9809-083 (BLCK)U) R
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LICENSED CONTRACTOR DECLARATION
„i`hereby affirm under penalty of perjury that I am licensed under provisions of
Ctapter 9 (commencing with Section 7000) of Division 3 of the Business and
.,Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
O/`8
Date Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason: '
( ) 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 & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
( )/,learn exempt under Section , B&P.C. for this reason
,I 4e Signature of Owner
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 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 & policy no. are:
Carrier Policy No.
(This section need not be completed if the permit valuation is for $100.00 or less).
I certify that in the performance of the work for which this permit is issued,
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.
,Zate: Applicant
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $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.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
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 applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
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.
1 certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
ySignature (Owner/Agent) .� Date
PERMIT # CONTROL #
BUILDING PERMIT .{#W
DATE VALUATION �ItS#,�� LOT TRACT8190
ADDRESS 52A25 AWMDA. DA. fi`<,�;.it�NIUD S
APN , 7b_2%,-019
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OWNER j
CONTRACTOR/DESIGNER/ENGINEER
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52-425 AVEN IDA BERMDAS
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LA Q1 JKJVA. CA ' 92253
I
USE OF PERMIT .s
f<ATIO C0* LR - Cry S.F.
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P'LANC'iffi CiiI-frF tt11-Qp()-�iZu 6i $#d�U
MN' lltJ4,TI*ON I"TIF 2 i11-Of_)il-4i 89)UO x2 > •f)ii
DNG 1140110N FIX • RE ID 101-000-241-000
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rte• t� �y
S39 45
CP LESS PRE -PAID ITES
$0.00
'
17e TA1, VERMI T T4.4,8 DUR' NCiW
$38.45
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs I I
Underground Ducts
Forms & Footings _
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
'%Smoke Detectors
Temp. Use of Power
r C.
Final
Eltility Notice (Perm)
COMMENTS:
L U - Z-0— V
Ilk RAFTER SIZE AND (SPACING SPECIFY a LATTICE
a X 6 0�7 � �/ ROOF'N. ML. S oT-L zx . E RS E)
-------- (SEE ROGFW� NOr ON aE1'ERSE)
------ �OLLb?D ,%IAD/-/�✓l1 _
YROF PRCH
��8y.
CONTINUOUS LEDGER
(SAME SIZE AS RAFTERS) i
X \-� AND v STRAPS'
-- 6'x6•cl'xl/lr MRM w
7 II l� i I (4) 16p NAILS OR BOLT I a
RAFTER SPAN:POST SP / 4 W
i/ 0.+1.a O.H. yA% cJi
OVERALL LENGTH:
a OVERAI LF.*,. f " t/
--- Y-- POST sm.
REAR SETBACK SIDE SETBACK (4''4' Mw
FINISH GRADE FINISH RE2000 P.S.I CONCRETE
— MIN. 12'a1T FOOTfw. I I
L_J I L_J 17 BELOW CPADE Li
PROVIDE 1' CLEARANCE
BETWEEN POST AND
NOTE• CONCRETE
OPEN LATTICE PATIO COVERS MAY BE ATTACHED TO EXISTING FASCIA
VIA ONE 1/4" x 5" LAG SCREW THROUGH FASCIA INTO EACH RAFTER TAIL.
3/8" x 5' LAG SCREWS INTO STUDS AT 16" O.C.
r— CONTINUOUS LEDGER i
JOIST HANGER OR SOLID BLOCKING
NAIL RAFTER TO BLOCKING
U—STRAP OR ANGLE —
NON—CORROSIVE PLATE
(4)— 16d NAILS
OR BOLT
U—STRAP OR ANGLE
(4)— 16d NAILS
OR BOLT
PROVIDE 1' CLEARANCE
BETWEEN POST AND
CONCRETE
RPpE
BUILDING DEPARTMENT APPROVAL BELOWkOFAPPUCATION
ILII
CITY OF LA QUI 1 Y 1 A (EMBED
BUILDING ��(, ������ CONCRETE)
COINOITONNAL.LY PICAL PATIO COVER
ACC: << ` iJ rUR T I�:l!`1"tt [
� ATION�U=3tel. s T '_' � Tk� I AS PER
AND ALL APPLICAGLE 00DES Cm, ST ZIP
TELEPHONE
DATE 8 gY
H.OA APPROVAL
Fl
w�
RAFTER SPAN TABLE 4z�:A�7 � A� p
GRADING RULES cl) cl) co � � O�
PS 20-70 vs�' psi psi
(FEET & INCHES) pJA� a AA? oJA�? Q �'
oco oma.
ti o
2x4
16" O.C.
24" "
10'-6"
9'-6"
7'-3"
8'-9"
8'-6" 8'-0" 6'-0"
7'-3"
DOUGLAS FIR
NO. 1
2x6
16" O.C.
