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LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
265214 0412. HIC 02t`7 l2C
Date _ Signature of Contractor � J•�, .�,,.,i,,�t ..
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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, Business & Professionals Code).
( ) 1, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
( ) I am exempt under Section B&P.C. for this reason
Date Signature of Owner
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
( ) I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 3700 of the Labor Code, for the
,performance of the work for which this permit is issued.
(( j,?l) have and will maintain workers' compensation insurance, as required by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued. My workers' compensation insurance carrier & policy no. are:
Carrier '!'.ATRIFUND Policy No. 446-00YW4i 203
(This section need not be completed if the permit valuation is for $100.00 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, and agree that if I should become
subject to the workers' compensation provisions of Section 3700 of the Labor
Code,:I shall forthwith comply with those°provisions.,
l.Daie: Applicantii��/..
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the. City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent)!/ 'f a A.`A =A Date
BUILDING PERMIT PERMIT//
DATE `i 10 VALUATION LOT 0303-034 TRACT
03/W10C =2�Wao
JOB SITE
APN
ADDRESS 51-315 .d.5 AWN9-4 A ]MYN! OZA
-
OWNER,
CONTRACTOR / DESIGNER / EN (NEER
MAMMA M1? MT
we
5'x•315 A ODA WHDOZ A
P. O.BCX W3
LA Q:UMA CA. 92253
T) L+�}L1/�7�35t���'ry..�ir�%1i�f3,S CA 921.12.40
�y g
60p729-6Qi5 LrJC.�114 0376
USE OF PERMIT
y�y
SEPTIC: ABIANDIDia; Sh"'WER. CONNECT
V.t WA'i`ION 21950.00 LS
M. SLIAMARY
PLUUM0 FF '... SEWER 101 -MO -419 -WO
nt
MAR 0 5 2003
CITY OF ILA QUINTA
FINANCE DEPT.
`4Y//�'��/>'�p
OTTI��q1p {{��((]] YY ��� %i�j'('>��'(� A�yMp��� 'y� ���Q �.G�P��j
]-�k�..'.7 AL CONM�8?U�Jjl�✓S�1 .�yh`I1.Y Pii.�i�i !-1-MCK
(71 /�;
$30.00
RECEIPT
DATE
BY
DATE FINALED
7,1-Kci
INSPECT
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. Test
Final
Gas Piping
PLUMBING APPROVALS
EacTestric Final
Waste Lines
Heater Final
!Nater Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection _�� fL3
Encapsulation
Gas Piping
Gas Test
Appliances '
Final�� aG7
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp: Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
Final
COMMENTS:
FES -26-2003 WED 12:51PH ID: pAC'=;2
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COACHELLA VALLEY WATER 01 STRICT
%
CASH RECEIPT. -DETAIL .
MY
Rai ;el" d.F
Address-
—Date: }—
Acoottrit No.
64
o Meter(s)
C-od
77
0 '8abkfic:w(a)
11 House LAtbral(e)
'-C) DGtDbt0'rCh'0Ck(a)
Q Meter $*
Orlrmltollon Capacity Chargd.
0 W.S.B.F.C.
0 Temporary Conatru'cllon Meter
0 Tuin ori Charge
0 Unc011ecred AccO* u*nt - Name
0 Inspection Fee _-,Fact
Fee -
u' PlAri'Cheok FOOD Water I Sower -
Tract - 7
(3 Bond P"moni - AD. - Bond—
mer I eposlt,**. ......
t1wr•
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:���dJY�NZ����...5'L'�frf���iliti''�3.L•`IS�AJC•j!`"`�.ii�BAP-i•.:'+wn•.1._�.�...�
.. .. : �•.i�•:�4 .. )'n. ... ... .......'.:w*''•:/..:,
.ly:�: �•�.u�l.. {:.... �. .
