PLBG (04-3571)r
Ot�ePAAU.
P=,� BUILDING &SAFETY DEPARTMENT
O BOX 1504-
(760) 777-7012
Of. 77"`78-495.CALLE'TAMPICO FAX (760) 777-7011
LA .QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number 04-00003571 Date -4/19/04
Property Address . . . . . 8.1810 MOUNTAIN VIEW LN
APN: 767-480-008- - -
Application description'. PLUMBING
Property Zoning . . . . . •LOW DENSITY RESIDENTIAL•
Application Valuation 2.500
Owner Contractor
FEIST JAMES JOSEPH ALMS UNDERGROUND CONST, INC'.
3540:W SAHARA AVENUE 113 38103 VISTA DRIVE
81816 MOUNTAT.N VIEW LANE CATHEDRAL CITY CA 92234,
LAS VEGAS... NV 89102
WCC: VIRGINIA INC
WC: 00500016007 -01/01/05
CSLB: 482180 11/30/05
CCC: C.42 -C21
Permit.,PLUMBING
Additional desc".
Permit Fee_ 37.50 Plan Check Fee 9.38
Issue Date Valuation 0
Qty. Unit Charge Per Extension
BASE FEE 15:0.0
1.00 22.5000 EA . PLB CESSPOOL 22.50
..Special.Notes and Comments
ADDITION. OF LEACH LINE TO EXISTING
SEPTIC .SYSTEM
Fee summary Charged Paid' ..Credited Due
Permit Fee Total 37.50 00 .00. 37.50
Plan Check' -Total .9.38. 00 .00 9.38
Grand Total 46.88 .00 00 46.88
UWP.O. BOX 1504 • VOICE (760) 777-7012
78-495 CALLE TAMtICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 449
INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number.
• ..Address:
Date:
Architect or Engineer. -
Architect or Engineer's Address:
N 4k
Lic. No.
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
Code. andd myyLicense is h tui tomonce and
1 hereby mm under penalty a y that 1 am licensed under PiVAsions d ter Chap9 (cam"cinp with section 7000) a Division 3 d the Business and-Prolessionels
x effect
�L7oer►se Mass — / Lkwm N,.
1 hereby afrirm under penally d perjury that I am OWNER•aULDER DECLARATION
City or �y that a pftn* b construct, � from" CorMractOrs' State License Law for the /opowig mason (Sec T031 b, Business snit Prdessbns Code: Any
*statenm lomat he or she Is licensed • demolish. or mW any struck' prior b its ksuanee. also requires the applicant for the permit b Goa signed
and Professions Code) or that he orexempt to of the Cw*aebW State License Law (Chapter 9 (oommencinp vMh Section 7000) of Division 3 d the Busi ess
the applicant b a dvi han lvhundrIt ed and the basis for the alleged exemption- Any violation a Section 7031.5 by any applicant for a permit subjects
U I, as owner a the property. . not mac than five hundred dollar: ($500).):
DroP«IY. or my empbyees with wages es their sola compensaion, will 00 the work, and the structure is not intended or offered for sale (Sec 7044,
Business and Professions Cafe: The mm=t: License Lew does not appy to an owner of property who builds or impmves thereon, and who does the work
himselfoar or through his or her own enployaes, provided that the improvements are not kdended or offered for sale. ff. haweyer. the building or improvvrtnent is
sold wOf Completion, the owneabrrlder will have the burden d proving that he or she lid not build or improve for the purpose of sale.).
U t, as owner a the one 1�
propeAy, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Coale: The Contractors'
State License Low does not appy b an owner of pi fly who builds or improves thereon, and who contacts for the projects with a COntracbr(s) icensed pursuant to
the Contractors! State License Law.).
