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003437 (SFD)` Building If Address Owner Mailing Address City Palm Contractor Address P.O. BOX 1504 78-105 CALLE ESTADO 52-565 Eiseht.=ar LA QUINTA, CALIFORNIA 92253 Coachella Valley Land Co. 247 E. Tahquitwz Way 02 Zip Tel. pzings - 92262 • .322-.1C20 No. 003437 BUILDING: TYPE CONST.- OCC'.-GRP.-- A.P. CC:GRP...A.P. Number- • • 773-295--017 Legal Description yProject Description Plan A Sinals, r ST ilV Mg. Q4UAUt; City Zip Tel." subject to the Workers' Compensation provisions of the Labor Code, you must "forthwith comply with such provisions or this permit shall be deemed revoked. Minimum Setback Distances: ' Front Setback from Center Line State Lic. City Side Street Setback from Center Line & Classif. 387934 Lic. # 895 Sq. Ft. 1410 No. No. Dw. Side Setback from Property Line Size Stories Units Lender's Address 'This FINAL DATE Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. / p,7Permit read application and state that the above information incorrect. Issued. by: Date 1 agree, to comply with all city and county ordinances and state laws relating to building City Zip State - Lic. # Validated by: 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 Validation: effect. j d-) at✓' .+' :r_.i� +% C'rr SIGNATURE.- _ - DATE OWNEWBUILDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following �.-�� 441 • reason'' (Sec. 7031.5,Business and Professions Code: Any city or county which requires a t 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 • -PERMIT. AMOUNT - the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of -r ' Divisiiin 3 of the Business and Professions Code• or that. he is exempt therefrom, and the basis for the Any Section 7031.5- 'any for Plan Cihk. Dep.-^,�r7,(� alleged exemption. violation or by applicant a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). Plan Chk.. Bal. - - - - - ❑ I, as owner of the property, or my employees with wages as their sole compensation, will Zp t A 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 andwho does such work himself or through his own employees, Mech.' " provided that such improvements are not intended or offered for sale. If, however, the building. 4 - inn or. improvement is sold within one year of completion, the owner -builder will have the burden Electrical 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 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. 1. - •a - such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading ❑ I am exempt under Sec. t3. & P.C. for this reason A on _ _ Driveway Enc. ->A,nn Date Owner Infrastructure 1 _ 19 WORKERS' COMPENSATION DECLARATION I hereby affirmthat 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., 0 Certified copy is hereby furnished. . TOTAL d Cl 79 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. .REMARKS . r,rtr: 4In't i!k `Inn: ; ,,. np.. n-:� ;7} Date Owner NOTICE TO APPLICANT. 9, after making this Certificate of Exemption you should become ZONE: BY: subject to the Workers' Compensation provisions of the Labor 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 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.) Side Setback from Property Line Lender's Name Lender's Address 'This FINAL DATE INSPECTOR 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 this / p,7Permit read application and state that the above information incorrect. Issued. by: Date 1 agree, to comply with all city and county ordinances and state laws relating to building r- - construction, and hereby authorize representatives -of this city to enter the above- bovementioned mentionedproperty for inspection purposes. Validated by: Signature of applicant Date Mailing Address Validation: City, State, Zip HARD COPYI - T CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. @ $ UNITS COLL. AREA LAB GRADE %�� %� �% 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 I ROOF DRAINS METER LOOP HEATING (FINAL) DRAINAGE PIPING CAR P. I 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 WASH ER(AUTO)(DISH) APPLIANCE DRYER NAL INSP. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED % LAUNDRYTRAY AIR HANDLING UNIT CFM REMARKS: 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. SQ. FT. RESID @ 11/a c SEWAGE DISPOSAL SQ.FT.GAR @ 3/ac HOUSE SEWER MESH GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES _[_MICRO FEE MECH.FEE EPL.CK.FEEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK ROUND PLUMBIN90' -�r 1 UNDERGROUND A.C. UNIT COLL. AREA LAB GRADE %�� %� �% ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SE ICT 6 ROUGH WIRING DUCT WORK ROCK STORAGE OUND. REINF. J/j/� GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) Z EMP. POLEIC) _ f;) GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. 