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11881 (SFD)P.O. BOX 1504 N o . 11881 Building 78-105 CALLE ESTADO Address 81-900 Mountain View LanLA QUINTA, CALIFORNIA 92253 Owner Mailing JCC Ht�' ID@8 BUILDING:- TYPE CONST. OCC. GRP.- �J Address 3480 Torrance Blyth. Ste, 300 A.P. Number cityTorrance,zip Tel. 'Lot 11 Tract 25769 L.Q. hctates Torrance, CA 94503 1(310)540-3990 Legal Description Contractor SPD SameProject Description Address Tel State Lic. & Classif. 223630 I City {fe: # Sq. Ft. 5226 he No. 2 No. Dw. Stories Units Arch., Engr., Alter ❑ Repair ❑ Demolition ❑ Designer not include block walls or , Address I Tel. CityI Zip I 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 e ect. ` SIGNATU 1 ' i 4 E OWN •BUILDER DECLARATION I hereby affirm that I am axe pt from the Contractor's License Law for the following reason: (Sec. 7031. S,Business and Professions Code: Any city or county which requires a 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 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 pena8y of not more than five hundred dollars ($500). ❑ I, 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.) ❑ 1,"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 contractors) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner 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 Dopy is filed with the city. 0 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 ($100) 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 I= 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 it 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 Sq. Ft. 5226 he No. 2 No. Dw. Stories Units New IN Add ❑ Alter ❑ Repair ❑ Demolition ❑ Permit does not include block walls or , pool. Estimated Valuation $287,858.00 PERMIT AMOUNT Plan Chk. Dep. 250.00 Plan Chk. Bal. $21.24 Const. 1,297.50 Mech. 83.00 Electrical 287. 08 Plumbing 204.00 S.M.I. 28880 Grading 20.00 Driveway Enc. Infrastructure 6, 000.00 A rEs Jn ' uta Y z Place8 46!#. 60 TOTAL tr'� • J 9,211.22 REMARKS 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 IST FL. SO. FT. ® $ UNITS COLL. AREA r 2ND FL. SO. FT. @ ROUGH PLUMB. BONDING YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS DUCT WORK DRAINAGE PIPING CAR P. SO. FT. ® AS (ROUGH). -21,6 „y G/ METER LOOP L WALL SO. FT. p HEATING (FINAL) DRINKING FOUNTAIN. SO. FT. ® GAS (FINAL) ' TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation WATER HEATER SERVICE FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GRADING cu. yd. plus x$ GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FINAL INSP./ / y LAUNDRY TRAY AIR HANDLING UNIT CFM ROOFING/ 3 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 FIREPLACE SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/a c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER 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 UND PLUMBIN UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS -�O SEWER OR SEPTIC TANKROUGH WIRING DUCT WORK ROCKSTORAGE ,CFOUND. REINF. SO. 4?,?- AS (ROUGH). -21,6 „y G/ METER LOOP L 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./ / y FRAMING FINAL INSP. t �j' ROOFING/ 3 wit R- ^/ ^f pluC REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH ULATION/SOUN FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL Tit�/ P.O. Box 1504 -APPLICATION ONLY ����� 7&105 CALLE ESTADO Addrress jt l i VNI' 1'(N v� 'U i- 11 LA QUINTA, CALIFORNIA 92253 Owner J&(" / 4mf�5 Mailing Address City Zip Tel. Contractor GvIZ, Address Zip State Lic. I City & Classif. Lic. # Arch., Engr., Designer Address Tel. CityI Zip I 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. SIGNATURE DATE 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 requires a 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 the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or thathe 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 five hundred dollars ($500). FJ I, 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 1 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.) I'] I am exempt under Sec. B. & P.C. for this reason Date Owner 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 ❑ 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 ($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. 