10447 (SFD)Building 50-9.- .z
Address
Owner
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Mailing
Address
City Zip
Contractor
Address
TwT 4 M(A Q94wrau
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P.O. Box lsaa No. 10447
78-1x5 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
BUILDING: TYPE CONST. OCC. GRP.,
A.P. Number W . -1/61, >2 Unit 3
r .
Legal Description
Tel.
City lZip I Tel.
State Lic.I City
& Classif. Lic. #
Arch., Engr., I
Designer
Address I Tel.
CityI Zip I State 1
Lic. # I
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provlslons-pf-Chapter-,,gg (commencing wlth Section
7000) of Division 3 of the Business�nd ! rolesslans uda and Firy license Is in full force and
effect.
SJSNATiJRE DATE
i 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 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 five hundred dollars ($500).
❑ 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 properly who builds or improves thereon, and who contracts for
such projects with a confracfor(s) licensed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPElSATION DECLARATION
I hereby affirm that I have a certlfica of consent to selFinsum, or a certificate of
Worker's Compensation Insurance, ora certted copy thereof -ySBC..2BBB; Gabor 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 orre hundred dollars ($100) vafuation
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 Callfornia.
Date Owner
NOTICE TO APPLICANT., If, after making this Carrilkate 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 shah 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 Nemo
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 carlify 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 abave-
mentloned property for Inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
Descripti
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
Validation:
Sq. Ft.
Size
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑
Repair ❑ Demolition ❑
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
- -'
Plan Chk. Bal.
Const.
Electrical
-1•
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
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
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMPING FEES
IST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SO. FT. ®
CARP. SQ. FT. ®
WALL SQ. FT.
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
IMOBILEHOME SVC.
POWER OUTLET
A.C. UNIT
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
FORMS
FLOOR DRAIN
MECHANICAL FEES
S4OUGH WIRING
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
REINF. STEEL
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
BOND BEAM
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1V. c
SEWAGE DISPOSAL
_$
SQ.FT.GAR ® Y4c
HOUSE SEWER
FINAL INSP ] •
FRAMING 3��
FINAL INSP.
GAS PIPING
PERMIT FEE
3
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 l
!'
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER -OR SEPTIC TANKS/
a
'
S4OUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
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 3��
FINAL INSP.
ROOFING -3/A2
3
CI /� Cl/
f� J � 1�
{
c
j�.
!0
L
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
J
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTIONS, X11 [[[
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 2/5/92 Type of Permit I La Quinta
No. 111166 Permit #
Owner Name A & M Builders Log #
No. 50915 street Paloma
city La Quinta zip 92253 study Area 0
APN # I Tract # I Lot # Square Footage 12104
Type of Development Single Family Residence No. of units 0
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 imposed puYsuant to Government Code 53080
in the amount of 1.58 X 2.104 or $ 3,324.32 have been paid to D.S.U.S.D. for
the property listed above and that building permits and/or Certificates of Occupancy for
this square footage in this proposed project may now be issued.
Fees Paid By
A & M Construction
Name on the check
By James E. Lively
Assistant Superintendent, Business Services
Fee collected /exempted by Vickie J. Durrett
Signature ELI
Telephone 5644832
Payment Received
Check No. 1642
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
°r�Rr
r
�rR.N
JAMES O. WALLACE
Agrlcullural Commbsloner
Dlreclor of Welghls &.measures
OFFICE OF
AGRICULTURAL COMMISSIONER
AND
WEIGHTS & MEASURES CALVIN C. KAMINSKAS
4080 LEMON STREET, ROOM 19 /lsshlanl Commissloner
BENRIVERSIDE, CALIFORNIA 92501 CLEMENT• Seaalerlar ISTE
(114) 787.2561
49613 Highway 86, Suite B12
Coachella, Ca. 92236
342-8291
DATE _� l CASE W.
DMWPER' S NAM A
ADDRESS: 56
La QV.A.� � <A- q ZZ
TUEPHONE: [ (r: ! l � 6 � 2 moV V1 I -S
q
�O 1(S 1%,(G CA,
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
immediately.
Thank you for protecting and preserving the Coachella Valley's pest -free environment.
s
cc: Indio and Riverside Office
7
RECEIPT NO. ' Issued BY J IDate
DISTRICT: ❑ Riverside, ,t ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe
DOH -SAN -122 (Rev 3190) DISTRIBUTION: WHITE - Office file YELLOW . Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records
COUNTY OF RIVERSIDE DEPARTMENT OF HEALTHAsomem Par O'I No.
ENVIRONMENTAL SERVICES DIVISION 769 —D6� —
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 IIaL
A non-refundable filing fee (see below) is required when the application is submitted. Check must be made payable to the County of
,Wy9r% . _Aj5proira1 df this application shall remain valid for a period not to exceed one year from date of approval.
VERIFY ITEMS IN SECTION A FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG A,
_
Ve
Q16 Gpnfraetorll,
Phone
dress
�Contact
LULU
co
Owner
d� /^-(�
Phone
Sks !,t <!.
