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11029 (SFD)f P.O. BOX 1504 Building 48. 750 Sart Vicente St LA QUINOTAC Address CALIFORNIA 92253 Owner Don Howard Mailing Address 79811 Country Club City Zip Tel. Bermuda Dune3 92201 Contractor Cherokee Homes Address same as above City lZip Tel." State Lic. & Classif. D 47007 Arch., Engr., Designer Address City / LICENSED I hereby affirm that I am licensed DWI of Divislon,3 of the Business Lic # 564 Tel. State / LIC. # ARATION ►pter 9 (commencing with Section and my license is in full force and . 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). ❑ 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 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 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 ($100) valuation or less.) I certify that in the performance of the work for which this permit is Issued, I shall not employ anyparson in any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above-. mentioned property for inspection purposes. Signature of applicant -Date- Mailing ateMailing Address City, State, Zip No. 11429 BUILDING: TYPE CONST. OCC: GRP. A.P. Number ,Legal Description Project Description SFD Sq.Ft. 3? No. No. Dw. Size 08 Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑ Permit does not include block walls or Poo.& Estimated Valuation 294,461.00 PERMIT AMOUNT Plan Chk. Dep. 2.4-7 "e, Plan Chk. Bal. 126.2 Const. 1322, 0 Mech. 89.5 Electrical 229.1 Plumbing 205.5 S.M.I. 29 � 5 Grading 20.0 Driveway Enc. 20.0 Infrastructure 6000.00 krtn in pllhlid 486.1 TOTAL 9478.A! .0,U$ ;3 REMARKS r4" -7v. , 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 Perm Validated by: Validation: e4 CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ 2ND FL. SO. FT. ® POR. SO. FT. ® GAR. SO. FT. ® CAR P. SO. FT. WALL SO. FT. ® SO FT ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD S ' PKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN. URINAL WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER DUCT WORK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM HEATING (FINAL) 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 BOND BEAM SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1% c SEWAGE DISPOSAL LUMBER GR. SO.FT.GAR ® 35c HOUSE SEWER FINAL INSP. a 31-73 L I ROOFING GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PLCK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBIN 0 %UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS-3R9;0�A ASEPTIC TANK UG WIRING. DUCT WORK ROCK STORAGE FOUND. REINF. AS(ROUGH) �!� / h METER LOOP GAS(ROUGH)//S-/13 HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE � uucc GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING CU. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. / L l FRAMING q S qA LV FINAL INSP. a 31-73 L I ROOFING „� Am L!�;) drew �1z •—/ «L� ��1� %OlZ(v(�ll�G� REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LA-VILA-VIW O O MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL Building Address n Maili g Address / city_ --,Zip G Contr t� Ad ress_ T4-tyl 4 tucv P.O. BOX 1504 APPLICATION ONLY 78-105 CALLE ESTADO 7tJT,„t 'f, f LA QUINTA, CALIFORNIA 92253 6-2 State Lic. C & Classif. Y9 ��l� -_7Lic. /ity # Arch., Engr., Designer4-GZ Address , Tel. City IZip I''ate . �) Vic. !f I hereb rm that I licensed der visions of Ch ter 9 (commencing with Section 000) of vision 3 of a Busines nd P fessions Code nd my Ilcense is in full force and OWNER -BUILDER DECLATION I hereby affirm that I am exempt from the Contra ors License Law for the following reason: (Sec. 7031.5,Susiness and Professions Code: y 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 (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. ff, 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, asowner 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 I hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3900, Labor Code.) Policy No. Company 0 Copy is filed with the city. O 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 (f 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: ff, 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 01\I a61r`C LDING: TYPE CONST. OCC. GRP. P. Number egal Description roject Description SF Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing 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: -.3 DESERT SANDS UNIFIED SCHOOL DISTRICT 82-879 Highway 111 NOTICE: Indio, CA 92201 Document Cannot Be Duplicated (619) 347-8631 Date 6/5/92 1 Type of Permit I La uinta No. 111459 Permit # Owner Name Don Howard Log # No. 48750 street San Vicente Street city La Quinta zip 92253 Study Area APN # I Tract # I Lot #E= . Square Footage 13708 Type of Development Single Family Residence No. of units 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 of 11.58 1 XF3_37W7 or $ 5,858.64 have been paid to D.S.U.