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 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 BUILDING DIVISION BUILDING: TYPE CONST.—OCC. GRP. - A.P. Number / —q90 Legal Description JO I 11 , t7Z y ���) • Q Project Description—K #- ry t5r24 jt7_� Sq. Ft. �i �� S'E .No. No. Dw. Size Stories Units New Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. _ Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure 9A5i8'1,A 1U Fi TrkY— —931)eZn ^A TOTAL REMARKS c 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. SO. FT. @ $ 2ND FL. SO. FT. @ POR. SO. FT. @ GAR. SO. FT. @ CAR P. SO. FT. @ WALL SO. FT. @ SO. FT. @ ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. I I 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 BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEOUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE KITCHEN SINK ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEM/PERM 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 @ 1V. c SEWAGE DISPOSAL SO.FT.GAR /a 3/4c 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. 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 INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC, FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL COACHELLA VALLEY UTIITIED SCHOOL DISTRICT CERTIFICATE OF COMPLIANCE (Government Code 53080) Project Name: Project Address: 81-900 Mountain View Lane, La Quinta, CA 92253 Project Owner's Name: Oswald LeWinter Phone No.: 198-7703 Project Description: Room Addition Game Room _ Building Type (Check one): Re!jdential xx Commercial � n us ri (Include No. of Di Tract No:: Lot No.: 11 (If tract attach Schedule "A" of all lots by tract, square footage for each lot and total.) Assessor's Parcel No.: (If Schedule "A" is used show Assessor's Parcel No. for each lot if one exists or Assessor's Parcel No. for parcels before subdivided.) Total square feet of Building Area: 990 Sq- Ft Certification of Applicant/Owners. The person signing certifies that the above information is correct and makes this statement under penalty of pe ry and flirt r represents that he/she is authorized to sign on behalf of the owner/developeraY Dated: City/County Certification: Signature: (Signature) Optional (Title) SCHOOL DISTRICT REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE) Gov. Code Gov. Code Agreement Existing Not subject to 53080/65995 65970 prior to 1/1/87 fee requirements (AB 181, SB 1287) (SB 201) Note: Total Nuber of Sq./Ft. 990 !, Amount per Sq/Ft. $ 1.72 Amount Collected $ 1,702.80 School District Official: Q s } Title: Asst. Superintendent. Admin. Serv. Foch "Tut" Pensi Date: September 27, 1994 Phone: (619) 399-5137 Ext. 235 Note: AB 2926 and SB 201 fees are capped at $1.72 per square foot for all residential Construction, and at $0.28 pee' square foot for commercial/industrial projects. t. ;�.rr.r^'r,...-�..�y-i•,.-..-.....rr:.-•+--••M: w -.Fry �..r+,-.:++•K"'(''ry'rcwf,y,..'�+-...r{y,n,,P..-,. �-^-+-�'.�.'e+�.+ti..+•..•• ... �,s.::..wT F�,s �....- ... �, Z 0 U W CIO Z O H U W CO X Z O U W 0) W Z O U W U) * _" s` ' Assessors Parcel No. COUNTY OF RIVERSIDE HEALTHySERVICES AGENCY DEPARTMENT OF ENVIRONMENTAL HEALTH — 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. /�' -' o LY LOG # t VERIFY ITEMS IN SECTION A FROM A NON -FEE BUILDING & SAFETY (goldenrod) APPLICATION Agent, Contracr, Wntact Person Phone Address City State Zip 32%a�rc� Owner 'JI/l/1- h i Phone 'jMe Address City State Zip x7 4 Job Property Address City State Zip Legal Description Prop. (PM, Tract, Lot) Lot Size afar Agaric Use of Permit P/P, CU, etc. Other cy vt 1/Lv-t , Dwelling, MH Site /Pre etc. V f. ' J Signature of Applicant Date CATEGORY , REV CODE FEE CATEGORY REV CODE FEE SUBSURFACE DISPOSAL (per system) 1238$153.0 ❑ SITE EVALUATION UPON REQUEST 7349 $120.00 ❑ MULTIPLE PARCELS WITHIN SAME LAND DIVISION (NO PLOT PLAN) ❑ SEWER/SEPTIC VERIFICATION 7348 $ 58.00 a. 1st 4 Parcels (Each) 1238 $153.00 ❑ PRELIMINARY ELECTIVE EVALUATION b. Each Parcel after 4 7344 $ 55.00 (Attach DOH -SAN -53) 7352 $ 69.00 ❑ REREVIEW (2nd review same parcel) 7344 $ 55.00 ❑ HOLDING TANK 7351 $119.00 ❑ SITE EVALUATION In Conjuction with Critical Area 7346 $197.00 ❑ ALTERNATIVE EXPERIMENTAL SYSTEM 7345 $656.00 ADING PLAN REVIEW DETAILED 1238 $104.00 ❑ SITE EVALUATION Lot Less than 10,000 Sq. Ft. 7347 $172.00 GRADING PLAN REVIEW CURSORY 1238 "55.00 ❑ SECOND FIELD VISIT (SITE EVALUATION) 7346 $ 85.00 ❑ COPIES (LAND USE) 7786-81 $ .50 INDTIAL DATE Iltdin ❑ Yes 3eNo eemeome Certification of Existing S.D. System Required ❑ Yes LT/No� WQCB Clearance Required ❑ Yes No (Attach Form DOH SAN 007, Santa Ana Region Only) Soils Percolation Report Required ❑ Yes L�eN r Special Feasibility Boring Report Required ❑ Yes QeNo. Detailed Contour Plot Plans Required (1 to 5 ft. interval) ❑ Yes 0"N o Grading Handout Provided ❑ Yes C3'No -No Staff Specialist Lot Inspection Required ❑ Yes 2 Maintenance Booklet Provided ❑ Yes B No Lot Inspection Da Initials 0/421/ Soils Percolation Boring Report by t 7, �Lfi¢/Project # ���� "'Olf Date q /a."I Soils Map Page Soil Type Approved By oDe' Date No. of Systems Type of System(s) d6ng No. Dwelling Units 1 (1) Septic Tank Soil Rate Grease/Sand Giraselntcp/LntTrap ❑OTank ❑ Replacement ❑Additiony647? Bedrooms, Fixture "Is A&V 0 Eris ❑ Existing iYfR3r� Gal. , Sq. Ft. Bottom Area Total Linear Ft. Sidewall Allowance ""'"� aA 02 50 3 Leach Bed sq. ft. ...-- ft. rock/ sq. ft. per running ft. nstall Lin s ft. long ft. wide with �) of�OttO Area 30V Q /00 k Inlet Tested Depth NA min. inches rock below drainlines or � Proposed Bottom Tested Depth Leachlines/bed special design for slope: (3) Pit Diameter No. Pits Pit Below Seepage Pit Total Depth _ ether: Applicable Inlet (BI) (TD) 'Max. Allowable Depth � ,,,,,_.,. N/A Overburden Factor ❑ 5 ❑ 6 ~ Well Review Approved: Signature Date Well Drilling Permit # / p Grading Plan Approved: Signature � ?. /f Y� Date REMARKS: Gf—C6, eLa..�l.r /1.frGr. /r�!'!.1/�1�•*0+. tet. 1 This application i APPROVED/Q. .,NED 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, usin ,th=raquilen( se ,jMrth i, n SECTION C above. A building permit is necessary for the installation of the above -designed syste (1 Septic tank must be 100' minimum from any wells(//0 2 Leach lines must be 100' minimum from any wells, incl din expansion area e, f / f` (3) Seepage pits must be 150' minimum from any wells, including expansion area � —'/_fes- 1� Signature of Health Official Date . 3uS7 RECEIPT NO. DISTRICT: ❑ Riverside DOH -SAN -122 (Rev 1/92) I -71 ❑ CASH / ©'CHE ,CK NO. � l)� � ) Issued By / � ` ' ' Date 3 q A-001111016 ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe DISTRIBUTION: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Plans/Records JLE ELEC. ? CARRIAGE F.E. 9095990155 P.03 J.1.B, E&chic 1023 ASaat CouAt San DimzL6, CA 91773 (714)599-0155 Load Schedule for Lot 11, Tract 26769 Calculation -fora _single ,family _residence.- 52 ---------------- 15 7KW __----••---------- Total A.C. Load___ 20.4KW 1 -Dishwasher •-------------------------,----r_.-�-----------------------------------.----1- 5 l-D1S�osc�1____-__ ' 2 -Small _App_l%�,nr_e-._._ 3.0 � 1 -Dryer ------ - 1 _ Washer-------------�-------.-------�--------------------------______-1.5 1 _ Qvet1__.__ .�..---------------------------------------------•---------- 7 _ 0 ] ,Cooktop_ i Gas �_ 2-Garac�e_doox openers ----------------------------------------- __-------------------------^------------- 2.0 - 1-Reriyertor __ _ 1.0 1- Sia _Tub ------- _.-------------------- 1 5 --- 1 --Central Vacuum ____ 2 - FAU ---------------------------------------------2.0 ------------------- 1-Futu.r, e pool_ Equip.________ 5.0 - 69.2KW Total A.C~. _x_100%-_-__ 20 KW First _10_KW__4d_ 100-__________ 10_ KW Remainder _@_ 40%, 15.7 KW 4.5 _7KW 45; 7- KW _X _1000 _WJKWa 230 Volts x__198.7 Amps _es_ L._ Brookes, _tate_Lir-. No._499222 CALVIN C. KAMINSKAS Asslslanl Commissioner (714) 275-3000 OFFICE OF AGRICULTURAL COMMISSIONER JAMES O. WALLACE, Commissioner 83-612 Avenue 45 Suite 7 Indio, CA 92201 (619) 342-8291 DEVELOPER'S NAME: DAN RILEY Seater, Weights & Measures (714)275.3030 CASE W. _PC C 14t 6dZ ADDRESS s 3�co TELEPHONE: . /i 4- .5 ,,.jles V Dear Developer: After reviewing your landscaping plans, all plant material listed is not in violation of quarantine laws governing the Coachella Valley. If substitutions do occur and they differ from plant material listed, this office must be notified imnediately. . r Thank you for protecting and preserving' the Coachella Valley's pest -free environment. Agricultural Comnissione ffice cc: Indio and Riverside 4080 LEMON STREET, ROOM 19, RIVERSIDE, CALIFORNIA 92501 — FAX (714) 275-3012 0 SEP -30-1994 15:57 GUUSD PERSONNELL DEPT. 6193995717 P.02 / C;OA(:FIL+'LL/k VALLEY 1JNIF1E1),801©01. C1 IMFICA'T E, OF COMPLIANCE � C'' 't (;, .Jr,L���... (Government Code 53080) U. r';p, K71AL5 Project Name: Project Address: 81-900 Mountain View Lane, Lit Quints, CA 92253 Project Owner's Nanne: Qewald LeW'1nter Phone No.: Project Description: Room Addition Game [loom Building Type (Check one): ReAderitial XX{Include No, of Dwelli s) Commercial Tn�iisTrr".rt��� Tract No,: _ Lot No.: 11 (If tract attach Schedule "A" of all lots by tract, square foowge for each lot and total.) Assessor's Parcel No,: _ (If Scliedule "A" is used show Assessor's Parcel No, for each lot if one exists or Assessor's Parcel No. for parcels before subdivided.) Total square feet of Building Arca: _q9g S, Certification ol'Applicant/Owners. The person signing certifies that the above information is correct and makes this statement under penalty ofper iy and fiirtl �r represents that lie/she is authorized to sign on behalf of the owner/developer. ,7 Dated: City/County Certification: Signature: (Signature) Optional (Title)- A!f*t�k*li***********kit*JY**fiKhltNR7117R****Jr 741klt!l 11t 7�*!t*7b******it***N7k**:Vi******A*717t 7k 1k 7i �ll� SCHOOL DISTRICT REQUIREMENTS FOR THE'ABOVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING; (CIRCLE ONE) Dov. Code Gov. Code Agreement Existing Not subject to 53080/65995 65970 prior to l/i/87 fee requirements (AB 181, SB 1287) (SB 20 1) Note: Total Nuber of Sq./Ft. 990. Amount per Sq/Ft. $ 1.72 Amount Collected $ 1,702,80 School AiStriCf biiiciali'/ U s 'Title: -Asst. Su erintendeht Adria' ° env. Foch ','Ttrt" Pensi : Date; September 27 19 Plione: 619 3995137 ,Ext. 235 Note: AB 2926 and SB 201 fees are capped at $1.72 per square foot for all residential Construction', and at $0.28 per square foot for coin mercial/industrial projects, TOTAL P.02