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05-0639 (PLBG)- BUILDING. & SAFETY DEPARTMENT P.O. Box 1504` (760).777-7012 OFTt�9 78-495 CALLE TAMPICO FAX (760) 777-7011 0 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 4 BUILDING PERMIT pplcation Z13�ib: 0`5=0'0`0'0'06+ "9 bate 2/22/05 cox L... P-mope � CA.. fir- - s s . . . . . 51230 A ' NIDA RUB I O APN: ceppT.r773-045-019-17 -000000- Applicationc�es.c.rr''�ption . . . PLUMBING Property Zoning . . . . MEDIUM DENSITY RES Application valuation . . . 2500 Owner Contractor BECKER F G SO CAL PLUMBING& REPIPE CO 356 BEAN AVE P.O. BOX 955 MONTE SERENO CA 95030 YUCCA VALLEY CA 92286 (760) 369-4104 WCC:' EXEMPT WC: EXEMPT 11/30/05 CSLB: 793482 04/30/05 CCC: C36-C42-B ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING SEWER Additional desc Permit Fee . . . 3`0.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 2500 _Qty Unit Charge Per Extension BASE FEE 30.00 -------------------------------------------------=-------------------------- Special Notes and Comments SEPTIC ABANDON; SEWER CONNECT Fee summary Charged Paid x Credited Due ----------- - - - --------------------------- - - - - ------ - - - - -- Permit Fee Total 30.00 .00 .00 30.00 Plan Check Total .00 .00 .00 .00 Grand Total 30.00 .00 .00 30.00 P.O. Box 1504 • VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: S" &31 Date: .2, CA • D.�' Applicant: I Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS 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 Professionals Pode and myIe i in ful force a effect. �� �� License Class / icense No. C ------- - OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a pennit 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 Contractors' 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).): U 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 or 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.). U 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 A the Contractors' State License Law.). -Lam exempt under Sec. , BA P.C. for this reason WORKERS' 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. 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. WARNING: FAILURE TO SEARS' COMPENSATION 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. 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 APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety 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 employeesfor 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 100 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 compl with all city and county ordinances and state laws relating to building construction, and hereby authorize rep entatives of this county to ente n purposes. etate��� Signature (Applic n r Received FroP5. Address: Account No. 43 Service Address 0 Meter(s) 0 Service(s) C3 Backflow(s) 0 House Lateral(s) 0 Detector Check(s) V0 M ter Surcharge Sanitation Capacity Charge 0 W.S.B.F.C. 0 Temporary Construction Meter 0 Turn on Charge 0 Uncollected Account - Name 0 Inspection Fee - Tract - Fee - 0 Plan Check Fees Water Sewer - Tract - 0 Bond Payment - A.D. - Bond Assmt. El Customer Deposit 0 Other Remarks: 1016opy to: F Cash Check Money COACHELLA VALLEY WATER DISTRICT CASH RECEIPT DETAIL - Tract- G.A. Code 7*, -6454 TOTAL $ Water Service Cashier_ -43801 11 e Desert Sands Unified School District CERTIFICATION OF PAYMENT NOTICE: THIS ®®CU OFIkAl �SQiOpF, CILITY FEES BE DUPLICATED. �Y19 JP TO: City of La Quinta DATE: to (G°A Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 This is to certi y tha developer of which is located at within this District, has paid school acility fees imposed pursuant o the authority generated by Government Code Sectio 53080 in the amou of cov ring a total of square feet of ( )-residential or ( ) industrial/commercial development and that building permits for this footage in this development may no%p� issued by your jurisdiction. f - (:5,r SERT SANDS-UNIFIAD SCHOOL DISTRICT White Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer (10)-37 2 Z O 1— U W V) . YZiY.