003057 (SFD)uu��u�cv
P.O. BOX 1504
No. ' 403057
Building.� _ 78-105 CALLE ESTADO
Address 51-835 Avonida ,Tuaroz LA QUINTA, CALIFORNIA 92253
Owner
Joseph a Shirley Carpini BUILDING: TYPE CONST. OCC. GRP.
Mailing
Address A.P. Number 773-154-016 '
City Zip Tel.
> � �� Legal Description 1K .
Contractor Project SIM01� 'FiIV 1�4 P_J_1.i CT
.. tet°/B1��.>�e� �
Address
City . Zip Tela.
State Lic. City
& Classif... Lic. # Sq. Ft: No. No. Dw.
-Arch., Engr., _ ..
Size 13.73 Stories - Units
• Designer New E7 - Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
1373 Dwellincr
City Zip State 462 Ga raae
Lic. #
LICENSED CONTRACTOR'S DECLARATION , • 200 111ii, f t s f ence
I hereby affirm 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 and190 }.
effect
SIGNATURE DATE '
O ER DECLARATION
I hereby affirm that I am exemptpt from 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 lile•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).
O. 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, Bulsness and
Professions Code: The Contractor's License Law does not apply to an owner of property who .
Estimated. Valuation..
-
-
PERMIT '
.a ..
.Plan Chk. Dep..
Plan Chk. Bal.
COnSt . -
Mech.
,
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
Electrical
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.) - ,
Plumbing
0 I, as owner of the property, am exclusively contracting with licensed contractors to con-
struot the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
S.M.I:
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
r Grading
Driveway Enc.
work for which this permit is issued. (Sec.,3097, Civil Code.)
Date ';fir; 7 Owner
Infrastructure
Lender's Name
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.)
INSPECTOR ;.
Policy No. Company
❑ Copy is filed with the city.. .❑ Certified copy is hereby furnished. —
expiration if work thereunder is suspended for 180 days.
TOTAL `
t y q
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS
Date 7 S ! Permit
(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.
Dt
Re�yy AMOUNT
iS# 1
32.39 #
367.00 �
36.00 i
74.63 f
5.43
20.00
20.00
1137.36 �
I
i
•
a e Owner
NOTICE TO APPLICANT. 9, after making this Certificate of Exemption you should become
ZONE:
BY: f
' subject to the Workers' Compensation provisions of the Labor Code; you must forthwith
comply with such provisions or this permit shall be deemed revoked
Minimum Setback Distances: !
-
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setbackfrom Center Line
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.)
Side Setback from Property Line
Lender's Name
Lender's Address
FINAL DATE
INSPECTOR ;.
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.
_
t y q
I certify that I have read this application and state that the above information is correct.
Issued, by:
Date 7 S ! Permit
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-
t
mentioned property for inspection purposes.
Validated by:
j
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
I
87770
4 16 65281 it
- l
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. p $
2ND FL. SQ. FT.
POR. SO. FT, ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SO. FT. ®
SO, FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
STORAGE TANK
FLOOR DRAIN
MECHANICAL FEES
DUCT WORK
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
REINF. STEEL
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FINAL INSP.
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1% C
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
LATHING a
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 PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
GStTBACK 5 —/y ` ?
ez
G OU PLUMBI UNDERGROUND
A.C. UNIT
COLL. AREA
?/GSLAB GRADE 57- / y - b
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
Y�y FORMS
�G-- 5 �� --• �- %
SEWER OR SEPTI TAN . ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL) g46EMP. POLE q- ,/
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
yd.
$ plus x$ _$
BER GR.
FINAL INSP.
FAV" -'cu.
(J
F AMING
FINAL INSP.
�^ /��1
PROOFING V��3�a /
8/•�ej®�
/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING a
MESH
9W INSULATIONISOUND��i,_�
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
OF l(3�
SCHOOL FACILITY FEES t
TO: City of La Quinta DATE:
Department of Community Development
78-105 Calle Estado
La Quinta, CA 92253
This is to certif( that
developer of , which is
located at /- - 113), within
this District, has paid school fac' ity fees 1 osed pursuant to the
authority generated by Government Code Section 5308 the amount of
S.
covering a total of IV
s uare feet of ( -residential or
( ) industrial/commercial development and that building permits for
this footage in this development may now be issued by your jurisdiction.
L,
for DESERT SANDS-UNIFIEb SCHOOL DISTRICT
White Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer
* 9,3 6 (10)-37
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CO%INTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION
' 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 specifications required on the attached check list.
A non-refundable filing fee of $37 is required when the application is submitted. Check must be made payable to the County of Riverside.
Building Department Application Log #
Name (Owner, Agent, Contractor, Etc.) f
Mailing Address
City 1
State
Zip Code
� ' .''
