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04753 (SFD)ATELY SIZED DEBRIS CONTAUVER5 P.O. BOX 1504 IS REQUIRED ON THE JOB -SITE DURING Building '� 78"610 BottlobMah LA QUINTA CALIFORNIA92253, n Address.. ALL PHASES OF CONSTRUCTION Owner , Ph6tioa & RaChelle SStellas BUILDING: TYPE CONST. ' OCC. GRP. Mailing Address "• City Zip Tel. • Contractor _ r �ti1 ki e/2 6 t.► + Address City lZip I Tel. State Lic. I City & Classif. Lic. # Arch., Engr., Designer Address Tel. CityI Zip I State I Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7(X10) of Division 3 of the Business and Professions Code, and my license is in full force and effect., - S�GNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors License Law for the following reason: (Sec. 7031.5,Buslness and Professions Code: Any city or county which requires a permit to construct, atter, Improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file 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 (E500). ❑ 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 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.) O 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.) ❑ 1 am exempt under Sec. B.' & P.C. for this reason Date r l 's►i.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 O 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 thg work for which this permit is issued, I shall not employ any peon in any manner so as to become subject to the Workers' Compensation Laws of Cal ifornirsa. Date '• r' r !Y Owner �✓ t 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. 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 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. Signature of applicant Date Mailing Address City, State, Zip A.P. Number KJ.LI JQ.L" ®4#i Legal Description Project Description g*'" 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 INSRELC70R, Issued by: Date Permit Validated by: Validation: I Ii WHITE -FINANCE, PINK -APPLICANT, GREEN -BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY- FILE Sq. Ft. Size 1.514 No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation��r�3 PERMIT AMOUNT Plan Chk. Dep. $250.00 Plan Chk. Bal. 74.98 Const. 379.00 Mech. 36.00 Electrical 76.95 Plumbing 103.00 S.M.I. 5.64 Grading 20.00 Driveway Enc. 20.00 Infrastructure 1,797.70 Fri ncTe-Toed r izard tee Od o a If TOTAL `�K� »X''�'(.TS�/ REMARKS 03 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 INSRELC70R, Issued by: Date Permit Validated by: Validation: I Ii WHITE -FINANCE, PINK -APPLICANT, GREEN -BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY- FILE CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES tSl FL SO Fl fp $ UNITS COLL. AREA ADE �/ YARD SPKLR SYSTEM 2ND FL SO FT. a HEATING (ROUGH) STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR SO FTa DUCT WORK ROCK STORAGE FOUND. REINF. POWER OUTLET ROOF DRAINS GAR SO. FT. HEATING (FINAL) OTHER APP.IEOUIP. REINF. STEEL DRAINAGE PIPING CARP. SO FT. a WALL SO. FT. @ DRINKING FOUNTAIN SERVICE FINAL INSP. URINAL SO FT g WATER SYSTEM ESTIMATED CONSTRUCTION VALUATION $ GRADING CU. yd. $ plus xE WATER PIPING NOTE: Not to be used as property tax valuation _ FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTOYDISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM FIRE ZONE ROOFING 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. ® c BATH TUB LATHING SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID t V. c SEWAGE DISPOSAL SO.FT.GAR (g 3/ic HOUSE SEWER FINISH GRADING GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.cEE CONST. FEE ELECT. FEE SMI FEE PLUMB FEE STRUCTURE PLUMBING ELECTRICAL HEATING 8 AIR COND. SOLAR SETBACK R PLUMBIN UNDERGROUND A.C. UNIT COLL. AREA ADE �/ ROUGH PWM!