BPLB2015-0003Application Number: BPLB2015-0003
Property Address: 49280 AVENIDA FERNANDO
APN: 658280019
Application Description: INSTALL SEEPAGE PIT
Property Zoning:
Application Valuation: $7,000.00
Applicant:
ALMS UNDERGROUND CONSTRUCTION
38703 VISTA DRIVE
CATHEDRAL CITY, CA 92234
VOICE (760) 777-7125
FAX (760) 777-7011
TjIpNS 777-7153
U L�IAN072015
Owner:
TED MI LER CITYOFIAQUIIJTA
1805 N S VELOPMENfDEPART
PORTLAND, OR 92253
Contractor:
ALMS UNDERGROUND CONSTRUCTION
38703 VISTA DRIVE
CATHEDRAL CITY, CA 92234
(760)324-1911
LIC. No.: 482180
1/7/2015
---------------------------------------------------------------------------------------------
c
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 Professions Code,
and my License is in full force and effect.
License Class: -C-21. C42 License No.: 482180
D e: 7-N a n . OI S Contractor -
OWNER -BUILDER DEC LAR ION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division
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).:
(1 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 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.).
() 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.).
I I I am exempt under Sec. . B.&P.C. for this reason
Date:
Owner:
. 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:
WORKER'S 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 issued. My workers' compensation insurance carrier and policy number are:
Carrier: _ Policy Number: _
_ 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, and agree that, if I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions. //
Date: 7 Jati . Z 0/ S Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENS ION 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.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official 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, indemnify 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.
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 upon the above•
mentioned property for inspection purposes.
Date: �s Signature (Applicant or Agent):r
C�
78-495 CALLEfTAMPICO
D
LA QUINTA, CALIFORNIA 92253\
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BPLB2015-0003
Property Address: 49280 AVENIDA FERNANDO
APN: 658280019
Application Description: INSTALL SEEPAGE PIT
Property Zoning:
Application Valuation: $7,000.00
Applicant:
ALMS UNDERGROUND CONSTRUCTION
38703 VISTA DRIVE
CATHEDRAL CITY, CA 92234
VOICE (760) 777-7125
FAX (760) 777-7011
TjIpNS 777-7153
U L�IAN072015
Owner:
TED MI LER CITYOFIAQUIIJTA
1805 N S VELOPMENfDEPART
PORTLAND, OR 92253
Contractor:
ALMS UNDERGROUND CONSTRUCTION
38703 VISTA DRIVE
CATHEDRAL CITY, CA 92234
(760)324-1911
LIC. No.: 482180
1/7/2015
---------------------------------------------------------------------------------------------
c
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 Professions Code,
and my License is in full force and effect.
License Class: -C-21. C42 License No.: 482180
D e: 7-N a n . OI S Contractor -
OWNER -BUILDER DEC LAR ION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division
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).:
(1 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 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.).
() 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.).
I I I am exempt under Sec. . B.&P.C. for this reason
Date:
Owner:
. 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:
WORKER'S 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 issued. My workers' compensation insurance carrier and policy number are:
Carrier: _ Policy Number: _
_ 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, and agree that, if I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions. //
Date: 7 Jati . Z 0/ S Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENS ION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application , the owner, and the applicant, each agrees to, and
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
employees for any act or omission related to the work being performed under or
following issuance of this permit.
2. Any permit issued.as a result of this application becomes null and void if work is
not commenced within 180 days from date of issuance of such permit, or cessation of
work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the above•
mentioned property for inspection purposes.
Date: �s Signature (Applicant or Agent):r
1 1 NFORMATIOkll
:?$ t i',•.:, :',tS ..'2. 3 a$' i-' s T tt , irc'4°'e'^ xj :&;SEs e.-' t f '.. E i; Y '. ': 4,4 £ a,. tr 4 Y
c ACCOUNT �_�_ QTY AMOUNT
DESCRIPTIONEa 7r PAID'
PAID DATE;
t r �i
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BSAS SB1473 FEE,
101-0000-20306: 0
$1.00 $1.00 • 1/7/15
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1
.RECEIPzT :: �
ALMS UNDERGROUND CONSTRUCTION
CHECK R3334 ., 1317 MFA
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA' $1.00 $1.00
..
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-ty
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CCOUNT
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a•eMOUNT:
OUTSCRIPTIONak3
ai,
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E:
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PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85.
1/7/15
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ALMS UNDERGROUND CONSTRUCTION
CHECK
R3334
1317
MFA
Total Paid forPERM1T ISSUANCE- $91.85 ' $91.85
dL ' SFX
ACCOUNT��yQC�7YF
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"I
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SEPTICSYSTEM
101-0000-42401.