2 / FRAMING 17 NAL INSP. /n� e4o ROOFING // // . i `C —VENTILATION % 7 REMARKS: FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS, GARDEN WALL FINAL Desert Sands Unified School District CERTIFICATION OF PAYMENT OF SCHOOL FACILITY FEES �r C� TO: City of La Quinta DATE: Department of Community Development 78-105 Calle Estado NOTICE: THIS DOCUMENT CANNOT La Quinta, CA 92253 BE DUPLICATED. This is to cert-ify, tha & , developer of 2 which is located atwithin this District, has paid school f cility fees imposed purs ant to the au hority generat d by Government Code Sectiol► 53080 in the am� t of s 36 , ao ( —�- covering a total of square feet of ( r sidential or ( ) industrial/commercial development and that building permits for this footage in this development may now be issued by your jurisdiction. for D ERT SANDS UN F ED SCHOOL DISTRICT White -Building Department • Yellow - Facilities Planning 0 Pink - Accounting • Gold - Developer (10)-37 RECORDING REQUESTED BY AND WHEN RECORDED MAIL TO NAME�COACHELLA VALLEY LAND CO. ADORNS 247 E. TaHQUITZ Way, Suitt; 2 Palm Springs, CA c?2262 CITY & 6TATE L MAIL TAX LLTATXMENTe TO NAME SAME Aooncee CITY e 6TATt L Fscrow N?,07783 — _--- Title Order No. 78587`L - I —J SPACE ABOVE THIS LINE FOR RECORDER'S USE 8.25 Documentary tran.>fcr. tax 8 ........................................... E3 Coml,uted on full value of property conveyed, or ❑ Cornputed on full talue le liens & enuumhrances remaining thereon at time of F -ale. ........................................................................................... 5:cn ture of de,larant or spent determinlnp tax firm name l La 'rllnr•orl,oratea area cit, of ..... Quint ............ .a ......... Grant Deed THIS FORM FURNISHED BY STEWART TITLE COMPANY OF RIVERSIDE COUNTY FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, CLINTON DOUGHERTY, a married man as his sole and separate.,property as to an undivided interest; and JAKE L. GREENWALL, a single man as to an undivided z interest; as tenants in common hereby GRANT(S) to COACHELLA VALLEY LAND COMPANY, A CALIFORNIA LIMITED PARTNERSHIP the following described real property in the county of RIVERSIDE state of California: LOT 3, BLOCK 150, UNIT #16, SANTA CARMELITA AT VALE LA QUINTA, AS SHOWN BY MAP ON FILE IN BOOK 18 PAGE 99, OF MAPS, RECORDS OF' RIVERSIDE COUNTY. Dated_ SEPTEMBER 23, 1 98.7 __ _ (lndhidual) STATE- OF CALIFORNIA SS RIVERSIDE COUNTY Of _— CLINTON-D U ERT. JAK1�L—GREENWALL \ 23rd of September, 1987 On b fore me, th understgnea, a Notary rablic in and for said State, personally appeared in on oug�r� an�cl -Tke :.1^ GGreenwal`1 (known to me) or (proved to me on the basis of satisfactory evidence) to be the person S whose name a a re— subscribed to the within instrument and acknowledged that they executed the. same. N•ITNf;SS my hand and official seal Signawre Dorothy Tates FORM 72.13 Name 0 ypcd or Printed I FOR NOTARY SEAL OR STAMP /l • y l . yh1. ,:. \. SIU. ' 9E-- Y'e ti` / W. b ' iA; t:wnrtt EXp. 11ft 11, ISM MAIL TAX STATEMENTS AS DIRECTED ABOVE 2 47 Z O_ O W CO rs" Z O H O LL) U) Y Q W Ir X Z O_ O W N r$.y7',>i..ti,^;��ii�4.i7+^t.h�S,�1R �•�+ .'.rgu7�•1- '.4{c Y`:'rti� f COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISIONo��r.. PERMIT APPLICATION FOR. SUBSURFACE SEWAGE DISPOSAL SYSTEM �� 7 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. Building Department Application Log # Name (Owner, Agent, Contractor, Etc.) Mailing Address % %' ?� City 6A <MZ1J4< State °� Zip Code od�e / 'Telephone on ''Job Property Address' eommunityA Legal Description of Property. (Lot, PM, TR) 'Assessor's Parcel No. (,�.`,.Watet A e�ncy -Well A'9 �J / ` Use of Permit !+(�r�/• [ih� ,2'%Plarfning Case N Lot Size 77,:?-) 2 G, �� KFS ��� ' SFD, MH Site Preparation Etc. nature of Applicant Date 'The above information must be verified from Building Application STAFF USE — DO NOT WRITE BELOW THIS LINE Initial Date Existing S.D. System El Yes 2` Certification of required. Nom! WOCB Clearance required. ❑ Yes 2 No Soils feasibility report required. ❑Yes E] No- oDetailed Detailedboring report required. ❑ Yes Detailed contour plot plans required. ❑Yes [] Nom Staff Specialist approval required. ❑ Yes .0 o Lot Inspection Date Soils/boring report by� Project # �� Date t!' Soils Map Page 1/ > Cf Soil Type � C Approved by lr�C�2-- �'� Date_2(0 - � ' . Type of System: v No. of Bedrooms (1) SepticT,arnk?. j� Soil Rate Required Existing New Additional Replacement ❑�` ❑ ❑ Gals. (2) Leach line sq. ft. h Sidewall allowance ft. Sq. Ft. Instalh.Line(s) Ft. Long, Ft. inches [ L, each bed Sq. Ft. (Bottom"tre area) `�•"w rock/ wldb-wit min. orbottQ per running ft. ZLN/A'� rock below drain lines. area Leach lines/bed-special design for slope: Applicable (3) Pit Diameter j No. Pits Pit BI1 Seepage Pit total depth 103,55! 6' t Max. allowable depth N/A Overburden factor Al /r ' r This application/.,isaapproveotdenied for the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements set forth in Section B a'aCove A building permit is necessary for the installation of the above -designed system. (1) Septic tank arid sewer lines must UAA e' , 0' from any wells�r(D� t^u�-. �^ t' '" a- '"�% "✓ 2 Leach lines must be 100' min. from an wells including ex anslonn� area () Y 9 p. (3 Seepage pits must be 150' min. from any wells including expansiioon area/ itj i'1 `Q.[.. rt.0 .t� ! Gr .LtT'l.�+r � -�. ,L p � f, !1• l � ,� Signature ofHeallh Official r/ r RECEIPT NO. ��� Issued by 57h_ 4 Date 161' District: ❑ Riverside E Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe tt Distribution: WHITE—Office file YELLOW -Applicant PINK—Bldg. Dept. GOLDENROD—Pending File DOH -SAN -122 (Rev. 6/86)