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BPLB2017-0028Applicant: Contractor: C];1„ VOICE (760) 777-7125 78-495 CALLE TAMPICO 38703 VISTA DRIVE D�. CATHEDRAL CITY, CA 92234 LA QUINTA,`GALIFORNIA 92253 DESIGN &DEVELOPMENT DEPARTMENT FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Llc. No.: 482180 BUILDING PERMIT Date: 2/9/2017 Application Number: BPLB2017-0028 -` . Owner: Property Address: '49575 AVENIDA MONTERO RICHARD KERR APN: 646182023 209 E MICHIGAN AVE Application Description: KERR / INSTALL NEW SEPAGE PIT BATTLE CREEK, MI 92253 Property Zoning: Application Valuation: $11,000.00 Applicant: Contractor: ALMS UNDERGROUND CONSTRUCTION INC ALMS UNDERGROUND CONSTRUCTION INC 38703 VISTA DRIVE 38703 VISTA DRIVE CATHEDRAL CITY, CA 92234 CATHEDRAL CITY, CA 92234 (760)324-1911 Llc. No.: 482180 LICENSED CONTRACTOR'S DECLARATION f 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 Professions Code, and my License is in full force and effect. License Class: C21, C422 License No.: 482480 Date`i / Contractor, _ .r —8 OWNER -BUILDER DECLAR N I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged_ exemption. Any violation of Section 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: I ) 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, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves.thereon, and who does the work himself or herself through his or her own employees, provided that the 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 or she did not build or improve for the purpose of sale.). (� I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ( ) I am exempt under Sec: B.&P.C. for this reason Date: Owner: _-/CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is. a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the•followirig 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: I 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 and policy number are: Carrier: ACE AMERICAN INSURANCE COMPANY Policy Number: RWCC48821078 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. ,Date: a0 1.7 Applicants. WARNING: FAILURE TO SECURE WORKERS' COMPEN ION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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. APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to the Building Official for a permit subject to the conditions and restrictions set forth on this application. t 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 application , the owner, and the applicant, each agrees to, and - shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and employees for any actor omission related to the work being performed, under or following issuance of this permit. 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 county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. Dat 9 FRl 20 J i Signature (Applicant or Agen .; FINANCIAUINFORMAT.ION DESCRIPTION. ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT QTY AMOUNT PERMIT ISSUANCE 101-00007-42404 0 $96.27 Total Paid for PERMIT ISSUANCE: $96.27 DESCRIPTION ACCOUNT QTY AMOUNT SEPTIC SYSTEM 101-0000-42401 0 '$12.67 DESCRIPTION ACCOUNT QTY AMOUNT SEPTIC SYSTEM PC 101-0000-42600 0 $5.07 Total. Paid for PLUMBING FEES: $17.74 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Bin ## Permit # nn Project Address: t' City of La Quin to Buifding 8i; Safety Division 78-495 Caffe Tampico La Quinta, CA 92253 - (760) 777-701,2 Building Permit Application and Tracking Sheet Owner's game: ' A. P. Number: Address: ..119-57,57'f1 v 1Y) r,+. y- o Legal Description: City, ST, Zip: Contractor: r e. Address:3 2,7 o 2 Telephone: �% o e. O 3 >6 / 9 $6 8' Project Description: City, ST, Zip: 92 Z3 _..----"--•- .Ls7 Sfat. .vt•e. Sem o. �. � TeleP hone: 2 Y 7 e_ 1 a' State Lic. # : $2/ S D City Lie" #c % 6 Arch.,-Engr., Designer: Address: City, ST, Zip: Telephone. one: n aneY Costructi n Type: Occupancy: : State Li. ,- t # c • Project type (circle one • New Add'n Alter Repair. m Demo 0 Name Name of Contact Person: Sq. Ft.: #Stories:. # Units: Telephone # of Contact Person: Estimated Value of Project: / / as b v APPLICANT:. DO NOT WRITE BELOW THIS LINE # Submittal Rcq'd Rcc'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount , Structural Calcs. Reviewed, ready for corrections.. . Plan Check Deposit Truss Calcs.. Called Contact Verson Plan Check Balance' Title 24 Calcs. 'Plans picked up Construction ' Flood plain plan - Plans resubmitted Mechanical Grading plan 2'. Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''J. Reyierv, ready for correctionstissuc. Developer'Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees, Total Permit Fees 4 County of Riverside PrP-- ��. • DEPARTMENT OF ENVIRONMENTAL HEALTH www.rivcoeh.org LAND USE APPLICATION OFFICE USE ONLY LJ 3880 Lemon Street • Suite 200 • Riverside • CA • 92501 - (951) 955-8980 0-47-950 Arabia Street • Suite A • Indio • CA 92201 - (760) 863-7570. PE CODE: FEE: EHS # 7 L+ TR/PM 3y y [i APN: ON # I LMS # A r. I LOT # e- USE OF PERMIT:. SECTION A j Name OWNER: Address /- Ji %.5 V2 / /j C City Lti ,:.