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003713 (SFD)• A' I/ 44 P.O. BOX 1504 No: 003713 Building 78-105 CALLE ESTADO Address 51-899 Carranza LA QUINTA, CALIFORNIA 92253 Address 72-850 Sonara Poad City Zip Tel. Contractor ress BUILDING:- TYPE CONST. OCC: GRP. A.P.,.Number 773-154.020 Legal Description Project Description S11 ale Fami1V rXin-13-incr City Zip Tel. State Lic. City & Classif. 517085 Lic. # ,Sq. Ft. 1385 No. No. Dw. Size Stories Units Arch., Engr., - . - - __ - Designer New. El Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. #- LICENSED CONTRACTOR'S DECLARATION. I hereby affirm that I am licensed,unde 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: Anycity 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 heis 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). ❑ 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.) - - O 1, 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'COMPENSATIONINSURANCE (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 i NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become 1 subject' to the' Workers' Compensation provisions of - the Libor 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.) 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 sof this city to enter the above- mentioned property for inspection purposes. Signature of applicant Date Mailing Address Estimated Valuation • BY: Minimum Setback Distances: PERMIT r: AMOUNT z - Plan Chk. Dep. 5250-.00 Side Street Setback from Center Line .Plan Chk:. Bal. Side Setback from Property Line $ 68.23 const. INSPECTOR 374.00 Mech. Validated by: 36.00 Electrical Validation: 73.74 Plumbing 105.00 S.M.I. 5.50 Grading 20-00 Driveway Enc. 20.00 Infrastructure 1,674.44 TOTAL �2.22,� "n ;' r " REMARKS il"�{'•i1!'R,'4!!€61 it r��11�ti2'-�'irl�ii�'1: �+) i': 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 3/15/8PPermit Validated by: Validation: City, State, Zip HARD COPY t�. T CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SO. FT. FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK FOR. SO. FT. ® GAS (ROUGH) METER LOOP GAR. SO. FT. @ POWER OUTLET ROOF DRAINS / (FINAL) - l' Y TEMP. POLE DRAINAGE PIPING CAR P. SD. FT. GROUT WATER HEATER WALL SO. FT. @ FINAL INSP. DRINKING FOUNTAIN SO. FT. ® WATER SYSTEM URINAL ESTIMATED CONSTRUCTION VALUATION $ =$ WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER VENTILATION 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 ® 3/.c HOUSE SEWER FINISH GRADING GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE EPLCI.FEEE --JCONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR ETBACK 2 —/,(� F1 GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE OUND. REINF. �`lA• `� c GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. REINF. STEEL / (FINAL) - l' Y TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. g/(ROOFING L (-, (^ �'d�YC�G K REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH I ULATIONISOUND/0—/j 4( FINISH GRADING FINAL INSPECTION/. CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL Building/^ Address Owner Mailing Address 7,;Z City Contractor S/1=r Address City State Lic. & Classif. r� 7 Arch., Engr., Designer Address r Qgh(& P.O. BOX 1504 APPLICATION ONLY 78-105 CALLE ESTADO C�/Lf1r Z LA QUINTA, CALIFORNIA 92253 k� Zip Tel. �yZGo 3 Lic. # 1 ,Jr "4 Tel. `I City / �y Zip State a / �-r+ //r-�� r-i� �`2 D Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 70D0) 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,Buslness 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.) O 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 ($100) valuation or less.) I certify that in the performance of lhp 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. 3097, 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 car illy 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 BUILDING DIVISION BUILDING: TYPE CONST. OCC. GRP. A.P. Number. -7 -7 — h �>/-- 61 2- -0 Legal Description Project Description Sq. Ft./ S — Size f No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. -Z 0, 0 0 Plan Chk. Bal. Const. 17 0 , DO Mech. S6 . G'0 Electrical Plumbing 42 430 S.M.I. Grading e apo Driveway Enc. AO Infrastructure #4L. 0; TOTAL 7 REMARKS 00�1i12 iU YcUCr 0.5 -iu-bb 1Z ZONE: BY V LHJr1 i IUIH.. i _t�J.lav 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: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SO. FT. @ FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SO. FT. ® GAS (ROUGH) METER LOOP GAR. SO. FT. ® POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. SO. FT. GROUT WATER HEATER WALL SO. FT. @ FINAL INSP. DRINKING FOUNTAIN BOND BEAM WATER SYSTEM URINAL SO. FT. ® LUMBER GR. ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. 