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BPLB2015-0069
I . 1 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 ce4&t 4 4 Q" COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: ' BPLB2015-0069 Property Address: 177942 LAGO DR APN: 658270029 Application Description: ZWASCHKA /INSTALL SEEPAGE PIT TO EXISTING SEPTIC SYSTEM Property Zoning: O N Application Valuation: $5,500.00 Applicant: ':5 g ALMS UNDERGROUND CONSTRUCTION 38703 VISTA DRIVE c�5Lu CATHEDRAL CITY, CA 92234 LICENSED CONTRACTOR'S 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 Professions Code, and my License is in full force and effect. License Class: C21, C42 License No.: 482180 /�1 I Date / A''A27) 5- Contractor: 121 v OWNER -BUILDER DECLAR ION 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 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, 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 Addre! VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 (760)324-1911 Llc. No.: 482180 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 w for which this permit is issued. C ✓ 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: _ Policy Number: 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 Date: f M Z J Ile Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSA N 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. 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 act or 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. Date:,%N%a 2'01--f Signature (Applicant or Agent) w D"a:t_5/1/2015, Owner: a MARY ZWASCHKA - ►� o P O BOX 55670 O N z SANTA CLARITA, CA 92253 rt ':5 g © c�5Lu G C w _o U Z Contractor: `L o ALMS UNDERGROUND CONSTRUCTI41V—� U 38703 VISTA DRIVE CATHEDRAL CITY, CA 92234 (760)324-1911 Llc. No.: 482180 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 w for which this permit is issued. C ✓ 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: _ Policy Number: 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 Date: f M Z J Ile Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSA N 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. 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 act or 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. Date:,%N%a 2'01--f Signature (Applicant or Agent) w FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forBUILDING STANDARDS ADMINISTRATION BSA; $1.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 -PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for PERMIT ISSUANCE: $91.85 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BUILDING SEWER 101-0000-42401 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BUILDING SEWER PC 101-0000-42600 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for PLUMBING FEES: $24.18 $0.00 TOTALS:• •0 OF Description: ZWASCHKA / INSTALL SEEPAGE PIT TO EXISTING SEPTIC SYSTEM Type: PLUMBING Subtype: Status: UNDER REVIEW Applied: 5/1/2015 SKH Approved: Parcel No: 658270029 Site Address: 77942 LAGO DR LA QUINTA CA 92253 Subdivision: TR 4418 & INT COMMON AREA Block: Lot: 4 Issued: Lot Sq Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $5,500.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: PLUMBING -INSTALL SEEPAGE PIT TO EXISTING SEPTIC SYSTEM. 2015 CALIFORNIA BUILDING CODES. - -..,k1fo mi Printed: Friday, May 01, 2015 11:45:31 AM 1 of 2 1 (C �%% V` �V V srsreMs COF '�h 'jf.:' �£' ^t w •y�r r... r+-� r? s1: ! ":`iF W .y'."`�, %j, 1 .:1sw*1 ��r'�..2i} a,1u., �,F>.�..: f.r—'^'f``� �s' ��y 0 • • �#;""'•z,I,cs!�,�2 %�'''�:�:- ,�,, q L " -..e ,e'z` ,..., _ t+ '.4 Printed: Friday, May 01, 2015 11:45:31 AM 2 of 2 CTLJ LJ SYSTEMS y.N � � ,_ � -+ ,�r, �„- a . z'•- '-�' s ,,,�'� �{ r .x r. b K CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID By INSPECTOR SCHEDULED COMPLETED RESULT REMARKS NOTES BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PLUMBING FINAL" BLD Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 Total Paid forPERMIT ISSUANCE: $91.85 $0.00 BUILDING SEWER 101-0000-42401 0 $12.09 $0.00 BUILDING SEWER PC 101-0000-42600 0 $12.09 $0.00 Total Paid for PLUMBING FEES: $24.18 $0.00 Am '�h 'jf.:' �£' ^t w •y�r r... r+-� r? s1: ! ":`iF W .y'."