Loading...
04396 (AR)Building Address Owner Mailing Address P.O. BOX 1504 78-105 CALLE ESTADO 46-485 • f"BIiK o Pal= , - _ LA QUINTA, CALIFORNIA 92253 ]Re ra✓mce Thomas - BUILDING: -TYPE CONST. OCC. GRP, A.P. Number 617-051431 City Zip r Contractor City jZip State Lic.I City & Classif. Lic. # Arch., Engr., 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 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, 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). O 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. 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 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 . r. ,1• --/7 j�P Date ,� Owner �+''��'���- � ' a �/I.— "" 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. 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 04396 Legal Description Project Description �A4144 hPkt_-b �' TM #Iv 4"-1�stntr^ An^'rrx Sq. Ft. Size No. Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ (Estimated Valuation $50000 PERMIT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS AMOUNT 442•uz toa00 22.00 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,I8 INFfEC�TOR Issued by: Date Permit Validated by: Validation: WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, G0LOEN1Q0 - ASSESSOR'S OFFICE, HARD COPY - FILE CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMTSNG FEES IST FL SO FT (4 = UNITS A.C. UNIT COLL. AREA SLAB GRADE YARD SPKLR SYSTEM 2ND FL SO FT. a BONDING HEATING (ROUGH) MOBILEHOME SVC. BAR SINK POR SO FTa SEWER OR SEPTIC TANK ROUGH WIRING GAR SO. FT. to POWER OUTLET ROOF DRAINS FOUND. REINF. DRAINAGE PIPING CAR P. SO FT. a HEATING (FINAL) WALL SO. FT. rd REINF. STEEL DRINKING FOUNTAIN GAS (FINAL) TEMP. POLE URINAL SO FT a GROUT ESTIMATED CONSTRUCTION VALUATION S WATER HEATER WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTONDISH) APPLIANCE DRYER LUMBER GR. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FRAMING LAUNDRYTRAY AIR HANDLING UNIT CFM 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 FIREPLACE SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT. B.T.U. SO. FT. RESID I'A c SEWAGE DISPOSAL SO.FT.GAR Iv:c HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEECONST. FEE ELECT. FEE SMI FEE PLUMB FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK A&ROUND PLUMBINCJ--/41' UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB r� 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.IEOUIP. REINF. STEEL r/� GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM S GRADING cu. yd. _plus_x$ -S LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING I S/ 4 , �� �jy� �ClYe� /- ^� /� / ✓� REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR, GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL Building .'0P - Address Owner P- 4 rit Address ,&?I&> I \ZVS-L-� City Zip Tel. (Cd;DLJ%#Fr_> L-41 I 15&4 i14, l f) Address ty State Lic. City & Classif. I Lic. # Arcn., tngr., Designer Address Tel. P.O. BOX 1504 APPLICATION ONLY 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 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 WOO) of Division 3 of the Business and Professions Code, and my license is in full force and fect. SIGNATURE DATE �r 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 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). 0 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, Bulsness 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.) ❑ 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 o/ props who builds or improves d who contracts for such projects with a contractor(s) licens u.u.1 to the Contra is License .) O 1 am exempt under Sec. P.C. for IN reason Date wn W MPENSATION DE RATION Ihereby 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 thg 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. 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 ateMailing Address City, State, Zip FINANCE BUILDING: TYPE CONST. OCC. GRP. A.P. Number //, -7 ON ,Legal Description Project Description/.!0,0 6,4T/rItZo P#A , W efWAN jna .e Q � _0,&r,0rr9N kI,4e-G /d/ C L c,! 1Q IE A Sq. Ft. No. Size Stories No. Dw. Units New ❑ Add ❑ Alter dQ Repair ❑ Demolition ❑ Estimated Valuation SQ�� PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Jy. ffo2 Const. O• I -M Mech. Electrical gyp. o 0 Plumbing c2o7. 00 S.M.I. Grading Driveway Enc. Infrastructure TOTAL 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 INSPECTOR Issued by: Date Permit Validated by: Validation: COT-], I-Ity Of � t.:I�'erside DEPARTMENT OFHLALTH TO: hllorn .11 PUY CorlCerl, DATE: 1-ebruary 18, l'l8i1 FROM:H. 1`;llph Lochs, 1t.S., Administrative Supervisor l.rwironnlent:ll Health ScrOces Division (714) 787-6543 RE: (:onnectint; to or Cert 1 f) -Ing an existing Subsurface Sewage Disposal S\ -stem (R11` 1 SH) Prior to am. ;lppro�•als from this Department, the following is required for conilecting to an existing subsurface sewage disposal. system: 1. 'Yhe existing subsurface sewage disposal system nnlst be examined by a C-42 State Licensed Plumber or State Licensed Septic Tanl: Contractor. The size and condition of the existing system must be certified on the attached form letter. In addition;'it may be necessary to verify the size of the system by obtaining a copy of the building permit and signed )ob card from the Riverside County/ Cit) Building and Safety Department. 2. The existing system must be plotted and submitted on four copies of a scaled plot plan (scale not smaller than 1-40). A Riverside County subsurface disposal system permit application will be completed with the above. 3. Detailed soils testing may be required if the above cannot be effected or: a. the area is within a high water table area or an area where soils have poor leaching characteristics. h. the existing subsurface system has failed or Is failing. 1RL: cg Attachment S1 3 s i * ''6. i 'tit •�+ D '11:: TO: County of Riverside 1ic;partment of Health I:m ironmental Health Services Division 3575 Eleventh Street 1,till I'.0. Box 1370 Riverside, CA Q'SO-' Attn: I -Ind Use Scction Subject: Cort if`'IT g the isting Sub 11 ace Scwage Disposal System. at__ 1- 17 � _ (Property 'Address) -(Legal Description and/ -c --r APNj i Applicant Show design and location (to scale) of the sev.age disposal system in relation to dwellinc-,s, structures, wells, etc. i examined the existing sLiusurface seg.==a€3s�al s stem at the above Location on _ and certify that the .sem,,,°��-- ' �' size is _ ,poa gallons and the tate leaching area consists of sq. ft. of ]each line/bed orZ _ seepage N1O o pits pits, 1S'ft. diameter and _ —_ ft. below inl.et ( ft. total depth) . It is my opinion that the system appears to be in good working order and can be expected to function properly with proper maintenance. if lucre aye am• further questions, feel free to contact the undersigned at _�-07?_ eA ennone Nc. (Si.gnature 1 C-42 State Licence or Septic Tank'Contractor State License r