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 Cherokee Homes Name on the check Telephone 345-6225 iBy James E. Lively Assistant Superintendent, Business Services! Fee collected /exempted by Shelley D. Bennett,�� = .. Payment R,eee ved, .'rJ� Signature Check Noy 0007 Collector: Attach a copy of county or city plan check application form to district copy fdir 0 w ivers. Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting E Z O U W U) CD A Z C U W V i9- COUNTY OF RIVERSIDE HEALTH. SERVICES AGENCY , ; - ° Assessors Parcel No. ' DEPARTMENT OF ENVIRONMENTAL HEALTH -- _30 2— 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 list. 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. aulv_� A FROM A NON BUILDING & SAFETY APPLICATIO LOG # VERIFY ITEMS IN SECTION -FEE (goldenrod) Ag� r or, ntact/ ersap f' Phone/ // Address City �State ip— f ,p Ow r Phone Address Ciry, State Zip J Property Address� Ci State Zip Legs escripti Prop. (PM, Tract, Lot) �S c - C .3 Lot Size star Agency U of Permit PIP, CU, etc. O O L / Dwelling p -etc. J D Si nature of A lica Date CATEGORY REV CODE FEE CATEGORY • REV CODE FEE UBSURFACE DISPOSAL (per ystem) 1238 $153.00 ❑ SITE EVALUATION UPON REQUEST 7349 $120.00 (NO PLOT PLAN) ❑ MULTIPLE PARCELS WITHIN SAME LAND DIVISION ❑ SEWER/SEPTIC VERIFICATION 7348 $ 58.00 a. 1st 4 Parcels (Each) 1238- $153.00 ❑ PRELIMINARY ELECTIVE EVALUATION b. Each Parcel after 4 7344 $ 55.00 (Attach DOH -SAN -53) 7352 $ 69.00 ❑ REREVIEW (2nd review same parcel) 7344 $ 55.00 ❑ HOLDING TANK 7351 $119.00 ❑ SITE EVALUATION in Conjuction with Critical Area 7346 �:, $197.00 ❑ALTERNATIVE EXPERIMENTAL SYSTEM 7345 $656.00 ❑ GRADING PLAN REVIEW DETAILED 1238 $104.00 ❑ SITE EVALUATION Lot Less than 10,000 Sq. Ft. 7347 $172.00 ❑ GRADING PLAN REVIEW CURSORY 1238 $ 55.00 ❑ SECOND FIELD VISIT (SITE EVALUATION) 7346 $ 85.00 ❑ COPIES (LAND USE) 7786-81 $ .50 ITIAL DATE Yes ��9_5r,26 z • Holding Tank Agreements Completed ❑ -,Y Certification of Existing S.D. System Required ❑ Yes C7No WQCB Clearance Required ❑ Yes (Attach Form DOH SAN 007, Santa Ana Region Only) ZN Soils Percolation Report Required ❑ Yes Special Feasibility Boring Report Required ❑ Yes N Detailed Contour Plot Plans Required (1 to 5 ft. interval) ❑ Yes [ ( Grading Handout Provided I ❑Yes t� Staff Specialist Lot Inspection. Required ❑ Yes � Maintenance Booklet Provided ❑ Yes Lot Insoection Date Initials - I C/42 / Soils Percolation Boring Report by Lic/Project #, Date � Soils Map Page Soil Type Approved By Date -�a7 �� No. of Systems Type of System(s) No. Dwelling Units (1) Septic Tank Soil Rate G q@je/Sand ❑ Holfling Tank ❑ Replacement Bedrooms; �ts ff/a GreaseN /Lint Trap ew ❑ Addition #d Pa- /, Q4M A1rr/a<� POO Gil. l ria n � Gal. ❑ Existing q. Ft. Total Linear Sidewall Allowance Leach Bed sq. ft. B om Area "m""g rock/ sq. ft. per running ft. Inlet Tested Depth A Install �,'Liine(s)_ng ft. wide with min.ainlines or of Bottom Area Proposed Bottom Tested Depth Leachlines/bed special design for slope: (3) Pit Diameter No. Pits Pit Below Seepage Pit Total Depth cher: Applicable �� r Inlet (BI) (TD) Max.�3 Allow ble Depth N/A kl;�.rburden Factor Ll�'6 ' �t7 / x. Well Review Approved: Signature Date Well Drilling Permit # Grading Plan Approved: Signature Date REMARKS: 0 �r W,4 C' 1140 ,, This appl' a to - f cat trInc ec e N a , cat�itj th� IC a suace 19— disposal system as indicated on the accompanie Ib cinn t . erre `" ., a building permit is nece sary for the installation of the above -designed Sy to perrinmded 117100% AXppnsion area J 1) Septic tank must be 100' minimum from any wells C/ /0 (� Leach lines must be 100' minimum from any wells, mcludi g ex nsion area `- 3 Seepage pits must be 150' minimum from any wells, including expansion area 01 /0 3_1 .2/�j - zz/v 0 Signature of Health Official Date ❑ CASH LACHECK NO. /40_ RECEIPT NO. Issued By Date DISTRICT. ❑ Riverside Olio" Imo' 0 Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe DOH -SAN -1 22 (Rev 1/92) �' DISTRIBUTION: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Plans/Records 0 7 , • ' • + n j�' r .r;,i . rl t-... _ , �• '� '�., �v'rt'�taf�-►y �}�h}.