`�, %j, 1 .:1sw*1 ��r'�..2i} a,1u., �,F>.�..: f.r—'^'f``� �s' ��y 0 • • �#;""'•z,I,cs!�,�2 %�'''�:�:- ,�,, q L " -..e ,e'z` ,..., _ t+ '.4 Printed: Friday, May 01, 2015 11:45:31 AM 2 of 2 CTLJ LJ SYSTEMS y.N � � ,_ � -+ ,�r, �„- a . z'•- '-�' s ,,,�'� �{ r .x r. b K _yr;_% ` SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED RESULT REMARKS NOTES DATE DATE PLUMBING FINAL" BLD '�h 'jf.:' �£' ^t w •y�r r... r+-� r? s1: ! ":`iF W .y'."`�, %j, 1 .:1sw*1 ��r'�..2i} a,1u., �,F>.�..: f.r—'^'f``� �s' ��y 0 • • �#;""'•z,I,cs!�,�2 %�'''�:�:- ,�,, q L " -..e ,e'z` ,..., _ t+ '.4 Printed: Friday, May 01, 2015 11:45:31 AM 2 of 2 CTLJ LJ SYSTEMS ALMS UNDERGROUND CONSTRUCTION, INC. 38703 VISTA DRIVE CATHEDRAL CITY, CA. 922.34 Ca. lit. 482186 760-324-1911 - Oi'fi.2 700-3.24-9541 - Pax 760 578-1510 - Cel} ,l rnsUnc}ergroundPmai}.com ' HIS ApPG^;4' L GRAM T ED BY T He } EYARTMENT OFE Ll ENVIRONMENTAL HEA TF} -;ALIT✓ .FOR ONE (1) YEAR' FROM • �— � -sr:, r;EF; . � 3E}tiT Or t �;:. Hn: , 1ltCE�S RG �:;Y _.P ✓} �:-'ME`±rALHEA'r PP 'c.. SQ Ll �. V t 1 f I 1 al, 2c - AN jt: Bin # City of La .Quinta Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: '7 72 t7l2 4 r Owner's Name: Brn�c. A. P. Number: 6�g . 2-70 • O �;,, 9 Address: 71-2 o (� r Legal Description: City, ST, Zip: • Q Contractor: lm s n der r �unC ns�Te Telephone: ne• Address: 3$ 70 3 V , S Project Description: ,� o See — City, ST, Zip: 4�a+hed,/ C14 C • 9,7z2 3,K &Jd `i o Telephone: e h o . 6 P 7 ,32 0 /9 State Lie. # : !f $2 / $Q City Lie. #.: 76% Arch., Engr., Designer: Address: City, ST, Zip: Telephone: ele h P . Construction n T o e• Occupancy: Type: P Y: Lie. #: Project type (circle rcle one New Add' n Alter Repair r Dem 0 Name of Contact Person: bw. 1M s Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: 760 57$ • /S/0 Estimated Value of Project: r 5 SGY� APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Cales. 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:- '"' Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees . [Total Permit Fees nt� :COUNTY OF RIVERSIDE: R k-R-TMENT OF. ENVIRONMENTAL H � A LAND. USE APPLICATION Ll 3880 Lemon Street - Suite 200 - Riverside- CA.- 92501 — (951) 955-8980 is PECODE� `FEE '0901" M, �447-950 Arabia Street - Suite A - Indio' - CA 92201 = (760) 863-75.70 _EHS # ON# LMS # APN- 0 2 9 TR/PM 'LOT # USE OF PERMIT: a SEClit A m M "Al 21;2 A. "a Name . OWNER: Address Phone Email Company Name J Agent(Contractor AGENT/ CONTRACTOR: Mailing Address '� 9 1b..pp t`„3.4V Phone 3-;l-. 9, "/1 E -114A0.9, Email Signature Date 4. it L Addres's La D _t e 2 -210 Site 7"" 41 2, q� PROPERTY INFO: Water Agency/Well Lot Size. 2,7 EC T,, '10"'121 R 1 ;g ...... N NO wMMEMEW CHECK BOX IF REQUIRED 'application If any box is checked, this shall. beconsidered, denied until the information is provided. • Holding Tank Agreements Required El Floor Plan and/or Plumbing Layout Required • Certificate of Existing OWTS,Rouired (C-42) El Special Feasibility boring Report Required • WQCB Clearance Required El Detailed Contour Plot Plan Required (1 to 5 foot intervals) El Soils.Percolation Report Required SITE EVALUATION INSPECTION REMARKS: EHS INITIALS/DATE: Igp ku. N$42. W. �SECTIONICJWIN. T a� D NEW JXREPAIR REPLACEMENT 11 EXISTING. 0 Pump 11 ATU OCONNECT TOSEWER FIXTURE UNITS # 7FBdlkms # Soils Percolation/Boring Report By: Date: Project# C-42 Certification By: Date' License# 6t, V -I C4 .S 3 0. 0 Septic tank cap.:poll it R e'. , , R Tested Depth: Max. trench depth:. Sq. Ft. Bottom Ared: Total Linear Ft.: 'Line (s), Length:. feet Each 3 feet wide Sidewall Allowance: Ft. RocVJ Sq. ft. Running.foot Rock below drain line: in. or 0 Plastic Chambers Leach Lines/bed special design for slope: 0 N/A 11 Overburden Factor: Pit Diameter: No. pits: _5epth"below Inlet (bi): Pit Total Depth: Max. allowable depth: CONSTRUCTION/INSTALLATION REMARKS-: SECTION OT -M M A This Application Approved 0 Denied. regarding the.design of the OWTS as indicated on the -accompanied plot plan using the requirements set forth in Section C ad j.No 66v��i'S,5`bonstruction is, 'Lrmifted in the required reserved 100% Expansion area. i" 'I, VI Signature- - .A,4"J - - Date:, - �V ( 70 1 J k�j DEH-SANJ22' Distribution: WHITE - Office File; YELLOW - Bldg. -Dept. PINK -Applicant .. 