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9587 (SFD)T 6 ity/ 4 �� r � Lk.# P.O. BOX 1504 9587 Building 78-105 CALLE ESTADO I Address 78-735 Bottlebrush LA QUINTA, CALIFORNIA 92253 Mailing Address City Zip Tel. Contractor Address same State Lic. City & Classif. B 613406 1 Lic. # 1858 Arcn., tngr., Designer Address Tel. 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 effecI. SIGNATURE DATE OWNER -BUILDER DECLARATION 1 hereby affirTn 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, after, Improve, demolish, or repair any structure, prior to its Issuance aso 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 rove 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, Busness 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. h however, the building or Improvement is sold within one year of completion, the owner -budder will have the burden of proving Nat he did not build or Improve for the purpose of sale.) ❑ 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.) O 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION k 1 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 f1 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, 1 shall not employ any ppeerson 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. 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 LDING: TYPE CONST OCC. GRP. - P. Number 617-382-023 gal Description Lot 73 Desert Club Manor oject Description SFD r Sq. Ft. 1600 No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Permit does not include block walla or pool Estimated Valuation $7.128.00 PERMIT AMOUNT Plan Chk. Dep. 1250 • U0 Plan Chk.. Bal. 256.85 Const. 585.50 Mech. 55.50 Electrical 139.84 Plumbing 157.50 S.M.I. 8.90 Grading 20.00 Driveway Enc. 20.00 Infrastructure 1960.38 25.00 F i nap, Toed L ' zard 68.87 TOTAL 350--1344 'i An n,4-r,r,j�34 y REMARKS 1V GASB l 1 U I AL t 3—Will, 34 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 INSPECTOR Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS COLL. AREA 2ND FL. SO. FT. Ui YARD SPKLR SYSTEM POR SO FT ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. I SO. FT. DUCT WORK DRAINAGE PIPING WALL SO. FT. DRINKING FOUNTAIN. SO FT ® HEATING (FINAL) URINAL ESTIMATED CONSTRUCTION VALUATION $ 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(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GRADING cu. yd. $ lus x$ LAUNDRY TRAY AIR HANDLING UNIT CFM FINAL INSP. �i / j7 y KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER. B.T.U. SO. FT. ®c BATH TUB FIREPLACE SO. FT. ® c WATER HEATER MAX HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL FINISH GRADING SO.FT.GAR ® 3/<c HOUSE SEWER FINAL INSPECTION `7 j CERT. OCC. (/ 111 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 � y SETBACK (l GROUND PLUMBING (! UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE Ui ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS( SEWER OR SEPTIC TANK UGH 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. $ lus x$ =$ LUMBER GR. FINAL INSP. �i / j7 y FRAMING o 221q L FINAL INSP. L / ROOFING ELc JJ 'f r J �jlN VVV tV r J � If 2- l �p ��• � .f1 l! AM i a / / "7 REMA S: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIR ALL HI n, �/J LA NG a T C(�` MESH INSULATION/SOUND �3 Q� FINISH GRADING FINAL INSPECTION `7 j CERT. OCC. (/ 111 FENCE FINAL INSPECTOR'S SIGNATURE I TIALS GARDEN WALL FINAL Contractor Address T..df 4.4QuW0 P.O. sox 1%4 76105 CALLE ESTADO LA OUINTA. CALIFORNIA 92253 Owner -_36 d Ar( ala,-� Job Address � La Quinta City License No.: Expires: - a% Bldg. Permit No.: This form shall be posted on the job with the Building Inspection Card and it shall be the duty of the General Contractor or if Owner -Builder Permit, the owner to see that all sub -contractors sign this card, giving his City of La Quinta Business License Number, Contractors License Number and a current certificate of Workman's Compensation Insurance Certificate when he starts the job. Failure to comply may cause Building Inspectors to stop work, or complaints to be filed against such contractors or owners. CITY CONT. SUB -CONTRACTORS NAME LIC. NO. EXPIRES LIC. NO. EXPIRES 1. 2. 3. 4. 5. 6. 7. 8. 9. l0. Ll. L2. L3. L4. 15. L6. 17. 18. 19. 20. 21. 12. 23. 24. 25. 26. 27. 28. Grade i Excavate Pipelines Cement -Foundations Cement Walks i Drives Asphalt Paving Framing Steel Structural Masonry Plumbing tS CIRA /2 - Lathing Drywall Plastering p HVAC v'�' S �i�L, .2 i s��a 7&7 Electrical 4- 7 a - 13 Oz. Roofing Sheet Metal Floors -All Types Glass - Glazing Insulation/Weatherstrip Sewage Disposal Painting/Decorating Tile Cabinets -Installations Ornamental Metal Fences/Blockwalls Landscaping Others DO NOT REMOVE THIS CARD Before Final Building Inspection Will Be Made This Form Must Be Completed and Filed With Title 24 Calcs and Plans I Building S ✓��� Address AMOUNT S T4tvl u P.O. BOX 1504 7&10.5 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Address City •: Zip ITel. Contractor 7 n p O PERMIT AMOUNT Plan Chk. Dep. BY - Plan Chk. Bal. 2-3-,6 _ Address _ _ .... . 5,5 Isy Electrical . 8 Plumbing /5-,7, City----- "" ' Grading Zip Driveway Enc. Tel.. State LiC. 20T49 -3 S• olv City & Classif. 6 TOTAL �------ dq Lic. # -Arch:, Engr.;- Designer. • '�� d�'•. Address Tel. (• APPLICATION ONLY BUILDING: TYPE CONST. OCC. GRP. A. P.. Number. l 7 Legal Description Project Descripti ' Sq. Ft./ _ No. No. Dw. Size (� Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affir that I arMtce ed under provisions of Chapter 9 (commencing with Section 7000) of Divi n 3 of the $ sin ss a r ss s Code, and my license is in full force and effect. S GNAT 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, 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 loi 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). O 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.) - ❑ 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 Date 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 the 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 Call forrsnia. 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. CONSTRUCTION LENDING AGENCY 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.) 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 BUILDING DIVISION stimated Valuation 7 n p O PERMIT AMOUNT Plan Chk. Dep. BY - Plan Chk. Bal. 2-3-,6 Const. 1�_ 8,S p Mech. 5,5 Isy Electrical . 8 Plumbing /5-,7, S.M.I. 1p.9Q Grading zp --- Driveway Enc. ;L0 -- Infrastructure 20T49 -3 S• olv TOTAL �------ dq REMARKS Pa ALP r eei ieiF'5i 65 i YL iV .mo itt f`ACH i TnTAI t ?Sia t7n 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 INSPECTOR Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE GROUND PLUMBING NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ n i+ UNITS BONDING HEATING (ROUGH) STORAGE TANK 2ND FL. SQ. FT. SEWER.OR SEPTIC TANK ROUGH WIRING DUCT WORK YARD SPKLR SYSTEM FOUND. REINF. POR. SO. FT. @ METER LOOP MOBILEHOME SVC. OTHER APPJEOUIP. BAR SINK GAS (FINAL) GAR. SQ. FT. ® POWER OUTLET GROUT ROOF DRAINS SERVICE FINAL INSP. BOND BEAM WATER SYSTEM DRAINAGE PIPING GRADING cu. yd. $ plus x$ CAR P. I SQ. FT. ® LUMBER GR. FINAL INSP. FRAMING FINAL INSP. WALL SQ. FT. ® Mg` DRINKING FOUNTAIN REMARKS: SQ. FT. ® VENTILATION URINAL ESTIMATED CONSTRUCTION VALUATION $ FIREPLACE WATER PIPING NOTE: Not to be used as property tax valuation SPARK ARRESTOR FLOOR DRAIN GAR. FIREWALL MECHANICAL FEES LATHING WATER SOFTENER MESH VENT SYSTEM AN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FINISH GRADING GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED CERT. OCC. i LAUNDRY TRAY AIR HANDLING UNIT CFM INSPECTOR'S SIGNATURES/INITIALS KITCHEN SINK w ABSORPTION SYSTEM. B.T.U. GARDEN WALL FINAL 71 TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEM/PERM LAVATORY .� HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. ® c BATH TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1 % cJ� SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac O HOUSE SEWER GAS PIPING PERMIT FEE .. PERMIT FEE ITPERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT.FEE SMI FEE P UMBB. FyE/E7971 OLA 17, 19 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 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 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL 71 77 , ' I Lu.J i...�LJ.. %l al (li'iJ' y::..,':'�'''.';..f.... �r:.;.1 .1:.'L,' ji". 'tiu�.n��•J ' 6� .. W:•d B.`d'r'r''�J+��•VDf.'' �n�i'JVi�`J�'ra'li.u.,. 8.�:�:l�Jtiis D::v.:��'uC WI n'. .• • '1.; �.�. •�lli�� EO�I�5111110M - ' - w'. Trdkarf: Oc (f Gel. equit tank -�-p-- : ;04,Ft tp LsOh 1:4 ft ��`• •-+�-'Dttg. BD/t�• /lirtl'rl� � � f •rig dal f3u 8 Copnectiom to ;mer sr:+rmu g pool i�v ow z@. ra ps^eL ig +r indSviCos tray be c#ivlts^ IM, the M�:vMu7i tyttt{� 11 i�E%ilil td�^s�2f'lit ?y� '�fti;t�'l3 F: t�ii �1Daq, 4irra D°f3 x" Ej1Ss�Yty.O�;, r� Y��(/�1Jt !' /Iv :t:PLPx rl 1��1i i-. LiL .57 �{i9 S"?S �f '-Sw��zt>7 :i0urm 1. L/Wz> All ai m �, '1 a M "P �ii77 aj.T%r a,:.rlh) �Ill..2 Ca7(i�:AYI��D YYiIiJ ��L i,4io•"11 .,° 0 G3F:` . �7E Jalq! P�.E1FSl 1i� i• , � AnyC57tt!rd ovdAl hi c-ArmI3 OS filar (>'d) ±b'+aa `J:i('e� mnmy "%%M'L ' 0 :h" trw ob elxd f = vio nsaona9 Wemr Qu -au y 003t�i Fpm: A. tw uNtsulow of the sew:go 1 i Ti'iS i3lo : '� ft r4ft ��7� C Y�th 8b tw. summm, awswuction w : a. 'nsijils2•iop the e �, � �Gate A MA MAN# Rte. ANYIMI. c lam. 10' FMV ANY frmirlbl ATER PAL tO , vcpeke vz,, 7, and Ii xrj R'tE.L` t be 50. ft. Ot3 'stmt be 150 ft. rMnimum tom any weNs. F ' PLOT PLAN SCALE: 1�8"- K If• t-:ri r3 y�-' •"? ,,.� �?' ;'� P.i)raval os tuszo plass Dy mg r: y�:; Vii'sir:�.a�z d �i�T 5 iF'�bi:•i �� Health o!ivCl7Sid© ComTtty doma naQ 1FEAA}ev6 ON E}, ' *.er -or Architect of tke reepsmaj3►iti r t Inc or Archltwwra l 13aakm . r 'ROM:GATE LE OF APPROVAL r: SVT 11 FJ+j `3u 2 r MAILING ­ADURESS' P 0 BOX ROWN CORP. Lar 73� (619)-3?�y.8266 L4--QUNTA,� OCALEi OA r' ARRI.L 1989 . ♦!'VO TITS•[ ,•• • •'• '• Q Z O W U) m Z O UJ CD U z O_ 8 W U) 0 LU COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH ANSU ' ftmW Na �- ENVIRONMENTAL 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 speculations as indicated on the attached check IIsL 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 # 41 4 Agent, Contractor, Contact Person Phone Address & Firm sG -/- Y07 7 Owner Phone Mailing Address P o -.136x 8'a'4 ZA7 City State Zip Job Property Address Legal Description Prop. (PM, Tract, Lot) 1/I Qcr/'VT4 eci•C- ' 22S3 -78_ 73S &7TLEB2u5N Z67 73 [/N/T%—DESc4T cwe, /t9 Lot Size ter Agenc Use of Permit P/P, CU, etc cc _- q Other Sox jao C.vtw,0. Dwelli a Prep, etc. SLIiEZOs gC.fy% • Date Signature of Applicant CATEGORY: REV CODE FEE CATEGORY: REV CODE FEE f7JiSUBSURFACE DISPOSAL 1238 ❑ SITE EVALUATION UPON REQUEST 7349 $ 43.00 �9 ❑ MULTIPLE PARCELS WITHIN SAME (NO PLOT PLAN) LAND DIVISION ❑ SEWER/SEPTIC VERIFICATION 7348 $ 17.00 a. 1 at 4 Parcels (Each) 1238 $ 57.00 (Less than 1 year) Parcel after 4 7344 $ 24.0 ❑ PRELIMINARY ELECTIVE 7352 $ 23.00 dVlEach Rereview (2nd review same parcel) 7344 37 O EVALUATION (Attach DOH SAN 53) ❑ She Evaluation in Conjunction with ❑ HOLDING TANK 7351 $ 47.00 Critical Area 7348 $111.00 ❑ ALTERNATIVE/EXPERIMENTAL 7345 $222.00 ❑ Site Evaluation Lot Less than SYSTEM 10,000 Sq. Ft. 7347 $ 87.00 !