`�}t!� ►KftF '•>r �F- `'� j -- r � - Y ..,y� �,,,... ,ti = ,� d i Z C U W to m Z C H U U.1 W U Z C U W C11 COUNTY OF RIVERSIDE HEALTH SERVICES AGENCY t Assessors Parcel No. DEPARTMENT OF,ENVIRONMENTAL HEALTH) 2 10 Q- 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 list. 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. LOG # ®t VERIFY ITEMS IN SECTION A FROM A NON -FEE BUILDING &SAFETY (goldenrod) APPLICATION Age r' or, Contact. erso Phone Address city State i / / bv� Owner Phone Address City State Zip DO A J b Property Address City State Zip Lega escription Prop. (PM, Tract, Lot) a i.� %. E .53..LA I Lot Size Mater Agency .. a of Permit P/P, CU, etc. Dwelling mac. O l Signature of Applicalt Date CATEGORY REV CODE FEE /UBSURFACE CATEGORY REV CODE FEE DISPOSAL (per system) 1238 $153.00 ❑ SITE EVALUATION UPON REQUEST 7349 $120.00 (NO PLOT PLAN) ❑ MULTIPLE PARCELS WITHIN SAME LAND DIVISION ❑ SEWER/SEPTIC VERIFICATION 7348 $ 58.00 a. 1st 4 Parcels (Each) 1238. $153.00 ❑ PRELIMINARY ELECTIVE EVALUATION b. Each Parcel after 4 7344 $ 55.00 (Attach DOH -SAN -53) 7352 $ 69.00 ❑ REREVIEW (2nd review same parcel) 7344 $ 55.00 ❑ HOLDING TANK 7351 $119:00 ❑ SITE EVALUATION in Conjuction with Critical Area 7346 , • , $197.00 ❑ ALTERNATIVE EXPERIMENTAL SYSTEM 7345 $656.00 ❑ GRADING PLAN REVIEW DETAILED�„ 1"238 $104.00 ❑ SITE EVALUATION Lot Less than 10,000 Sq. Ft. 7347 $172.00 E:] GRADING PLAN REVIEW CURSORY 1238 $ 55M0 ❑ SECOND FIELD VISIT (SITE EVALUATION) 7346 $ 85.00 ❑ COPIES (LAND USE) 7786-81 $ .50 INITIAL DATE Holding Tank Agreements Completed ❑ Yes ��•h-9.�z.. Certification of Existing S:D' System Required ❑ Yes No WQCB Clearance Required ❑ Yes (Attach Form DOH SAN 007, Santa Ana Region Only) Soils Percolation Report Required ❑ Yes Special Feasibility Boring Report Required ❑ Yes N. Detailed Contour Plot Plans Required (1 to 5 ft. interval) ❑ Yes ¢f Grading Handout Provided ❑Yes �Q I Staff Specialist Lot Inspection Required C3Yes % Maintenance Booklet Provided ❑ Yes 0 No Lot Insoection Date Initials C/42 / Soils Percolation Boring Report by lac/Project # Date Soils Map Page Soil Type 0 ! Approved By R- �✓�-- Date _ No. of Systems Type of System(s) No. DwellingUnits r (1) Septic Tank Soil Rate Grease/Sand ❑ H��Iding Tank C3 Replacement ®eiQew ❑Addition Bedrooms; ' Greased.tcp. /UntTra p #610ahl �/� Od Gal. I f al. ❑ Existing Sq. Ft. Total Linear Sidewall Allowance Leach Bed sq. ft. DWI= Area— ft. rock/ � sq. n. per running n. Inlet Tested Depth I3NA j Install Line(s) n. long ft. wide with min. ock below drainlines or t` of Bottom Area Proposed Bottom Tested Depth Leachlines/bed special design for slope: (3) Pit Diameter No. Pits Pit Below Seepage Pit Total Depth (TD) 41Othe Inlet (BI) Applicable I iMax. Allo wable Depth N/A.Overburden Factor /0 !/ r-� Well Review Approved: Signature Date Well Drilling Permit'i Grading Plan Approved: Signature Date REMARKS: I - _ .. -A 0 VU//;)� This applicalidDryl°' a ategory cheik�iir�5f�t;f16N a �;ref�rd�i+gkthe �ei��o>-sUbsuri�C"e�sposal system as indicated =67afnlyt on the accompaniere uire a is C abov A building permit is necessary for the installation of the above -designed syste in —the required raI;Arvarj lonomp axpan�1 Septic tank must be 100' minimum from any wellsd Leach lines must be 100' minimum from any wells, includi gexansin area 6,2 Seepage pits must be 150' minimum from any wells, including expansion area p((A G/ '*► Gt.c- ZE& I ate Sof Signature of Health,. Official �� a� 6'L-$ � 49v •Y U 0 ❑ CASH CHECK NO. M� RECEIPT NO. 7 Issued By �►� to/t Date DISTRICT ❑ Riverside wl I& ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe f DOH-SAN-122(Rev1/92)' DISTRIBUTION: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Plans/Records A.