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9878 (BLCK)TA. a9b; tyl 4 U- P.O. BOX 1504 Building 51350 Montezuma LA CALLS Address LA QUINTA, CALIFOORNIARNIA 92253 Owner A E 1-1 B ui.iders Mailing P 0 BASS 366 Address • City La QuintaZtigi253 Tel -564-4832 Contractor Same Address Zip State Lic. I City & Classif. 4$7.584 Lic. # 526 Arch., Engr., Designer Address Tel. city ZiP State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section t. 7000) of Division 3 of the Bu$iness and Professions.Code, and my license is in full force and effec! .!� e f 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 the, a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to rile 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 rive hundred dollars.(8500). ❑ 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 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.) ❑ I, 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 1 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,-3866—rg&57;C Poljcy No. Company 1 (— Copy is filed with the city. ❑ 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 (S100) 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 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 r 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 No.x9878 _. f AY ~tl' f 4 BUILDING: TYPE CONST. OCC. GRP. A.P. Number Legal Description Project Description 1101 -of 41 slump atone wall Sq. Ft. Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ 'Demolition ❑' Estimated Valuation . 1015.20 PERMIT AMOUNT Plan Chk. Dep. 41 Plan Chk. Bal. Const. 54.60 :r. Mech. Electrical Plumbing S.M.-I. .30 Grading Driveway Enc. Infrastructure TOTAL 54.30 REMARKS 51 T.�.�61g• n �� .'T.t AV N11—e, w ,.... •. — -.. 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 ,Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ 2ND FL. SQ. FT. POR. SQ. FT. ® GAR. SO. Fr. ® CAR P. SQ. FT. WALL SQ. FT. @ SQ FT ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. I 1POWEROUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN. URINAL WATER PIPING NOTE: Not to be used as property tax valuation SLAB GRADE FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER SEWER OR SEPTIC TANK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED ROCK STORAGE LAUNDRYTRAY AIR HANDLING UNIT CFM GAS (ROUGH) 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 WATER HEATER SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1 Vi c SEWAGE DISPOSAL SQ.FT.GAR ® V4c HOUSE SEWER GRADING cu. yd. $ plus x$ GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PLCK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING. DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION• CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESRNITIALS GARDEN WALL FINAL DESERT SANDS UNIFIED SCHOOL DISTRICT ti =82=879 Highway 111 NOTICE: -Indio, CA 92201 Document Cannot Be Duplicated: (619)347-8631 Date 3/7/91 No. 110455 Type of Permit I La Q Uinta Permit # Log # Owner Name Roy Pina/A&M Construction No. 51350 street Montezuma city La Quinta zip 92253 study Area 113 APN # 773-081-001 Tract # ILot # Square Footage 11480 Type of Development Single Family. Residence No. of units Comments At the present time, the Desert -Sands Unified School District does not collect fees .on garages/carports; covered patios/walkways, residential additions under 500 square feet, detached accessory structures or replacement mobilehomes. It has been determined the above-named owner is exempt from paying school fees at this time due to the following reason: EXEMPTION NOT APPLICABLE This certifies that school facility fees 'unposed pursuant to Government Code 53080. in the amount of 11.58 1 X 1480 or $ 2,338.40 have been paid to D.S.U.SM. for the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposedproject may now be issued. Fees Paid By A & M Construction Telephone 5644= Name on the check By Richard M. Beck ' x ^E,� Director,, Facilities Planning & Developments Fee collected /exempted by Shelley D. Bennett . rt,.a Paymen aRec6vq,,%k.s Signature _3-"y . > f; CACheck �N .