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SFD (0475)
51885 Avenida Madero 04875 - P.O. BOX 1504 Building 78 105 CALLE ESTADO Address LA QU,INTA, CALIFORNIA 92253 Owner, w» - 4K . z'Nd,61 To Bakeril, Enterprises r...Inc, BUILDING: TYPE CONST: - - OCC. GRP. Mailing Address. 1875 Business C>~3ntar ^Dr. A.P. Number .771-151-019 019 City Zip Tel. Sin Dern r -di 1t" 92408 71t-«884-72+$ Legal Description Contractor` i Project Description- q :. V,n _ Y Address:. City • - Zip Tel. State Lic. City & Classif. 2.57254 Lic. # Sq. Ft. 1S17 No. No. DIN. Arch., Engr., Size Stories Units - Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ 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 '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). O 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 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 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 (E100) 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, alter 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. stimated Valuation e347 + x A• 6 PERMIT, AMOUNT Plan Chk. Dep. $$250 4' 00 Plan Chk. Bal. $ 83.33 Const. 38C.00 Mech. 33.00 Electrical 78.61 Plumbing 112.00 S.M.I. 5.92 Grading 20.00 Driveway Enc. 20.00 Infrastructure 1,966.33 construction, and hereby authorize representatives -of this city to enter the above- mentioned property for inspection purposes. Validated by: Signature of applicant Date TOTAL 5716 an=i r .9 : 3.! ,f : It REMARKS YiY11 ?:4`it ,ir+f1 Ri •. 3'>9r,,.i,'7+,!Sp_f 1 '! t 6 4 ZONE: BY: 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 INSPECTOR ECT 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. GaO 1 certify 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 1 WHITE - FINANCE, PINK - APPLICANT, GREEN -- BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES ISl FL SO FT (a $ UNITS i 4 'LAB GRADE &—,)ICI ROUGH PLUMB BONDING YARD SPKLR §YSTEM ' 2ND FL SO FT. a FORMS N `r SEPTIC TANK/144 POR SO FT at MOBILEHOME SVC. BAR SINK GAR SO. FT. fpr POWER OUTLET ROOF DRAINS HEATING (FINAL) OTHER APP.IEOUIP. DRAINAGE PIPING CAR P. I SO FT. a TEMP. POLE WALL SO. Ft. (d GROUT DRINKING FOUNTAIN SO. FT. r# FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER SYSTEM WATER PIPING NOTE: Not to be used as property lax valuation _ $ FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTWDISH) 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 GAR. FIREWALL SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID a t'A c SEWAGE DISPOSAL SO.FT.GAR @ tic HOUSE SEWER INSULATIONISOUND C. /- GAS PIPING PERMIT FEE FINISH GRADING PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE JELECT.FEE SMI FEE PLUMB FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR R6@ETBACK —/% " / ri 111 .ROUND PLUMBIN — UNDERGROUND A.C. UNIT COLL. AREA i 4 'LAB GRADE &—,)ICI ROUGH PLUMB BONDING HEATING (ROUGH) STORAGE TANK FORMS N `r SEPTIC TANK/144 ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS( OUGH }/( 2 9 / METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. 0( CREINF. STEEL—/6 tl,AS (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. / 7 q—ROOFING JU y ( / / //] rte'/'( /V (O •f REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR" GAR. FIREWALL THING MESH INSULATIONISOUND C. /- FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESlINITIALS GARDEN WALL FINAL Desert Sands Unified School District CERTIFICATION OF PAYMENT OF ti ,. •'• -SCHOOL FACILITY FEES 4A T0: City of La Quinta DATE: . Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 This is to certify that a developer of which is located at - g- aAegl- //,3 within this District, has paid school facility fees imposed purs.,dant to the authorit enerated 4y Govern ent Code S tion 510,80 in the aptount of co eying a total of Ug quare feet of re idential or e ( ) industrial/commrcial development and that building permits for this footage in this development may w be issu d by your sdiction. or DESERT SANDS UNI IED SCHOOL DISTRICT White - Buildi g Departtrneent • llow - Facilities Planning • Pink-QAccounting • old - Developer 3"/) —JU 0137 51 %S M A6& ro &j- Dear Developers After reviewillg your landsc pi.ng plans, 111 plant material listed is not III violation of yuaralltine la+ s Llovecniilg the Cvacllella Valley. JE subst-itutions do occur and they differ fron plant nkaterial listed, tills office must- be notified imur-diately. TIIaIIk you for protect3ulg slid tueserving the