Mailing Address
wf `Ea -
City
State
Zip
Job Property Address 7 $S Description Prop. (PM, Tract, Lot) �jj'
Lot Size
Water Agency/Well
Use of Permh P/P, CU, etc. Other
Ying H Site Prep, etc.
Signature of Applicant
Data
CATEGORY: REV CODE FEE
CATEGORY: REV CODE FEE
SUBSURFACE DISPOSAL 1238
❑ SITE EVALUATION UPON REQUEST 7349 $ 43.00
co❑
MULTIPLE PARCELS WITHIN SAME �4
(NO PLOT PLAN)
LAND DIVISION
❑ SEWER/SEPTIC VERIFICATION 7348 $ 17.00
Z
O
a. 1 at 4 Parcels (Each) 1238 $ 57.00
(Less than 1 year)
8
b. Each Parcel after 4 7344 $ 24.00
❑ PRELIMINARY ELECTIVE 7352 $ 23.00
LU
❑ Rereview (2nd review same parcel) 7344 $ 24.00
EVALUATION (Attach DOH SAN 53)
Cn
❑ Site Evaluation in Conjunction with
❑ HOLDING TANK 7351 $ 47.00
Critical Area 7346 $111.00
❑ ALTERNATIVE/EXPERIMENTAL 7345 $222.00
❑ Site Evaluation Lot Less than
SYSTEM
10,000 Sq. Ft. 7347 $ 87.00
INITIAL IPATIE
Holding Tank Agreements Completed ❑ Yes 0 Noti,i/� �!
Certification of Existing S.D. System Required ❑ Yes Q No
WOCB Cleeranoe required. (Attach Form ❑ Yes No
DOH SAN 007, Santa Ana Region Only)
Solis Percolation Report Required. ❑ Yes No
Special Feasibility Boring Report Required. ❑ Yes No
Detailed Contour Plot Plans Required (1 to 5 ft interval) ❑ Yes No
Other _ ❑ Yes No
Staff Specialist Lot Inspection Required ❑ Yes No
Lot Inspection Date
Soils boring report by ((� - Progjjecct Dade - --
Sol Type Approved by iA Dade
U
Soils Map Page _ f�V
No. of System
Type of Systems)
fAlw�lling Units (1) Septic Tank
Soil Rate GrsaeelSerrd
Z
❑Holding Tank ❑Existing
Fixture Unita
GreaeB.tnei;p
O
New ❑ R �
'
«^ rr^
lL
U)
2) Leech Line Sq- Ft
Skk wall allowance
Install Lins(s) R long 1t
Leach Sed sq. It
Bottom hB(nCh 9re6t
ft rock/ sq. R
min. below dralnlinee
of bottom area
per running ft
NA
i
L.eachlines/bed special design for slope:
(3) Pit Diameter
No. Pits
Pit BelowSeepage
Pit Total Depth
r.
Other.
Applicable
Inlet (BI)
_�--6--' 6
Max. Allowable Depth
N/A Overburden factor
y y
No. 2 System
REMARKS:
This application is APPROV£DIDENIED for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated
on the accompanied ptof 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% expansion area.
(i] Septic tank and sewer lines must be 50' minimum from any wells
b
Leach lines must be 11X)' minimum from any wells, including expansion area
W
3] Seepage pits must tae 1 minimum from anywells, including expansionarea
Q1n 4 .— of Hwarfh C7FFY^3al ?��vV L.f I `l/ V.Gf7 ►%IL{�LCJ.!•+ � DaLe
7
RECEIPT NO. ' Issued BY J IDate
DISTRICT: ❑ Riverside, ,t ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe
DOH -SAN -122 (Rev 3190) DISTRIBUTION: WHITE - Office file YELLOW . Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records
c•Uc-vv/ Y OF Rtt�EQ 5 /OE ST.vTE OFCA� /FoQN/4
TEN7.4T/�E �.sAtPC' WAS
OESE.?T ell -446 7;e,4C7' c/n/iT N0. S' LoT.3 .VO. 77 ,r' 7B
OCTOBER x990
3
G
5
RECHULD
OCT 2 ^ 1990
CITY OF LA QUINTA
PLANNING d DEMPMENT DEPT.
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SC'.44E / =Qp,
ATTACHMENT No. 2
A, P. N. 769 - O 72 - Oo/ oo2
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NO TES
2. P.FOPOSEO ZON//1/G: S.R.
3 EXIST/NG LANO USE'
4 �OPOSEO LANG USE.' S/NGL E Fi�,s-/�L Yr,'.9.+JE
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G. !•V.4T6P. el Ty 0,--- '+TELL. 4
7 SE{f�i4CEUi500 SAL e17Y OF ea,4e•SlEL L4
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9 SC'HOOG O/ST,P/0'r
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P. O BOX 366 L/•1 4U/NTi1, C.A
92253 Ah 6/9 -064-9832
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