` 1003 Collector:- Attach.a copy of county or city plan check application form to districtG6py.for all waivers.. Embossed Original- Building Dept./Applicant Copy ; Applicant/Receipt Copy - Accounting low t. cc 0 AND WHEN RECORDED MAIL TO IL 0or Wome Roy L. Pina stre" Ouiet Cove O 0 to CD W. .6925 Carlsbad, CA 92004 L City 6 W T F9 MAIL TAX Ci'ATEMEiiTs TO SANG AS ABOVE 'Ad*on son L X., SPACE ABOVE THIS LINE FOR RECORDER'S USE CAT. No.,0111011100502 -!red, I lvlt��xal Grant Deed TO 1923 CA 12 831 . Two room run"I9"90 law vicom TITLIt 8 "Sumane The undersigned grmitor(s) declare(s): Documentary transicir tax is $ A IL (XX ) computed on full value of property conveyed, or 11 computed on full value less value of.licns and encumbrances remaining at time of $31L.. ".Unincorporated area: (XX )City of lt�And ,11 -OR A VAI.UARI.E CONSIDERATION, receipt of which is hereby acknowledged, C. SHERMAN, An Unmarried -'WL,m.-jn hereby G;RAW(S) to RQtli.. PrNA, An Unmirried Man the following described real property in the Cit y of La ouinta county of Rivcr -i dt. State of Qlifornia: Lot J# Block 19 of Santa Carmelita at Vale LA ouinta, Unit No. 2 as per Pap .recorded in Book 18, Pdgcs 55 and 56 of mapi; in the office of the County Recorder of said county; A19--h—ir 17 J,4 1j. 4,14 Marj rIe C. Yhermsn sw,q: oi., cwd Lzilh. ol.- ('A On isir. I the tindmignivd. A Nfi(ari- Public in and for said Stoic, priminalk- aplicared . .. . . ... .... e. 110q^ pei—nAlli. kn ... A -n 141 Ow itr llrivuej to Me on the basis of %av be Iiir.11cmin' Whow none i! 1. •I Ir Ili, ..nlrrn uialrnmrnr and acknowled$rd MAR 1991, 6 1991 01,?f�978-105 CALLE ESTADO - LA.QUINTA, CALIFORNIA 92253 (619) 56ti ffo LA pultgTA March`5,- 1991 Mr. Brian Monroe Subj'e'ct.-.; A & M Builders Setback Adjustment #91-044' PO -Box 366 Location.: Cove La Quinta: CA 92253 51=35`0 --- Dear Mr. Monroe.: This letter is to report', approval of your recent. application for a setback adjustment, pursuant to Chapter`9.1'88 of the City. of La Quinta Planning & Zoning. Regulations. The following setback adjustmenthas been approved subject to conditions and in accordance with attached Exhibit•A. SETBACK ADJUSTMENT: 20% -reduction on front setback. (i.e.-20 foot setback reduced to 16 feet) FOR: House and patio. After review and the attachment of conditions.it•'was determined that: :1'. This adjustment is consistent.with the intent and purpose of the zoning ordinance. 2.- There are special circumstances applicable to tile - property, including such factors as size•, shape, topography, location or surroundings that justify approval of.the.adjustment. These special 'circumstances are: this is'a triangular 'shaped lot with a`limited developable.area. If you. have any questions, please contact the undersigned.' Very truly yours., JERRY HERMAN PLANNING & DEVELOPMENT DIRECTOR Glenda M. Lainis Assistant Planner GML:ccs Attachment: Exhibit A cc: ,Building & Safety Department t, Mr.' -Roy pina; Property Owner LTRGL. 153LING ADDRESS P.(V. BOX 1504 - -LA .QUINTA, CALIFORNIA 92253 .x,{'.11•^ F'1 5��"Si•.�i�. vr. 4_.' 4 i.}`Pry!�Fil•}:'/f•'jn�%jji•���',,'�Ne![�6W.,•/f,�F'n.`iPtT�`�Il M1b�j^yrrlhJ•�.'.'.