NO PERMIT- •r 1 •• V 1r
>,.01AY
1
1 Building _ - u� #''s F`'B
Address
F- Owner 1 +
--� -- Clem G. + Davidson - - , -- -_--
Mailin
Address
3375 Vickers'-:kVe. _..
t.:City Y :,. zip _ r ' T -I. -
W-Tli 4
-P.O. BOX 4504
-47,' 578.105'CALLE EST
- 171i OUINTA; CALIFORP
BUILDIN
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Project.Description Santa Carnia to V
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IS City----; _ — - Zip - --- i- ; - Tel.:-
TOTAL
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11.1
1 -120-4638-
- CERTIFICATEOF EXEMPTION FROM
r WORKERS' COMPENSATION INSURANCE
I State Lic.'._ !
TYPE CONST.
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Size' ---134.8:__.. �—,Stories ----=� -:
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i Contractor F3y!1I �1:3:F+•L j -
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Project.Description Santa Carnia to V
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Address. +
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IS City----; _ — - Zip - --- i- ; - Tel.:-
TOTAL
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1 -120-4638-
- CERTIFICATEOF EXEMPTION FROM
r WORKERS' COMPENSATION INSURANCE
I State Lic.'._ !
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Size' ---134.8:__.. �—,Stories ----=� -:
I `Arch.; Engr.11�-
Designer :--
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? 41
Minlmtim Setback Distances:
l�
Cd�,c rc •nJi, -,-,v.-. -
No. Dw.
—Units -011e — pair- E) Demolition O -
L Address , $ i Tel. } t r _{ _ `
i e� 1, ,7 - # i ..714=830=1405—IJ 1,0
ity
Zip State
C
r 2691 Lic. # C. 5442
! ... _ LICENSED CONTRACTOR'S DECLARATION
1 I hereby affirm that I am licensed dpFDrovislon'a of Chapter 9 (commencing with Section ` f
7000) of D Isloh 3 of4he 9p fP s Code, and my license Is full to - * - - -- i--•-- • - -- - -
-I� a
i ---DATE' - -- i'
OWNER -BUILDER DECLARATION • _..-' :..,.. , .,,......_..
I hereby afflrfn that I am exempt from the Contrector's License Law for the. following Estimated Valuation --74
/! SG - -- --- -�
mason: (Sec. 7031.5,Business and Professkms Code: Any city or county which requbes a
permft ro construct, after, fmprove,.dsmollsh,.or repair,any structure, prior to ft issuance also _.. -__•�
�requ/res the applicant for such pemut to So a signed -statement that he Is licensed pursuant to _ _ .-y _ --.PERMIT----= -.� `�— - AMOUNT �.--�-
the provisions of the Contractor's License law, Chapter 9 (commencing with Section 7000) of 1-�T���J -
Division 3 of the Business and Professions Code, or that. he Is exempt therefrom, and the basis6v
--40r the staged exemption.vkmlcilon-of section 7031.5,.by--any,appilcanf-tor•-a-oemA--_.Plan.Chk. Dep.---."----.
th
subods e app�nt to a CIW penally of not more than Ove hundred do8ars.($500).
I{{{ ❑ I, as owner of the property, or my employees with wages as their sole compensation, will
i do the work, and the structure Is not Intended or offered for sale. (Sec. 7044, Bulsness and -
Professions Code: The Contractors License Lew does not apply to an owner of property who
1 builds or Improves thereon and who . does such work himself or through; his own employees-_
' provided that such improvements are not intended or offered for safe. ff, however, the buadig
• j or improvement Is.sold wfthl one year of completion, the owner-Du6der will have the burden 4C
• of proving that he did not bulld or improve for the purpose of eels.) ---_ -_y _,__,,,_•,-_
_
t: ,, • H • _ to
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Plan Chk: Bal. ¢
_
Const. i i
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-'Mach.--- ------`- -_---.-,,.
': Electrical ` • ` -1 cr i
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y :Plumbing
O I, as owner of the property, am exclusively contracting with licensed contractors to coo 3
' struct the project. (Sec: J044, Business and Prolesslons Code: The Contractor's License Law
--does not apply to an owner of property -Who bu8ds or improves thereon, and who contracts -tor --
--$.M.I: -�"�•" •�c_.-_
such projects wfth a cartrectdr(s) Ycensed pursuant to the Contractor's License Law.)
--0 1 am exempt unc)V Sec - - - A.'6 P.0 for this reason
3 -Grading i
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• I , WORKERS' COMPENSATION DECLARATION j
j I hereby"affinh that t have'a-certificate-of'tionsent"to-self=Insure, or a.certificate�f
-Worker's Compensafibir Insurance,`or a certified copy thereof. (Sec. 3800, Labor Code.)
