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9978 (SFD)4. Building Owner Aaron Hamilton Mailing Address P. 0. Box 1771 City Zip La Quinta [92253 Contractor X dk Owner/Builder •414 a 7&105 CALOLE ESTADO X 1504 � � . 997 8. LA QUINTA, CALIFORNIA 92253 I iR State Lic.I City & Classif.. Lic. # rlrcn., r=nyr., . Designer Address Tel. City Zip State • : ' Lic. # LICENSED CONTRACTOR'S DECLARATION 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 and effect. SIGNATURE LATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law forthe following reason: (Sec. 7031.5;Buisiness and Professions Code: Any city or county which requires a permit to construct, atter, improve, demolish; or repair any structure, prior to its issuance also requires the applicant for such permit to rile 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 exernpt 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 dogars ($500). IV I, as owner of the property, or my employees with wages as their sole compensation, will Ido the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and . Professions Code: The Contractor's License Law does not apply to an owner of property who 'stiuilds or improeps thereon and who does -such work himself or through his own -employees, provided that such improvements are not intended or offered tot safe. If, however, the building or improvement is sold within one year of completion, the owner udder wrTl 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.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date/ �/ / ` r Owner /1'X1, 20-17 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. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed it the permit is for one hundred donars ($100) valuation or less.) I certify that in the performance of thg 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. Date ' owner NOTICE TO APPLICANT: If, after making this CerWkXe 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 which3his 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 if 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 Address City, State, Zip BUILDING: TYPE CONST. OCC: GRP. A.P. Number 773-244-010-2 Legal Description Lot 1 Block 267 Unit 17 Project Description SFT) . Sq. Ft.157. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Permit includes wooden fence, permit Foes not include patio or pool m Estimated Valuation q /y 0/� 92.317.0 PERMIT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure Precise Plan TOTAL REMARKS i m 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 Issued by: Date Permit Validated by: Validation: AMOUNT .00 27(l[- X744 55.50 129.06 163.53 9.30 20.00 20.00 2038.88 00 qr-S { Iu F 4".,- 1 _ 3315. 98 c98 -. .98. 3315.98 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 Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL SQ. FT. ® $ 2ND FL SQ. FT. POR. SO. FT. ® GAR. SO. FT. ® CAR P. SQ. FT. WALL SQ. FT. ® SQ 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 HEATING (ROUGH) FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) METER LOOP GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED REINF. STEEL 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. SO. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1Vi c ISEWAGE DISPOSAL FIRE ZONE ROOFING: SQ.FT.GAR ® 3/4c HOUSE SEWER SPARK ARRESTOR GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PLCK.FEE CONST. FEE ELECT. FEE SMI FEEPLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK !� /L1 <f/ s GROUND PLUMBING ��klNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER O%X&P*l0-iAW( ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL % GAS (FINAL) TEMP. POLE ` GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM FINAL INSP. FINAL INSP. GRADING cu. yd. $ plus x$ =$ LUMBER GR. FRAMING Z11 1/ ROOFING VENTILATION Jm i • /3 REMARKS: FIRE ZONE ROOFING: FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING"fOW4/ MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL (11 DESERT SANDS UNIFIED SCHOOL DISTRICT 82-879 Highway 111 NOTICE: Indio, CA 92201 t" Document Cannot Be Duplicated (619) 347-8631 Date 10/9/91 Type of Permit I La Quinta No. 10919 Permit # Owner Name Aaron Hamilton Log # No. 52485 street Ave Juarez City La Quinta zip 92253 Study Area 112 APN # 773-244010-2 Tract # Lot # 0 Square Footage 11573 Type of Development Single Family Residence No. of units 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 This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 1.58 X 11.573 or $ 2,485.34 have been paid to D.S.U.