08059 (SFD)Building
Owner
•4 614
P.O. BOX 1504 L N o .
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253,
Address VO Box 804
City Zip Tel.
La Quinta 92253
Contractor
Address
Zip I Tel.
State Lic.I City
& Classif. Lic. #
Arch., Engr.,
Designer
Address Tel.
CityI Zip I State I
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
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 that. he 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).
❑ 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, Bussness 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.)
O 1, 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 contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date Owner P, J
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. O 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 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: 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
BUILDING: TYPE CONST. OCC. GRP
A.P. Number 773-091-019
Legal Description Lot 7
Project Description Single Family 9w_111n%
Sq. Ft. 14m
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
25000
Plan Chk. Bal.
174-73
Const.
Mech.
Ing A
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
9A fA
Infrastructure
Arra 0
0 I"
TOTAL
11 0472,i11.222,64
REMARKS
pp -31W Ap y �
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 511190 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE6 �/ �®
2ND FL. SO. FT.
ROU,2 PLUMB. BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. I SO. FT.
DRAINAGE PIPING
WALL SO. FT. ®
OTHER APPJEOUIP.
DRINKING FOUNTAIN. '
SO FT ®
GAS (FINAL) TEMP. POLE 6 O
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN t EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
ROOFINGREMARKS:
Qv
VENTILATION
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
CERT. OCC.
GAS PIPING
PERMIT FEE
PERMIT FEE Ed
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 GOND. SOLAR
SETBACK L,
GROUND PLUMBIN�Q UNDERGROUND
A.C. UNIT
COLL, AREA
SLAB GRADE6 �/ �®
ROU,2 PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
4azc SEPTIC TANK ROUGH WIRING.
DUCT WORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH) METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL) TEMP. POLE 6 O
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
FINAL INSP. $
GRADING
cu. yd.
plus x$
=$
LUMBER GR.
FRAMING ��
ROOFINGREMARKS:
Qv
VENTILATION
d l,�2A/' ��/ /9d 7/A
�-7
LJ
�j /�J�
Y� /' "" 0
C
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
��i�/
LATHING.i�j�/
MESH
INSULATION/SOUN
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
•-
..1
GARDEN WALL FINAL
Escrow
..Kr ...... ........................-.Number.
RECORDING REQUESTED BY
.............•-•---------....................------.................._....------.........
WHEN RECORDED. PLEASE MAIL TO
Palm Desert National Bank
73--745...E1 ... Pa.s.e.Q... - ... -
Pa...... s x.t C.a..... 9.,2260.............................
Attention :-E.M..-.-.S.e.ikel.,.___Vic.e._Eresid en.t
SPACE ABOVE THIS LINE FOR RECORDER'S USE
CONSTRUCTION
Deed .of Trust
With Assignment of Renta
THIS DEED OF TRUST, made this..�_2.3zd_______-_.--___._�daY af___ _i�ay__ ..................................... . 19 0---,
bet ween_Ronald L. Ford.._and_ Rena- R, Fordz husband_and._wife___aa--- j_Qi)t... tenaaits..as--- to ... am...........
undivided 1/2.interest and
JEFFREY S.. QqI )I N� a single man-,---as_-to_-Vin__-und y de_d�_/2�nt_ere.st........................... as TRUSTOR
------------------••------ ,
whose address is ------ ...... Ca. ....9.2253 ...........................................
(Number and"Street) (City) (State)
E1 Paseo Financial IriC: , a California corporation, as TRUSTEE, and
Palm Desert National Bank, a National Association, as BENEFICIARY,
WITNESSETH: That Trustor irrevocably GRANTS, TRANSFERS and ASSIGNS to TRUSTEE IN TRUST,
WITH POWER OF SALE, the property in ..... River-tilde...............................................County, California, described as:
Lot 7 in Block 139 of Santa Carmelita at Vale La Quinta, Unit No. 14,
as shown by Map on file in book 18, pages 82 and 83, of Maps, Records
of Riverside County, California.
including all appurtenances, all easements used in connection therewith, all water and water rights (whether riparian, appropriative, or other-
wise, and whether or not appurtenant) used in connection therewith, all shares of stock evidencing the same, pumping stations, engines,
machinery, and pipes, TOGETHER WITH the rents, issues and profits thereof, SUBJECT, HOWEVER, to the assignment, as hereinafter
set out, to Beneficiary of the rents, issues and profits; and also including as part of said property all fixtures and equipment now or hereafter
thereto attached or thereon situated and intended or designed for use*in connection therewith.
FOR THE PURPOSE OF SECURING (1) Payment of the sum of 78 OOO OO with interest thereon according to the
terms of a promissory note or notes of even date herewith,
made by Trustor, payable to order of Beneficiary, and extensions or renewals thereof;. (2) Performance of each agreement of Trustor herein
contained; (3) Payment hof ."' and all, obligations now or hereafter owing from any Trustor hereunder to Beneficiary and secured by
REA
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COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH Ase.sam PaW01 No.
ENVIRONMENTAL SERVICES DIVISION
PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM
Applicant: Submit this form.with-four copies of a scaled plot plan (1-20 scale) drawn to County speculations as indicated on the attached check Ilai
A non-refundable filing fee (see below) is required when the application is submitted. Check must be made payable to the County of
M�f"d Appnov cof this application shall remain valid for a period not to exceed one year from date of approval.