0
•$12.09
$12.09
1/7/15
PAID BYg
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RECEIPT #�
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ALMS UNDERGROUND CONSTRUCTION '
CHECK
R3334
1317
MFA
• �`:.
DESCRIPTIONe
,t-''.is:'"f7.n
ACCOUNTNT
."� '"
i �..b� Egy, `s.
a PAID
DATE
;. r, a a<F
x��ClTlfAMOUNTzwi
3,
{PAID
SEPTIC SYSTEM, PC
101-0000-42600
0
$4.83
$4.83 •
1/7/15
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ECEIPTS#
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_.CHECK
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ALMS UNDERGROUND CONSTRUCTION
CHECK,
R3334
1317
MFA
' Total Paid forPLUMBING FEES: $16.92 $16.92 '
• •• �•
Description: INSTALL SEEPAGE PIT
CONDITIONS
NAME TYPE
-NAME
Type: PLUMBING
Subtype:
Status: APPROVED
Applied: 1/7/2015 MFA
Approved: 1/7/2015 MFA
Parcel No: 658280019 Site Address: 49280 AVENIDA FERNANDO LA QUINTA,CA 92253
Subdivision: LA QUINTA GOLF ESTATES 1 Block:
Lot: 152
Issued:
Lot Sq Ft: 0
Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $7,000.00
Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0
No. Unites: 0
CATHEDRAL
CITY
Details: INSTALL SEEPAGE PIT PER 2013 CBC -
92234
(
Printed: Wednesday, January 07, 2015 2:13:48 PM 1 of 2 Or
SYSTEMS
a� ui
5'1
�`�C�., ^..*cry`¢•
'y OF
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY'
CLTD ..
-
BY
ALMS
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$1.00
1/7/15
R3334
1317
CHECK
UNDERGROUND
MFA
CONSTRUCTION
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00 $1.00
BSA:
ALMS
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
1/7/15
R3334
1317
CHECK
UNDERGROUND
MFA'
CONSTRUCTION
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
ALMS
SEPTIC SYSTEM
101-0000-42401
0
$12.09
$12.09
1/7/15
R3334
1317
CHECK
UNDERGROUND
MFA
CONSTRUCTION
ALMS
SEPTIC SYSTEM PC
101-0000-42600
0
$4.83
$4.83
1/7/15
R3334
1317
CHECK
UNDERGROUND
MFA
CONSTRUCTION
Total Paid for PLUMBING FEES: $16.92 $16.92
$109.77 $104.77
INSPECTIONS
SEQID . INSPECTION TYPE INSPECTOR SCHEDULEDCOMPLETED
DATE DATE
RESULT REMARKS NOTES
_..
PLUMBING FINAL"
PARENT PROJECTS
Printed: Wednesday, January 07, 2015 2:13:48 PM 2 of 2
SVSTEIv1S
Bin #Qty
of La QUTnta.
Building &r Safety Division
P.O. Box 1504, 78 495 Cage Tampico .
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: 2 f} ve , re rn n o
Owner's Name: -7;d jx/; 1/e r—
A. P. Number: 6 S-3 , a%<), O 1 i
i
Address: S E�vwe�
Legal Description:
City, ST, Zip:
Contractor:
„� ne�e� oK� C
Tele hone: $
p
'-''%%s"''^ "z .i';'.': =; %r> <`.'>.<'s?•
Address: "8703 V' a r
Project.Description: �v,s-���� See a
City, ST, Zip:. - t�i 9 -ZZ3 41
J.
Telephone:' 760 32 L(-) 9
State Lic. # : y 82 / Sp
city Lic. #; 7 69
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
'
:
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n . Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
if Units:
Telephone # of Contact Person:
T Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES.
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Revic-,ved, ready for corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Plan Check Balance.
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for corrections/issue
Electrical
Subeontactor List
Called Contact Person
Plumbing
Grant Decd
Plans picked up
S.M.I.
II.O.A. Approval
Plans resubmitted
Grading
IN If OUSE:-
'`" Rcyiew, ready for corrections issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Jan 12 2015 9:32AM HP Fax
page 2
EBvcoiuloebtsf:
t 'n G C �aC L G �"•r i
op -
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- 44
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0
z:GL.� �I: LQ_k aL DEPARTMENT REQUIREMENTS
045' LL SEPTIC SYSTEM IN NATIVE SOIL
k PROVIUE FOR 100% FUTURE EXPANSION
COMPLY WITH ALL SETBACK REQUIREMENTS'
T HIS APPROVAL GRANTED BY THE
DEPARTMENT OF ENVIRONMENTAL HEALTH
!S VALID FOR ONE (1) YEAR FROM
DATE :?F APPROVAL.