U I am exempt under Sec. . B.3 P.C. for this reason
Date Owner
1 hereby affirm under penalty d perjury one d lone WARS' COMPENSATION DECLARATION
1 have and will maintain a certificate of consent to for wprkers'
of the work for w! id this per.. Is issued compensation. as provided for by Section 3700 of the Labor Code. ler the pdxfarmmmarmoe
_ 1 have and will maintain workers' compensationkmsurence. as required by Section 3700 of the Labor Code. for the performance d the wok ler which this pa" is
issued' My mvor�ters' d�orrlpensatwn'o k>;nasrmoe coroner and poky number aro:
er 7
_ 1 that, In the aloe work ler which lois Pemst is issued, l shall nil empioy any person in any manner so as to becon subject to the workers'
CMVN salon law: Of Caibmmia, and agree that, if 1 shaAd became subpd to the workers' compensation provisions of Section 3700 of the Labor Code. I shall
brlonwith.corrply with those provisions.
ff/LIft,
WARNING: FAILURE TO SECURE WORKERS' coo,"TION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CML FINES UP TO ONE 14UNDRED THOUSAND DOLLARS ($100,, NJ ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, M (TEREST, AND ATTORNEYS000)FEES. .
1 hereby affirm under penalty d perjury that there is a constructionCONSTRUCTION LENDING AGENCY
lending agency ler the Performance Of ftwork ler which this permit is issued (Sec. 3097. Civ. C.).
Lender's Name
Lenders Address
IMPORTANT Application is hereby moo to the Daedor a Build; and Sof APPLICANT ty SACKNOWLEDGEMENT
1. Each person upon whose behalf this hermit subject b the conditions and restrictions set forth on this application.
trisect as o result d this application, �a e� terse► at wtrose request and for whose benefit work is performed under or pursuant b any permit
officers, agents and aced to
each agrees p and shall, defend. indemnify and hold hamnleas the City a la Qukmta, its
employees for any act ti omission related b the wok being performed under or following issuance of this permit.
2 Any Permit issued or 1 result a this application b000mes n ull and void K work is not commenced within 100 days from date of issuance a such permit, or
cessation d wok ler 180 days will subject Perinit to cancellation.
1 certify that I have mead this application and state that the above infomnation is cared 1 agree to comply with an
construction, and hereby authorize representatives d this city and county ordinances and state laws relating b building
comfy b eller upon the ebove{rmentioned property ler inspection purposes.
—IV.—te /9,4112 r. 2 DU df ignature (Applicant or
Agent):
COUNTY OF RIVERSIDE COMMUNITY HEALTH AGENCY ASSESSOR'S PARCEL NUMBER%6
DEPARTMENT OF ENVIRONMENTAL HEALTH % _ � � � _ L) � 8
APPLICATION FOR WASTEWATER DISPOSAL APPROVAL"
APPLICANT: Submit this form with four copies of a SCALED plot plan (1"=20' to 1"=40' SCALE) drawn to County specifications as indicated on the attached
check list. A non-refundable filing fee 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 payment.
LMS #
Agent, Contractor, Contact Person
City State Zip
Address/�
Telephone
f"(�".S. CfnG'1,inrJ1-,kNP(
..�1
38%33 VrSl-, br• C51{},Pdrod Cr f,, Ca • iZZ3/
321/•/9/�
Owner f
� SA'✓.�
Address r City State Zip
Telephone
Q
OJob
Property Address
City
Zip
IU
Lot Size
Water Agency/Well
Use of Permit, P/P, SUP, PUP, etc.
Legal Description
DBA
r
, A CA
J �
� /
/ f�
41C �
Dwelling, MH Site Prep., etc.
` b
Signature of Applican t�'
Date
(1 FOR OFFICE
USE ONLY
CHECK BOX IF REQUIRED
If any box is checked, this application shall be considered rejected until the
❑ Detailed Contour Plot Plans Required (1 to 5 foot interval)
information is provided and the fee paid. Resubmittals later than 90 days
after date noted below may require repayment of fees.
❑ Other
❑ Staff Specialist Lot Inspection Required
m
Z
C)Holding Tank Agreements Completed
LD
❑ Certification of Existing S.D. System Required
Thomas Bros. Page Grid
W❑
WQCB Clearance Required
❑ Date Lot Inspection Completed: Initials
(Attach for DOH-SAN-007, Santa Ana Region Only)
Remarks:
❑ Soils Percolation Report Required
Cl Maintenance Booklet Provided
❑ Special Feasibility Boring Report Required
❑ Final Inspection by Department of Environmental Health is required.
❑ Rereview Required Initials Date
Please call 24 hours PRIOR to inspection.
