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002820 (SFD)4 P.O. BOX 1504 No. - 002820 Building 53-5135 1 vemicaa Nexrema78-105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Owner .. J '£ Job—aim Mailing ' Address CityZip Tel. Contractor Address . Sit City" '- Zip Sam State Lic. & Classif. Arch:, Engr., Designer el. - City Lic. # BUILDING: TYPE CONST. • OCC. GRP. A.P. Number 774-123.013 Legal Description Project Description _13 WG 1350 Vt. 2( Sq. Ft. �s R 552 No. Size _ Stories ' New a AddI10 Alter ❑ No. Dw. Units Repair ❑ Demolition ❑ Address Tel. City Zip State l l Lic. # 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. _ SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation w�emolish, i reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires' a ' J�p��.�Q permit to construct, alter, improve, dor 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 .-PERMIT - -• Y AMOUNT. I the provisions of the Contractor's License Law, Chapter 9 (commencing with Section. 7000) of - ` I Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis Any Section 7031.5 'any for Chk. Dep. 250.00 for the alleged exemption. violation of by applicant a permit i subjects the applicant to a civil penalty of not*more than live hundred dollars (8500). .Plan Plan Chk. Bal. ❑ 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 Const. 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, Mech.. 361311) 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 Electrical - i4..50 of proving that he did not build or improve for the purpose of sale.) .' ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing Se t+� tits 103-.00 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 S.M.I. JsKs. - such projects with a contractor(s) licensed pursuant to the Contractor's License -Law.) Gradingi.t{� ❑ 1 am exempt under Sec. B. & P.C. for this reason Driveway Enc. 20.00 I Date Owner ` r`• N Infrastructure 11084.65 f 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 0 Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL�C�.T CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars (8100) valuation - or less.) - - I certify that in the performance of the 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 ZONE: BY: subject to the' Workers' Compensation provisions of the Lab;Dr Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. - Minimum Setback Distances: - Front Setback from Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center'Line 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.) Side Setback from Property Line Lender's Name Lender's Address FINAL DATE—INSPECTOR 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. _.Issued by: Date Permit 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. Validated by: Signature of applicant �� Date f - Mailing Address ) ` r ; Validation: City, State, Zip 1 _ A70�),. 12.l, 31 I %6.l•28 Ck HARD COPY T CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS A.C. UNIT COLL. AREA YARD SPKLR SYSTEM 2ND FL. SQ. FT. ® GH PLUMB. //tl g77 BONDING MOBILEHOME SVC. BAR SINK POR. SQ. FT. p FORMS GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS DUCT WORK DRAINAGE PIPING CAR P. SO. FT. ® GAS (ROUGH) WALL SQ. FT. @ METER LOOP DRINKING FOUNTAIN SO. FT. ® OTHER APP.IEQUIP. URINAL ESTIMATED CONSTRUCTION VALUATION $ GAS (FINAL) WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES GROUT WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. 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,TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. ®c BATH TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/4c HOUSE SEWER PELECT. GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE GH PLUMB. //tl g77 BONDING HEATING (ROUGH) STORAGE TANK FORMS EWER OR SEPTIC TANK H WIRING 'I /� DUCT WORK ROCK STORAGE FOUND. REINF, GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM $ GRADING cu. yd. plus x$ _$ UMBER GR. FI L INSP. 1 NG 5 �� FINAL INSP. ROOFING .12 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL / LATHING MESH VINSULATIONISOUND J FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS, GARDEN WALL FINAL xNf1ECoIS- S 2 `\W %o Desert Sands Unified School District y BERMUDA DUNES r RANCHO MIRAGE 82-879 HIGHWAY 111 0, INDIO, CALIFORNIA 92201-5678 • 1619) 347-8631 INDIAN WELLS H PALM DESERT a December 30, 1986 JP LA OUINTA INDIO y� * City of La Quinta Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 Re: Lot 5, Block 230, Unit 22, Santa Carmelita at Vale Gentlemen: The developer of the above referenced project has mitigated its impacts on our overcrowded schools by payment of the amount of.