DEPARTMENT OF ENVIRONMENTAL HEALTH
Food Gallon Septic Tank
Trailer Park Sq. Ft. of Leach Line
.X_ Dwellihng u No_'—Dia..G BI TDaMD Ll d
Commercial Connection to Sewer .
Swimlausg Pooi Connect to Existing S. S. D. S.
'LNo on-site reger c:.nuj g wafer softening, devices may be discharged into the individual seweb. , ..,.� ..
.systzml herewitp dppzuvcd wafiuut cieaia:wx horn the Waioi Quality Control Board.
°All sewage disposal irisrallation must conform with requirements. of current Unifbrtn. Plumbing
curtiue,, grading of filling iii area of Ictwhwg system may nullity sewage disposdl xppro�141.
Approval has beau oDmii cd from the Regiunal Water Quality Contrut Hoard fbr installation of the
sewnge disposal system.
t-
COUNTY OF RIVERSIDE ,
DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND USE APPLICATION
OFFICE USE ONLY
❑ 3880 Lemon Street • Suite 200 • Riverside • CA • 92501 - (951) 955-8980
PE CODE:
FEE:
9147-950 Arabia Street • Suite A • Indio • CA 92201 - (760) 863-7570
EHS #
ON #
LMS #
APN:
TR/PM
LOT #
USE OF PERMIT:
L Cf Wiz I F L;% A-te J j?
SECTION A .
Name
OWNER:
Address �; g 7 uV i t vic
i
PhonefS Email
Com an Name /1)"-g I./. Joen P.,�,,.,.� A enUC no tractor 0atr 4
AGENTL,
J
CONTRACTOR:-
�•- r
Mailing Address 7;-'670-2 (/, c •� ,, �r ` e/Xr a t C
Phone -769, :L d ` 19 11 a � %- �a. "Nf-1e r Ci r , v . t_ c' ,rkn , � . �.0 by
--`:i
! �,Emm�ail
Date 0
� ��, �,{�y�
Si nature � :.,e � o�ca...-. �►.-) ('
wC�, l2 f:�X." �r ,
Ss.
18157 11 11 217 A III
Site Address N 115 � • tic rrVO4 f"#:+^NAw0 d
PROPERTY INFO:
,
Water Agency/Well %JV-0Lot Size 12M.Sill
SECTION B Below -for Office Use Only.'
CHECK BOX IF REQUIRED
If any box is checked, this application shall be considered denied until the information is provided. CHENN V•!1.1
❑ Holding Tank Agreements Required
❑ Floor Plan and/or Plumbing Layout Required
❑ Certificate of Existing OWTS Required (C-42)
❑ Special Feasibility Boring Report Required
❑ WQCB Clearance Required
❑ Detailed Contour Plot Plan Required (1 to 5 foot intervals)
❑ Soils Percolation Report Required
SITE EVALUATION INSPECTION REMARKS:
A t)p1'l rr;,.v/f C FKILI PIF L/i,4 0oy.. 01.1 ,.;+ 144t, -f- 4etlSy
®r✓r1� i on fv/-/SPL. D- 11 U, Md v s f`i or c��-cnt rt P� 0
EHS INITIALS /DATE:
SECTION C
❑ NEW I LI REPAIR / REPLACEMENT 1 ❑ EXISTING ❑ PUMP ❑ A ❑ CONNECT TO SEWER FIXTURE UNITS # BDRMS #
Soils Percolation/Boring Report By:
Date:
Project#
C-42 Certification By:
Date:
License#
Septic tank cap.:
Soil Rate:
Tested Depth:
Max. trench depth:
1000
a
Sq. Ft. Bottom Area:
Total Linear Ft.:
Line(s):
Length: feet -Each 3 feet wide
Sidewall Allowance: Ft. Rock/Sq. ft. Running foot
Rock below drain line: in. or ❑ Plastic Chambers
Leach Lines/bed special design for slope: ❑ N/A ❑ Overburden Factor:
Pit Diameter: No. pits:
Depth below Inlet (bi):
Pit Total Depth:
Max. allowable depth:
-t !
1 14
Z
CONSTRUCTION/INSTALLATION REMARKS':
CRY of l,-,4 0,v1P.rA -1v hu I,S�ctr�vr
-SECTION D
This Application islS Approved ❑-Denied regarding the design of the OWTS as indicated on the accompanied plot plan using the requirements set forth in
Section C above. No construction is permitted in the required reserved 100% Expansion area.
EHS Signature:Date:
/ / ,�•
DEH -SAN -122 Rev. 10114 Distribution: WHITE—Office File: YELLOW —Bldg. Dept. PINK—Applicant
P: