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SFD (002176)Building Address Owner i P.O. BOX 1504•, No. 002176 78-105 CALL,F�",,E ESTADO WS Pmerd& navarro LA QUINTA, CALIFORNIA 92253 a BUILDING: TYPE CONST. mailing Address g_p, BM 1.178773-334x-016 A.P. Number City I Zip ITel. Ia QW nta 1 92253 I 564-3594 ress City' � Zip Tel. Val 92307 State Lic. City & Classif. ytr,n«sne Lic. # MIL;Y., r-ngr., . . . 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 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. SIGNATURE DATE OWNER -BUILDER DECLARATION 1 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 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 penally'of not more than five hundred dollars ($500). O 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.) O 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 contractor(s) licensed pursuant to the Contractor's License Law.) 0 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 O Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATIONINSURANCE (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 anyperson 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., g_ Signature of applicant X •� ��•"'"ri • Date Mailing Address City, State, Zip I f HARD COPY I OCC. GRP Legal Description 3 Project Description _qJncJt_ fmilily rNPIl.iM 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 86 Issued by: Date 3-12— Permit Validated by: Validation: A4791 3 14 .i 734,21 R Sq. Ft. DW 1412 Size GM 4'40 No. No. Dw. Stories � Units � New Ad(i" Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation ,�{{O� 6.80 PERMIT AMOUNT Plan Chk. Dep. 2W.00 Plan Chk. Bal. ✓IL.1!3 Const. 358.00 Mech. 31.00 Electrical £7.10 Plumbing 85.00 S.M.I. 5.25 Grading Driveway Enc 20.00 Infrastructure 1,116.11 TOTAL 11984.21 1,734.21 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 86 Issued by: Date 3-12— Permit Validated by: Validation: A4791 3 14 .i 734,21 R CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ 2ND FL. SQ. FT. POR. SO. FT. ® GAR. SQ. FT. ® CAR P. SO. FT. WALL SO. FT. ® SO. 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 SLAB GRADE FLOOR DRAIN MECHANICAL FEES BONDING WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED DUCT WORK LAUNDRY TRAY AIR HANDLING UNIT CFM GAS (ROUGH) 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. SQ. FT. ®c BATH TUB WATER HEATER SO. FT. ®c I WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL BOND BEAM 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 GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE UGH PLUMB. '��3 BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC UGH WIRING 5 DUCT WORK ROCK STORAGE 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. $ P lus x$ _$ GR. 46xFINAL INSP. G /�USLUMBER /llFRAMING �INAL INSP. ! lilt ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING 5 LzI, 'y MESH �U<e JNSULATION/SOUND r^ GRADING ''//FINISH 4/F/� INAL INSPECTION 1N ✓ /' //////������CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL 'tk�FIED o N 8ERMUDA DUNES r RANCHO MIRAGE INDIAN WELLS H PALM DESERT v %P LA OUINTA �a 110 INDIO Desert Sands UAed School District 82-879 HIGHWAY 111 • INDIO, CALIFORNIA 92201-5678 • (619) 347-8631 March 13, 1986 City of La Quinta Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 Re: 52805 Navarro Gentlemen: The developer of the above referenced lot has mitigated i:ts impacts on our overcrowded schools by payment of the amount of $628 per unit to be applied to the cost of district educational faci'li.ties made necessary by such new development. Sincerely, VrL1. V-1 ...k John D. Brooks Assistant Superintendent Business Services JDB/crm JIM PETTUS CONSTRUCTION • P.O. BOX 1059 c xF APPLE'VALLEY, CA. 92307 619-247-6468 ---------------------------------------------------------------- V February 28, 1986 Mr. Larry Rogers 53705 Martinez La Ouinta, Ca. 92253 Re: Project for Mr. Charles Stebbins. Dear Larry, In response to our phone conversation this morning, I am happy to supply you with this notarized authorization to sign con- tracts for the Stebbins project. This will relieve me of the time consuming necessity of driving down to your area, as well as allowing us to proceed with the greatest amount of'speed on Mr. Stebbins home. Therefore, I, James C. Pettus do hereby authorize and instruct my business associate, Larry Rogers, whom you know, to sign and validate such contracts and encumbrances as may be necessary to initiate and satisfactorily complete all lending and con- struction requirements, including loan documents binding me and or my company to the extent necessary to complete the above named project for Mr. Stebbins. Sincerely, a 8 C. Pettus 1 O)SAFECO TITLE INSURANCE 1 STATE OF CALIFORNIA SS. COUNTY OF 9nn Rprnardinn On this the 28th day of ebruary 19, before me the undersigned, a - Notary Public in and for said County and State, personally appeared Tamp c r- P t , k v 'v c " personally known a to me or proved to me on the basis of satisfactory evidence to be the person whose name -j-&-- subscribed to the within instrument Go a d acknowledged th executed the e. m C1. f9 10 Si ture of Notary J Q U FOR NOTARY SEAL OR STAMP --------------- OFFICIAL SEAL GLORIA J. W 11 'CK :.p Notary Public • California L San Bernardino County My Com. Exp. Feb. 18, 1987 Z O U W U) U Z O P U W COUNTY OF RIVERSIDE, DEPARTMENT OF HEALTH PERMIT APPLICATION FOR A SUBSURFACE DISPOSAL SYSTEM Applicant: Submit this form with three copies of a scaled plot plan drawn to county specifications required on the attached check list. A non refundable filing fee of $15 is required when the application is submitted. Check must be made payable to County of Riverside. Name /-RRkl 'R 6 G-efZ-S Mailing Address f t o /% City State Zip Code Phone LP Q. xf TIA 22-53 1,5(,q 35 9 9 'Property Address All 'City or Community 'Legal Description of Property (Lot, Parcel Map, Tract) -F2-845 vAR o L� Ou rti int 1-0-r-3 BLOCK IL/8 'Assessors Parcel No. Water Serving Property From Lot size -3314-0 -� C c EIA -A VAQti--' '-Ek btST Som /do Si nature Applicant o ppDate above information must be verified from Building Application Staff Use — Do Not Write Below This Line Initial Date WQCB Clearance required Yes ❑ No 1�, SFp Soils feasibility report required Yes ❑ No Detailed boring report required Yes ❑ No Detailed contour plot required Yes ❑ No Comments: Soils or boring report by Date Approved by Date Soils Map Page Soil Type Tract File No. Other Number of Bedrooms "3 Septic Tank Size (gallons) Rate Required / 19— Type of System New Addition Replacement Hsu /ooa �S /ov ❑ ❑ Leach line sq. ft. of bottom area trench Leach bed (sq. ft. of bottom area bed) Seepage Pit Diameter Number of Pits Seepage Pit Depth B.I. Total Depth of Pit 5' El' 61C�' otic /S'' ice, Location of System Additional Requirements / / n L A permit is fi�ppraved%denied for the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements set forth in Section B above. A building permit is necessary for the installation of the above stem. designe7,'-t--� 5 2, z c Signature of Health Official Date Receipt No. District: Riverside ❑ D19 2'72 DISTRIBUTION: WHITE - Office File DOH SAN 122 (Rev 10/84) Indio 11' Hemet ❑ YELLOW - Applicant Issued By Date 2 1 - PINK - Building Dept. GOLDENROD - Pending File