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04706 (SFD)Building Address 52--815 1edaa ------------- . 04706 P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Mailing Address P. 0, BOX 967 City Zip Tel. ., palm Dwert 1 42260 , Contractor Address State Lic. 1439V& Classif. Lic. # Arcn., tngr., Designer Address Tel. 0. LDING: TYPE CONST. OCC. GRP. Number- 773-335-017 Legal Description Project Description'�'� --s Sq. Ft. V400 No. No. Dw.• Size Stories Units CityI Zip I 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,Susiness and Professions Code: Any city or county which requires a; permit to construct, after, Improve, demolish, or repair any structure, prior to its issuance also, requires the applicant for such permit to rile 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). ❑ 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 or 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 -budder will have the burden of proving that he did not build or improve for the purpose of sale.) 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 a contractor(s) licensed pursuant to the Contractor's License Law..)) ,y ❑ 1 am exempt under Sec. B. & P . Ior this reason +/ Date �fi i l.sf 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 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 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. i ' 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 -of this city to enter the above- mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ r L Estimated Valuation $768219 PERMIT AMOUNT Plan Chk. Dep. $250400 Plan Chk. Bal. $ 64411 Const. 364.00 Mech. 36.00 Electrical 74.43 Plumbing 105.00 S.M.I. 3.36 Grading 20.00 Driveway Enc. 20.00 Infrastructure 1.662.41 n TOTAL �2a621.31 ; REMARKS 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-INSPECTORIssued by: Date Permit Validated by: Validation: WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOL09NOOD - ASSESSOR'S OFFICE, HARD COPY - FILE CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES tST FL 50 Fl y S UNITS SLAB GRADE ROUGH PLUM • BONDING YARD SPKLR SYSTEM 2ND FL SO FT, e FORMS R SEPTIC ROUGH WIRING MOBILEHOME SVC. BAR SINK POR SO FTof GAS (ROUGH) METER LOOP HEATING (FINAL) OUTLET ROOF DRAINS GAR SO. FT. aPOWER TEMP. POLE GROUT DRAINAGE PIPING CAR P. SO FT. 0 FINAL INSP. WALL SO. FT. a WATER SYSTEM DRINKING FOUNTAIN GRADING cu. yd. E plus xE =$ URINAL SO FT 0 FRAMING FINAL INSP. 2 O ESTIMATED CONSTRUCTION VALUATION $ �/T � � WATER PIPING NOTE: Not to be used as property tax valuation REMARKS: FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTONDISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY 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. SO. FT. a c BATH TUB INSULATIONISOUND SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT. B.T.U. SO. FT. RESID ( I IA c SEWAGE DISPOSAL SO.FT.GAR r& 3/4c 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 8 AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUM • BONDING HEATING (ROUGH) STORAGE TANK FORMS R SEPTIC ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. E plus xE =$ LUMBER GR. FINAL INSP. Z /l E� FRAMING FINAL INSP. 2 O ROOFING �/T � � � '� � / S � REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL THING _ r If MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESlINITIALS GARDEN WALL FINAL :d Building Address Ow Miff 4 4aQ" P.O. BOX 1504 APPLICATION ONLY 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST. OCC. GRP. mailing �� �a� �� I Address /Cites L1�',c� zip ITO, 'Contractor / XI�,, // A.P. Number Legal Description C, 7 - Project Description S. /". // 76-7 Citjr /� �75ee5"07 Zip '/2 Tel.. 