$628 per unit. This amount.is to be applied to the cost of additional district educational.'facilities made necessary by such new development. Sincerely, John D. BroWeerntendent Assistan Businesst S ry By: JDB/vmm Kicnara ri. becx Facilities Planner * This certification of payment of developer fees is valid for issuance of building permits only up to and including December 31, 1986. RECORDING REQUESTED BY TND WHEN RECORDED MAIL THIS DEED AND. UNLESS OTHER - ISE .SHOWN BELOW. MAIL TAX STATEMENTS TO: NAwE Jerry L. Johnson C713oRESS Paulette M. Johnson CITY e P.O. BOX 1091 STA YE zip L Idyllwild, Ca. 92349 Title Order No. 1-��00':�o Escrow No. l e5—( o,2--4 , CID 0 CID» 0 ooLIDI ( aC U co o w Ul c-•- m u �� �' � 7 ct a w p L f y Q d _ y c- . L0 WA L a j E U� i 0 C rJ aCc Cq ,W uj v 0 u� pec I iLt tea 1. SPACE ABOVE THIS LINE FOR RECORDER'S USE GRANT DEED (�96 The undersigned declares that the documentary transfer tax is 9.............................:....................................._........._.... and is ® computed on the full value of the interest or property conveyed, or is computed on the full value less the value of liens or encumbrances remaining thereon at the time of sale. The land, tenements or realty is located in ❑ unincorporated area ❑ city of.................................................................................................... and FOR A VALUABLE CONSIDERATION, ,receipt of which is hereby acknowledged, LUDIWG KOLM , a widower hereby GRANT(S) to JERRY L. JOHNSON and PAULETTE M. JOHNSON, husband and wife as joint tenants the follo%%•in; described real property in the City of La Quinta county of Riverside ; state of California: Lot 1, Block 230 of Santa Carmelita Unit #22 as per map there recorded in the Office of the Recorder of Riverside County at page 24 of book 20 of maps. Dated October 08, 1986 LUDWIG KOLM I— STATE OF CALIFORNIA SS. COUNTY OF On this the day of _1)_.\.=,LLQ.Q �K./� Notary Public in and for said County and State, personally appeared __b—c- yK u ___Ludwia_.._Koln personally known to me or proved to me on the basis of satisfactory evidence to be. the person-_ whose name —i.s- subscribed to the within instrument and acknowledged that _he_- executed the same. '1 T I / N. Signature of Notary 19 -C -A-9, before me the undersigned, a FOR NOTARY SEAL OR STAMP MAIL 'rAX STATEMENTS TO PARTY SHOWN' ON FOLLOW'iNG LINE: IF NO PAR'n,' SO SHOVIN. MAIL. AS DIRE(:TED ARO\"F: Name, Street Address CAL -1 (Rev. 8-82) City S State OFrICIA , SE-AL� ,:,� '(;"•, :;�1 TAMARA SU(: i,i Ei'IT ' (.;• ,�z t.;OT�,f�'r PUS! tr_ - ::.�...�.... ..-� ^. e;:r!re AUG i,;, l: Assessor's Parcel 'No. . ....... ............................ MAIL 'rAX STATEMENTS TO PARTY SHOWN' ON FOLLOW'iNG LINE: IF NO PAR'n,' SO SHOVIN. MAIL. AS DIRE(:TED ARO\"F: Name, Street Address CAL -1 (Rev. 8-82) City S State i� z O f— U w U) Z O F_ U Ilf U) Y Q W Cr X ry.ftll r l 5- "'rAt`i�'t—2 COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION p ! X7q - F7 '� - PERMIT APPLICATION FORA SUBSURFACE SEWAGE DISPOSAL SYSTEM Applicant: Submit this form with four copies of a scaled plot plan (1.20 scale) drawn to County specifications required on the attached check list. A non-refundable filing fee of $37 is required when the application is submitted. Check must be made payable to the County of Riverside. ,1o. ter Building Department Application Log # Name (Owner, Agent, Contractor, Etc.) Mailing Address it City State Zip Code Telephone % `Job Property Address 'City or Community ;-Legal Description of Property. (Lot, PM, TR)— ),.t 1 J )n.. i'I ', r4 f, i it f -ti': �.`-l< , .r1 I � -2— 'Assessor's Parcel No. Water Agency or Well Lot Size use of PermitPla ]Ring Case b SFO, MH Site Preparation Etc. r Signature of Applicant ( Date - 'The above information must be verified from Building Application STAFF USE DO NOT WRITE BELOW THIS LINE Initial Date Certification of Existing S.D. System required. ❑ Yes © No WQCB Clearance required. ❑ Yes 4 No 1 Soils feasibility report required. ❑ Yes © No _ Detailed boring report required. ❑ Yes L9 No Detailed contour plot plans required. ❑ Yes ❑ No Staff Specialist approval required. ❑ Yes d No Lot Inspection Date Soils/boring report by b -Y\ �� Project # Date Soils Map Page Soil Type Approved by Date Type of System: No. of Bedrooms (1) Septic Tank Soil Rate Required ❑ Existing 2 New . ❑ Additional ❑ Replacement �� ",%L M (AX � Gals. `� 5a (2) Leach line sq. ft.Sidewall allowance ZSq. Install Line(s) Ft. Long, Leach bed Sq (Bottom trench area` ft. rock/ Ft. Ft. wide with min. inches Ft. of bolt running ft. ❑/N/A rock below drain lines area ,f per Leach lines/bed-special designrfor slope: (3) Pit Diameter ' No. Pits Pit BI t Seepage Pit total depth t r Applicable ❑ 5' E] 6' f �ci Max. allowable depth N/A Overburden factor 1 t\nCk > V'' Cl VX i U v / t X�w t ,,, S fit \,, Ct This application is,,aapprovdd/denied for the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements set forth in Section B above. A building permit is necessary for the installation of the above -designed system. Q-1,)) Septic tank and sewer lines must be 50' from any wells (2) Leach lines must be 100' min. from any wells including expansion area 1 (3) Seepage pits mu'tst be 150' min. from any wells including expansion areaw: �. - \U -4,0— A \\QIL 1 2 - Signature of Health Official Date ' RECEIPT NO. } ` C . I District: ❑ Riverside Indio Distribution: WHITE—Office file DOH -SAN -122 (Rev. 6/86) Issued by ❑ Hemet ❑ Perris ❑ Rancho Calif YELLOW—Applicant PINK—Bldg. Dept. L-. 1 k- �, t ❑ Blythe GOLDENROD—Pending File -,-I ( 301 oaf,