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003745 (SFD)414 +. P.O. BOX 1504 No. 00.3745 Building 78-105 CALLE ESTADO Address 51-870 Morale.—, LA-QUINTA„CALIFORNIA,92253 . Owner Boni 21%%Pbrraster Mailing BUILDING:' TYPE CONST. OCC: GRP. Address 11210 Coolwater A.P. Number 771 -I S7-01117 City Zip r Legal Description Contractor Project Description Y �:i nrt fa waif Sass t1we�1 4 4-%04 Address. . City Zip _ Tel.. State Lic. City & Classif. - Lic. # Sq. Ft. 141$ No. No. Dw. 'Arch., Engr:,.. __ .. Size - Stories • Units Designer - New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ 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 7000) of Division 3 of the Business and Professions Code, and my license is in -full force and effect. .. . OWNER -BUILDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following �e�r 4 $75.110 $ 5 reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a - i Permit to construct, t, 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 - :a Division 3 of the Business and Professions Code, or that. he is exempt thereliom, -and the basis' for the alleged exemption. Any Section 7031.5 by 'any for Plan Chk: Dep. violation of applicant a permit "subjects the applicant to a civil penalty of not more than five hundred dollars ($500).- ' ❑ I, the .. Plan Chk, Bal.. 61.45 as owner of 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 COf1Stj i>� Professions Code: The Contractor's License Law does not apply to an owner of property who . w builds or improves thereon and who does such work himself or through his own employees, Mech..-j� provided, that such improvements are not intended or offered for sale. if,. ho��yyever; the building or improvement is ' • • sold within one year of completion, the owner -builder will have the burden + Electrical - �, 38 . of proving that he did not build or improve for the purpose of sale.) l s 0 1, as owner of the property, am exclusively contracting with licensed contractors to con. Plumbing 103100 - 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.I. ' - S-.29 such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - Grading 20.00 O Lam exempt under.Sec. B. & P.C. for this reason Driveway Enc. 20.00 f _....�,, v .f- — Date 4 F � • Owner + +/� >y ,l Infrastructure 1 �S Qt,(ZEj e 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 O. Copy is filed with the city. O.Certified copy is hereby furnished. �{ TOTAL S2 R 58S. 12 CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation „ a ,,., :<n A I ..or less.) ., .. .. �. .. .. I certify that in the performance of the work for which this permit is issued, I shall not c; -aa.,• xc.rA: a,w . —i r ,:. ” 4,y f OLA Lk { itiTr`x!1TZ's { h • 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 _ 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 • Lenders Address FINAL.DATEINS9PCECTOR' This is'a building permit when properly filled out, signed and validated, and is subject to expiration it work thereunder is suspended for 180 days. ' 3 /6ar8y' "8 1 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 city and county ordinances and state laws relating to building z construction, and hereby authorize ,representatives sof this city to enter the above-. mentioned property for inspection purposes. Validated by: Signature of applicant Date Mailing Address - ._Validation: City, State, Zip HARD COPY - CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. @ $ 2ND FL. SO. FT. @ POR. SQ. FT. @ GAR. SQ. FT. @ CARP. SQ. FT. WALL SO. FT. @ SQ, FT, @ ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used as property tax valuation ONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APP./EQUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE 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. SQ. FT. @ c BATH TUB SQ. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID @ 11/4 c SEWAGE DISPOSAL A SQ.FT.GAR @ 3/ac HOUSE SEWER REMARKS: VENTILATION 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 & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. ONDING HEATING (ROUGH) STORAGE TANK FORMS W= -OR SEPTTtAI 29- ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. 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. %ROOFINGd— / _ v` A REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL m,rr%.1 V AJ JI V NA 1 UMCW INI I IALb. GARDEN WALL FINAL Desert Sands Unified School District CERTIFICATION OF PAYMENT OF ; SCHOOL FACILITY FEES} TO: City of La Quinta DATE: Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 NOTICE: THIS DOCUMENT CANNOT BE DUPLICATED. This is to certify that developer of which is located at , —1-B ; within this District, has paid school facility fees imposed pursuant to the authorite era ed by Government Code Sec ion 53080 iq t e am un of $ covering a total of square feet of ( , esi a ial or. ( ) industrial/commercial development and that building permi s for this footage in this development may now be issued by your jurisdiction. for DESERT SANDS•UNIFI D SCHOOL DISTRICT White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer (� 3db (10)-37 �..; +�: ��• � Cyt^+•��`:i�.'+:"'"fa':_.,.p��vf��R'�.ivyA �1�•�••+'i�'r.�'�".'�;�e�7�'.