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07986 (SFD)Addrdes9 48-720 Ave. Fernando If=1 Mailing Address City Tit el. Address - 631-3M—ni11 a 13144AaCalf EeiatAma t QA Single Family Dwelling 789111 Coentxy Club Wye Distances: ;4 City $� Zip Tela • State Lic. City & Classif. Lic. # Arch., Engr., ` Alter ❑ - Designer INSPECTOR ' Kddress j Tel. .. Issued by: Date I City ' "� Zip State Lic. # f P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 !� BUILDING: TYPE CONST. LICENSED CONTRA S DECLARATIO eby affirm that I am licensed under p v ions of Chapter 9 ommencing with Section of Divisi _w3'of the Business i P fesions Code, and my icense is in full force and OWNER -BUILDER DECLARATION t 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 q_ unty 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 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 (5500). ❑ 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, Bussness 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.) O 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. O Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM f 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. Dale - 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 Addres ateMailingAddress City, State,^Zip No. OCC. GRP._ A.P. Number Legal Description Project Description 631-3M—ni11 a 13144AaCalf EeiatAma t QA Single Family Dwelling Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Sq. Ft. Size 2876 No. Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑. Demolition ❑ INSPECTOR 6r 24190Permit Issued by: Date Validated by: Validation: Estimated Valuation AA PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. ltmc co Mech. Electrical q .Plumbing S.M.I. Grading Driveway Enc. 2000 Infrastructure 9 26 TOTAL s • • 5 REMARKS >*t n A "I . sz ?_# :t.+�.., _. TASK x -- a RI x ar: 4%. f _10 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 6r 24190Permit Issued by: Date Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES , 1ST FL. SO. FT. ® $ UNITS SLAB GRADE 2ND FL. SQ. FT. ROUGH PLUMB. BONDING YARD SPKLR SYSTEM STORAGE TANK MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® DUCT WORK ROCK STORAGE GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) OTHER APPJEQUIP. DRAINAGE PIPING CARP. SQ. FT. ® GAS (FINAL) TEMP. POLE WALL SQ. FT. GROUT DRINKING FOUNTAIN. SQ FT ® FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation _$ FLOOR DRAIN MECHANICAL FEES FRAMING 1�// d [ WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER REMARKS: GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM 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. SQ. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/. c SEWAGE DISPOSAL MESH SO.FT.GAR ® 3/ac HOUSE SEWER INSULATION/SOUND 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 nn / PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR a'I� SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMSEWER OR SEPTIC TANKQ/t3lO ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) 41t Iq l c e METER LOOP _l HEATING (FINAL) OTHER APPJEQUIP. 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 1�// d [ FINAL INSP. N 01 (()7$ l ROOFING /.� L p[' �� ��� P /, IL. pY (/Wi.� 3e�2^ Gb REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL MING —q 4b MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL DESERT SANDS UNIFIED SCHOOL DISTRICT 82-879 Highway 111 NOTICE: Indio, CA 92201 Document Cannot Be Duplicated (619) 347-8631 Date 9/26190 Type of Permit I La Quinta No. 110172 Permit # Log # Owner Name Don Howard No. 48720 street Avenue Fernando city La Quinta Zip 92253 Study Area APN # 631-322-011 I Tract # I DLot # ® Square Footage 12876 Type of Development Single Family Residence No. of unite 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 Ibis certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of Fi—.5-8­1 X 12.876 or $ 4,544.08 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 Cherokee Homes Telephone Name on the check By John D. Brooks Associate Superintendent, Business Services Fee collected /exempted by Martha Reves Payment Received Signa / Check No. 6918 Collector: Attach a copy of County or City plan check application form to District copy. Embossed Original- Building DeptJApplicant Copy - Applicant/Receipt Copy - Accounting ` Of ' ,`••C OFFICE OF o' V ' AGRICULTURAL COMMISSIONER ' AND *':• ;;:� WEIGHTS & MEASURES CALVIN C. KAMINSKAS JAMES O. WALLACE 4080 LEMON STREET, ROOM 19 Assistant Commissioner Agricultural Commissioner RIVERSIDE, CALIFORNIA 92501 CLEMENT BENVENISTE, Urector of Welghts'A Measures Sealer (714) 781-2561 49613 Highway 86, Suite B12 Coachella, Ca. 92236 DATE 3- 2 Z (619) 342-8291 DATE PC .,?&/S 03 2 2.9451r DEVELOPER'S NAME: (� ADDRESS: % % g Cd ( TELEPHONE3 _YS/72_&' 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. Agricultural Com-nissioner s Office cc: Indio and Riverside Office f COUNTY OF RIVERSIDE ENVIRONMENTAL- Asenem Pao.l Nm HEALTH SERVICES DIVISION � 3 — 324- D PUCATION POR A SUBSURFACE SEWAGE DISPOSAL SYSTEM bmit 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-Fefu"ndable filing fee (see below) is required when the application is submitted. Check must be made payable to the County of f Riverside. Approval of this application shall remain valid for a period not to exceed one year from date of approval. Q VERIFY ITEMS IN SECTION A FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG # OC1 �t �.-t•xLt=t • < +O �n � ���!rSOX,,,,, p��Address Flry_�- W, Phone Mailing A d181 Cfly. State Zip Job Property � A7ddress Legal Description Prop. (PM, Tract, Lot) eX V 5 allC • Lot We Water Agency/Well Use -of Permit P/P, CU, etc. Otherf l I el%V • v Dwelling, MH She Prep, etc. 0 DATE urease/Sena Grease Intcp U) (2) Leach Lineenc Sq. Ft Sidewall allowance �•+ Install Line(s) n long it wide with Leach Bed_ s�.n Bottom trench area •rOf 0� �• R• min. inches rock below dnainlinee or om area Wrung ft ❑ NA Leachlines/bed special design for slope: (3) Pit Diameter No: Pits Pit Below Seepage Pit Toil Depth Other. Applicable / le Inlet (BI) (TD) 4--3 N/A '\ Overburden factor ❑ 5 6 LL� Max. Allowable Depth No. 2 System j •�✓• REMARKS: _f in This application isffPROV�ED/DENIED for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated on the accompanied t/plan, using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the Z above -designed system. No constructjon is permittgd in the requlf6tk reserved 100% expansion area. O (1 Septic tank.,,and sewer lines must beZO minimum from any wells (2) Leach, lines must be 100' minimum from any wells, including expansion area � Seepage pits must be 150' mi.ini m from any wells, ink ding expansion area RECEIPT NO. t D ❑ Site Evaluation lot Less than - SYSTEM ��iv Date -3/z 10,000•Sq. Ft. 7347 $ 87.00 Signature of Applicant Date DISTRICT: ❑ Riverside, ❑ Indio < - CATEGORY: REV CODE FEE Holding Tank Agreements Completed CATEGORY: REV CODE FEE w ❑ Yes No — SUBSURFACE DISPOSAL 1238 $ 57.00 ❑ SITE EVALUATION UPON REQUEST 7349 $ 43.00 m ❑ MULTIPLE PARCELS WITHIN SAME ❑ Yes No — (NO PLOT PLAN) ❑ Yes No — Detailed Contour Plot Plans Required (1 to 5 it interval) LAND DIVISION — ❑ SEWER/SEPTIC VERIFICATION 7348 $ 17.00 Staff Specialist Lot Inspection Required Z U a. 1 at 4 Parcels (Each) 1238 $ 57.00 (Less than 1 year) 15 b. Each Parcel after 4 7344 $ 24.00 ❑ PRELIMINARY ELECTIVE 7352 $ 23.00 ❑ Rereview (2nd review same parcel) 7344 $ 24.00 Type of Systems) EVALUATION (Attach DOH SAN 53) (1) Septi; Tank Soil Rate UY ❑ Site Evaluation in Conjunction with ❑ Holding Tank ❑ Existing `aWew ❑ Replaoenwnt Bedroomre s, FlxtuUnits 36drw. 36u�L, ❑ HOLDING TANK 7351 $ 47.00 Critical Area 7348 $111.00. ❑ ALTERNATIVE/EXPERIMENTAL 7345 $222.00 / 0 DATE urease/Sena Grease Intcp U) (2) Leach Lineenc Sq. Ft Sidewall allowance �•+ Install Line(s) n long it wide with Leach Bed_ s�.n Bottom trench area •rOf 0� �• R• min. inches rock below dnainlinee or om area Wrung ft ❑ NA Leachlines/bed special design for slope: (3) Pit Diameter No: Pits Pit Below Seepage Pit Toil Depth Other. Applicable / le Inlet (BI) (TD) 4--3 N/A '\ Overburden factor ❑ 5 6 LL� Max. Allowable Depth No. 2 System j •�✓• REMARKS: _f in This application isffPROV�ED/DENIED for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated on the accompanied t/plan, using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the Z above -designed system. No constructjon is permittgd in the requlf6tk reserved 100% expansion area. O (1 Septic tank.,,and sewer lines must beZO minimum from any wells (2) Leach, lines must be 100' minimum from any wells, including expansion area � Seepage pits must be 150' mi.ini m from any wells, ink ding expansion area RECEIPT NO. t D ❑ Site Evaluation lot Less than - SYSTEM ��iv Date -3/z 10,000•Sq. Ft. 7347 $ 87.00 DISTRICT: ❑ Riverside, ❑ Indio ❑ Hemet q Perris ❑ INITIAL Calif. Holding Tank Agreements Completed ❑ Yes Nod r — WHITE - Office file YELLOW - Applicant Certification of Existing S.D. System Required ❑ Yes No — WQCB Clearance required. (Attach Form ❑ Yes No — DOH SAN 007, Santa Ana Region Only) i Soils Percolation Report Required. ❑ Yes No — Special Feasibility Boring Report Required. ❑ Yes No — Detailed Contour Plot Plans Required (1 to 5 it interval) ❑ Yes No — Other W ❑ Yes No — Staff Specialist Lot Inspection Required ❑ Yes No Lot lnpection Date Solis boring report by rr, (i� Project Date Soils Map Page Sol Type Approved by "r . Date _ -.No. of Systems Type of Systems) No. Dwelling Unna (1) Septi; Tank Soil Rate Z 1 �.� ❑ Holding Tank ❑ Existing `aWew ❑ Replaoenwnt Bedroomre s, FlxtuUnits 36drw. 36u�L, z vy �3 c; i�t c, w / 0 DATE urease/Sena Grease Intcp U) (2) Leach Lineenc Sq. Ft Sidewall allowance �•+ Install Line(s) n long it wide with Leach Bed_ s�.n Bottom trench area •rOf 0� �• R• min. inches rock below dnainlinee or om area Wrung ft ❑ NA Leachlines/bed special design for slope: (3) Pit Diameter No: Pits Pit Below Seepage Pit Toil Depth Other. Applicable / le Inlet (BI) (TD) 4--3 N/A '\ Overburden factor ❑ 5 6 LL� Max. Allowable Depth No. 2 System j •�✓• REMARKS: _f in This application isffPROV�ED/DENIED for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated on the accompanied t/plan, using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the Z above -designed system. No constructjon is permittgd in the requlf6tk reserved 100% expansion area. O (1 Septic tank.,,and sewer lines must beZO minimum from any wells (2) Leach, lines must be 100' minimum from any wells, including expansion area � Seepage pits must be 150' mi.ini m from any wells, ink ding expansion area RECEIPT NO. t D Issued By - ` ��iv Date -3/z DISTRICT: ❑ Riverside, ❑ Indio ❑ Hemet q Perris ❑ Rancho Calif. ❑ Blythe DOH -SAN -122 (Rev. 7189) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records 11