24" "
32" "
15'-0"
14'-0"
10'-9"
13'4'
12'-6" 11'-6" 8'-9"
10'-6"
10'-0" 1 8'-6" N/A
N/A
4x6
6'-0'
M.
16" O.C."
24" "
32" "
18'-0"
17'-0"
13'-6"
16'-0"
15'-6" 14'-6" 11'-0"
13'-0"
13'-0" 11'-6" N A
N/A
4x12
2'-0'
NOTE:
32" O.C. SPANS ARE ALLOWABLE FOR OPEN LATTICE
PATIO COVERS ONLY.
LATTICE
ROOF
BUILT-UP
ROOF
HEADERS
HEADERS
DOUGLAS
FIR NO. 1
DOUGLAS FIR
NO. 1
SIZE
SPAN
SIZE
SPAN
4x4
5'-0"
x
4x6
8'-0'
4x6
6'-0'
4x8
11'-0"
4x8
8'-0"
4x10
14'-0"
10
10' 0'
4x12
17'-0"
4x12
2'-0'
6x8
14'-0"
6x8
12'-0"
6x 10
17'-0"
WO
14'-0"
ALL CONSTRUCTION SHALL CONFORM
TO THE PROVISIONS OF THE 1994
UNIFORM BUILQIN& CODE.
SUPPLEMENTAL NOTES:
ROOFING NOTES:
A. BUILT-UP, ROLLED ROOF: SLOPE TO DRAIN,
B. ROCK ROOF: 3/12 MAXIMUM PITCH.
:.l
Desert Sands Uniiied School District
CERTIFICATION OF PAYMENT
NOTICE: THIS D0CUMEN&AAVq1hyr,,y FEES
BE DUPLICAT
'Aa
TO: City of La Quinta DATE: %xz
Department of Community Development
78-105 Calle Estado
La Quinta, CA 92253
This is to cer�pify that
developer of which is
located at within
this District, has paid school facility fees imposed pursuant to the
authority generated by Government Code Sect'ou 53080 in the amount of
covering a total of 0 square feet of (i--�ggsi ?ntial or
0
industrial/commercial development and that building permits for
this footage in this development may now be issued by your jurisdiction.
for DESERT SP616S U6fFIED SCHOOL DISTRICT
White - Building Department 0 Yellow - Facilities Planning 0 Pink - Accounting 0 Gold - Developer
(10)-37
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COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION
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 #
Name (Owner. Agent. Contractor. Etc.)
Mailing Address
.I
! 6 �i Y. I
City
Stale
Zip Code Telephone
-Job Property Address
-City oi•Certittnuaity
„ram
• Legal Description of Property (Lot PM TR)
-.3� 4w< - RQr
C_3ut�J L,
'Assessors Parcel No
.Water Agen_cypr Well
Lot Size
• -
Use of Permit Planning Case e
SFD MH Sae Preparation Etc ,t rl)
LI ApptiCanl bate
'The above information must be verified from Building Application
STAFF USE — DO NOT WRITE BELOW THIS LINE
Initial Date
Certification of Existing S.D. System required. ❑ Yes ❑ No
WOCB ClearancA required. ❑ Yes []'No
Soils feasibility rQport required. ❑ Yes EJNo
Special feasibility boring report required. ❑ Yes ❑ No
Detailed contour plot plans required. .' - ❑ Yes ❑ No
Staff Specialist approval required. ❑ Yes ❑ No Lot Inspection Date
Soils/boring report by + r _ Project # Date_.
Soils Map Page._- r r '' Soil Type`-_- Approved by 4 Date
.I
Type of System: r
No. of Bedrooms
(1) Septic Tank
Soil Rate Required
❑ Existing ❑New ❑ Additional ❑ Replacement
r
/l Gals
(2) Leach line sq. ft.
Sidewall allowance
Install Line(s)Ft Long,
Leach bed Sq
(Bottom trench area)
ft. rock/ Sq. Ft
Ft' wide with min. inches
Ft. of bottom
per running ft. ❑r . N'/A
rock below drain Iin,—,--
area
Leach lines/bed-special design for slope:
(3) Pit Diameter
No. Pits Pit BI
Seepage Pit total depth
Applicable_
factor
❑ 5' D`6'
l
Max allowable depth
N/A - Overburden
This application Is.approvedl3JeAAddfor 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.
4.(1). Septic tank and sewer lines must be 50' from an wells f -7• ` -
(2) Leach lines must be 100' min. from any wells including expansion area __17�= —=----
(3) Seepage pits must be 150' min. from any wells including expansion area
Signature of Health Official Dale
Issued h RECEIPT N0. y Date
District: ❑ Riverside ❑ Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe
Distribution: WHITE —Office file YELLOW —Applicant PINK —Bldg. Dept GOLDENROD —Pending File
DOH SAN 122 (Rev 8l87)