'State Lic. & Classif4- City Lic. # Sq. Ft. c� Size / No. No. Dw. Stories Units Arch., Engr: , Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State r 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 Contractors License Law for the following reason: (Sec. 7031.5,Business 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 rile 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 Cade, 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 rive 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, Buisnessand 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.) Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. �� a, O 0 Plan Chk. Bal. Const. �a �v Mech. Electrical r Plumbing ,Gt7 ❑ 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 S.M,I. ' Grading ct Driveway Enc. 2� 0 . v 0 Date Owner Infrastructure WORKERS' COMPENSATION DECLARATION r r 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. �GSH i�7QT �L i r 275.0© TOTAL 7 a p REMARKS ,3 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 thip 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, alter 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 Set back Distances: Front Setback from Center Line Rear Setback from Rear Prop. -Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line Ihereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Side Setback from Property Line Lender's 'Name FINAL DATE INSPECTOR Lender's Address This Is a building permit when properly filled out, signed and validated, and is subject to expiration it 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' -of this city to enter the above-. mentioned property for inspection purposes. Issued by: Validated by: Date Permit Signature of applicant Date .Mailing Address Validation: City, State, Zip BUILDING DIVISION CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES UNDERGROUND —` �0 �•�v $ UNITS 7YARD ROUGH PLUMB. 1ST FL. SQ. FT.® HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK , 2ND FL. SQ. FT. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. MOBILEHOME SVC. GAS (FINAL) BAR SINK POR. SQ. FT. ® GROUT WATER HEATER GAR. SO. FT. ® T75- 7 POWER OUTLET ROOF DRAINS WATER SYSTEM GRADING cu. yd. $ plus x$ DRAINAGE PIPING CAR P.�1 SQ. FT. ® FINAL INSP. FRAMING r, ` ROOFING DRINKING FOUNTAIN WALL `0 SO. FT. ® V ISO'[ REMARKS: SQ. FT. URINAL ESTIMATED CONSTRUCTION VALUATION $ FIRE ZONE ROOFING WATER PIPING FIREPLACE NOTE: Not to be used as property tax valuation SPARK ARRESTOR FLOOR DRAIN MECHANICAL FEES GAR. FIREWALL WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FINISH GRADING LAUNDRY TRAY AIR HANDLING UNIT CFM FINAL INSPECTION KITCHEN SINK CERT. OCC. ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC FENCE FINAL WATER CLOSET COMPRESSOR HP POLE, TEM/PERM LAVATORY GARDEN WALL FINAL HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT 7/ SHOWER BOILER B.T.U. SO. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/. c SEWAGE DISPOSAL SQ.FT.GAR ® 3Ac 3 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 x.Y13 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 APP./EQUIP. 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 INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL of R Of NCE OF E. LEON SPAUGY QlJ COLntIS;10'.Eq s AGRICULTURAL COMMISSIONER J d LAMES O WALLACE o 1 ' Al Y A55:STANI CI)MMISSIONEP. WEIGHTS S & MEASURES CLEMEN7EgVEIrISTE MAL49-613 IlwY 86, Suite B-12 'Coachella, CA 92236 184 619-342-8'L91 DATE C11SE N0. DEVELOPER'S NAM s �,J ; �, l /� , v. Cy y IA) 6 iV S ADDRESS: TELEPILONEs ( (o l �) <j (1 �, / 4(, �� Dear Developers After reviewing your landscaping plans, all plant material listed is not in violation of quarantine laws governing the Coachella Valley. If substitutions do occur and they differ frun plaint nk3terial listed, this office nnust be notified immediately. Thank you for protecting and presembig the Coachella Valley's pest -free envi.roment. tA/1- /C gyycultural Canmissioner's office ccs Indio and Riverside office I �.