FES -26-2003 WED 12:51PH ID: pAC'=;2
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CvWn_Al.lA 1441pal
FES -26-2003 WED 12:51PH ID: pAC'=;2
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A-1 Cesspool Service, Inc....
P.O. Box 580188, North Pal m.Springs, Ca 92258 ...JOB INVOICE
`Since 1959'.
(760) 329-6875 Fax (760) 251-3405
Date Ordered
State Lic. #265214 Customer Order No.
www.alcesspool.com Order Taken By Date9romised
BILI. TO
& SS t-�0O
CITY I ...... /
JOB ADDRESS rn�: N D a 7 A L
SERVICE UMP,SEPTIC TANK HAS SEPTIC TANK BEEN DUG UP? 04<70 No ❑ PMT. ON SITE
❑,p
REQUESTED lib'rP SEEPAGE PIT AT ITS RISER b.9P rCE BILLING
ooiFa AMOUNT
umping Fee per 1000 Gallons (or fraction)
Waste Discharge Fee per 1000 Gallons
Locating and Opening Fee (1hr. Min.)
Out of Area Fee
S 7012
❑ THE LEACHING SYSTEM HAS FAILED.
. ❑ THERE IS AN OBSTRUCTION "UPSTREAM" OF THE SEPTIC TANK.
It will be necessary to contact a lune cleaning company.
❑ WE RECOMMEND MAINTENANCE PUMPING OF THE SEPTIC TANK EVERY
[] YEAR ❑ OTHER YEAR ❑ 2-3 YEARS
To remove built up solids. This will increase the lifeof your leaching system.
❑ THIS PUMPING WILL PROVIDE ONLY TEMPORARY RELIEF AND NOT
SOLVE CUSTOMERS SEPTIC PROBLEM BECAUSE OF THE ABOVE.
❑ CUSTOMER HAS BEEN GI VEN AN "EXPLAHNATION" PACKET.
A SERVICE CHARGE OF 822 WILL BE DUE
ON ALL RETRUNED CHECKS.
A FINANCE CHARGE OF I I/2% PER MONTH, 18% PER YEAR, WILL BE
CHARGED ON PAST DUE ACCOUNTS OVER 30 DAYS.
IF PAYMENT IS BY CHECK
DRIVERS LIC.p STATE
I hereby acknowledge the satisfactory completion of the above described work:
SIGNATURE �
Total
Due
P.O. BOX 1504 No. 003418
Building 78-105 CALLE ESTADO
Address 52-315 Mendoza LA QUINTA, CALIFORNIA 92253
Mailing
Address 43576 Washington street
City Zip Tel.
-PalmDeaert 92260 1 345-2`696
Contractor
City
State Lia I City
& Classif. 448018 Lic. #
Arch.,Engr.;
-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
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, after, 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
,r 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).
❑ 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 improvesthereon 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 it 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 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 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. 23097, 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.
Signature of applicant Dale
Mailing Address
City, State, Zip
HARD COPY
BUILDING: TYPE CONST.r OCC: GRP.
A.P. Number 773-272-215
Legal Description
Project Description .,a'1,'J•2aln F'n—vRi n, i3wo+ll i i ", rT
Sq. Ft. 3&�
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
GAR 480'
Parch 216'
Pence 2001
Estimated Valuation
6.05 .
PERMIT
AMOUNT
Plan'Chk. Dep.
5250.00
Plan Chk. Bal.
S 61.96
Const.
364.00
Mech.
30. no
Electrical
7 2 A 30
Plumbing
xn�. tti
S.M.I.
T
Grading
2o. tin
Driveway Enc.
n�
Infrastructure
TOTAL
REMARKS
i.��?it�i it. '`t if t 21riT+1�;y`Y4tt -:�'rti•: .n 1L
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 I011/87permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SQ. FT. ®
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SQ. FT.
WALL SQ. FT. ®
SQ. FT. Cid
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
ROUGH PLUMB.
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
FOUND. REINF.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
METER LOOP
LAUNDRY TRAY
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
FRAMING
SQ.FT.GAR ® 3/ac
HOUSE SEWER
'^FINAL
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GAS PIPING
PERMIT FEE
VENTILATION
PERMIT FEE
PERMIT FEE
DBL
1116—
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
�41/LSETBACK G-/ 9- ql� �
GROUND PLUMBIN
/ -
UNDERGROUND
A.C. UNIT
COLL. AREA
(SLAB GRADE/D'" / ` ir
ROUGH PLUMB.
HEATING (ROUGH)
STORAGE TANK
FORMS
/BONDING
SEWER OR SEPTIC TANK /ROUGH WIRINGZ-/
CROCK
DUCT WORK
STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
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
INSP.
ROOFING
'^FINAL
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REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
_
ULATION/SOUND2' � -
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
tli l V n A A urm l unrwi1YMALA
GARDEN WALL FINAL
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
OF
NOTICE: THIS FACILITY
FEES
r-114BE DUPLICATED.
TO: City of La Quinta DATE;
Department of Community Development
78-105 Calle Estado
La Quinta, CA 92253
This is to certify that I C A' —H'
�I
ON
developer of, which is
located at — f within
this District, has paid school fa .lity fees imposed pursuant to the
authorit genera ed by overnment,Code S ct. 53 80 in the amount,o� 2/�
$ ( C:� �/
covering a total of square eet of ( ) residential or,
( ) industrial/commercial development and that building permits for
this footage in this development may now be issued by your jurisdiction.
�L i�v
IOQI ,W for DESERT ffANDS UNIFIED SCHOOL DISTRICT
.p
White - Building Department • Yellow - Facilities Planning 0 Pink - Accounting • Gold - Developer
0007
qw�
Building
Address
Owner
Mich
Mailing
Address 43-9
City
Pa 1 m lliesPrt.
Contractor .
Address
IT, t"' 0
��,460&(4*x
P.O. BOX 1504
78.105 CALLE ESTADO
LA OUINTA, CALIFORNIA 92253
Zip TL;.
92260 1 1345-
-576 Washinaton st.
Palm Desert 1 92260 1 345-2696
.8 Classif. ..., ,, . „ I Liw. #
Designer Michael C. Head _
Address -Tel. "
Zip St:Ae
Lic. #
LICENSED CONTRACTOR'S DECLARA i &ON
I hereby affirm that I am licensed under provisions of Chapter it (commencing with Section
7000) of Division 3 of the Business and Professions Code, and I:fy license is In full force and
effect.
SIGNATURF a DATE
OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractors Licsnse Law lot the following
reason: (Sec. 7031.5,ausiness and Professions Code: Any city cr county 1rNCh requires a
Permit to construct, after. Improve, demolish, or repair any structwa, prior t0 Is issuance also
requires the applicant lot such permit to fife a signed statement v,j� he is licensed pursuant 10
the provisions of the Contractor's License Law, Chapter 0 (cohn,onwn0 with Section 7000) of
Division 3 of the Business and Professions Code, or 11181.116 is 6A6n .rf tharetn)m, and the basis
for the alleged oxwnplion. Any violation of Section 7031.5 by any applicant for a pormil
'subjocis Inv appllcanl to a civil penalty of not mote than live hundred d^l.urs ($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 s.11a. (Sec. 7044, Buisndss and
Professions Code: The Contractor's License Law does not apply ;r, an owner of property who
Diads or inptoves thereon and who does such work himself or ;.rough his own employees,.
provided that such improvements are not intended or Offered for r&a. it. however, the building
or Inprovemont is sold within one year of completion, the owner sunder will have the burden
of proving that he did not build or Inptove lot the purpose of sale.)
O I, as 'owner of the property, am exclusively contracting with !'Qansed contractors to torr,
slrucl the project. '(Sec. 7041. Business and Professions Code: 7•;a Contractor's License Law
does not apply to an owner of Properly who builds or improves r;.a,00n, and who contracts to
such projects with a confrectorts) !,tensed pursudrmj to the Contractor', :..cense Law.)
