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05049 (SFD)_W" A— 4.4 P.O. BOX 1504 Building 78-105 CALLE ESTADO Address 53-760 Ramirez LA.QUINTA, CALIFORNIA 92253 Owner Mailing Address P. 0. BOX 1379 City Zip La Quanta - 1 92253 564-7411 Contractor No. 05,049 i BUILDING: TYPE CONST. . I .., OCC: GRP. - A.P. Number 774-162-001 Legal Description Project Description Address P. -,)- Rnv A07 City 1000 palmse Zip 92176 Tel.: -346-0408 State Lic. City & Classif.4 69157 Lic. # Sq. Ft. 1832 Size No. No. Dw. Stories Units Arch., Engr., Designer New El Add 0 Alter 0 Repair 0 Demolition 0 IL Address' Tel. Hool permit not included City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm 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 - 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: Any city or county which requires, a Permit to construct, alter, hirprove, demoish,'f4i repair any strKcture,.prior to its issuance alsd Zr:.,U,e V iiican" fora such -permit -to Iltd a: -signed statement'lli6t he is ficeni�d[p6rsDaAtjio7 & the Cbntractorslikense; Laiv,-'Chapt6t 9 (commencing with Se6tion 7000) of akision 3 of the Bustneiss and Prolessiong -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 sWects the applicant to a cin? penalty of not more than rive hundred dollars (8500). -I 0 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, 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. 11, however, the building or Improvement is sold within one year of completion, the owner -builder will have the burden of proving that did not build or iinprove for the purpose of sale.) Estimated Valuation $ 98,209 PERMIT AMOUNT Plan Chk. Dep. $250.00 Plan Chk. Bal. 56.60 Const. Mech. Electrical Plumbing 0 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 contractor(s) licensed pursuant to the Contractor's License Law.) 0 1 am exempt under Sec B. & P.C. for this reason S.M.I. .50 Grading Driveway Enc. Date Owner Infrastructure 796.08 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 0 Copy is filed with the city. 0 Certified copy is hereby furnished. TOTAL $1.103.08 REMARKS CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE or(Thissssection need not be completed if the peodIff-for one,. hundred'dollars (M106) ­valuation le.) I certify that in the performance of thp work for whict(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. AA 4 0 il).-i 13-139- llllft�- I DateOwner NOTICE TO APPLICANT- fl, 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. ZONE:— BY: Minimum Setback Distances: Front Setback from.Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line I hereby affirm that there is a construction lending agency for the performance of the work forwhich this permit is issued. (Sec. 3097, CM/Code.) Side Setback from Property Line • Lenders Name FINAL DATE INSPECTOR —IN2/27/88 I 1 Lenders Address This a buildjnpermit when properly filled out, signed and validated, and is subject to it work thereunder is suspended for 180 days. * . 