�,c: r v ? wft :�,4.d• .,; lS-:'•a , l..S�+i. y ��.�:�.s-ck. 7�.i�'��� r b'r 4'�'a?';�!^'4�r"-•^• �'' .�F ^, -3 �;_ ^'f , :v4*y'f �; "s ti 71, Z O U W U) W, Z 0 U W U) Z 0 r�W f� COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH Assessors Parcel No. ENVIRONMENTAL HEALTH SERVICES 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. VERIFY ITEMS IN SECTION A FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG'* Agerit; Contractor, Contact Pers �^ /11"*w! ✓ . C:' c�X i �d�✓5 Phone " 3 q6 1,76 �( Address & Phone /zl /3 , >C 5;-6 > -- 444, rl-- r 1�z Owner Phc0e Mailing Address city/� 1A State Zip Job Property Address Legal Description Prop. (PM, Tract, Lot)5,�'�rti6 ' tt�Cl%N C &,-4A ,rc�DA! � �/ - /31 PL litii 7- Lot Size / f ater� g c'y/1N�11` ,�/�7'P� Use of Permit P/P, CU, etc. Other in MH Site Prep, etc. Signature of Ap cant Date CATEGORY: REV CODE FEE CATEGORY: REV CODE FEE ©SUBSURFACE DISPOSAL 12385_ O;r? ❑ SITE EVALUATION UPON REQUEST 7349 $42.00 ❑ MULTIPLE PARCELS WITHIN SAME (NO PLOT PLAN) LAND DIVISION ❑ SEWER/SEPTIC VERIFICATION 7348 $11.00 a. 1 st 4 Parcels (Each) 1238 $45.00 (Less than 1 year) b. Each Parcel after 4 7344 $16.00 ❑ PRELIMINARY ELECTIVE 7352 $45.00 ❑ 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/EXPERIMENTAL 7345 $132.00 ❑ Site Evaluation Lot Less than SYSTEM 10,000 Sq. Ft. 7347 $86.00 /INITIAL DATE,'. '* ,r Zu-,(X Holding Tank Agreements Completed ❑ Yes ❑ o Certification of Existing S.D. System Required ❑ Yes DIN F'• '" WQCB Clearance required. (Attach Form ❑ Yes `Nc DOH SAN 007, Santa Ana Region Only) f " Soils Percolation Report Required. ❑ Yes,' NNe d' Special Feasibility Boring Report Required. ❑ Yes No Detailed Contour Plot Plans Required (1 to 5 ft. interval) ❑ Yes ❑,Zf�pi Other ❑ Yes �� 6 Staff Specialist Lot Inspection Required ❑ Yes No Lot Inspection Date Soils boring report by' jProject #%} Date ° Type Approved by Date Soils Map Page Soil No. of Systems Ty a of System(s) No. Dwelling Units (1) (1) Septic Tank Soil Rate ItC ease/Sand ❑ H� Iding Tank ❑ Existing ?JNew ❑Replacement Bedrooms, FixtereUnits* u� /qj Ge Intcp � r r (2) Leach Line Sq. Ft. bottom trench areaft Sidewall allowance Install ��* _ Line(s)�ft long ft wide with L�aclh Bed sq. ft „ rockt sq. ft per running ft. l�'' NA min. mches roc cl'bebw drain of Botta area i Leachlines/bed special design for slope: Applicable (3) Pit Diameter 1.,/ Y No. Pits Pit Below Inlet (BI) Seepage Pit Total Depth '•�V�' Ofher. Max. Allo oble;Depth BOF6 006 � f (� t N/A Overburden factor No. 2 System All REMARKS:` -1 Gt- •: i/j��•C r/.' r'�/^1--}.,r � ��'i'�u d / l��`il�,� ,fi3� `fd,`'-'i' �/ � �(/�2/'jay✓.L�!._n. J. -`r �:. �...+c? �n .•.��,1.. .<1- l ti�% �'L.^_-•'i'" LC/ t.�1.•f r c't`�f / ,.✓,`"—G,.�`.Fijf J_. 7 ..�' .�.: !/t.✓f+f!.t• ' .! (it � � .� W � CiL.•�' � L � moi_..! �fit^t.CI I � e r C a This applicationAPROV EDE�IIED-for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated on the accompanied plot plan, using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the above -designed system. No construction is permitted in the required reserved 100% expansion area. t 1 Septic tank and sewer lines must be 50' minimum from any wells;1/0 2 Leach lines must be 100' minimum from any wells, including expansion are (3) Seepage pits must be 1150' minimum from,any wells, including expansion area 41 Signature of Health Officialr Date RECEIPT NO. ` ` V Issued By—- Date DISTRICT: ❑ Riverside, D/Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept. GOLDENROD - Plans/Records