O lam exempt under Sec. • B. & P.C. for this roast
Date Owner
WORKERS' COMPENSATION DECLARL' ,ON
1 hereby affirm that I have a certificate of consent to s:,lf•insure, or a certificate of
Workers Compensation Insurance, or a certified copy thereof. (S c. 3800, Labor Code.)
Policy No Company
O Copy Is filed with the city. O Certified copy is hereby t. nlshed.
CERTIFICATE OF EXEMPTION FRONT
WORKERS' COMPENSATION INSURA�.E
(This section need not DO completed if the permit is for one hr-,,.lred dollars ($100) valuation
or less.)
I certify that In the performancb of thli work for which thIt rermil is Issued, 1 shall not
employ any person In any manner 30 as to become subject Ir, '.he Workers' Compensation
Laws of Calllornia.
Data Owner
NOTICE TO APPLICANT: N, after making this Certificate of Eamption you should become
subject to the Workers' Compensation provisions of the Lada Code, you must forthwith
comply with such provisions or Ws permit shall be downed revoked.
CONSTRUCTION LENDING AGENCY
1hereby affirm that there Is a construction lending agency '•Jf the perfortnance of the
work for which this permit is issued. (Sec. 3007, Civil Code.)
Lenders Name
Lenders Address
This is a building permit when properly filled out, signed anc: '.rlidated, and Is subject to
expiration It work thereunder is suspended for 180 days.
1 Ce(llfy that 1 have read this application and stale that the i:bove Information is correct.
1 agree to comply with all city and county ordinances and sl�:a laws relating to building
construction, and hereby authorize representatives -of this -city to enter the above.
mentioned Property for Ir(spectlon purposes.
Signature of applicant. _._Dela
Mailing Address
Qty, State, 21p
FINANCE
MICHAEL C. HEAL)
faENF-RAL CONTRACTOR
"LIC. #448018
TFL: (ir19) 564-4075
APPLICATION ONLY
C 7)
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number
Legal Description Lot# 3 Blk #100
Project Description Santa Carmelita at Vale
Sq. Ft. No. No, Dw.
Size 1361 Stories 1 Units 1
New M Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
L
Electrical
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 by:
Validation;
04
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COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION
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 df� 7 is required when the application is submitted. Check must be made payable to the County of Riverside.
Building Department Application Log #
Name (Owner, Agent, Cottractor, Etc.)
1AAIc 11> ,4; C ' )� /;i-(0
Mailing Address
it 1-5 X76 WO' --
city
Slate
Zip Code
Telephone
'Job Property Adds
jLcitty,or nomaaug(ty„
'Legal Description of Property. (Lot, PM;--TR)s=
'Assessor's
Parcel No.
�/W�ater Agency Qr Weil,
1 +
Use of Permit +� +-�/%+''` . '50, iyplanning Case #
Lot Size
,`
+
�� . � � •
SFD, MH Site Preparation Etc. 6,44
It e-6
,Signature of'Applicant /{ . i Date
'The above information must be verified from Building Application
STAFF USE — DO NOT WRITE BELOW THIS LINE
- Initial
Certification of Existing S.D. System required. ❑ Yes EJ40 - /Date
� 7
WQCB Clearance required. ❑ Yes ❑-NQ/ /
Soils feasibility ❑
report required. Yes _
!DeMend)bo gFre�-Ort`"*Wquired. ❑
Yes
Detailed ❑
contour plot plans required. Yes Nom
Staff Specialist approval required. ❑ Yes bNo Lot Inspection Date
r
Soils/boring report by // Project # Date
Soils Map Page �� ��Soil TypeApproved by !/ 1,��/r� Date
Type of System: i
o. of Bedrooms
(1) Septic Tank
Soil Rate Required
❑ Existing aMe"w El Additional El Replacement
TN3
P;^a- •
Gals.
