The URL can be used to link to this page

04-5593 (PLBG)n BUILDING & SAFETY DEPARTMENT P.O. BOX 1504 (760).77777012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) .777-7153 BUILDING PERMIT ,. Application Number. 04-00,005593. Date 7/21/'04 Property Address . . . . . . 80131 PALM CIRCLE ,DR APN: 649-090-030-1.9. -4518 - Application description PLUMBING Property Zoning LOW DENSITY RESIDEN'-'IAL Application valuation . .'. . ,,4950 _ h r { s Owner Contractor ------------=----------------------- -------= ' MYLL GREGORY TRI . STAR CON'-'R.ACTING, INC. 74057 VELARDO..DR P.O. BOX. 542 .PALM DESERT:- CA 92260 CATHEDRAL CI' -Y CA 92234 (76.0) 321-0898 r, WCC . -- ' STA -_E FUND WC: 197982003 08-/03/04 CSLB:"' 475515. 01/31/05 CCC: A -B. Permit PLUMBING ' Additional desc Permit Fee 60.00 Plan Check Fe'e 15.00 'Issue Date . . . . ;Valuation 0, _ Qty- 1- =Un .t„ Charge Per .. _t; _ j_.. _.z_ _ .:.. Extension-�,_. BASE. FEE .15.00 1.00 4:5. 0000 EA _ .PLB. SEPTIC 'tt --———=--——--———--————————-—--------- —————— — — — — -- ---------------"------------ ..-4-5.00 ; Spec ia-1 ' Not'es .and Comments ABANDON EXISTING PIT/INSTALL NEW 6.X 10' PIT PER HEALTH. DEPT APPROVED:, PLAN/BACKFILL & COMPACT. - -Fee ' summary '" Charged Paid Credited Due Permit Fee Total, 60.00 ..00 .00 .60.00 -Plan Check Total 15.00 .00 .00 15..0,0,, Grand Total 75.00 - .00 .00 75.00 P.O. BOX 1504 a". VOICE (760) 777-7012 78-495 CALLS TAMPJCO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: c9q > >' 3 Date: --V Applicant: I Architect or Engineer: O' O ti Applicant's Mailing Address: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is i force end effect. License Cl, Y, 4 V Lice—ns—e No. Date b-1 / Contractor I r— 5�� [_a ny'i P--lgGrt I Y� OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she 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).): U 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, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself or through his or her own employees,'provided that the 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 or she did not build or improve for the purpose of sale.). U I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). U I am exempt under Sec. , BA P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. _ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is _his re My�e{co pensation insurance carrier and 1' nu�Q Cartier -L� XJI�i �,T " t(;1 Policy Number �"1 L % _ 1 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, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall i forthwith comply with those provisions. Date Oi Applicant 0, 0-r ZQ 2 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000); IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name Lender's Address APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall, defend, indemnity and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work Is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. certify that I have read this application and state that the above informat' 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 county to a er n the above-mentioned for inspection purposes. Date -1 1 OU Signature (Applicant or Agent): a ,{ 4 O w o •n - w w z T-r C P�: o c-3Dot LU .0 m m� cn v uj J z W. ;Y �� o ^ % W �. a � li : _� ...�.. tE I COUNTY- OF RIVERSIDE DEPARTMENT OF" ENVIRONMENTAL HEALTH Sewage Disposal Dwelling Oil. Septic Tangy is Commercial Sq. Ft. of Leach Line _ Seepage Picts hu�f No. Dia OBI /qD/ SMD Connect to Sewer —Connect to Existing Systenn aI - —No on-site water softening devices shall be discharged into the septic system without clearance �r from the Calif. Regional 'Vater Quality Control Board. LAll sewage disposal installation shall conform to the current UPC r; Any ra ing f the area of the proposed dsach lin s s al re u` e a new approval by this,_�epg:��"'�JJ I HIS APPROVAL GRANTED BY THE ?;a j DEPARTMENT OF ENVIRONMENTAL HEALTH f IS VALID FOR ONE (1) YEAR FROM i' DATE OF APPROVAL . COUNTY OF RIVERSIDE COMMUNITY HEALTH AGENCY ASsessoR's PARCEL NUMBER It 'Acl DEPARTMENT OF ENVIRONMENTAL HEALTH APPLICATION FOR WASTE WATER DISPOSAL APPROVAL APPLICANT: Submit this form with four copies of.a SCALED plot plan (1"=20' to V=40' SCALE) drawn to County specifications as indicated on the attached check list. A non-refundable filing fee 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 payment. LMS# c.& f1 I -A IQ --474 r Agent, Contraetor, Contact Person Address City State Zip Telephone DAS <'A CI��7Q �7 i 5`�s�' .O•�wner! t A t Address )✓ City State Zip LkV C (, bJL0 , Telephone jL1- qC+ :e l V�.Ot�tt, Yv.�W'tis .. ►/ Z Job Property Address City Zips Lot Size Water Agency/Well Use of Permit, P/P, SUP, PUP, etc. Legal Description DBA U-1 Tt�t"1 519 1 -ZIT LL C0 -.re' L . welling; MH Site Prep., etc. Signature1of Applicant- )`� ':_7 7 � Date FOR OFFICE USE ONLY CHECK BOX IF REQUIRED If any box is checked, this application shall be considered rejected until the ❑ Detailed Contour Plot Plans Required (1 to 5 foot interval) information is provided and the fee paid. Resubmittals later than 90 days after date noted below may require repayment of fees. Cl Other ❑ Staff Specialist Lot Inspection Required m Z O C]Holding Tank Agreements Completed i t t b til ("1 1 ( P: Certification of Existing S.D. System Required Lty.,"I.tG), Thomas Bros. Page Grid (-) ❑ WQCB Clearance Required S t' ❑ Date Lot Inspection Completed: Initials U) (Attach for DOH -SAN -007, Santa Ana Region Only) '%' j�j / Remarks: ❑ . Soils Percolation Report Required ill CjQ .1_� ❑ Maintenance Booklet Provided ❑ Special Feasibility Boring Report Required %�d �/01 Q Final Inspection by Department of Environmental Health is required. ❑ Rereview Required Initials Date Please call 24 hours PRIOR to inspection. C/42 / Soils Percolation Boring Report By Lic/Project # Date Soils Map Page Soil Type Approved By Date No. of Systems Type of System(s) No. Dwelling Units (1) Septic Tank Soil Rate Grease/Sand ❑ Holding Tank -Replacement Bedrooms, Fixture Units .$,�,>J�«� Grease Intcp/Lint Trap / ❑ New ❑ Addition ❑ Existing ❑ Connect to Sewer ;� -t� e2t712 /Af h O�- 7Sl% Gal. �iJd Gal. Sq. Ft. Total Linear Sidewall Allowance a Leach Bed sq. ft. Bottom Area Ft. ft. rock/ sq. ft. running ft. Install Line(s) ft. long ft. wide of Bottom Area Inlet Tested .Depth ❑ N/A with min. inches rock below drainlines U Proposed Bottom Tested Depth or Z Leach lines/bed, special design for slope: (3) Pit Diameter No. Pits Pit Below Inlet (61) Seepage Pit Maximum Other: 0 Applicable AJ e4-,) Total Depth Allowable WN/A Overburden Factor ❑ 5' *,6'�0 ' TD Depth Well Review Approved: Date: Well Drilling Permit# SIGNATURE Grading Plan Approved: Date: SIGNATURE Plan Check Only Approved: Date: REMARKS: 7/1- IIvv( t'to+ AvaI fatxt j?t.►1�n�t�s, 0Vw1J , %Lt,+EI mac. IA' Q �'_/. / /1�17�/ 1� ./�/l�i.0 �i�Rd_/UaA t T 11//GC�►�t L�1 /sit / w iit.�iK� /�/rin Xa /tY/6r_ /� n`�.n ,�1��.a�_ dl..,/�h..�•�J RX�' � ��.. sa .ac ,aa ��t•r 11 a_ ��i� ��ll�i � �.�.+-�.a...'v� �`.i� This application(ls APPROVED�DENIED for the�°category checked in SECTION B above regarding of a 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- e- Revenue Code _ _1 S Fee $032. .l c'—/ designed system. No construction is permitted in the reauired reserved 100% expansion area. L� > Check # e— (1'pSeptic Tank must be 100' minimum from any wells. 7 J f Z (2) Leach lines must be 100' minimum from any wells, including expansion Date )/,j/! /i t/ Initial ` 0 - area. ! U(3) Sewer lines must be 50' minimum from any wells. W 4 Seepage pits must be 150' minimum from any wells, including expansion RIVERSIDE: 909-955-8980 area. INDIO: 760-863-7000 SOUTHWEST. 909-600-6180 Signature "' J' Date -••�•••• •«<••�• -�v visuiuuuon: vvnllt—unite rue; rtl_wvv—Applicant•, FINK—bldg. Dept.; GOLDENROD—Plans/Records