1 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 the -above-. mentionedI property for inspection purposes. Issued by: Validated by: —Date Permit Signature of applicant —Date Mailing Address Validation:. City,- State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ® $ UNITS ' ROUGH PLU B. 44 BONDING YARD SPKLR SYSTEM 2ND FL SQ. FT. FORMS SEWER N ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® GAS (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR. SO. FT. ® TEMP. POLE GROUT DRAINAGE PIPING CAR P. SO. FT. ® FINAL INSP. WALL SQ. Ff. WATER SYSTEM DRINKING FOUNTAIN. GRADING cu. yd. $ plus x$ =$ URINAL SQ FT ® FRAMING FINAL INSP. ESTIMATED CONSTRUCTION VALUATION $ U O WATER PIPING NOTE: Not to be used as property tax valuation REMARKS: FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM SPARK ARRESTOR 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. SQ. FT. ® c BATH TUB INSULATIONISOUND SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1+/a c SEWAGE DISPOSAL SO.FT.GAR ® Vbc 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 OUND PLUMBING(/, S� Lp UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE 1 _7 Q'�� ROUGH PLU B. 44 BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER N 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 `� ' b U O /1 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FI AL INSPECTION /^'' `� 6 / CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL .'t !@�i.*y'!' •t;5�w1 �� ,a. a .r•��'tib"i��'iw%'�-�+"'..S.i�YY-eWSr•-c.,.,.F""a'�.R'v�a,:..-t"` ....-.i'���'i,.�-.- ..r�.^k: t"y',,,'sryri.`.Si `� COUNTY OF RIVERSIDE DEPARTMENTOF HEALTH Assessors Parcel No. ENVIRONMENTAL HEALTH SERVICES 774 — 162 — 001 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 speculations as indicated on the attached checklist A non-refundable filing fee (see below) 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 approval. Q VEAIFY'ITEMs IN SECTION A FROM BUILDING4^9AFETY`APPLICATIONwoUILDING DEPARTINENT APPLICATION LOG # Z Q Agent, Contractor, Contact Person Phone Address & Phone HARRY BURNS 564-7411 P 0 Box 1379, La Quinta, CA 92253 U Owner Phone Mailing Address W t� WESTERN AMERICAN CONSTRUCTION CO 564-7411 P 0 Box 1379', La.Quinta,'CA 92253 City State - -Zip - Job Property Address Legal Description Prop. (PM, Tract, Lot)-. La Qti' nta GA 92253 53'=760 Ramirez Lot 23%24 Blk 236, . U 22 Lot Size Water Agency/Well Use of Permit P/P, CU, etc. ; Other ° 100 X 100 CVV7D SPR " -Dwelling, MH Site'Prep, etc: -•' - WESTERN AMERICAN CONSTRUCTION CQ, . December 15. 198R s 4r---,--=Signatureof Appticant w _ rte-,.- _President nate tf CATEGORY: REV CODE FEE CATEGORY: REV CODE FEE IX SUBSURFACE DISPOSAL 1238 $45.00 ❑ SITE EVALUATION U) ON REQUEST 7349 $42.00 ❑ MULTIPLE PARCELS WITHIN SAME (NO PLOT PLAN) m LAND DIVISION ❑- SEWER/SEPTIC VERIFICATION 7348. $11.00 Z il O a. 1 at 4 Parcels (Each) 1238 $45.00 (Less than 1 year) I- b. Each Parcel after 4 7344 $16.00 ❑ PRELIMINARY ELECTIVE . 7352 $45.00 W ❑ Rereview (2nd review same parcel) 7344 $16.00 EVALUATION (Attach DOH SAN 53) ❑ Site Evaluation in Conjunction with ❑ HOLDING TANK 7351 $45.00 Critical Area... 7346 $86.00 ❑ ALTERNATIVE/EXPERIMENTA& 7345 $132.00 ❑ Site Evaluation Lot Less than SYSTEM �•:, 10,000 Sq. Ft. 7347- $86.00 I INITIAL DATE Holding Tank Agreements Completed _ ❑ Yes No Certification of Existing S.D. System Required ❑ Yes No WQCB Clearance required. (Attach Form ❑ Yes No DOH SAN 007;.Santa Ana Region