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(AUTO)(DISH) APPLIANCE DRYER VENTILATION GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FIRE ZONE ROOFING LAUNDRYTRAY AIR HANDLING UNIT CFM FIREPLACE 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 I IBATH TUB MESH SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac 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 SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK 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 FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS ' GARDEN WALL FINAL 2 Z O P U LU rn DO Z O U w U) Y cr Q 2 W CC U W U) tkar`�'i�yrw.rf�$yii+'t• COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION ` -7737� -16/ Y —�� 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 of $40 is required when the application is submitted. Check must be made payable to the County of Riverside. Building. Department Application Log N Name (Owner, Agent. Contractor. Etc) - Mailing Address ,. City / �,�.-• Lle State Zip Code Telee7p�hoon%e 'Job Property AAddress w I C.i�tN�/�a+'��iy/�r �-•.��a-ter. Cdmmunitr'1 A /14f1 'Legal Description offProperty (Lot. PM. TR) A- ry/% ?a' :Irbloek 5-7 JIWarMf4r 'Assessor's Parcel Flo ��-enc r'WW-� /i./ �l���Q/i/ /.� fanning �/ /�Y►� Use of Permit / f/ ,/�,N Planning Case M Lot Size - ". 1:) it/ J/, ISFD. MH Site Preparation Etc V S� 1 re of Applicant Date 'The above information must be verified from Building Application STAFF USE — DO NOT WRITE BELOW THIS LINE f� Initial /Date �, p ❑ (5 Certification of Existing S.D. System required. Yes No- WOCB Clearance required. ❑ Yes ©No. ED Yes ®'No Soils feasibility report required. Special feasibility boring report required. ElYes E]' No Detailed contour plot plans required. ❑ Yes ®"No r Staff Specialist approval required. Dyes O No Lot Inspection Date -Soils/boring report(by - i ^' P,1oject N f Date Soils Map Page < < Soil Type Approved by I - er Type of System: VNo. of Bedrooms (1) SepticTankSoil Rate Required ❑ Existing New ❑Additional ❑ Replacement G>�(, wvy Gals. ;2. 3f (2) Leach line sq. ft.. Sidewall allowanceInstall�� ft. Sq. Ft. Line(s)- Ft. Long, Ft. widewith, mi inches Leach bed Sq. Ftt of bottom (Bolt' - trench area) rock/ — running ft. ©-N/A rock below drain lines area per Leach lines/bed-special design for slope: Applicable (3) Pit Diameter/ `GF,!P No. Pits Pit BI f Seepage Pit total depth LH'6'/ f ly[ Max. allowable depth Overburden factor ^(N///A v nieor the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements This application islapproa eed/ dded f set forth in Section B abovem. A building permit is necessary for the installation of the above -designed syste'� "((i�Septic tank and sewer lines must b 50' from any wells -140 (2) Leach lines must be 100' min. from any wells including expanslo0//%area L►­ct C)Seepage its must be 150' min. from any wells including expansion areal/ fd f c �! crZ:t. Signature of Health Official / ) /7),` RECEIPT NO. 3 3 cZ S-- Issued by / % -r �� Date District: ❑ Riverside O'Indlo ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe Distribution: WHITE -Office file YELLOW -Applicant PINK -Bldg. Dept. GOLDENROD -Pending File DOH SAN 122 (Rev 8187) Desert Sands Unified School District CERTIFICATION OF PAYMENT 140TICE: THIS ©OC"Uf ENTSCH0OF ILITY FEES BE DUPLICATED. (ray TO: City of La Quinta DATE: Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 This is to certify that J developer of / Wilis located at - -%2 G'ua; f t�5in this District, has paid scho facility fees imposed rsuant to the authority generate by Gov rnment C de Sect•ot► 53080 in the amount f $ , c 0 G� ltd covering .a total of quare feet of ( residential or ( ) industrial/commercial evelopment and that building permits for this footage in this development may now be issued by your jurisdiction. 1P 13 'Cr" 0-1- 2A - u 000 0/b = 1109 ".t6bLc- White - Building Department • Yellow Ja for DESERT SAND616NIFIED SCHOOL DISTRICT Facilities Planning • Pink - Accounting • Gold - Developer (10)-37 Of R OMFE ir_E OF E. LEON SPAI;Gv AGRICUL'I URAL COiMMISSIONEIZ C0''115i1O'EA OJ JA ,�I �)) MES 0 WALLACE d AND ASS;SrAN1 n3>tr•USSIuNEP. " WEIGHTS S & MEASURES CLEMENT SB ERvE�Is1E E 49-613 IlwY 86, Suite 11-12 , ��,,,u„yo•''� Coachel.la, CA 92236 4 ► s, 1 Sq 619-342-8291 DATE 3— 9— 8' 8' USE W. 89 85 O 300,0 DEVELOPER'S NAME- ADDRESS: AME-ADDRESS: 2 IS -0 �W P�.2�,., 12,E z.�`, ca► 9 z i e o TELUPI ZONE: ( 4m) ) Dear Developer: 2 S 72S'. QA. i Goc After reviewing your landscaphig plaits, all plant material listed is not in violation of quarantine laws governing the Coachella Valley. If substitutions do occur and they differ fruit plant material listed, this office "Ust be notified hartediately. Thank you for protecting and preserving the Coachella Valley's pest -free environment. Agricultural Catnussi ier's OCEice cc: Indio and Riverside Office.