(2).Leeach line sq. ft.
(Bottom trench area)
Sidewall allowance
ft.
Install`+, Line(s)Ft. Long, l
Leach bed Sq.
rock/ Sq. Ft.
per running ft. E�,N/K'
de with min. inches
below
Ft.'of,btto� m
"�•'"`^-
\
rock drain lines
area
Leach lines/bed-special design for slope:
(3) Pit Diameter
No. Pits
Pit BISeepage
Pit total depth
Applicable
N/AL-"'Overburden factor
f+'
` �`�
a
I
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Max. allowable depth 40
This application i. 1aEpr:oved load 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 permittiisnecessary for the installation of the above -designed system.
(OSeptic Septic tank and sewer lines must b '515 from any wells //op.
(ALeach lines must be 100' min. from any wells including exp nsiori area
(3)) Seepage pits must be 150' min. from any wells including expansion area/
Signature of Health Official?
Date �i /
RECEIPT NO. G'`' Issued by
Date I( /5--,,F'7
District: ❑ Riverside 91ndio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe
Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD— Pending File
DOH -SAN -122 (Rev. 6/86)
i�
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\q 1.9 1s%
Dear Developer/Landscaper:
MICHAEL C. HEAD
'GENERAL CONTRACTOR
l(C. #448018
ItL-
f4
OFFICE OF
AGRICULTURAL COMMISSIONER
4080 LEMON STREET. ROOM 19
RIVERSIDE. CALIFORNIA 92501
(714) 787.2561
49-613 Hwy 86, Suite B-12
Coachella, CA 92236
(619) 342-8291
E. LEON SPAUGY
COMMISSIONER
JAMES O. WALLACE
ASSISTANT COMMISSIONER
Thank you for inquiring with the Agricultural Commissioner's Office regarding
local quarantine laws. .
Any diseases or insects associated with the plants/landscaping material presented
on your landscaping plans do not pose a threat to the Coachella Valley Citrus,
Date, Grape, Vegetable, or Field Crop industry. We therefore approve your
landscaping plans.
If however, any substitutions of plants/landscaping materials within your plans
occurs between now and the actual planting date, you must contact this office
within 48 hours before delivery into the Coachella Valley. Also, the substituted
plants/landscaping material must be held for inspection upon arrival. Any sub-
stituted landscaping material found infected/infested with quarantine pests will
be immediately treated or shipped out of the Coachella Valley at the discretion
of the Agricultural Commissioner's Office.
Under penalty of perjury, I the undersigned will comply with the above.
Authorized Agent:
Name_"Ir Date
Signature `
Permit Number(�AIs)_
/ /
Develops �f,,C , h12.�._�AaaaeAddress
67
AGRICULTURAL COMMISSIONER'S APPROVAL 112-L
Gig= 3 z2- yPIX
G
Date f -/.S-9-2
Authority cited: Agricultural Code; Sections 6301, 6461, 6462, 6464, 6501, 6521-
6524
cc: 2 Plan Check, Indio Office, Riverside Office
Lou:
4
cF,y`oF 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 (619) 564-2246
VIA CERTIFIED MAIL
January 20, 1988
Michael Head
43-576 Washington Street
Palm .Desert, California 92-260
Dear Mr. Head:
At present, your company has three (3) applications for
single-family dwellings that have been submitted to the
Building Division for permit- issuance. Original application
was made prior to October 5, 1987; however, to date, the
permits have still not been picked up or the fees paid.
This is to inform you that if these permits are not paid for by
February 5, 1988, the new infrastructure fee`will be levied on
these permits.
Please contact.me if.you have any questions.
Very truly yours,
Tom Hartung
'Building" Official
TH/mr
MR/LTRTH.009
MAILING ADDRESS - P.O. BOX 1504 LA QUINTA, CALIFORNIA 92253