_., BONDING HEATING (ROUGH) STORAGE TANK FORMS �/ OR SEP YA ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. REINF. STEEL GAS (FINAL) . POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING CU. yd. $ plus xE _$ BER GR. FINAL INSP. FRAMING. Z"� 3�-1 FINAL INSP. REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR, GAR. FIREWALLIt LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS - GARDEN WALL FINAL M Z O 0 W U) 0 Z 0 0 LU U) ?F± 3 Eye} }+ ny C1 i•�. l p �vr { ry}+'1FY S *.i Rr Y r n Jn `�o �tFr w vs� ✓w •r; KJ as .::p^ai" 7i 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' # Agent,Contractor, Contact Perssojn Phone Address & Phone /y Owner Phone Mailing Address City State Zip Job Property Address cX- t/J Legal Desd6j)tion Plops ( 6 Tract, Lot)y0/4_ o „_, r C_ � t 4 0 i 4,0 Lot Size � f }' o4e_* r Agency%Well Use of Permit P/P, CU, etc. + �s, ' ,�p � © ` f) % , �Gt.crd..�r,�1 C her 83 a 1 /i/'7• e G t``T'� 6 F /..!? J V i' MH Site Prep, Yr.. 91e, etc. T /r Signature of Applicant ' f ` V " Date CATEGORY: REV CODE FEE CATEGORY: REV CODE FEE C. SUBSURFACE DISPOSAL 1238 t$45.00 ❑ 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..1 "$45.00 ❑ Rereview (2nd review same parcel) 7344 $16.00 EVALUATION (Attach DOH SAN 53) ❑ Site Evaluation in Conjunction with ❑ HOLDING TANK 7351 y :.$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 INITIA / DATE Holding Tank Agreements Completed ❑ Yes ❑ V t Certification of Existing S.D. System Required ❑ Yes 1.201INo ► WQCB Clearance required. (Attach Form ❑ Yes 12No DOH SAN 007, Santa Ana Region Only) Soils Percolation Report Required. ❑ Yes Oho` 1 Special Feasibility Boring Report Required. ❑ Yes Detailed Contour Plot Plans Required (1 to 5 ft. interval) ❑ Yes o Other ❑ Yes /No Staff Specialist Lot Inspection Required ❑ Yes F7 No Lot Inspection Date Soils boring report by' Project # Date Soils Map Page 111411r Soil Type Approved by 4 Date r . No. of Systems TyR Iof System(s) No. Dwelling Units(1) (1) Septic Tank Soil Rate grease/Sand G Holdlhg Tank ❑ Existing M16w ❑Replacement&M Bedrooms, F_bdure,Uraifs.- JAW—Gal G se IInttcp �' �— �• la 4 G�1* v (2) Leach Line Sq. Ft. Sidewall allowance InstallLines) ft long ft wide with Leach Bed sq. ft. Cott m trete nch area n rock/ sq, ry, per running ft. G)�sNA min. inches roC be drainl: or of•.bottom area Leachlines/bed special design for slope: Applicable (3) Pit Diameter No. Pits Pit Below Seepage Pit Total Depth Other. �� N/A Overburden factor ©r,"T, & IV, 8 ! 7U Max. Allowable Depth �n r No. 2 System REMARKS: �' 3'> Glrr ,arc •c /ZO�i k . y�a11/!/r% d .�'�y.•-4G+ This application is f. APPROVED%6l —WEE)for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated on the accomparne pl�St�pfan, 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. 1 Septic tank and sewer lines must be 50' minimum from any wells/ 0 ®'9 (y � f2 Leach lines must be 100' minimum from any wells, including expansio are f 3) Seepage pits must be 150' minimum from any wells, including expansi • n area rn`2 z rM,: , /,t� d,cr.,'jfic.R� Nr�J" �" ryV1.�„•„�� Si nature of Health Official �'-! A �i/�� - Date `�dt �. } t' RECEIPT NO.Issued By S�f Date DISTRICT: ❑ Riverside, O Indio ❑ Hemet ' ❑ Perris ❑ Rancho Calif. ❑ Blythe DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept. GOLDENROD - Plans/Records wt Q Z O F- 0 W co CD Z O H U W LN Z O H U U.1 W • K i';R .:, x;r 'r up.^�*;. 0 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' # Agent, Contractor, Contact Person Phone Address & Phone t I D k' C Owner Phone Mailing Address 9av City. a __ -. State.