�"1-��R.FY•F•9 '��'i\•�lY ryµ'. COUNTY OF RIVERSIDE DEPARTMENT. OF HEALTH A""0°" ftmW No. ENVIRONMENTAL SERVICES DIVISION", : • 773 -08/ = 00 PERMIT APPLICATION FOR A SUBSU10FACE 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 IISL �p A n�opsiefurrc�abAeffiling fee (see below) is required when ;the application is submitted.' Check must bemade payable to the County Of. Riverside Approval this valid fora application shall remain period not to'exceed:one year''from date of approveJ: Q "VERIFY IA : ITEMSrIW);SECTION FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION L'OG # .3 Contractor, Contact"Person,Phone Ad ress & Firm �4 Owner UJ Phone . Mailing Address CO city State Zip Job Property Address" Legal Description Prop. (PM, -Tract Lot) JS cA 41t4 Lot Size Water Agency/Well Use of Penni, P/P, CU, etc. Other • S�aoo G v �� • . . Dwelling MH Site Prep, etc. 7,1Signature of Applicant Dats CATEGORY: REV•CODE FEE CATEGORY: REV CODE :. FEE SUBSURFACE DISPOSAL 12380 SITE EVALUATION UPON REQUEST 7349 $ 43.00 . m ❑ MULTIPLE PARCELS WITHIN SAME SQA (NO PLOT PLAN) LAND DIVISION+, ' ❑ SEWER/SEPTIC VERIFICATION. 7348. $ 17.00 0 a. 1 at 4 Parcels (Each) 1238 $ 57.00 (Less,than,l year) ' ��•;- b. Each Parcel after 4 7344 $ 24.00 ❑ PRELIMINARY ELECTIVE 7352: . ` $ 23.00 ...W. ❑' Rereview, (2nd review sameparcel) 7344 $ 24.00 EVALUATION (Attach DOH SAN 53) U) ❑ Site Evaluation in Conjunction with ❑ HOLDING TANK 7351- : $ 47.00 Critical Area 7346 $111.00 ❑ ALTERNATIVE/EXPERIMENTAL . 7345 ' $222.06' ❑ • Site Evaluation Lot Less than SYSTEM 10,000 Sq. Ft. 7347 $ 87.00 INITIAL PATE Holding Tank Agreements Completed ❑ Yes No��_ . Cedtficatio^ of Existing S.D. System Required ❑ Yes . No WOCS 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 R interval) ❑ Yes No Otter ❑ Yes No Staff Specialist Lot Inspection Required ❑ Yes No Lot Inspection Date Solis boring report by i'•/ /lam Pro # Date U Soils Map Page Sol Type Approved by AA h Date ' Z No. of Syetertre Type of System(s) ❑HoldingTenk ❑.Existing eliing UnMa (1) Sepik Tank Soil Rate G Bed .Ir Units Grease New ❑ ReptaCe^wnt 141 T JyGalLU (2) Leech LineSqrFt ec4tom area Sidewall allowance tL rook/ sq. Rf�a IrsteII L k*s) R long wide with Leach. Bed sq. o per running tt. NA min. rods below draMl or Leachlines/bed special design ovs p -e: (3) Pit Diameter No. Pits Pit Below Seepage Pik Total Depth - (TD) Other: Applicable Inlet (BI) Z� Max. Allowable Depth . N/A rden factor - ❑ 5 IiC 6 / yo No. 2 System REMARKS: 1A 0 This application i APPROVFD ENIED for the category checked in SECTION B above, regarding the design of a subsurface disposal system as, indicated ' on the acoompan' p t plan, using the requirements set forth in SECTION C above. A building permit is necessary for the . installation of. the 2 above -designed system. No constriction 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 W �s(3 Seepage pits must be 150' minimum from any wells, including expansion area Signature of Health Offic•iift e 4�i . ,... ,,78-105 -CALLE ESTADO — LA =QUINTA, CALIFORNIA 92253 - (619) .564-2246 �x'T,�•. `-• FAX (619).,564.561.7 August 32,11 .1991 Riverside County Assessor 46-209 Oasis Street, Indio, CA 92201 _ • .. ' , Re: Parcel 4;#773-08.1-001-1, '`Lot 1, Block 19 TO WHOM'JTMAY CONCERN: t In• reference,�to the above-mentioned- parcel, please be ..advised' that - _ ,this lot was. 'assigned the 'address of 51'-350 Avenida Montezuma ,by lthe•' City of La Quinta. The property. owneris aware'. of • "this 'and would appreciate -your correcting ''your ­ records ,--to A, show ;the `_,correct address• of r51-350 Avenida.Monte'zuma,, instead'of 51-350 Avenida'Obregon._. „ _ Your, prompt attention to this Patter ,is appreciated. , Sincerely, ,- ' ; • , B G AND FET ARTMENT - • ` _. Tom• Hartung'j Director of-Buildirig and`SafetyA cc: Roy L. Pina _ .....• r n' :.LTRTH50 .f > �.P • '•'.r<{y' - 's * , ; Jam+ # MAILING', ADDRESS'.' P.O. BOX 1504 SLA, QUINTA, CALIFORNIA 92253 =''