05467 (SFD)Building
Address 51-615
T4ht 4 4 Q"
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Owner I
C. Kauff�
Address 71-351 Eleanora
City Zip Tel.
Randbo Mirage 92270 619/346-8483
Contractor
Alegi; G. Torres
Address
City
Zip
Tela
-La @t3Iata
92253
619
State Lic.
City
& Classif. 550498 $„Z
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. F
SIGNATURE4` DATE
OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractors 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 stnuctu re, prior to its issuance also
requires the applicant for such permit to file a signed statement that hes 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).
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. ff, however, the building
or improvement is sold within one year of completion, the owner -budder 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 briproves thereon, and who contracts for
such projects with a contractor(s) 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
Workers Compensation Insurance, or a cerlified,uopy 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 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: It, 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.),
Lenders Name
Lenders 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
No. 45457
BUILDING: TYPE CONST. IOCC: GRP.
A.P. Number 793-123-016
Legal Description Lot 5 South 1/2
Project Description SFD
Sq. Ft. 15317 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ . Repair ❑ Demolition ❑
imated
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
ti
$82,960.0e-
AMOUNT
233-19
5b3.
53.50
111.61
157.50
5.81
20.00
7.0.00
1,828.35
REMARKS ,et".6:1<i.Gei .i Ab t AP :rt7_e ti•,:.�.t �l+
.1:^3? w.s'tes:•Y ' �.— i -'4"Y t -fl. �+,,�
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 3/9189 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
/ SLAB GRADE /a " (J
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. Sp. FT. ®
FORMS
FZ4EWER OR SEPTIC
ROUGH WIRING.
MOBILEHOME SVC.
BAR SINK
POR. Sp, FT. ®
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. SO. FT. ®
FINAL INSP.
WALL SO. FT.
WATER SYSTEM
DRINKING FOUNTAIN.
GRADING
cu. yd.
$ plus x$
=$
URINAL
SOFT ®
FINAL INSP.
FRAMING d --7-.
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOXOISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
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. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® V4c
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
ETBACK 51--/6 • Sti
GROUND PLUMBINGS -d
UNDERGROUND
A.C. UNIT
COLL. AREA
/ SLAB GRADE /a " (J
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
FZ4EWER OR SEPTIC
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 d --7-.
FINAL INSP.
ROOFING �/F
v
/�
0,e ' 0 W ��� `� / ��
D. Gam, r✓` l yr ��L
I U
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
THING 1
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTIO
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
1
I .. . I .1W IV Assessors Pe No.
COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH
ENVIRONMENTAL HEALTH SERVICES7_�— xa 3.
I
PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM
Submit form four scaled scale) drawn County indicated the list�
Applicant: this with copies of a plot plan (1-20 to Speculations as on attache4eck
A non-refundable filing fee (see below) is required when the application is submitted. Check must be mad6 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.
'fly.
VERIFY ITEMS IN SECTION A FROM'BUILDING & SAFETY. -APPLICATION BUILDING DEPARTMENT APPLICATION LOG.*
Agen •Md—r, Contact n
�0
A , - Muzz lies
Phone
3.5 -9 -
Address yhone,
Owner
Phone •
MaillpAdd res
77
7
City State
Zip,
Job Property Address
Leggipescription Prop. (Py, Tract, Lot)
Lot Size ftr Age, W)/We 4_— Use of Permit P/P, CU, at C"r.
ailing . 1-1 Prep, etc.
Amu,,
*nature of Applicant Date
CATEGORY�<Y-- REV CODE DgE�
CATEGORY: REV CODEae*!FEE
relUBSURIFACE DISPOSAL 1238: 00"$45.00).
b SITE EVALUATION UPON REQUEST 7349 $42.00
0 MULTIPLE PARCELS WITHIN SAME
(NO PLOT PLAN)
LAND DIVISION
0 SEWER/SEPTIC VERIFICATION 7348 $11.00'*
a. 1 k 4 Parcels (Each) 1238 $45.00
(Less than ,1 year), ;
b. Each Parcel after 4 7344 $16.00
0 PRELIMINARY ELECTIVE 7352 $45.00
'0 Rervvled(2nd review same parcel) 7344. $16.00,..
EVALUATION (Attach DOH SAN 53)
0 SireEvaluationin Conjunction with
0 HOLDING TANK 7351 $45.00
Critical Area 7346 $86.00
0 ALTERNATIVE/EXPERIMENTAL 7345 $13200
0 She Evaluation Lot Less than
SYSTEM
10,000 Sq. Ft. 7347 $86.00
/I MAL DATE
-5 cp
;
Holding Tank Agreements Completed 0 Yes eN.'