��`- Zip Phone"// Email AGENT/ Company Name A Y�\5 ,� def: r'7 A ent/Contractor CONTRACTOR: Mailing Address F< -7 7 -3 ;5 to Cit Co' f6z fo, l C-, Zlp V aZ3 Phone 760 Email PROPERTY INFO: Site Address q V 7-5 ve /"-10 lite rC Cit L 'k zip. Water Aaencv/Well C V WJ� Lot Size APPLICANTS SIGNATURE: e,' � DATE: 6 �"t'✓� Z C7 I SECTION B UBelow— For Office Use Only CHECK BOX IF REQUIRED. If any box is checked,, this application shall be considered denied until the information is provided. ❑ Holding Tank Agreements Required ❑ Certificate of Existing OWTS Required (C-42) ❑ WQCB Clearance Required ❑ Soils Percolation Report Required ❑ Floor Plan and/or Plumbing Layout Required ❑ Special Feasibility Boring Report Required ❑ Detailed Contour Plot Plan Required (1 to 5 foot intervals), SITE EVALUATION INSPECTION REMARKS: EHS INITIALS/DATE: SECTION C ❑ NEW EPAIR / REPLACEMENT ❑ EXISTING ❑ PUMP ❑ ATU ❑ CONNECT TO SEWER I FIXTURE UNITS # BDRMS # Soils Percolation/Boring Report By: Date: Project# C-42 Certification By: '�/ Date: / License# Septic tank cap.: Soil Rate: Tested .Depth: Max. trench depth: Sq. Ft. Bottom Area: Total Linear Ft.: Line(s): Length: feet - Each 3 feet �McI Sidewall Allowance: Ft. Rock/ Sq. ft. Running foot Rock below drain line: in. or ❑ Plastic Chambers Leach Lines/bed special design for slope: ❑ N/A ❑ Overburden Factor: Pit Diameter. L7 r I No. pits: % I Depth below Inlet bi :•� Pit Total Dept': Max. allowable depth: CONSTRUCTION/INSTALLATION REMARKS: ��. �z��1 -� C - zP ..�� ;� -t SECTIONt f % This Application is Approved ❑ Denied regarding the design of the OWTS.as indicated on the accompanied plot plan using the requirements set forth in Section C above. No construction is permitted in the required reserved 100% Expansion area. EHS Signature: t „ `.}-- / _ I I7,^,_.E.G,, y� t v,���� ✓�� Date: •� f EPG -K- ,�:b� ! - Disinbution, WHITE _ EL O � Office File: Y_ L.�N – 31Cg. Oept.. INI: – Acolicant 0 b, County of Riverside DEPARTMENT OF ENVIRONMENTAL HEALTH www.rivc-ceh.arg CERTIFICATION OF EXISTING SUBSURFACE DISPOSAL SYSTEM ❑ 3880 L,.,,, Street - Suite 200 - Riverside - CA - 92501 - (951) 955-8980 ❑ 47-950 Arabia Street - Suite A - Indio - CA 92201 - (760) 863-7570 -Property Information: APN: Date'of Inspection: 7 Kerr 'Addr 5 75 -4 ve o nleon QA;VN+r1,- 1. Owner: t1w Address: Cit�y: FAILURE TO PROVIDE ALL REQUIRED INFORMATION SHALL PREVENT 0VINER FROM'OSTAINING ENVIRONMENTAL HEALTH APPROVAL 2. Show design and location on a scale of 1-20 or 1:40 of the sewage disposal system and 100% expansion area in relation to dwellings, structures, wells, rock outcroppings, drainage, watercourses: etc. 3. a.. I examined existing- subsurface sewage disposal system at the above location on . 7 reA L?oi 7 and determined that the 'Lank capacity is jo01D 'gallons and that there is - s , q. ft. of leach line bottom area. There are 3 bedrooms.in the dwelling and -there'are fixture units'. b. There are [each line(s), each ft. long Depth Rock 0 Plastic Chamber c. There are Seepage pit(s), each 6� ft. in diaineter, and ft: TD. ft. BI. The leach bed is ft. by ft., total sq. ft. o . f leached area. Depth is ft.' 4, a. C onstruction of septic tank (Please check one of the following): . La"Concrete 0 Fiberglass .0 Steei Cl Other: b. Internal dimensions of septic: Length ft. Width 6 ft. Depth C. Condition of tank (please check yes or no for each uestion Inlet Tee present? ❑ Yes ❑ NO Tank Structuredeteriorated? C) Yes 911,11COutlet Tee present? ❑ Yes ❑ NO Effluent Filter Present? 0 Yes O'No Two compartments? . LTYes El No d. Condition of D -Box: Level? ❑ Yes ❑ No Replaced? ❑ Yes ❑ No' a. 'Alhile ' o6mping tank, did effluent flow back into tank from abscroticr, system? -C�'Yes 0 No b.-. Prior to pumping, was the liquid level in the tank above the outlet 6L= -e? eyes ❑ No c. Was the area around the lids oxidized? ❑ Yes YNo d. Is design of system gravity feed? &Yes- 0 No e. Were well(s) observed onJhis or adjacent property? ❑ Yes &No If yes, indicate distance of well from: Septic tank ft. Leach lines Seepage Pits f. Distance from springs, lakes. and natural water courses. (check all that apply): ❑ Septic Tank ft. 0 Leach' lines ft. CJ Seepage Pits ft. g. Is sewer within'200 ft. of structure and abuts property line? ❑ Yes No Additional Comments: h. How long has dwelling been vacant? (if applicable) :a- months weeks ❑ N/A 6. It is my opinion Chat the system appears to be in good working order and can 'ieexpected to function properly with proper maintenance. No repairs are necessary at this time. b L It is my opinion that the system is not in good working order and will- not functicn properly �Nithout the following repairs.- 0 fk5-(-7 �oxge 'J I certify under penaltI, of perjury that the foregoing is true and correct. Signature, Print Name: - Contractor License No.: U i-/ Expiration Date: A p r 7 Pumper Co.. -Phone Number, Address: 733 ­,?0 City. 4, Zip: .97- .2- -3 Ll ALMS UNDERGROUND CONSTRUCTION, INC.... 38703 Vista .Drive, Cathedral City, CA" 92234 F CA Lic. 482180 760-324-1911 Office 760-324-9541 Fax 760-578=.1510 Ce.11- Almsunderaroun'd.(@omail.com 2oi?