. i---Policy No Company .: .
-
(=:2,575-Z' - --- -
Copy Is filed with the city. O Certified copy is hereby furnished.
TOTAL
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REMARKS
609182 16 2007 09-21-138 -13
- CERTIFICATEOF EXEMPTION FROM
r WORKERS' COMPENSATION INSURANCE
JO CASH -' 4 •'-1 1 •i• A L. -1 ---• �-' 2 7 5 -. 4DO �-- -
-..(limns section need not be completed If the pennft is for one hundred dolars (S100) veivation
or less.) -
I ____-1 certify that In.the performance of the work for.which.this permit is Issued, I shall riot
, ii - j°=" '-
' =any ppeerson In any manner so as to become subject to the Workers' Compensation
Laws of Calitomla
---"--'-"---•---'•`-
NOTICE. TO APPLICANT. 9, after.malrlg this. Certificate of -Exemption you should become
ZONE:
BY:_
i - subject to the Workers' Compensation provisions of the Labor Code, you must tofthwfth
comply wah such provisions or tius permit shail be deemed revoked.
Minlmtim Setback Distances:
Front Setback from Center Line -
Rear Setback from Rear -Prop. Line-
i
_.. CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
1 hereby affirm. that there Is a construction lending agency .for the performance of the
-work for which this`pernit is issued.'(Sec. 3087, CM Code.) ;
Side Setback from Property Line
' Lender's 'Name
Lender's Address }M
FINAL DATE
INSPECTOR
I This is a building permit when property filled out, signed and validated, and is subject to
expiration It work thereunder is suspended for 180 days. '
> -- -- - •- -
i A certify that I have read this application and state that the above information is correct
Issued by:
Date Permit
1 agree to comply with all tinny and county ordinances and elate Jews relating to building
hereby representatives wf -this' to the
j-_—�__...__ __ _ _.____.
--construction, and authorize city enter above.
mentioned property for inspeetlon purposes i
Validated by:
Signature of applicant Date
-.Mailing Address - - - - - -
-Validation:
City, State, Zip
BUILDING DIVISION
�r p, 16-71,
WIKE of
AGI(ICUL I URAL_ CU;MMISSIONER
nyu
kVI:IGI I US & IAEASURES
49-613 Ilwy 06, 3ulte I1-12
Conchelln, CA 92236
619-34t-8291
E. LEON SPAUGY
co•.ttin` �ar..En
)AMES O WALLACE
�SS�Sta�t rg•t•.ut41p`EP
CLEMENT E1E`vEvIS1E
SL{ttn
VNEE 9- 2/- 9k CASE IU. %' 88/Z� 0 9 -Z L3
nuUltEsst 3 3 ?S' ka, .
7/20
TUEPI 101,M t 2`10 - 7 / 2
Dear Developers
After reviewing your landscaping plans, 111 plant mterial listed is not in
violation of quarantine laws governing the Coachella Valley. If substitutions
do occur and they differ iron plant material listed, this office must- be notified
bur-diately. .
Thank you [:or protecting and preserving the Coachella Valley's pest -free envirolnnent.
Agricultural Commiss%one UL[ice
ccs Indio and Riverside office
SEP 2 1 1988
CITY OF LA QUINTA
PLANNING & DEVELOPMENT DEPT.
44
James C. Fivash
Land Surveyor
P. O. Box 1130 Indio, CA 92202
619/346-3342
CLIENT L D& V ZON JOB NO. 3___—___
L D7'' !O_8.4�4 l'�9B S.i4�T_� SHT. � OF._
C,4,f MEC/TA RTyAta t4 DATE LL�Z���
00
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CALL&;7 ENsE
N/a DA
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NB9-5�>' 52"VV
O = 5ET 3 141P-?P4.UG 4-S4Q7-0
3"A M E-:5 C. F t v� S N LS 44w
Pi-,q,r or' 5OR ve y
L67T /o BLOCK— 90
R/VC�s1�E cov�vey
MRP 0001c- /8 PA6E75:
m
0
CLIENT L D& V ZON JOB NO. 3___—___
L D7'' !O_8.4�4 l'�9B S.i4�T_� SHT. � OF._
C,4,f MEC/TA RTyAta t4 DATE LL�Z���
00
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CALL&;7 ENsE
N/a DA
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O = 5ET 3 141P-?P4.UG 4-S4Q7-0
3"A M E-:5 C. F t v� S N LS 44w
Pi-,q,r or' 5OR ve y
L67T /o BLOCK— 90
R/VC�s1�E cov�vey
MRP 0001c- /8 PA6E75:
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COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH Assessors Parcel No.