Coachella. Valley's pest -free envirolanent. Agr c ural CoIUILissivllerls office cct Indio and Riverside Mice ol I WE Or E. LEON S11AUGY s AGR..ICU 1 URAL CUMMISSIONER JA IEs o WALLACE y' 1 AND v ASSiSTA`f 1; )'•1'•11SSIU LP O v . . •, S 1 fk•' wi-IGI I I'S b.. MEASURES CLEMEN1 CUNVENISIE SLucn 49-613 Ilwy 06, 5ulte 11-12 'kq Conchel.ln, CA 92236 619-342-0'l91 DATE QJ J 1 `1 1 Si CASE 11U . R i~ R % I 1 n3- t C l`fJr Sc 5 Tn3C DEVELOPER'S IWW t G ADDRESS '-Jt ✓_ 11'ELL•NIONEt 32 i 5 3 - ® -L) $ 51 %S M A6& ro &j- Dear Developers After reviewillg your landsc pi.ng plans, 111 plant material listed is not III violation of yuaralltine la+ s Llovecniilg the Cvacllella Valley. JE subst-itutions do occur and they differ fron plant nkaterial listed, tills office must- be notified imur-diately. TIIaIIk you for protect3ulg slid tueserving the Coachella. Valley's pest -free envirolanent. Agr c ural CoIUILissivllerls office cct Indio and Riverside Mice I f 0 a F o RECEIPT NO. Y 330 T4331 Issued By SAL ate lT - v DISTRICT: ❑ Riverside, n Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑. Blythe DOH SAN 122 (Rev: 5/88) DISTRIBUTION` WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept. GOLDENROD - Plans/Records t • COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH Assessors Parcel No. ENVIRONMENTAL HEALTH SERVICES -7%3 — /J-3 — O 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 checklist. A non-refundable filing fee (see below) is required when the application is submitted. Check must be made 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. Q VERIFY ITEMS IN SECTION A FROM BUILDING NG 8 SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG,* Z O Agent, Contractor, Co9W A C Person w Phone Z4/( & P ne d 0J - TV Q l v F_ W fA1... Owner1 , Phone Mailing Address ,S N n `^ / O to Zip Job Props Address (j It& 5 ' legal Description Pro . (PM, Tnsct Lot) Zor' L K `/ A4 a o - Deeo Lo U Lott Size - terAgency Use of Permit P/P, CU, etc. A t/,,.%174 Other r / ` xy a wellingrM Site Prep etc. — -/ —, 1A/ — Os— Signature of Applicant Date CATEGORY: REV CODE FEE CATEGORY: REV CODE FEE © Ss' UBSURFACE DISPOSAL 1238$45:00 , . ❑ SITE EVALUATION UPON REQUEST 7349 $42.00 13 MULTIPLE PARCELS WITHIN SAME (NO PLOT PLAN) m Z LAND DIVISION ❑ SEWER/SERC VERIFICATION 7348 $11.00 O a. 1 at 4 Parcels (Each) 1238 $45.00 (Less than 1 year) 15=. b. Each Parcel after 7344 $16.00 ❑ PRELIMINARY ELECTIVE 7352 $45.00 ❑ Rereview (2nd review same parcel) 7344 $16.00 EVALUATION (Attach DOH SAN 53) 0 ❑ Site Evaluation In Conjunction with ❑ HOLDING TANK 7351 $45.00 Critical Area 7346 $86.00 ❑ ALTERNATIVE/EXPERIMENTAL 7345 $132.00 ❑ Site Evaluation Lot Less than SYSTEM 10,000 Sq. Ft. 7347 $86.00 ` INITIff DATE Holding Tank Agreements Completed 13 Yes eNo Certification of Existing S.D. System Required ❑ Yes No WOCB Clearance required. (Attach Form ❑ Yes o DOH SAN 007, Santa Ana Region Only) Sons Percolation Report Required. ❑ Yes Special Feasibility Boring Report Required. ❑ Yes / Detailed Contour Plot Plans Required (1 to 5 ft interval) ❑ Yes Other ❑ Yeses Staff Specialist Lot Inspection Required ❑ Yes ❑ No r Lot Inspection Date Soils boring report by' Date Soils Map Page Soil Type Approved by ' "" Date U No. of Systems Tfie of System(s) No. Dwelling Units/ (1) Septic Tank Rate /Sand tln xiaep g eNewing Tank ❑❑ ERWDernent V ( G+ gSoil GW al trench )Leach Line Sq. Ft Sidewail allowance Install *a) fL long R wide with .Leach Bed sq. ft. area R rock/ sq. R _ per running ft. 0 --- NA min. irxmes nick dralniirm or a Leachlines/bed special design for slope: (3) Pit Diameter No. Pits Pit Below Seepage PiLTp 9,-pth ' App / Inlet (B)) I ( N/A rden tactor 8 - (f Max. AllovYle Depth 7"0 No. 2 System NIA REMARKS: ( % /"/d Daa t. --G X14 This application ' APPROVED -for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated 0 Z on the accompame p of plan, using 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. ®1 Septic tank and sewer lines must be 50' minimum from any well 1 LIQ (2 Leach lines must be 100' minimum from any wells, including expansio ar Seepage pits must be 150' minimuum/from any wells, Includi expansion a ems/ 10 Signature of Health Official Date F o RECEIPT NO. Y 330 T4331 Issued By SAL ate lT - v DISTRICT: ❑ Riverside, n Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑. Blythe DOH SAN 122 (Rev: 5/88) DISTRIBUTION` WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept. GOLDENROD - Plans/Records t