V -
Certification of Existing S.D. System Required 13 Yes`N
No
1�
0
W0C8 Clearance required. (Attach Form 103 Yes' r"o
DOH SAN 007, Santa Ana Region Only)
Solls- PeM0,W1%WRepor't.RequIrqq,_ 0 Yes 'Noe,
Special Fwalbility Boring Report Required. 0 Yes Pr:_kq_
Detailed Coniourkot'Plans Required (1 to 5 ft. interval) . 13 yes 0
IT V
Clow 0 Yes
Staff Specialist W Inspection Required - Yes VNo
Lot Inspection Date
Soils boring report by Project # Ewe
f
Soils Map Page Soo ode Approved by Data
No. of Syslanns
T)WO Of Sys"s)
No. Dwelling Units
(1) Septic Tank
= Soil Rate
,2rease/Sand
T3 0 Existing
Ing Tank
,=
9 0 Replaceent
m
B9drooms.J4xhirwWntt&
Grease Intop
eo_Gai
l
op?, 3 1116rl
*%k(2 Leech Line Sq F
Sklewall allowancei
I )—fL low wkJo with
111sach Bed s% ft.
trench area
- It. row_ . sq. fLr
in. ��=�,;d,
per running ft. 0� MAS
Leachlines/bed special design -for slope:
(3) Ph Diameter
No. Pits
Ph Below
Seepage Pit Total Depth
Other.
__
Applicable
��Overt,urd.n
-0-5, �6
Inlet (BI)
Max. Allowable Depth
factor
No. 2 System IV14
�REMARKS: 00
4�22
APPROVED
0
This appficatiorsA_00�mj§ for' the category checked in SECTION.B above, regarding the design of a subsurfaceldisposal system as indicated':
on the ,accompanka the 'requirements set forth in SECTION C above. A building permit is necessary for the installation of the
above -designed system. No construction is permitted in the required reserved 100% expansion area.
Septic tank andrsewer lines must be 50' minimum from any,wells�//Ojy-
�o
Leach lines must be 100' minimum from any wells, including exparigi—o a
g expansion
&3". 'Seepage pits must b9ol 59 minimum from any wells, including expansion area*
L�� 4 J;
Al 3
SigI nature of Healthi0ificial -Dat
R
RECEIPT NO. -L-4
�
Sk
0/7 Issued I Date F9
0 (i3;. Blythe
DISTRICT: Riverside, Indio 0 Heffiet 17 0 RanchoCalif.. 0
'WHITE -Office file YELLOW -Applicant - PINK Plans/Records
DOH SAN 122 (Rev. 5/88) DISTRIBUTION: GOLDENROD /Record
op `
`NrA�rjE�R� ESTABLISHED IN 1918 AS A PUBLIC AGENCY
°isriRic��
COACHELLA VALLEY WATER DISTRICT
POST OFFICE BOX 1058 • COACHELLA, CALIFORNIA 92236 • TELEPHONE (760) 398-2651 • FAX (760) 398-3711
DIRECTORS: OFFICERS:
JOHN W. McFADDEN, PRESIDENT STEVEN B. ROBBINS,
PETER NELSON, VICE PRESIDENT GENERAL MANAGER -CHIEF ENGINEER
TELLIS CODEKAS JULIA FERNANDEZ, SECRETARY
RUSSELL KITAHARA DAN PARKS, ASST. TO GENERAL MANAGER
PATRICIA A. LARSON REDWINE AND SHERRILL, ATTORNEYS
September 19, 2003
Roseanne Wells
Prudential Realty
72-895 Fred Waring Drive
Palm Desert, California 92260
Dear Ms. Wells:
Subject: Account No. 606013,335.0.3
51-615 Avenida Obregon, La Quinta
File: 1112.
In researching our records, we found that the above -referenced property has
not met the sewer requirements of the district.
The district has no record of receiving a signed petition for annexation or
the payment of sewer fees, which would authorize connection to the sewer
system.
If you have any questions please contact Rosie Anacleto, Customer Service
Representative, extension 2420.
Yours very truly,
Steve Robbins
General Ylanager-Chief Engineer
RIA:ra
bc: City of La Quinta
Post Office Box 1504
La Quinta, California 92253
TRUE CONSERVATION
USE WATER WISELY