Only) Soils Percolation Report Required. ❑ Yes No ' �j Special Feasibility Boring Report Required. ❑ Yes No j Detailed Contour Plot Plans Required (1 to 5 fL interval) ❑ Yes No Other } ❑ Yes No Staff Specialist Lot'Inspection Required ❑ Yes! No t" Lot Inspection Date Soils borig4p rt;by Project # Date Soils Map -Page. Soil Type S �` + Approved by I i /P Date o- U No. of Sys6ems, Type of system(s) No. Dwelling Units (1) Septic Tank Soil Rate Grease/Sand Z ❑ Hold Tank ❑ Existing Bedrooms, Fixture Grease Intop A11.0 Unitsdy D Replaoemerrt 2 S F- M Gal Gal , W (2) Leach Una Sq. Ft Sidewall allowance Install Une(s) R long' ff wide with Leach Bed sq. ft. to Bottom trench area ft rock/-- sq. R �' min. inches rock below drainlinea or of.bottom.ar a p� ti ❑ NA Leachlines/bed special design for slope: (3) Pit Diameter No. Pits Pit Below Seepage Pit Total Depth Other. Applicable -�' Inlet (BI) ��// ❑ 5 s` 6 `' / J Max. Allowable Depth N/A Ovgrtiurden factor -Z y No. 2 System REMARKS: This application is, P EDNIED for.the category checked in SECTION B above, regarding the design of -a subsurface O disposal system as indicated 0 on the accomparned`plot-pla the requirements set forth in SECTION C above. "A.building permit'ls•.4cessary for the installation of the Oabove -designed system., No construction is permitted in the required reserved 100% expansion area.,, . 0 (1) Septic tank and sewer lines. must -be 50' minimum from -any wells ; (2) Leach lines must 100' minimum from any wells, including -expansion area IU ;be . Seepage pits must be 150 minimum from any wells,, including expansion area a ; - Signature. of Health , Official �b S o _. RECEIPT NO. Issued By s 'Date ` � ' DISTRICT: ❑ . Riverside, E Indio 0 Hemet ❑ Perris- O Rancho Calif. J ❑ BlytFie t `-; z ;:. DOH SAN•122 (Rev. 5/88) DISTRIBUTION . WHITE -Office file YEL I_6w Applicant. '.'PINK - Bldg. Dept ;GOLDENROD.- Plans/Records ti Date `� COUNTY OF RIVERSIDE DEPARTMENTOF HEALTH Assessors Parcel No. ENVIRONMENTAL HEALTH SERVICES 774 — 162 — 001 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 speculations as indicated on the attached checklist A non-refundable filing fee (see below) 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 approval. Q VEAIFY'ITEMs IN SECTION A FROM BUILDING4^9AFETY`APPLICATIONwoUILDING DEPARTINENT APPLICATION LOG # Z Q Agent, Contractor, Contact Person Phone Address & Phone HARRY BURNS 564-7411 P 0 Box 1379, La Quinta, CA 92253 U Owner Phone Mailing Address W t� WESTERN AMERICAN CONSTRUCTION CO 564-7411 P 0 Box 1379', La.Quinta,'CA 92253 City State - -Zip - Job Property Address Legal Description Prop. (PM, Tract, Lot)-. La Qti' nta GA 92253 53'=760 Ramirez Lot 23%24 Blk 236, . U 22 Lot Size Water Agency/Well Use of Permit P/P, CU, etc. ; Other ° 100 X 100 CVV7D SPR " -Dwelling, MH Site'Prep, etc: -•' - WESTERN AMERICAN CONSTRUCTION CQ, . December 15. 198R s 4r---,--=Signatureof Appticant w _ rte-,.- _President nate tf CATEGORY: REV CODE FEE CATEGORY: REV CODE FEE IX SUBSURFACE DISPOSAL 1238 $45.00 ❑ SITE EVALUATION U) ON REQUEST 7349 $42.00 ❑ MULTIPLE PARCELS WITHIN SAME (NO PLOT PLAN) m LAND DIVISION ❑- SEWER/SEPTIC VERIFICATION 7348. $11.00 Z il O a. 1 at 4 Parcels (Each) 1238 $45.00 (Less than 1 year) I- b. Each Parcel after 4 7344 $16.00 ❑ PRELIMINARY ELECTIVE . 