VERIFY ITEMSVN SECTION A FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG #
iikwtiContractkx Cont�cttiy"---n
�
Phone
Address & Firm s a
EF • s R
i .7
li A &t!!r l�lA all FMC�M
Owner /
Phone
Mailing Address
City
a
Zip
Job Property Address
Legal Description Prop. (PM, TractkLot) S
Lot Size,/
Water Agency/Well
Use of Pe it P/P, CU, etc.
U
Other
C ► �i ` r
Jct/• 5 ba
Dwelli H Site Prep, etc.f
/��%�
i�'l'N rg .. � N • � _514- � do
14142
r- Date
Signature of Applicant
. CATEGORY: REV CODE
CATEGORY: REV CODE FEE
�17C SUBSURFACE DISPOSAL 1238 $ 57.00
❑ SITE EVALUATION UPON REOUEST 7349 $ 43.00
Cl MULTIPLE PARCELS WITHIN SAME
(NO PLOT PLAN) r
LAND DIVISION
❑ SEWER/SEPTIC VERIFICATION 7348 $ 17.00
a 1 at 4 Parcels (Each) 1238 $ 57.00
(Less 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 Less than
SYSTEM
10,000 Sq. Ft. 7347 $ 87.00
INITIAL DATE
Holding Tank Agreements Completed ❑ Yes No '1A
Certification of Existing S.D. System Required ❑ Yes O No
;
WOCB Clearance required. (Attach Form ❑ Yes No
DOH SAN 007, Santa Ana Region Only)
Soils Percolation Report Required. ❑ Yes No
Special Feasibility Boring Report Required. ❑ Yes .No
Detailed Contour Plot Plans Required (1 to 5 fl. interval) ❑ Yes No
Otter ❑ Yes No
Staff Specialist Lot Inspection Required ❑ Yes No
Lot Inspection Deme
r;
Sills boring report by Ile Project f< Data
Soils Map Page w Sol Type Approved by - 124.AQ Dame
No. of Systams
Type of Systexn(s)
No. Dwelling Units
(1) Septic Tank
Soil Rate
Greasepro
[I Holding Tank ❑ Existing
Bedrooms, Fixture Unita
G nlrp
5k'New ❑ Replecernent
7/K`U/OOW,•i�+lydt
Loco Gal
/
rne�� P z a%
Gd
(2) Leech41. Ft
Bottom area
Sidewall
q• fi•
Install Lines) K long with
r6d/c
min. indLbabes drekrl'mes�o
Leach Bed_per
d area
per rur)n ng ft
❑ NA
/ /
i �fal desig or slope:
(3) Pit Diameter
No. Pita
Pit Below
Inlet (&)
Seepage Pi! Total Depth
(TD)rden
.
7-
Max. Allowable Depth
N5_factor
❑ 5 ;R1 6
/
`,O,
7
No. 2 System
REMARKS:
if.
This application i APPROVED ENIED for the
app �'�/ category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated
on the accompany "t"T3 n, 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% expansion area.
Septic tank and sewer lines must be 50' minimum from any wells
(2) Leach lines must be 100' minimum from any wells, including expansion area
40 Seepage pits must bee 15/0' minimum from any wells, including area
{expansion
Signature of Health Official '%rllUl��' /1 /l1/.LCGt l �'1 /s c �7 L!l Date 3 91
RECEIPT NO. Issued By�g 4l&LL4. Date S qZ2_
i9.0.
DISTRICT: ❑ Riverside, OC Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe
DOH -SAN -122 (Rev,. 3190)
DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept. GOLDENROD - Plans/Records
' e�. �``•, OFFICE OF
AGRICULTURAL COMMISSIONER
• AND
WEIGHTS & MEASURES CALVIN C. KAMINSKAS
JAMES O. WALLACE 4080 LEMON STREET, ROOM 19 AssIslant Commissloner
AgrWhnal CommIssioner RIVERSIDE, CALIFORNIA 92501 CLEMENT BENVENISTE.
Dlreotar of Weights & Measures Sealer
. (714) 787.2561
49613 Highway 86, Suite B12
Coachella, Ca. 92236
DATE � ®2 9lqo (619) 342-91
DATE
DEVELOPER'S NAME: -1�4)myu) d
ADDRESS: "dowhAPT( ►
TELEPHONE: (4111) -
Dear Developer:
After reviewing your landscaping plans, all plant material listed is not in
violation of quarantine laws governing the Coachella Valley. If substitutions
do occur and they differ frau plant material listed, this office must be notified "
immediately.
Thank you for protecting and preserving
the Coachella Valley's pest -free environment.
Agricultural Caimis ner's Office
cc: Indio and Riverside Office
u4 ,
! ^111
lr
T,dT
"
78-105 CALLE ESTADO — LA QUINTA, CALIFORNIA 92253 - (619) 564-2246
FAX (619) 564-5617 -
August 20, 1991
To Whom It May Concern:
The structure located at 51-385 Avenida Eisenhower is now located
in a "X" flood zone per the revised F.I.R.M. (panels 060709 0005B)
forLa Quinta. This change became effective August 19, 1991.
IL you have any questions, feel free to contact me.
/Sincerely,
B G AND AAFE
Tom Hartung
Director of Building and Safety
TH/es
LTRTH30
MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253