SFD (05611).4 • P.O. BOX 1504 N o . 05611
Building 78-105 CALLE ESTADO
Address 51-607 NAVUKO LA QUINTA, CALIFORNIA 92253
Owner
Jacques idfebv re
Mailing BUILDING: TYPE CONST. OCC: GRP.
Address P.O. Boz 2795 , A.P. Number 773-144-017
City Zip Tel
Palm Desert 92261. 619/394-:942Q_ , Legal Description test 5
Contractor
Jaeques Lefebvre Project Description
Address
34--901 Marcia ltd.
City Zip Tela
Cathedral. City 92234 -619/324-9420
State Lic. City
& Classif. 477507 Lic. # " Sq. Ft. 1503 No. No. Dw.
Arch., Engr., Size Stories Units
Designer Jaequ" Lefebvre New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel. '
• satge
City Zip State
Lic- #
LICENSED CONTRACTOR'S DECLARATION '
I hereby affirm that I am licensed -under Provisions-66Chapter 9 (commencing with Section
7000) of Division 3 of the, Business and P_roofees-s-iioris code, and my license is in full force and
effecI- i .' r.o" : �' - - ^� 7 :1 /
SIGNATURE' DATE
<`15WNER-BUILDER DECLARATION Estimated Valuation q
1 hereby affirm,:that I am exempt from the Contractor's License Law for the following01,023.00
reason: (sec.a764.5,Buskness and Professions Code: Any city or county which requires a
permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rife a signed statement that he is licensedpursuantto PERMIT AMOUNT
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 Plan Chk. Dep.•��
subjects the applicant to a civil penatly of not more than rive hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. 222. Y3
do the work, and the structure is not intended or offered for sate. (Sec. 7044, Buisness and Const.
Professions Code: The Contractor's License Law does not apply to an owner of property who -
builds or knproves thereon and who does such work himself or through his own employees, Mech. `.i:l! •
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 Electrical �t}ti
.7
of proving that he did not build or inprove for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 154.50
struct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law * l'9
does not apply to an owner of property who builds or improves thereon, and who contracts for S.M.I. 12.31
such projects with a contractorfs) licensed pursuant to the Contractor's License Law.)
Grading 20..00
❑ I am exempt under Sec B. & P.C. for this reason
Driveway Enc. 20.QO
Date Owner Infrastructure 1,784.7
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of -consent to self -insure, -&r a certificate of
Worker's Compensation Insurance, or a,certified copy thereof.,(Sec.73800, Labor Code.)
Policy No. Companyzy.. 1 m , ' ,. �"` - +�^
❑ Copy is filed with the city- ❑ Certified&py is hereby furnished.
TOTALVW-5
CERTIFICATE OF EXEMPTION FROM REMARKS r
WORKERS' COMPENSATION INSURANCE
(This section need not be compieeted ff the permit is for one hundred dollars ($100) valuation i' �' t• "tA1Y•ti a'+-•Yzktt tf�r �i- a 'ti'r .rw...» 4 x
or less.)
I certify that in the performance of lhp 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: n, 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 FINAL DATE INSPECTOR
This Is a building permit when property filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days. 4/6/89
1 certity that I have read this application and state that the above information is correct. Issued by: Date Permit
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,Validated by:
Signature of applicant Date
Mailing Address Validation:
City, State, Zip `
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
YARD SPKL9 SYSTEM
2ND FL SQ. Ff.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
DUCT WORK
ROCKSTORAGE
GAR. SQ. Fr. ®
POWER OUTLET
ROOF DRAINS
METER LOOP
HEATING (FINAL)
DRAINAGE PIPING
CAR P. SQ. FT. ®
GAS (FINAL)
WALL SQ. FT.
DRINKING FOUNTAIN
SQ FT. ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
GRADING
cu. yd.
$ plus x$
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
ROOFING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
REMARKS:
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIRE ZONE ROOFING
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.
SO. Ff. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ic
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
`GROUND PLUMBIN
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
WER ORS 'GAIT Lb
ROUGH WIRING
DUCT WORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH) /
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
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. � m3 /oI
�y
FRAMING _ 2 e7 -
FINAL INSP. 1 � L 0�
�!(�
ROOFING
to /Z 76 111 � � -
, eA `✓ �/ o
(J
t✓
�' C
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
l
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
' GARDEN WALL FINAL
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
NOTICE: THIS DOCUMENT�+pM nn F (W:S�iU(��'F7�+ ILITY FEES
BE DUPLICATED,
TO: City of La Quinta DATE:
Department of Community Development
78-105 Calle Estado
La Quinta, CA 92253
This is to certify t t Z
developer ofw4kich is
located at -• Q //J ithin
this District, has paid school Ocility fees imposed pursuant tfo the
auth rit generated by Govqcnment Code Sect' St 53080 in the am_ount•o
cov ring a total of square feet of esidenti 1 or
( ) industrial/commerci 1 development and that bui ding permits for
this footage in this development may ngw be issued by your jurisdiction.
aA 1660 . \,1J-/ I
f r D SERT SANDS Uf4IFIAD SCHOOL DISTRICT
White - Building Department • Yellow - Facilities Planning • Pink - Accounting ill Gold - Developer
(10)-37
�. d•.
COUNTY OF RIVERSIDE DEPARTIdiENT OF HEALTH Aeseswrs Parcel No.
f ENVIRONMENTAL HEALTH'SEdtVICES —
y PERMIT APPLICATION FOR A SUBSURFACE SEWAGt:,nISPOSAL SYSTEM
Applicant: , Submit this form with four copies of a scaled plot plan (1-20 scale) o% -,n to County speculations as indicated on the attached check Iist
A non-refundable filing fee (see below) is required when the applicati4%' - -
Riverside. Approval of this application shall remain valid for a period nutssubmitted. Check must be made payable to the County of
ceed one year from date of approval.
Q VERIFY ITEMS IN SECTION A FROM BUILDING Q SAFETY APPLICATION BUILDING DEPARTI E:,
Z m+
APPLICATION LOG-*
O 1 Agent Contractor, Contact Person Phone Address 8 Phone
. W O_# Phone . Mailing Address r :L "
City State Zip ob pe" Aresao Legal Description
•Tract' Lot)1
Lot Size 1-IN—giawk Agency II Use of Permit P/P, CU, etc a Q Other _ . � � �/
�O )(/ Op �. V . iQ 9! arae Prep, etc.
ture of Applicant 3 `- Date `
I
-Siga�y
CA ORY: REV CODE CATEGORY: REV CODE FEE �
❑�' SUBSUFW 12
DISPOSAL 38 $45 ❑ SITE EVALUATION UPON REQUEST. '7349 $42.00 - .
❑ MULTIPLE PARCELS WITHIN SAME� (NO PLOT PLAN)
LAND DIVISION ❑ SEWER/SEPTIC VERIFICATION 7348 $11.00
Z
O a. 1 at 4 Parcels (Each) 1238 $45.00 (Less than 1 year)
7
rE . b. 'Each.Parcel after 4 7344 $16.00 ❑ PRELIMINARY ELECTIVE 7352 $45.00
W ❑ Rereview (2nd review same parcel) 7344 $16.00 EVALUATION (Attach DOH SAN 53)
i ❑ Site Evaluation in Conjunction with ❑ HOLDING TANK 7351 $45.00
r Critical Area .7346 ' $86.00 . ❑ ALTERNATIVE/EXPERIMENTAL " 7345 $13200
❑ Site Evaluation Lot Less than SYSTEM
10,000 Sq. Ft. 7347 $86.00
fINITIAL DATE/ r
Holding Tank Agreements Completed - ❑Yes, C�"No/z�C� T
Certification of Existing S.D. System. Required ❑ Yes ❑='/Pio, t
WOCB Clearance required. (Attach Form ❑ Yes p • N� o
DOH SAN. 007; Santa Ana Region Only)
Solis Percolation Report Required: ❑ Yes �'No
Special Feasibility Boring Report Required. ❑ Yes Q
Detailed Contour Plot Plans Required (1 to 5 ft interval) ❑ Yes N.
Outer . ❑ Yes Q No/
Staff Specialist Lot Inspection Required ❑ Yes NoLot Irtspecllan Date
Sills boring report by" pate
Sills Map Page 7" Soo Typal Approired by ��(�(J/E�- Dame
U No. of Systema T of Syatem(s) Na. Dwelling Units / (1) Septic Tank Soil Rate Gfea"Q!`nd
Z ❑ Holding Tank ❑ Existing Bedrooms, Rxturedi1nits _ „Grease IntCp
O m
�'4W ❑ Replacement
Gal
�
2) Leach Line Sq. Ft F Sidewall allowance Install Lines) It. long ft wide with Leach Bed sq. It
trench area " frock/ running
tL aq. R min. ro�bebw drainitirm or Of area
Leachllnes/bed special design for slope: (3) Pit Diameter No. Pits Pk Below Seepage Pit Tota Depth
q/t Inkert+(BI)'0
APPI� ON -61 ifs 1 // D Max. Allowably Depth
N/A Overburden factor 4.- (�O
No. 2 System
REMARKS: ��� t/1- lu��-4�. iL(`T3k v`�! t •�(J7/(J. - �L.✓J'to+_ _.G?�12C •- - -
This application i •APPROVED EQfIM for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated
on the accompanied plot plan, using the "requirements set forth in SECTION C above. A building permit is necessary for the installation of the
Z above -designed system. No construction is permitted in • the required reserved 100% ex rasion area.
1) Septic tank and sewer lines must be 50' minimum from any we11sq10
f / Leach lines must be 100' minimum from any wells, including expansion rea
V r 3 Seepage pits must be 50' minimum from any wells, including -,expansion a
i nature of Hearth Official pate
RECEIPT NO. ��' Issued By ` : Date _ 3-A f% -r "*
DISTRICT: ❑ Riverside,0-Indio ❑ Hemet q Perris ❑ Rancho Calif: 0 Blythe
DOH SAN 122 (Rev. 5/88) DISTRIBUTION.: WHITE - Office file • YELLOW Applicant PINK -Bldg. Dept GOLDENROD - Plans/Recoids °'-