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05453 (SFD)Building 52--230 „ A[I(frPSC � setbb-_ Edward S'. Archuleta Mailing Address a City Zip Tel. .La Quints 1 92253 Contractor Address el. State Lic. I City & Classif. Lic. # Arch.; Engr., Designer Address Tel. City Zip State , Lic. # P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section effect- 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 1 am exempt from the Contractors License Law for the following reason: (Sec. 7031.5,I3usinass and Professions Code: Any city or county which requires a permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such pemr@ 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 subiects the applicant to a civit penalty of not more Man five hundred dollars (5500). ❑ 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 Professions Code: The Contractors 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. 1/, however, the building or improvement is sok/ wllhir one year of completion, the owner -budder wig have the burden ofprovfng that he did not build or improve for the purpose of sate.) ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who burp or improves thereon, and who contracts for such protects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec B. 6 P.C. for this reason r - Date /t i .) Owner !/ ._• .n 'i : , 1,� .4. Y: . WORKERS' COMPENSATION DECLARATION I 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 (This section need not be completed ff the permit is for one hundred dollars ($100) valuation or less.) Icertify that in the perfomance 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. r— , Date owner s/ NOTICE TO APPLICANT: It. after mating this Certificate of Exemption you should become subiect 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.) Lenders Name Lenders Address This is abuilding permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I car ity 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 No. ®5453 JILDING: TYPE CONST. OCC: GRP. - P. Number 773-271--002 Legal Description Lot 21 Project Description Sint FINAL DATE INSPECTOR 3/8/89 Issued by: Date Permit Validated by: Validation: Sq. Ft. Size 1,785 No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $96.934-00 PERMIT AMOUNT " Plan Chk. Dep. 250.00 Plan Chk. Bal. 280.22 Const. 626.00 Mech. 53.53 Electrical 119.53 Plumbing 1.57.50 S.M.I. 6.79 Grading 20.00 Driveway Enc. 20.00 Infrastructure 2.162.76 TOTAL 1141/ REMARKS !ss, "if P a 40 s w5 L'.4 v!r✓{I .w. tv if+Y. r �. .s. w.r i . 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 3/8/89 Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ UNITS COLL. AREA //SETBACK Q( &AB GRADE LV- _ ROUGH PLUMB. YARD SPKLR SYSTEM 2ND FL. SQ. FT. HEATING (ROUGH) STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® DUCT WORK ROCK STORAGE GAR. SQ, FT. ® POWER OUTLET ROOF DRAINS METER LOOP HEATING (FINAL) DRAINAGE PIPING CAR P. SQ. FT. GAS (FINAL) WALL SQ. FT. DRINKING FOUNTAIN SQ FT ® WATER HEATER URINAL ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation WATER SYSTEM FLOOR DRAIN MECHANICAL FEES GRADING cu. yd. $ plus x$ WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED ©�G / D (� /a :7 _ /o%-� 1 I nn �D 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. SO. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ec HOUSE SEWER MESH 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 R AIR COND. SOLAR G — % UND PLUMBIN - 6 UNDERGROUND A.C. UNIT COLL. AREA //SETBACK Q( &AB GRADE LV- _ ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS ER OR SEPTI ROUGH WIRING DUCT WORK ROCK STORAGE REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. //FOUND. ,lAEINF. STEEL C t - GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM , / WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. 1 f FRAMING FINAL INSP. ROOFING -�Q ©�G / D (� /a :7 _ /o%-� 1 I nn �D REMARKS. VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR FIREWALL IGAR. t ( LATHING 3 !/ MESH INSULATIONISOUN _ _ EC FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL Desert Sands Unified School District *' CERTIFICATION OF PAYMENT NOTICE: 1 THIS DOCU6� �c� r BE DUa�sMxkkffL1�P 0T (Q'-:1 TO: City of La Quinta DATE: Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 This is to certify that developer of"4J which is located at - within this District, has paid school facilit fees imposed pursuant to the , authority generated by �Gpvernment god co3ering a total of ( ) industrial/comme; cial developmen this footage in this development may be issued by your jurisdiction. g3(/f '//4 or DESERT SANDS UNIFI D SCHOOL DISTRICT White - Building Department 9 Yellow - Facilities Planning • Pink - Accounting • Gold - Developer (10)-37 0 M v 7.. Parcel No. I COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH _assessors ENVIRONMENTAL HEALTH SERVICES 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 list 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. Q VERIFY ITEMS IN SECTION A FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG' Z O Agent, Contractor, Cgntact Person Pho Address &Phone 3e, ' 2�s�• &J - Owner k, I Phone . Mailing Address . �c ,Jr-.Ar.c -k ,n City State Zip Job Property Address Legal D nption Prop. (PM, Tract, Lot) EA Lot Size r Water Agent �JJ I>-.- Use of Permit P/P, CU, etc. E 15enlN 0 ^ ?_.Other It^� V W4 �c T A'S �Dwelli g; MH Site Prep, etc. (O} / % 2 1 —� 'v Signature of Applicant 1 Date CATEGORY: REV CODE • FEE CATEGORY: REV CODE FEE I34UBSURFACE DISPOSAL 1238 $45.00 ❑ SITE EVALUATION UPON REQUEST 7349 $42.00 ❑ MULTIPLE PARCELS WITHIN SAME (NO PLOT PLAN) m Z LAND DIVISION ❑ SEWER/SEPTIC VERIFICATION 7348 $11.00 p a. 1 at 4 Parcels (Each) 1238 $45.00 (Less than 1 year) H- b. Each Parcel after 4 7344 $16.00 ❑ PRELIMINARY ELECTIVE 7352 $45.00 W ❑ Rereview (2nd review same parcel) 7344 $16.00 EVALUATION.(Attach DOH SAN 53) V) ❑ Site Evaluation in Conjunction with ❑ HOLDING TANK 7351 $45.00 Critical Area 7346 $86.00 ❑ ALTERNATIVE/EXPERIMENTAL 7345 $132.00 ❑ Site Evaluation lot Less than SYSTEM 10,000 Sq. Ft. 7347 $86.00 INITIA DATE Holding Tank Agreements Completed ❑Yes l�} o R y - � " ` � ' � ,N" T Certification of Existing S.D. System Required ❑ Yes O N� �ro, f WOCB Cleauanoe required. (Attach Form ❑ Yes l<}°'No ! DOH SAN 007, Santa Ana Region Only) Soils Percolation Report Required. ❑ Yes No, or Special Feasibility Boring Report Required. ❑ Yes C3r, ,,• F' Detailed Contour Plot Plans Required (1 to 5 R interval) ❑ Yes m NNo-"1 ❑ Yes �, N. Other . Staff Specialist Lot Inspection Required ❑ Yea [T No Lot inspection Date Soils boring report by Project # Date Soils Map Page f r� Sol Type ✓' Approved by Date 'V �L ,72 U Z O No. of Systems ' Type of Systema) d Holding Tank ❑ Existing 0CNew O Replacement No. Dwelling