04589 (SFD)P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 5a~�1�i (;t,Z'7~!iSl'^. LA QUINTA, CALIFORNIA 92253
Owner
"'mZ00, t` � BUILDING: TYPE CONST. OCC. GRP.
Mailing
Address %2.10 a�I'..`''�` Z,t. s OCuit'1 103 773. 251 -309
A.P. Number
City Zip Tel.
�' ) �. : �' �'• ' ��� Legal Description
Contractor Project Description
Address
"a )
ty lZip Tel.
State Lic. City
& Classif. 330531 1 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 r DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Buslness and Professions Code: Any city or county which requires a
permit to construct, atter, 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).
0 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, 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 -�
❑ 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 (5100) 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 shouts 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 it work thereunder is suspended for 180 days.
1 certify that 1 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
1
WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENiIOD - ASSESSOR'S OFFICE, HARD COPY - FILE
Sq. Ft.
Size �•�7,
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
3�a�
r
•:.TJ�:i1i1 r � �
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
'��'J • Utl
Plan Chk. Bal.
Const.
" • `' ='
Mech.
�' • "'
Electrical
j •
Plumbing
14 . • UJ
S.M.I.
Grading
4v o i I J
Driveway Enc.
f • '�
Infrastructure
A�' �' • �
TOTAL
-r'""
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 IN P,ECTOR
j ..../-
Issued by: Date Permit
Validated by:
Validation:
1
WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENiIOD - ASSESSOR'S OFFICE, HARD COPY - FILE
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEh
IST FL SO Fl rp $
UNITS
LAB GRADE /
ROUGH PLUMB
BONDING
YARD SPKLR SYSTW
2ND FL SO FT. IB
FORMS
SEWER OR ,
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
VOR SO FT a
GAS (ROUGH)
METER LOOP
GAR SO. FT. ra
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CARP. SO FT. a
GROUT
WATER HEATER
WALL SO FT. ra
FINAL INSP,
DRINKING FOUNTAIN
SO. FT. ra
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
_$
WATER PIPING
NOTE Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTOXDISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
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
SO. FT. g c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID (g I 1 c
SEWAGE DISPOSA^_
SO.FT.GAR rg 3/4c
MOUSE SEWER
FINISH GRADING
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
1.
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB FEE
STRUCTURE PLUMBING ELECTRICAL HEATING 8 AIR COND. SOLAR
�ETBACK
GROUND PLUMBINC}/�-,
UNDERGROUND
A.C. UNIT
COLL. AREA
LAB GRADE /
ROUGH PLUMB
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR ,
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EOUIP.
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.
//}}�� n /
//J �GROOFING G/ 1 /„ .
��w// VENTILATION (/�{C/ UUU
n � ,
{✓
I I_ G ��/G��
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING "
MESH
I SULATIONISOUND 4
FINISH GRADING
F AL INSPECTIO — �oc
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
,
GARDEN WALL FINAL
�4t
of rir_E of
E. LEON SrnuGY
AGRICUL1 URAL CO,AMISSIUNER
co
IANfES o WALLACE
O
AN U
AWSTAM (:•).NIMISSIONER
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1 E1611 I S' &.. MEASURES
CLEMENT BE`�VENISIE
S[ALEn
- —
49-613 Hwy 86, .Suite B-12 ,.
Cmichella, CA 92236
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619-342-8291
DATE % — Z -
8 CASE W. R
DEVELOPER'S NAME:
4e_r+N.
ADDRESS:
S` 3 7 S S
2-1 - 3
TELEPI IONE:
u -a �i�, G4
Dear Developer:
JA After reviewing your
landscapi_nq plans, all plant nv3terial
listed is not in
violation of quarafftine laws governing the Coachella
Valley. If substitutions
do occur and they differ fruit plant nuterial listed,
this office nfust be notified
immediately.
r
Thank you for protecting
and. preserving the Coachella Valley's pest -free envirofunent.
Agricultura CE�fn►uss.1 : 's Of f ice
cc: Indio and Riverside Office
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COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION 773 -291 -009-8
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 $37 -is required when the application is submitted. Check must be made payable to the County of Riverside.
' Y' J
Building Department Application Log #
Name (Owner, Agent, Contractor, Etc.)
Mailing Address
DESERET HOMES, LTD.
7220 TRADE ST., SUITE 100
City
State
Zip Code
Telephone
SAN DIEGO
CA
92111
619/693-8444
Job Property Address
Tity},�pmmuaityLegal
Description of Property. (Lot, PM, TR)
52-680 HVEW1DA CARRANZA
Li;QOINTH
LOT 15 BLK 154 SANTA CAXIAELI
fTf tl . , y+ t., r. T'�Y"Irn l -",tTM 1 /.