C/42 / Soils Percolation Boring Report By Lic/Project # Date
Soils Map Page Soil Type Approved By Date
No. of Systems
Type of System(s)
No. Dwelling Units
(1) Septic Tank
fi
Soil Rate
Grease/Sand
❑ Holding Tank ❑ Replacement
❑ New.fir] Addition
Existing
Bedrooms, Fixture Units
7 11%
1� t-'' 4
--A->t
�-7y
(' XX 00
Grease Intcp/Lint Trap
❑ C] Connect to Sewer
Nt
Gal.
Gal.
Sq. Ft.
Bottom Area
Total Linear
Ft.
Sidewall Allowance
Z
/ 4 �ft.
Leach Bed sq. ft.
Ne
ft. rock/ sq. ft. running ft.
Install Line(s) long -' ft. wide
ofBottomArea
Inlet Tested Depth
p ❑ N/A
with min. inches rock bel/ow drainlines
/ 'e ,i ,[� 'J�
C)
/
�C -17-n .,5 i t
Proposed Bottom Tested Depth
or A :7:�e 14
Z
Leach lines/bed special design Or slope:
(3) Pit Diameter
No. Pits
Pit Below Inlet (b1)
Seepage Pit
Maximum
Other:
0
Applicable
Total Depth
Allowable
0
N/A Overburden Factor
❑ 5' ❑ 6'
TD
Depth
Well Review Approved: Date: Well Drilling Permit#
SIGNATURE
Grading Plan Approved: Date:
SIGNATURE
Plan Check Only Approved: Date:
REMARKS: i� Q�r17l. / S �1 z_ A �c r'I;o..-� 4/1
66 ?C l� �l rr�, / �'y, A- •tr /lt'� `l�t�t r a� `d�l�l-� -� 7
w�
This application is APPROVED/DENIED for the category checked in
SECTION B above,egarding the design of a disposal system as indicated
on the accompanied plot plan;-using the requirements set forth in SECTION
R. ;
7•
C above. A building permit is necessary for the installation of the above-
Revenue Code Fee $ "�
designed system. No construction is Permitted in the required reserved
100% expansion area.
,
p� /
Check #
(1') Septic Tank must be 100' minimum from any wells.
�/�
Z(
Leach lines must be 100' minimum from any wells, including expansion
(area.
Date Initial
O
(~j
(3) Sewer lines must be 50' minimum from any wells.
W
U)
(4) Seepage pits must be 150' minimum from any wells, including expansion
RIV R_SS,IDE: 909-955-8980
area. A
4ZL14
IND 10: 760-863-7000
SOUTHWEST: 909-600-6180
Signature
Date
DEH -SAN -122 (Rev 8/01) Distribution: WHITE—Office File; YELLOW—Applicant; PINK—Bldg. Dept.; GOLDENROD—Plans/Records
it
ALMS. UNDERGROUND CONSTRUCTION
38703 Vista Drive, Cathedral City, Ca. 92234
f 760-324-1911, FAX: 760-324-9541 -
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5t b LA S
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ciTY OF LA QUINTA
DEPT. -
BUILDING & SAFETY
APPROVED
RUCTION
FOR CONST
y
BU
I , , - F
DATE
A,
i I
MEPARTIV"IIEKII C. -F PUKIC IS
fiS VALID FGR UNE (1) YEAR
POM AP
1� RVUE OF AP
c, �4o %4 5 e--
. R1810
! .- i
Lav Q U•;vx rte -
'A RE -INSPECTION FEE OF $ 3,r
WILL BE CHARGED IF THE APPROVED
PLANS AND JOB CARD ARE NOT ON
THE SITE FOR A SCHEDULED
INSPECTION..,
COI'' NTY OF fVi.i,aiiDE
DF
�PARTMEN T OF ENVIRONMENTAL HEALTH
Sewage Disposal.
>%— Dwelling -.GteJ 710 Gal. Sept- le Tan
Z-20 'Sq., Ft. of Leach Line
IT —Commercial• 've,
B1 _TP—M
Seepage Pits No. ia D
Convect to Sewer —Cbnnect to Existing System
A,
c o ojnj.sjmrwatkr softening devices shall be discharged Into the septic system without clearance
from the Calif.. Regio n—a-ti'�'Lr_Quanty Control.Board.
ent
31 All sewage disposal installation shall con.form to the current :UPC
Qp a new appr6val by this Dept.,
h of the proposed 1pach H
Any din iq the area
Date