�3X?i�'e�..,,`?,^S�''�n+•k.•r�'.-,.-v..e�'�d'�'✓'`°4v.�4}9C�s:t'��.�, , -.,��. .--r.ryr��t 0 Z O F_ U W U) 727 Z O U W U) U) `1 Q 2 W r COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH 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 specifications required on the attached check list. A non-refundable filing fee of $40 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.) / Malting Address Gly /—(7, State CG/ r Zip Code / 3 Telephone 5�/_ od"3 ^ yes 'Job Properly Addr s • �Cny/,or. eommomy r 'Legal Description of Property. (Lot. PM. TR).,[ (� ///Gjl B� �✓, 1 �s 1 t..3 / /<iIr Z�l 5-e,Cr LG i ,�.r.iIKh4 J •Assessor's Parcel No ater Agenc ."we, Permit a )A tX�3-l�0• i/ic.�r /.c�"`PIa'r)ning Case M 4Lo(sfieCr`u+ d It Use of SPD. MH Site Preparation Etc. /;; ZS Signature of Applicant Date 'The above information must be verified from Building Application STAFF USE — DO NOT WRITE BELOW THIS LINE Initial Date r ❑ ��w� Certification of Existing S.D. System required. Yes .®"No / fd'A WOCB Clearance required. ❑ Yes ❑Yes ©fJo� Soils feasibility report required. Special feasibility boring report required. ❑ Yes Detailed contour plot plans required. ❑ Yes 0� Staff Specialist approval required. ❑ Yes ,O No Lot Inspection Date Soils/boring report by /PM Project # Date Soils Map Page / Soil Type/ ' Approved by Date -3._/0 Type of System: U No. of Bedrooms (1) Septic Tank Soil Rate Required ❑ Existing ❑'New ❑ Additional ❑ Replacement 3r Gals. 7, , (2) Leac line sq. ft. (Bottom h area) Sidewall allowance ft. rock/ Sq. Ft. Install Line(s) Ft. Long, Ft. wld8twit, min. inches f Leach bed �q. Ft. of bottom ft. a'N/A below drain lines per running rock area Leach lines/bed-special design for slope: (3) Pit Diameter � No. Pits Pit BI Seepage Pit total depth _. fe Applicable factor TIM. aQ Max. allowable depth 410 � N/A Overburden 114 100a � This application i approvednced for the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements set forth in Section a ove. A building permitis necessary for the installation of the above designed s stem. (1 Septic tank and sewer lines must be 50' from any wells / D .eQQ.+� S� �.� Leach lines must be 100' min. from any wells including expapslon area v� s (3) %Seepage pits must be 150' min. from any wells including expansion area y� 1`,��� Signature OI Hea ih Official - f �� Date RECEIPT NO. 3 3 3() District: ❑ Riverside F0 -In -di -0— ❑ Hemet Distribution: WHITE—Office file YELLOW—App DOH SAN 122 (Rev 8187) Issued by—r st Date T 3-11) ^ �p ❑ Perris ❑ Rancho Calif. ❑ Blythe ;ant PINK—Bldg. Dept. GOLDENROD—Pending File �ac /qr f 4h RECORDING REQUESTED BY :7 it RCcoRD146 IIEQUESTLD TICAR TITLC INZUIlANGS AND WHEN RECORDED'MAIL TO F .Li Name Mr. & Mrs. Roni.Armbruster Street 11210 Coolwater Drive Address' Riverside, CA 92505 City a state L _f MAIL TAX STATEMV.,!'F& TO F Name Same as Above Street Address la a C9 LL V = Uj �. a +. H V L f City & 71 SPACE ABOVE THIS LiNI.7UR RECO$tt)ER'S-USE _ - CAT. NO. NNO0582 Individual Grant Deed f0 1923 CA (2-83) THIS FORM FURNISHED BY TICOR TITLE INSURERS The undersigned grantor(s) declare(s): Z. Documentary transfer tax is $ 9.90 a I- ( X ) computed on full value of property conveyed, or IL ( ) computed on full value less value of liens and encumbrances remaining at time of sale. ( ) Unincorporated area: '( x j City of La QjIi n t A and FOR -A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Bill Hanan, as.his sole and separate.property, hereby GRANT(S) to R. H. Armbruster and Merilyn J. Armbruster, husband and wife.as':Joint tenants" the following described real property in the' city of La Quinta County of Riverside ,State of California: 1 J �+:�'�r sN"�• 5�t,��r,��..'•.�yr�'r�Y s :.'y. C.a A,..�e � (Y, .3'f"X, • q ^;�^ � y� .. ��it.( :' f � - .• ,. } 2-. -� tlale .La -l. cs�`1rta: fiiil in_ the o fics -of -tlie County`"Recoidei^" of` said counrty J . Dated: ` STATE OF. CALIF RNIA "'• -- 000NTY OF 5 �Ss. On \SCC¢ vY pf �j - 1 C, $, before me, the undersigned, a Notary Public in and for said State, personally appeared 7Vk 1,1 l v�,0111V_N . personally known to me or proved to me on the bas's of sat- isfactory evidence to be the person_,, whose name„ subscri ed to the within instrument and acknowledged that executed the same. WITNESS my hand and official seal. Signature JESSICA DIAZ My Commission Expires March.25, 1991 151,11 arla OFFICIAL SEAL JESSICA DIAZ NOTARY FUrLIC - CALIFORNIA PRINCIPAL OFFICE IN LOS ANGELES COUNTY My Commission Exp. Mar. 25. 1991 (This area for official notarial seal) Title Order No. Escrow or Loan No. f MAIL TAX STATEMENTS AS DIRECTED ABOVE k State of CALIFORNIA SS. County of RIVERSIDE OFFICIAL SEAL CHERYL .I CARLINI NOTARY PUBLIC CALIFORNIA PRINCIPAL OFFICE IN RIVERSIDE COUNTY MY Commission Exp. Jan. 12, 1999 GENERAL ACKNOWLEDGMENT FORM M-16 12/82 On this the—L8 t �ayof JANUARY CHERYL J. CARLINI 19 8 $ , before me, the undersigned Notary Public, personally appeared R.H. ARMBRUSTER ❑ pe sonally known to me proved to me on the basis of satisfactory evidence to be the person (s) whose name (s) subscribed to the within instrument, and acknowleged that _executed it. WITNESS my hand and official seal. otary's Sign I