Units Bedrooms, FixtU-M - (1) Septic Tank Soil Rate vpresse/Sand G'resse intrp , - , 11. AA • /k JC' f t�lfC! 7 l _ Gal e(2�L each Line Sq. Ft Sidewall allowance Install Line(s) R long -----it wide with *,._Leach Bed sq. it Bottom�trench areait '-'*•� rodV sq. R min. �-hld—wiock:helow drainlines or of bottom area per running it Leachlines/bed special design for slope: .. (3) Pit Diameter No. Pits Pt Below Seepage Pit Total Depth � /,v I Other ApPlloable �,,/ N/A factor - �� Inlet (BI) % A Max. Allw� Ie�Depth ___f --+°`Overburden No. 2 System IV14- REMARKS:! i .�.f -� l'';�P �h.,•:...�~/�,�a,/,/,�,,�`•-r;'7.� j/��o �-r-''.. .,���aar.�vt`.�'4*i. _ �z���r' ' / .�.d? �.s�,C .w t3 .�'l is !r' li,. f/f ,cam ''./f-• t�f..�• .�', r_�,..i.,� This application1s AP RO ED/D QP�for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated on the accompani plot Ian, using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the Z above -designed system. No construction is permitted in the required reserved 100% expansion area. Septic lines (t1) tank and sewer must be 50' minimum from any wells C� .LUL 2 Leach lines must be 100' .minimum from any wells, including ezpaifsion Seepage be 150' fro (3 pits must minimum any wells, including expansion area , r '. 21Date ' 'S inature of Health Official`Ih��i'► fi ,(/.�..^ c� RECEIPT NO. c1 f 0 Issued By -5/f' f Date DISTRICT: ❑ Riverside, 9O`Indro ❑ Hemet Q Perris ❑ Rancho Cal f. ❑ Blythe r' DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHRE - Office file YELLOW - Applicant PINK -Bldg. Dept GOLDENROD - Plans/Records �4 DAILY REPORT OF GRADING CONTROL SOIL and TESTING ENGINEERS INC. JOB LOCATION 141 4%1-t4 CLIENT OR -OWNER (FI),g1l1,,1,TO C,�r. O REPORT SEQUENCE NO. GENERAL LOCATION OF FILL �/ r{." ptlr+ PURPOSE OF FILL OR NATURE OF STRUCTURE TO BE SUPPORTED / It, c;.t /'F,,) DATE /1-!1- i - DAY OF WEEK !.(,,Fp GENERAL CONTRACTOR /IrrkIGTu GRADING OR EARTHWORK CONTRACTOR tl#rt.1/IG JOB ENGINEER r?lr, HRS. CHARGED 715' CONTRACTOR'S SHIFT CONTRACTOR'S SUPT. OR FORMAN ASSISTANTS HRS. CHARGED SOURCE & DESCRIPTION OF FILL MATERIAL & MAXIMUM DENSITY & M/C Sol c WEATHER APPROXIMATE YARDAGE PLACED THIS SHIFT TOTAL TO -DATE TEST NO. TEST LOCATION ELEVATION IN FEET COMP. CURVE NO. TEST MOISTURE % TEST DRY DENSITY LBS./CU. FT. RELATIVE COMP. % RETEST NO. NOTES LOT �Il.)n KcoiL %, u Z /17'( i SUPPLEMENTARY REPORT(DESCRIBE EQUIPMENT USED AND NUMBER OF ROLLER TRIPS.) FOR HAULING, SPREADING, WATERING, CONDITIONING & COMPACTING; ALSO REPORT THICKNESS OF LIFTS, AND '77� 'p -t !(�a•r• %Ic %) /�i rl7ic� c� i 47r rbc 11, 1 I1.. Y J r JOB NO. 7j ' s 13 i t! COPY SENT TO CLIENT CONTINUED ON NEXT PAGE PAGE ( OF 1� AUGUST 7, 1989. TO WHOM IT MAY CONCERN: RE: TRUSS ALTERATION AT FIREPLACE ED ARCHULETA RESIDENCE 52230 EISENHOWER DRIVE LAQUINTA, CA RECEIVED AUG - 71989 CITY Or LA QUINTA PLANNING & DEVELOPMENT DEPT, THE ALTERATIONS MADE TO THE TRUSSES AT THE FIRE PLACE, '-z" PLYWOOD ATTACHED TO TRUSSES AT FIELD TRIM LOCATION, IS IN ACCORDANCE TO THE TRUSS FABRICATORS INSTRUCTION AS PER FIELD MODIFICATION REQUIRED FOR FIREPLACE FRAMING. THE INDICATED MODIFICATIONS DO NOT REDUCE THE LOAD BEARING CAPACITY OF THE TRUSSES.BE OW THE REQUIRED DESIGN VALUES. SIGNED, TOM WHITE TRUSS,PLANT MANAGER A.C. HOUSTON LUMBER CO. THE A.C. HOUSTON. LUMBER Co. "Lumbermen Since 1884" 83-490 Indio Blvd./P.O. Box GG /Indio, California 92201/(714) 347-3692