;'
'Assessor's Parcel No.
Water Agency QWgell
„j
�m'� �
" 1 ---
Use of PermiD ."Lli�G V;/ Planning Case #
�
`Lot'Siie
7 7 3- 2 91 -009-8
GA
SF'D
�
0X10
C,�,�D
SFD, MH Site Preparation Etc.
0
DESERET HWILS, LTD. f/' 9/7/88
Signature of Applicant A. r . L iYt rti ,JL , PALS.Date
LLWDEL CORP, GEN PTR The above information must be verified from Building Application
STAFF USE — DO NOT WRITE BELOW THIS LINE
Initial Date
r
Certification of Existing S.D. System required. ❑ Yes allo
WOCB Clearance required. ❑ Yes CP -Nor
Soils feasibility report required. ❑ Yes P4N0,
Detailed boring report required. ❑ Yes ❑,No -
Detailed contour plot plans required. ❑ Yes �6o
Staff Specialist approval required. ❑ Yes a'No Lot Inspection Date
Soils/boring report by Project # Date
Soils Map Page..i ; n Soil Type � Wy Approved by �- Date L �~
Type of System: (
No. of Bedrooms
(1) Tank
Soil Rate Required
❑ ❑ ❑
Existing ❑•New Additional Replacement
Septic
16rx� Gals.
�
(2) Leach line sq. ft.
Sidewall allowance
Install_ - Lines) Ft. Long,
Leach bed Sq.
(Bottom .. ench area)
ft. rock/ _ Sq. Ft.
_
Ft. widb,withi, min. inches
Ft. of bottom -
per running ft. Q,tfA
rock below drain lines
area
Leach lines/bed-special design for slope:
(3) Pit Diameter
No. Pits
Pit BI
Seepage Pit total depth
ApplicableQ-5'
N/A� �OJverburden factor/
D 6'
'�
Max. allowable depth
04
This application is approved/de ed, for the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements
set forth in Sectior>4fi,cApDv01e6Uilding is necessary for the installation of the above -designed system. {
permit s
-"(1) Se tic tank and sewer lines must be 50' from any wells +
r i (2) —_
Leach lines must be 100' min. from any wells including expanslonn-,aree-a •' . '
(39seepage pits must be 150' min. from any wells including expansion area /�
Signature of Health Official������ Date r / le,
t
RECEIPT NO. /? Issued by S,r//- Date_1
District: #0 El Riverside 53 -Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe
Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File
DOH -SAN -122 (Rev. 6/86)
rA
100A (4.77)
WHITE — File Copy YELLOW — Client Copy PINK — Field Copy —GOLD — Office Copy
DAILY FIELD REPORT -
No:
Job Name:
Project No.:
S—g GIS
Date:
Location:
Q s2-6
Weather:
sV ,..,
Day:
Contractor:
Foreman:
Field Technician
Miles :
Hours:
Equipment Working:
Inspection / Testing of
Test
No.
Test
Location
Elevation
or Depth
Soil
Type
Optimum
Moisture
Field
Moisture
Maximum
Density
field.
Density
Rel.
Comp.
I
rJ "" 6
of
o 3-
S
�� .�
��
C) C� •
9
c-0 & ^
OI.
s.
r
�_- �_
-
-
�-.Ga_
5�
Summary of
Operations •
__.1 ... ----
U IVq�e
Lf
" \-0
.01
;
0J
Supervisor :
Engineer:
Geologist:
Todays Yardage:,
Yardage to Date:
'
_.LEIGHTON and ASSOCIATES
17975 Sky Park Circle, Suite E, Irvine, California 92714
Tel: (714) 556-1421 556-1422
100A (4.77)
WHITE — File Copy YELLOW — Client Copy PINK — Field Copy —GOLD — Office Copy
T4'tt 4 4(v Q"
78-105 CALLE ESTADO - LA QUINTA, CALIFORNIA 92253 - (619) 564-2246
August 8, 1989
To Whom It May Concern:
The structures located at the following addresses in La Quinta
were inspected by the City of La Quinta prior to the slab being
52-710 Martinez 52-035 Madero
52-700 Martinez 52-110 Madero
5 2. �6-8 0_C_a rx-an.z a
7-7
Although not required by.the City, two #4 bars were placed in
the footings and wire mesh was placed in the slab at the time of
inspection.
Should you have any questions
contact the undersigned..
Sincerely,
concerning the above, please
JERRY HERMAN
PLANNING AND DEVELOPMENT DEPARTMENT
Tom Hartung
Building Official
TH:bja
BJ/LTRTH.002
MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253