1 County of Riverside Community Health Agency Department of Environmental Health 4080 Lemon Street, 2nd Floor P.O. Box 1206 Riverside, CA 92502 (951) 955-8980 1. Certification of Existing Subsurface Sewage Disposal System. Date of Inspection: ?1015- w r (Property Address) % 'Y 1 e (Owner's Name) (Legal Description and APN) FAILURE TO PROVIDE ALL REQUIRED INFORMATION SHALL PREVENT OWNER FROM OBTAINING ENVIRONMENTAL HEALTH SERVICES APPROVAL. 2. Show design and location on a scale of 1" = 10' to 1" = 40' of the sewage disposal system and 100% expansion area in relation to attached dwellings, structures, wells, rocks, watercourses, etc. on required plot plan. 3. a. I examined the existing subsurface sewage disposal system at the above location on (date) 2 2 A i r, ms s, T date and determined that the septic tank capacity is gallons and that there is sq. ft. of leachline bottom area. There are -3 bedrooms in the dwelling. There are fixture units. b.. There are leachline(s), each ft. long. C. There are plastic chamber(s), each ft. long. d. There are / seepage pit(s), each A_ fin diameter, JA/ ft. deep. e. The leach bed is ft. by " ft., total sq. ft. of leachbed area. 4. a. Construction of septic tank (please check one of the following): 0 concrete ❑ fiberglass ❑ steel ❑ other: b. Internal dimensions of septic (length ft., width depth 47/ ft.) c. Condition of tank (please answer yes or no for each question): Yes No Inlet Tee present? Q' ❑ Outlet Tee present? 0' ❑ Two compartments? 0 ❑ Tank structure deteriorated?* ❑ 0'' "If yes, briefly explain and indicate appropriate correction suggested: d. Condition of D -Box (if needed) Level ❑ Yes ❑ No replaced ❑ Yes ❑ No A// full of septic effluent ❑ Yes ❑ No 5. a. While pumping the tank, did effluent flow back into tank from the absorption system? ©` es ❑ No b. Prior to pumping, was the liquid level in the tank above the outlet tee? O'Yes ❑ No c. Was the area around the lids oxidized? , ❑ Yes O1No d. Is design of system gravity feed? Qel es ❑ No e. Were well(s) observed on this or adjacent property? ❑ Yes 0'No If yes, indicate distance of well from: Septic Tank ft. Leachlines _•- ft. Seepage Pits ft. f. Distance from springs, lakes Septic Tank ft. and natural drainage courses: Leachlines ft. (circle appropriate item) Seepage Pits / ft. g. Sewer is within 200 ft. of system and abuts property line. ❑ Yes 3 No ADDITIONAL COMMENTS: e,C' fj; CO- 1( h. How long has dwelling been vacant? (if applicable) months weeks N/A 6a. ❑ It is my opinion that the system appears to be in good working order and can be expected to function properly with proper maintenance. No repairs are necessary at this time. 6b. 21t is my opinion that the system is not in good working order and will not function properly ,without the following repairs: /t/•Gt.'F! S ;.rR''hu ):r'N/).Stc:.ee �\ `l - J t I certify under penalty of perjury that the foregoing is true and correct: A( 0) / fSignature C-42 State License Number / Expira'tion Date `�,'*,• 1 .1 , G' F"I 1 1 )ti c f �t�N vr1 N� n 1_' �"��.i t,^I 1 11 Cf Print-Nd`me� Name of Pumper Company and Receipt Number/Name of Company Holding �-42 License' �7y 1l't ,.. Ia8"J�c^i C ", r^ S/.2-3<1 74- t.) 2V Address t fj ? Phone Number The Department of�Environmental Health has eviewed nd approved this certification � j]jj/4�uV"ilf �t , )- JkdlJ '_art ! �vi I ► � l� .l Ml l J ■ Envuonme�taI"Health§pecialist = { ate v DEH -SAN -184 (Rev 6/04)' Distribution: WHITE—Office; PINKS Contractor; YELLOW—Applicant FAR ALMS UNDERGROUND CONSTRUCTION, INC. 38703 VlSiT A DRIVE CATHEDRAL CITY, CA. 92234 Ca. Lit. 482.186 760:324-1911 - Office 760-314-9541 - pax 760 578-1510 Ceil �.ni^is'Underground(,cDi.�_Maii.com 77 � Z. L9- z, �)(- , -1H,','; AJ-pp' .Li A I 5- . P OVA L GRAN T CD BY TH DEPARTMENTOF ENVIRONMENTAL "'-.;ALID FOR ONE (1) YEAR' ROM OATE JF APPROVAL. KVqRS19 e4t.W uNlyc) 6:e r-YEPi^k A( "TAL L IMIEW, GFRlVJRC,�-JMBN4 HEA! D. T- j n' DATE: (11 lk Lf �. .-e. --" ". .'ie dig iL X TH .