� . +.; w'rY'�pd"'.`•4:ArS'srl�+�T'++'+..�rr`ti:Y� f"�"�y�SYt" y .{. r}. c....} �6. 1 �l'..Cf y "yid G#�'r„ '�'I' 1 °�y,,, is rzW �. y� •.s.,• t(�( ��,,. 1tY1' f•"` 't �tl7 'r'�''I hl; t-,� COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION �c�� QO/ DOS 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. r ,f Building Department Application Log # Name (Owner. Agent. Contractor. Etc.) �A� 2 �d.c/sr2u.cr�a o Mailing Address �L 7.F.: ,7A;. iTZ City Slate Zip Code - Z- Telephone 'Job Property Address <Gt ., 40ommvmty- 'Legal Description of Property. (Lot. PM. TR) ti"•O'+•�T " 5/ C2.3 0 'Ll B / 40 4,00 10-r,4 4";7• _ .;/7 GL ?-r 'Assessor's Parcel No - r A ency ell- :D 1• - I G'G'�L A use of Permit /1r z��f/ fanning Case N Lot Size ��r /00 x �� — O 4S OQ "_ 4eod/ 2- n f/ !t Y bI�AT� SFD. MH Site Preparation Etc. Sir• I XA3. x Y, Sign alure,�ol Applicant - `'`�"" •• Date 'The above information must be veevied from Building Application STAFF USE — DO NOT WRITE BELOW THIS LINE t •'� 3 Initial Date • Certification of Existing'S.D. System required. ❑Yes ®o� WOCB Clearance required. ❑ Yes ©,f Jo t 0 Soils feasibility report required. El Yes LEf J Special feasibility boring report required. , ❑ Yes Detailed contour plot plans required.. ❑ Yes Staff Specialist approval required. f ❑ Yes' ❑ No Lot Inspection Date " Soils/boring report by Pr`oject # Date Soils Map Page '� � Soil Type!( � Approved by �W�-- Date . Type of System: ' ,,� ❑ N"f ew ❑ ❑ No. of Bedrooms 3 B/%2M 3 8411 / Ae nu (1) Septic Tank ���� Soil Rate Required e .n ' Si G� V'� Existing Additional Replacement 5'i itw. %'1n/ 3G ) Gals. �+" (2) �each line sq. ft. Sidewall allowance Ft.76� Install Lines) Ft. Long, Ft Leach bed Sq. oPbottom' (Bottoo 14<h' area) ft. rock/ Sq. wl ewwjtinches. Ft . per running ft. O'N/A rock below drain lines: area Leach lines/bed-special design for slope: Applicable. (3) Pit Diameter No. Pits Pit BI 1 Seepage Pit total depth �V t _ y N/A � Overburden factor� 1B 6' 3 $ Max. allowable depth ,( /T lfY�%z.l�Yt//I�CZr-:.: /1..C77' '� �OT%�t1 ,% .��,�',ts•" /� .� V>, /-�rv�o d' t} �' i:��! eY4 e , • 1_�C -A'' r!i -.I �A...s ,+•w+/I This application i a rgve enrefd 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 permit is necessary for the installation of the above -designed system. (1 Septic tank and sewer lines must be 50' from any wellty-/-V � d Lf/zF Y+- R.1,•o lr v`a�ce� �• Leach lines must be 100' min. from any wells including expansion area' (3) Seepage pits must A�be 150min. from any wells including expansion areae(/Q -y-r ,(�'y'C.��,e�W. .0 �-/1�-•,.. 11�� �i. � ���,C...C.Y/+J�G�L��(�iG•+.L1i>Ac/�J`, Signature of Health Official RECEIPT NO._ J / Issued by S�1/_ Date 7 District: ❑ Riverside ❑` ndio ❑ Hemet ❑ Perris ❑-Raft alit. ❑ Blythe t Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File DOH SAN 122 (Rev 8/87) 1 yf4 u.P DEVELOPER'S NAME: ADDRESS: TELEPHONE: ( 6 Dear Developer: Of ►If_E OF AGRICULI URAL COMMISSIONER AND WEIGHTS E MEASURES 49-613 Ilwy 86, Suite 8-12 'Coachella, CA 92236 619-342-8291 E. LEON SPAUGY CON�IIS;10.`.ER JAMES 0 WALLACE ASS:S7aNf CONP-115SIUNER CLEMENT BENvENISTE SULER .W After reviewing your landscapiuig plans, all plant mterial 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 must be :ratified imn2diately. Thank you for protecting and preserving the Coachella Valley's pest -free environment. . vV Agricultural Caimission ' office cc: Indio and Riverside Office