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 checklist.
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 & Phone
"
VA
Owner �,
Phone
Mailing Address 11
AW, '5<� / Aid , 9—
City
city
State
Zip
Job Property Address
Legal D ription Prop. (PM, Tract, Lot)
a�A
�
En/ u/
�-` ° D — 6/, 26
Lot Size
Water Agency eN
Use off Permit PP/P, CU, etc.
'CJC X5c'—C
Other X
t C
CSCLl.c �/
.S%0/ /00
Dwelling, MH Siteprep, etc.
Signature of Applicant
Date
CATEGORY: REV CODE FE
CATEGOR=Y.:.__ % REV CODE FEE
CY SUBSURFACE DISPOSAL 1238 $45.00
❑ SITE EVALUATION UPON REQUEST 7349 $42.00
❑ MULTIPLE PARCELS WITHIN SAME
(NO PLOT PLAN)
LAND DIVISION
❑ SEWER/SEPTIC VERIFICATION 7348 $11.00
a. 1st 4 Parcels (Each) 1238 $45.00
(Less than 1 year)
b. Each Parcel after 4 7344 $16.00
❑ PRELIMINARY ELECTIVE 7352 $45.00
❑ Rereview (2nd review same parcel) 7344 $16.00
EVALUATION (Attach DOH SAN 53)
❑ 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
I NITIA� DATE
Holding Tank Agreements Completed ❑ Yes m No 2,0
Certification of Existing S.D. System Required ❑Yes No,
;�
WQCB Clearance required. (Attach Form ❑ Yes No
DOH SAN 007, Santa Ana Region Only)
Soils Percolation Report Required. ❑ Yes 12/N'
Special Feasibility Boring Report Required. ❑ Yes P N
Detailed Contour Plot Plans Required (1 to 5 ft. interval) ❑ Yes
Other ❑ YesO'Nd
Staff Specialist Lot Inspection Required ❑ Yes No
Lot Inspection Date
Soils boring report by Project # Date
Soils Map Page f Soil Type Approved by Date
,
No. of Systems
Typ6lof System(s)
No. Dwelling Units (/
(1) Septic Tank
Soil Rate
Grease/Sand
❑ HH�AAlding Tank ❑ Existing
19�'New ❑Replacement
Bedrooms, Fixture Units
/,('
/�jtG�
t;�
a Intcp
AAw
� ,vLi�ne((ssi)
!y
(2,Leach Line Sq. FL
trench
Sidewall allowance
Install tt. long ,ft wide with
ac h Bed sq. ft
Bono area
ft mak/ sq. ft
min. inches below drainlines or
of botto rea
per running ft.
Leachlines/bed special design for slope:
(3) Pit Diameter
No. Pits
Pit Below
Seepage Pit Totpl Depth
�''��
Otho
Applicable
1
6//
�
Inlet (BU
AllgSable
N/A Overburden factor
Max. Depth
t��LL
No. 2 System jtt/A
REMARKS: YY^��►- �o7JI o CGv-�4 c O>r Q,c ¢�
This application i PPROVED . ED for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated
on the accompanied p o p 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% expansion area. n ,�
(1) Septic tank and sewer lines must be 50' minimum from any well/Q
Leach lines must be 100' minimum from any wells, including expansio/1 ar
(3) Seepage pits must be 1' 0' mmlmum from an. wells, including expansion area
Sao
.Signature of Health Official/,y��.,:� ate
V
RECEIPT NO. qo1 4 Issued By �""r'�F Date �r `� Q �0O
DISTRICT: ❑ Riverside,Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe
DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file YELLOW -Applicant PINK - Bldg. Dept. GOLDENROD - Plans/Records
i
a
Desert Sands Unified School District
N011CCERTIFICATION OF PAYMENT
.:'-SCHOOL '#AC%I."IvTYl FEES
IND
TO: City of La Quinta DATE:
Department of Community Development
78-105 Calle Estado
La Quinta, CA 92253
This is to certify that 107th
developer of which is
located at 3 Q� �a within
this District, has paid school facility fees imposed pursuant to the
author't a era d by overnme t Code ecti tt 5 80 in the amount. f
covering a total of ware feet f ( ) residential or
( ) industrial/commercial development and that building permits for
this footage in this development may now be issued by your jurisdiction.
y coI
X_60
for DESERT ANDS UNIFIED SCHOOL DISTRICT
White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer
(10)-37