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 Aaron Hamilton TelephoneV Name on the check By James E. Lively Assistant Superintendent, Business Services Fee collected /exempted by Vickie J. Durrett Payment Receive*,,* j ` Signature r��C�211!l�.iJU Check No. 1378 Collector: Attach a copy of county or city plan check application form to district copy for all waivers. Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting i' x ►�i f fir � Payment Receive*,,* j ` Signature r��C�211!l�.iJU Check No. 1378 Collector: Attach a copy of county or city plan check application form to district copy for all waivers. Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting q.,,,S.„,ti,�.a'�' �,yk�i`'tisM��T'6�,.,,��`�ta'YZ�'-`F..,, �. __-;�....^,r„r,'.."-r.:..T="�7'i'a:'''_'yt-+�'-37"'IJs'Y.`us9s-'�"""Xt"^nr<�^^���,''�: *•-"�-�..w•..r—+nt`r. RECEIPT NO. ` �3 Issued By Date— !S DISTRICT: ❑ Riverside,'. ` T] In45-11f ❑ ' Hemet ❑ Perris O Rancho Calif. ❑ Blythe DOH -SAN -122 (Rev. 3/90) DISTRIBUTION: WHrTE - Office file YELLOW - Applicant PINK - Bldg. Dept— GOLDENROD - Plans/Records Ifs " a.e., COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH::,..,•_..,;JA,/s=PaMelN°' 11DENVIRONMENTAL SERVICES DIVISION �`i `T 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 speculations as Indicated on the attached check list A non-refundable filing fee (see below) is required when the application is submitted. Check must be made payable to the County of Oiiverside. Approval of this application shall remain valid for a period not to exceed one year from date of approval. ,p /) VERIFY ITEMS IN SECTION A FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG # Z ° Agee rector, t 1tact Person rio 14 r-014:7-00 Phone Addres .& . ',an .✓ ,.�- W �Owner Phone Malling dress /?7 m CityZq Slate ip Job Property Address Sa-fBSG Legalript' Prop. (PM, TrecL Lot) LaT %oa /6SA,✓r4 C,fa ,1�Gtit�13 Lot Size ter A encr I Use of Permit P/P, CU, etc — Other ailing, H Site Prep, etc. Signature of Applicant Date CATEGORY: REV CODE FEE CATEGORY: REV CODE FEESUSURFACE DISPOSAL 1238 $Z. SITE EVALUATION UPON REQUEST 7349 $ 43.00 J000 m ❑ MULTIPLE PARCELS WITHIN SAME (NO PLOT PLAN) LAND DMSION SEWER/SEPTIC VERIFICATION 7348 $ 17.00 Z O a. 1 at 4 Parcels (Each) 1238 $ 57.00 {Lass than 1 year) b. Each Parcel after 4 7344 $ 24.00. ❑ PRELIMINARY ELECTIVE 7352 $ 23.00 W ❑ Rereview (2nd review same parcel) 7344 $ 24.00 EVALUATION (Attach DOH SAN 53) U) ❑ Site Evaluation in Conjunction with ❑ HOLDING TANK 7351 $ 47.00 Critical Area 7346 $111.00 ❑ ALTERNATIVE/EXPERIMENTAL 7345 $222.00 ❑ Site Evaluation Lot Less than SYSTEM 10,000 Sq. Ft. 7347 $ 87.00 IAV Holding Tank Agreements Completed ❑ Yes C�� l D Certification of Existing S.D. System Required ❑ Yes l�No WOCB Clearance required. (Attach Form ❑ * Yes P` ?O DOH SAN 007, Santa Ana Region Only) Solis Percolation Report Required. ❑ Yes Special Feasibility Boring Report Required. ❑ Yes ■ Detailed Contour Plot Plans Required (1 to 5 ft interval) ❑ Yes �" N/cy Other ❑ Yes f�d,'/NN,,o,, Staff -Specialist Lot Inspection Required - ❑ Yes '" "" Lot Inspection Date Soils boring report by Project Date / p Soils Map Page t Sol Type Approved by �� Date U Z No. of Systems TyVe of Systems) Tank ❑ Existing No. Dwelling Unita Bedrooms, Fixt wWriits (1) Septic Tank Solt Rate 'a,� ,G_rease/Sand (3Tbaee Intop _O / rO=ing ❑ Replacement 3 // /Li�,,� /� Gd NR). Leach Line Sq. Ft tnfnch area Sidewall allowance �fL sq. ft. InstaThy L.ine(s) ft long H wide min. rc below drafnlinea or pd leach Bed aq ft be` per runni ng NA L.eachlines/bed special design for slope: (3) Pit Diameter No. Pits Pit Below Seepage Pit�Tc)tal Depth (TD) ^��O Applicable ej � �/�/ �' 6 Inlet (81) / Max. Albwagle Depth N/A Overburden f actor Q No. 2 System IA - REMARKS: C�:��/�Crtd� � /G��(� /�/JL4'�Jr•�. ��% S / /C/Li C�..s{✓^. �io-'e /Ale i/ J This application is PPROVED' ENIED'for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated on the accompanied plot �slttg-tAe—ra)remenfs—set„f in SECTION C above. A building permit is necessary for the installation of the Z above -designed system. construction is permitted in the required reserved 1 expansion area 1) Septic tank and sewer lines must be 50' minimum from Q( / any wells o / t. Leach LU I y� lines must be 100' minimum from any wells, including expansion area 1 (3). Seepage pits must be 150', minimum from any wells including expansbn areJa� r!0 (��6 / p �/ `!3 / Signature of HeaRh Official V - l i— GZ�G Date { RECEIPT NO. ` �3 Issued By Date— !S DISTRICT: ❑ Riverside,'. ` T] In45-11f ❑ ' Hemet ❑ Perris O Rancho Calif. ❑ Blythe DOH -SAN -122 (Rev. 3/90) DISTRIBUTION: WHrTE - Office file YELLOW - Applicant PINK - Bldg. Dept— GOLDENROD - Plans/Records Ifs " a.e.,