__: _... Zip-. Job Prope_rtyAddress 60777 Legal Desbptfo opf OFaV(M�cWLLo4t *"P,41• Lot Size o,,Vatier Agency . _, I Use of Permit P/P, CU, etc. -DV, i 6F �,q 1Q a Il/ t e rl U 0 F (, m!� P # a�- �-`&-3 wellih2___,g, MH Sitd Prep, etc. a , f. Date Signature of Applicant / CATEGORY: REV CODE FEE CATEGORY: REV CODE FEE ©®SUBSURFACE DISPOSAL 1238 $45.00 ❑ 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 INITIA DATE Holding Tank Agreements Completed ❑ Yes No Certification of Existing S.D. System Required ❑ Yes 10011NO'o WQCB Clearance required. (Attach Form ❑ Yes o DOH SAN 007, Santa Ana Region Only) Soils Percolation Report Required. ❑ Yes N / .Special Feasibility Boring Report Required. ❑ Yes Detailed Contour Plot Plans Required (1 to 5 ft. interval) ❑ Yes 0i Other ❑ Yes Staff Specialist Lot Inspection Required ❑ Yes No Lot Inspection Date Soils boring report by' Project # Date t % Soils Map Page f f Soil Type Approved by���. w Date a'� No. of Systems TyRof System(s) No. Dwelling UnR 1) (1) Septic Tank rease/Sand Hyy(ding Tank ❑Existing Bedrooms, Fixture Uras_ LSoilRate G se Intcp ❑Replacement-3Q10&MX Gal 2) Leach Line Sq. Ft. trench area Sidewall allowance Install Line(s) ft long ft wide with ' Leach Bed sq. ft. ft rock/ sq. ft min. hes roc{C drainlines or inc of om area per running ft. A Leachlines/bed special design for slope: (3) Ph Diameter No. Pits Pit BeloW Seepage Pit Total Depth Other. Applicable 61 lN) / Max. AI(owable Depth N/A Overburden factor 5 7Q / ` No. 2 System /,4 " REMARKS: -)P, � a,� N- Q•�.. � d This application 9 APPROVED E IE@Y for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated on the accompanied � 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. 1 Septic tank and sewer lines must be 50' minimum from any wellsq/ a a Leach lines must be 100' minimum from any wells, including expansion are fir' 3 Seepage be 150' from including pits must minimum any wells, expans n a� a 3i nature of Health Official NO./o Issued By Date ❑ Riverside,0,0 Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept. GOLDENROD - Plans/Records w* Desert Sands Unified School District CERTIFICATION OF PAYMENT OF NOTICE: THIS QOCUP.4tNCHOOL FACILITY FEES NOT BE DUPLICATED, TO: City of La Quinta DATE: Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 CTI This is to certify that ' , developer of which is located at , within this District, has paid school facility fees imposed pursuant to the aut rity enera by overnmen Code Sec iost 5 080 i a oun $ ( 1 covering a total of /� / quare feet of ( ) residential or ( ) industrial/commercial development and that building permits for this footage in this develo men may now be issued by your jurisdiction. ryc/4 154kB% = IglI (d)-41 99 k/1 Ll '/ a 6�� for DESERT S NDS UNIFIED SCHOOL DISTRICT White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer (10)-37 O: q OFFICE OF E. LEON SPAUGY PCOMMIWONE4 ? AGRICULTURAL CONIMISSIONER JAMES O WALLACE A p v AND �ss�srr�r'cn�+wssw.Ea Fc MEASURES CLEMENT BENVENISTE WEIGHTS SEALER .•�; 49-613 Ilwy 86, Suite B-12 6.4' lb Coachella, CA 92236 Mq r q 619-342-8291 DATE D6 l I �� ccs CASE NO. DEVELOPER'S NAME: S ADDRESS: S4- L/ rJ ��Q vua 1`c ( o rl\A,(%Idr- CA- TELEPHONE: ( 3 l 6 t--�+ �"(o C�(� (�d+-Eli k�✓�w5 � ��LiUI: Dear Developer: 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 fmn plant Fnaterial listed, this office nest be notified immediately. Thank you for protecting and preserving the Coachella Valley's pest -free environment. Agric "tural Cannissioner's Office cc: Indio and Riverside Office