�Lq� INI I DATE / /� Holding Tank Agreements Completed ❑Yes (/-9, L CeRNication of Existing S.D. System Required ❑ Yes N W0C8 Clearance Form ❑ Yes No required. (Attach DOH SAN 007, Santa Ana Region Only) Soils PencoWbn Report Required. ❑ Yes Np// Special Feasibility Boring Report Required. ❑ Yes m/N6 Detailed Contour Plot Plans Required (1 to 5 ft interval) ❑ Yes Odw ❑ Yes 13 Staff Specialist Lot Inspection Required ❑ Yes No Lot Inspection Date Sella boring report by Project Date i�ti �1 �"`^'' v — V Soils Map Page SCA Type Approved by DamIt No. of Systems Types) D Ing Tank O Existing Na Dwelling Unita �!) Bedrooms, (1) Septic Tank Soil Rate (G='— InDcp New ❑ Repleownt" Leach Line Sq. FL Sidewall ofbwence Instail Linea) ft long rt wide with Bed a% K trench area tL rock/sq. ft. per running fL l� NA min. inches draMl'mea or Of iaftw4w I eachlines/bed special design for slope: ApplicaW� (3) Ph Diameter No. Pita Pit Below Inlet IN (TD) Seepage Pit Total �epth (� N/A v Overbu factor 1"�a M.. A owsblle 9epth No. 2 System REMARKS: Qic�—cr�- r This application is PROVE the category cfril4i in SECTION B above, regarding the design of a subsurface disposal system as indicated on the accompan' of plan. usi t TION C above. A building permit is' necessary for the installation of the above -designed system. No construction is permitted in the required reserved 1 ex larr-area---, ( Septic tank and sewer lines must be 50' minimum from any wells pr 1 0 7L�� (X\ leach lines must be 100' minimum from any wells, including expansion res J /� T � �� /�•� 3 Seepage pits must be minimum frrolm/any wells including expans' a/rea� �r� Signature of Health Official e6&t RECEIPT N � Issued By Date DI RCT: ❑ Riverside, P ❑ Hemet ❑ Perris a�o alit. ❑ Blythe 9'91 DOH -SAN -122 (Rev. 3r90) DISTRIBUTION: WHITE - Office The YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records n/02 `•}-. RZ,.F(`_+ �a.�_-^t-, .a.-:A. y�.rr ti7��:^".^ �.:, T,.� __ •� r _�' -,- ty`t-.. 13 8R 0 s .r^ ILL t • I t�. :r. t� 4 i - - X61 •.z' i• i 1 S - J'= ---- � `a' z„ q: ,•' ' ` I ^l —moi - nLt� •:.� , . � u fps � 11 i ti• 'y.. �' n . Ld ` � ! - - � - .... - .. L . _ Iii,=,�� � � � ; r P l�:'i � •�§ � � 8 N I - I4 II V _ L, i - t.4 - J d — — j Z' �.77, _ :rS DESERT SANDS UNIFIED SCHOOL DISTRICT 82-879 Highway 111 NOTICE: Indio, CA 92201 Document Cannot Be Duplicated (619) 347-8631 Date 6/5/91 No. 110638 Owner Name Type of Permit Roger Snellenberger No. 78-735 street Bottlebrush city La Quinta zip 92253 La Quinta Permit # Log # Study Area APN # 617-382-023 1 Tract # I i Lot # Square Footage 11600 Type of Development Single Family Residence No. of unite 0 Comments At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 500 square feet, detached accessory structures or replacement mobilehomes. It has been determined the above-named owner is exempt from paying school fees at this time due to the following reason: EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of1.58 X 11.600 1 or $ 2,528.00 have been paid to D.S.0 S.D. for the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued. Fees Paid By Roger Snellenberger/Jim Snellenberger Name on the check Telephone gy Richard M. Beck Director, Facilities Planning & Developmenti.e` Fee collected /exempted by Shelley D. Bennett �i /%� n Payment`1 vecei�iPci�•, Signature �X�-P -D,I-�� Check No" Cil 73 Collector: Attach a copy of county or city plan check application form to districtkcopy fins All waivers. Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting + O DIY CALVIN C. KAMINSKAS Assistant Commissioner O (714) 275-3000 M y iro __641 OFFICE OFFICE OF AGRICULTURAL COMMISSIONER JAMES O. WALLACE, Commissioner 83-612 Avenue 45 Suite 7 Indio, CA 92201 (619) 342-8291 DAN RILEY Sealer, Weights & Measures (714) 275-3030 DATE -/(D-9/ CASE NO. C C 10 S 3 � ( 4 DEVELOPER'S NAME: o -s-'(\ ADDRESS: S_y 36 C7 LA TELEPHONE: (6 /2 3 Zd -7 3 ewe k C\�•� �.r�,...�� �.` l SRN G-7-38')L-C�0-7 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 from plant material listed, this office must be notified immediately. Thank you for protecting and preserving the Coachella Valley's pest -free environment. j Agricultur Commissioner's Office. cc: Indio and Riverside 4080 LEMON STREET, ROOM 19, RIVERSIDE, CALIFORNIA 92501 = FAX (714) 275-3012 0