Telephone
(�� "" , ��
'Job Property Address r
1`.f1
City o C"iAwign `.
Legal Description of Property. (Lot, PQM, TR)
fl,
3 I /Ij
'Assessors Parcel No.
ater Agenc �C, welly
&A F
r
Use of Pemnt_pt e /,"t Planning Case N
Lot Size
l
'
MH Site Preparation Etc.
/fSFD,
Signature of Applicant / � _ Date,IM
The above information must be verified from Building Application /
STAFF USE — DO NOT WRITE BELOW THIS LINE
���niittiall Date
Certification of Existing S.D. System required. ❑ Yes « ErNo'
,
WOCB Clearance required.. El Yes L�f Nom
Nor
Soils feasibility'report required. ❑ Yes ❑ 1 /
Detailed boring report required. ❑ Yes ❑Nor -
Detailed contour plot plans required. ❑ Yes Z No
Staff Specialist approval required. ❑ Yes ❑'No Lot Inspection Date
Soils/boring report by Project # Date
Soils Map Pagel{9 Soil Type•/ C- Approved by—fI- Date
Type of System:
No. of Bedrooms
(1) Septic Tank
Soil Rate Required
i
ElExisting ❑°`New ❑ Additional ❑ Replacement
,� Gals.
Ue,Ile
(2) Leach line sq. ft.
tto om trench
Sidewall allowance
ft. Sq. Ft.
Instal6.�Line(s) Ft. Long,
�Ft%, ide inches
Leach bed Sq.
Ft of-bottoom
(B area)
rock/
C9"N/N/A
with min.
per running ft.
rock below drain Ines
area
Leach lines/bed-special design for slope:
Applicable r
(3) Pit Diameter
No. Pits
Pit BI
f
Seepage Pit total depth 9,`0
N/A 40 -Overburden factor
U'S' E9 61
4�0
Max. allowable depth u (11
`�)il f ._ i.� s n s ,.✓+' /,i�; �a 1 lP c� . rfi �/)r!Er�I -
� � ���c ��j �� ``/
�.^r-?�-c. t� rrx� .,�.,%��" . /[�-...:s � - )�-1 _ isa �•�J�P..c�, f d� ,,
�
Ce
This application is-apo^ved%denied for the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements
set forth in Section B above. A building permit is necessary for the installation of the above -designed system.
�1(��Septic tank and sewer lines musNe 50' from any wells %/9 `. 1vr t Pte, v `/ t
(2) Leach lines must be 100' min. from any wells including expansionarea
(3) Seepage pits must be 150' /min. from any wells including /expansion area i /V�# ��y
�T
Signature of Health Official Date
RECEIPT NO. 13-36- Issued by S/� Date % 2 el - k %
District: ❑ Riverside lh'Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe
Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File
DOH -SAN -122 (Rev. 6186) f
!4-411 .p
J
3.
0
OFFICE OF
AGRICULTURAL COW-IISSIOINER
4080 LEMON STREET. R0011•1 j9
RIVERSIDE. CALIFORNIA 92501
(714) 787-2561
dear Developer/Landscaper:
46-209 Oasis Street, Room 14
Indio, CA .92201
(619) 342-8291
.0
E. LEON SPAUGY
COM•.IISSIWIFR
)Ab1ES O. WALLACE
ASSISTANT COMMISSIONER
Thank you for inquiring with the Agricultural Commissioner's Office regarding
local quarantine laws.
Any diseases or insects associated with the plants/landscaping material presented
on your landscaping plans do not pose a threat to the Coachella Valley Citrus,
Date, Grape, Vegetable, or Field Crop industry. We therefore approve your
• landscaping plans.
If however, any substitutions of plants/landscaping materials within your plans
occurs between now and the actual planting date, you must contact this office
within 48 hours before delivery into the Coachella Valley. Also, the substituted
plants/lardscaping material must be held for inspection upon arrival. Any sub-
stituted landscaping material found infected/infested with quarantine pests will
be innediately treated or shipped out of the Coachella Valley at the discretion
of the Agricultural Commissioner's Office,
Under penalty, gf.perjury, I.the undersigned will comply with the above,
Authorized Agent:
Name V o 3 /'��
C� /f fr�Ai /
Date
p
Signature
1
Permit Number(s) �is7 5
C) 2z 6 q
_
Developer
Address
AGRICULTURAL CO�EMISSIO`;ER' S
APPROVAL
��
—R-494u
Date
2 -
Authority cited: Agricultural
Code; Sections 6301,
6461, 6462, 6464,
6501, 6521-
6524
cc: 2 Plan Check, Indio Office, Riverside Office
Form A - 10/84
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