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