa Carmelita at Vale LaQuinta_, Unit No 16, as per
map recorded in book 18 page 99 of maps, in the office of the county
recorder of said county.
Dated: Tamm,-& 17, 19R9
STATE OF CALIFORNIA
COUNTY OF /i/J,�j c�.(. /� }SS.
On before
me, undersigne a Notary Public in nd fox said State,
personally a peared X
personally known to me or proved to me on the basis of sat-
isfactory evidence to be the person whose names -0. Q
subs 'b d to the within instrument and acknowledged
that executed the same.
WITNESS hand and official seal.
Signature CQ7 G/L1
Title Order No
Edward E. Roseman, trustee /
Pear]. E. Roseman , trustee
OFFICIAL SEAL
ROCIO ESCOBAR
om NOTARY PUBLIC . CALIFORNIA
PRINCIPAL OFFICE IN
LOS ANGELES COUNTY
(This area for official notarial seal)
Escrow or Loan No.
MAIL TAX STATEMENTS AS DIRECTED ABOVE
COACHELLA VALLEY WATER DISTRICT
CASH RECEIPT DETAIL
Received Fro
r
Address:
Account No.L'
Loot(.)
7• a
Service Address
Cash
❑ Meter(s)
t•,}. S
f
❑ Service(s)
❑ Backflow(s)
❑. House Lateral(s)
❑ DetectorCheck(s)
❑ Meter Surcharge
anitation Capacity Charge
❑ W.S.B.F.C.
❑ Temporary Construction Meter
❑ Turn on Charge
❑ Uncollected Account - Name
❑ Inspection Fee -Tract -
Fee -
❑� Plan Check Fees Water I Sewer -
Tract -
❑ Bond Payment - A.D. - Bond
Assmt.
❑ Customer Deposit
❑ Other
1�ffjird
/ j 1
Remarks:
❑Copy to:
Cash
t•,}. S
f
�`
M ; 34643
�/nntp. /O-
— { Tract "
G.A. Code
TOTAL $
Water Service /
•.� Cashier
CVWD-438 (11189)
?.Z' - � .. ;t+�. , ar-ti.,. ,..�. •, as : r
COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH Aseseam Pw f4m
ENVIRONMENTAL SERVICES DIVISION
AIPERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM
Applicant: Submit this form with four copies of a scaled'piot plan (1-20 scale) drawn to County speculations as indicated on the attached check II9L
A non-refundable filing fee (see below) is required when the application is submitted. Check must be made payable to the County of
Riverside. Approval of this application shall remain valid for a period not to exceed one year from date of approval.
VERIFY ITEMS IN SECTION A FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG #�
Agent, Contractor, Contact Person Phone Address & Firm
, ,
Me va
O;hww , r k PhonB " L 13 Mailing Address
ttY State Zip M, Property Address Legal Deet ' tion Prop. (PTract, Lot)
� �611,Vr r
Lot Sae ter Agency I Use of Permit P/P, CU, etc. Q QIGc•�i+� Other; - *
t�,�
f
SO 1Qf% O�"Z�Il
� • sill , Bt .la�
Signature of Applicant
Date
��'' CATEGORY: REV CODE FEE
CATEGORY: REV CODE FEE
/SUB
mSURFACE DISPOSAL 1238 •=!,
, " 0 SITE EVALUATION UPON REQUEST 7349 $ 43.00
❑ MULTIPLE PARCELS WITHIN SAME
(NO PLOT PLAN)
LAND DIVISION
O•, SEWER/SEPTIC VERIFICATION 7348 $ 17.00
a. 1 st 4 Parcels (Each) 1238 $ 57.00
(4ess than 1 year)
b. Each Parcel after 4 7344 $ 24.00
❑ PRELIMINARY ELECTIVE 7352 $ 23.00
❑ Rereview (2nd review same parcel) 7344 $ 24.00
EVALUATION (Attach DOH SAN 53)
❑ Site Evaluation in Conjunction with
❑ HOLDING TANK 7351 $ 47.00
Critical Area 7346 $111.00
❑ ALTERNATIVE/EXPERIMENTAL 7345 $222.00
❑ Site Evaluation Lot Lees than
SYSTEM
10,,000 Sq. Ft. 7347 $ 87.00
NIT DATE
/Np
Holding Tank Agreements Completed ❑ Yes
Certification of Existing S.D. System Required ❑ Yes
WQCB Clearance required. (Attach Form ❑Yes No
DOH SAN 007, Santa Ana Region Only)
Solis Percolation Report Required. ❑ Yea /No""
Special Feasibility Boring Report Required. ❑ Yes
Detailed Contour Plot Plans Required (1 to 5 R interval) ; ❑ Yes
Other ❑ Yes
Staff Specialist Lot Inspection Required ❑ Yes NoLot
Inspection Date
Solis boring report'!�y ""— Project Data
Soils Map Page STyp Approved byDate —
No. of Systeme
Typtof System(s)
No. Dwelling Unite (f)
(1) Septi: Tank
. Greae/Sand
�Tank
Bedrooms
qO Repaoerrwm
Gal4,A114
zowL
Leach Line SQ• Ft
Sidewall allowance
Inata _ Une(s) It long wide w11
f Bed sq. tL
trench area
R R
min. in Is„�bw drak>anes or
,r
t.
per running iL_'••,,,`-
J
—
f
Leachlinee/bed special design for slope:.
(3) PN Diameter
No. Pita
PN Below(TD)
Seepe�PN Total Depth
Applicabb
In (Ell)
Max. Albwab Depth
N/A Overburden factor
No. 2 System A11A
REMARKS:
This application i PROVED or the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated
on the accompan an, 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% expans' area.
�'
�L -.—
( Septic tank and sewer lines must be 50' minimum from any wells ()i to , --'P.c q
(29 Leach lines must be 100' minimum from any wells, including expansion a#sa
7��
(� Seepage pits must be 1 minimum frrom%any wells, including expansion area /fQ
70
Signature of Health Official ' . Date _17Q
L
RECEIPT NO. 07 7 Issued By `" " Date / ' 3 90 r
DISTRICT: ❑ Riverside, CF r1 ❑ Hemet Q Perris ❑ Rancho Calif. ❑ Blythe r
DOH -SAN -122 (Rev. 3M) DISTRIBUTION: WHfTE - Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records
tats 7
�+ r '�, OFFICE OF
s �(
AGRICULTURAL COMMISSIONER
° AND
WEIGHTS & MEASURES cnlvlN c. KnMINSICnS
JAMES O. WAUACE 4000 LEMON SIREEI. ROOM 19 AerNtontCommtntonm
AwkvlhnolCommbdoner RIVERSIDE. CALIFORNIA 92501 CLEMENT BENVENISIE
Oeeotw of Weights & Meawlel (714) 797.2561 seater
49613 Highway 86, Suite B12
Coachella, Ca. 92236
(619) 342-8291-•�,
CASE W.
Imo. EWPERI S %Il1MF't �ti1 £!/
ADDRESS. 7?• i ;;2 p
Dear Developers
After reviewing your landscaping plaits, all plant material listed is slot in
violation of quarantine -laws governing the Coachella Valley. If substitutions
j�I do occur and they differ fran plant material listed, this office tttust be notified'
• immediately.:
.11jank you for protecting and preserving the Coachella Valley's pest-free.environment.
Agr cultural Can ssione s OFf cue
ccs Indio and Riverside Office
(�I •
lit •i
t �t
:'■