7352 $45.00 W ❑ Rereview (2nd review same parcel) 7344 $16.00 EVALUATION (Attach DOH SAN 53) ❑ Site Evaluation in Conjunction with ❑ HOLDING TANK 7351 $45.00 Critical Area... 7346 $86.00 ❑ ALTERNATIVE/EXPERIMENTA& 7345 $132.00 ❑ Site Evaluation Lot Less than SYSTEM �•:, 10,000 Sq. Ft. 7347- $86.00 I INITIAL DATE Holding Tank Agreements Completed _ ❑ Yes No Certification of Existing S.D. System Required ❑ Yes No WQCB Clearance required. (Attach Form ❑ Yes No DOH SAN 007;.Santa Ana Region Only) Soils Percolation Report Required. ❑ Yes No ' �j Special Feasibility Boring Report Required. ❑ Yes No j Detailed Contour Plot Plans Required (1 to 5 fL interval) ❑ Yes No Other } ❑ Yes No Staff Specialist Lot'Inspection Required ❑ Yes! No t" Lot Inspection Date Soils borig4p rt;by Project # Date Soils Map -Page. Soil Type S �` + Approved by I i /P Date o- U No. of Sys6ems, Type of system(s) No. Dwelling Units (1) Septic Tank Soil Rate Grease/Sand Z ❑ Hold Tank ❑ Existing Bedrooms, Fixture Grease Intop A11.0 Unitsdy D Replaoemerrt 2 S F- M Gal Gal , W (2) Leach Una Sq. Ft Sidewall allowance Install Une(s) R long' ff wide with Leach Bed sq. ft. to Bottom trench area ft rock/-- sq. R �' min. inches rock below drainlinea or of.bottom.ar a p� ti ❑ NA Leachlines/bed special design for slope: (3) Pit Diameter No. Pits Pit Below Seepage Pit Total Depth Other. Applicable -�' Inlet (BI) ��// ❑ 5 s` 6 `' / J Max. Allowable Depth N/A Ovgrtiurden factor -Z y No. 2 System REMARKS: This application is, P EDNIED for.the category checked in SECTION B above, regarding the design of -a subsurface O disposal system as indicated 0 on the accomparned`plot-pla the requirements set forth in SECTION C above. "A.building permit'ls•.4cessary for the installation of the Oabove -designed system., No construction is permitted in the required reserved 100% expansion area.,, . 0 (1) Septic tank and sewer lines. must -be 50' minimum from -any wells ; (2) Leach lines must 100' minimum from any wells, including -expansion area IU ;be . Seepage pits must be 150 minimum from any wells,, including expansion area a ; - Signature. of Health , Official �b S o _. RECEIPT NO. Issued By s 'Date ` � ' DISTRICT: ❑ . Riverside, E Indio 0 Hemet ❑ Perris- O Rancho Calif. J ❑ BlytFie t `-; z ;:. DOH SAN•122 (Rev. 5/88) DISTRIBUTION . WHITE -Office file YEL I_6w Applicant. '.'PINK - Bldg. Dept ;GOLDENROD.- Plans/Records ti 01 f tr E OF E. LEON'SPAUGY f'a � ; Ca�nnS;iu�.[a GI;�ICUL l URAL CU.NIM15SIONER f� to -,s)V lES0 WALLACE .,WV V WEIGI I S'E N1C��Sl1.lsLS CLEMENT d EgVEhISiE 49-613 Iiiq ,.86-, 5ul,te 11 1.2.:' lCubcllel116 CA 192236, q► v q� 619: 3'4.2-8291. DA7E 2 .= 2 0 8;y 0m, DEVELOPER'S. NAME(NJ�G.t�+^,n�.L�� �• ADDRESS: TEL,EP110NE: c 69) s Dear Developer:,%,,;,„ - After reviewing your. all plant n»terial listed is [lot in violation of` quara[[t he laws gq'vei[[ Sig the Coacl�ella'Vallety If substitutions do occur. aiid they. differ fr6ii. pla[ik npterial listed', this office ntust be notified i[[mediately.: Th&nk you. for. prvtecti6g+ and preserving: the Coachella Valley's pest -free enviroment. Agricultural•Canni:s [er's;©lEice cc: Indio and Riverside office 4.w