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003542 (SFD)Building A/ Address Owner Mailing Address • Y. �� Box 1379 t City Zip -' La -Quints .922 r Contractor Cam Reynolds Address 4 P.O. BDX 1504 No. 003542 78-105 CAL.LE ESTADO LA QUINTA, CALIFORNIA 92253 w�Ra R T7A'R�i:C Sir:1 :ISASe BUILDING: TYPE CONST. OCC. GRP. ' ~. N.P. Number 774.071--OOS T34Te ,�S�,i 267?. Legal Description Project Description singlo, Family D>IM17.1ma Cvnmtructioh _ City ' Zip Tel Thousand Palms 92276 R _343-267X State Lic. City & Classif.46:f �` 9/� 1S7 Lic. # Sq. Ft. 1600 No. No. Dw. Size Stories Units -- Arch., Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ 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 .DATE - "' OWNER•BUILDERDECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractors License Law for the following L►� 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 file a signed statement that he is licensed pursuant No "• PERMIT - - -AMOUNT 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. • Plan Chk. Dep. ' $250.00 . subjects the applicant to a civil penalty of not more than five hundred dollars ($500).' I, Plan Chk. Bal.. 83.30 ❑ as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and ' COr1St. 36$ 00 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, ' Mech.30.00 + _ ' 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 burdenElectrical �>� of proving that he did not build or improve for the purpose of sale.) .. - • 0 I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing' I 15 I�/ • strutt 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 S.M.I. . 5-.92 • such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)- •- Grading 20.00 . O I am exempt under Sec. B. 8 P.C. for this reason Driveway Enc. 20 .00 Date Owner Infrastructure 1*862..55 WORKERS' COMPENSATION DECLARATION I hereby affiim 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 O Copy is filed with the city. ❑ Certified copy is hereby furnished. . TOTAL S ..18513.27 _ 'V%.ate A� CERTIFICATE EXEMPTION FROM � REMARKS _ WORKERS' COMPENSATION INSURANCE - - (This section need not be completed If the permit is for one hundred dollars ($100) valuation - orless.) I certify that in the performance of thg work for which this permit is issued, I shall not c•; tsrl ; ^r arc ?; _n�l_s1e e • •employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT: If, alter making this Certificate of Exemption you'should become' ZONE: BY: ' subject to the Workers' 'Compensation provisions. of the`Labor Code, you must forthwith I comply with such provisions or this permit shall be deemed revoked. Minimum Setback Distances: r Front Setback from Center Line CONSTRUCTION LENDING AGENCY Ihereby 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 sof this city to enter the above- mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip HARD COPY Rear Setback from Rear Prop. Line Side Street Setback from Center Line' Side Setback from Property Line FINAL DATE INSPECTOR - Issued by: Date 12f 29/8Permit r , Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING.: —S �� ! 1ST FL. SQ. FT. ® $ 2ND FL. SQ. FT. POR. SO. FT. ® GAR. SO. FT. ® CAR P. I SO. 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 BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT , WALL FLOOR SUSPENDED OTHER APPJEQUIP. LAUNDRYTRAY AIR HANDLING UNIT CFM TEMP. POLE 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL +� S G r I J` SQ.FT.GAR ® 3/ac HOUSE SEWER VENTILATION S 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 SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB` —7_ C—L_ BONDING HEATING (ROUGH) STORAGE TANK FORMS ArISEWER OR SEPTIC Y 1 C4ROUGH WIRING 3�G� ��/" 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 GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. 2 `( {�� &(/—FRAMING 3 ^ � � � FINAL INSP. 17 n ROOFING 3 y�� v +� S G r I J` REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTORF� GAR. FIREWALL LATHING MESH 'INSULATION/SOUND 'FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL . ' �.� _.. ^ ♦r ��:: fir.• rt ,rs T �_ y .. .:*;` � .. ,..� n 2 47 co Z O U W U) Y Cr Q W I RECEIPT NO. bb6cN 2 0Issued by \-,l,1, \, �—\ Date 2- t i ► ' %.d f District: ❑ Riverside Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File DOH SAN 122 (Rev 8187) Oce ► COUNTY 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 S40 is required when the application is submitted. Check must be made payable to the County of Riverside. —� 9 Department Buildin De Application J �61r� v' E—dC .. ��►� �� Ppication Lo 9 At Name (Own+er`.)Agent . Contractor. Etc..) Mailing Address City r /State Zip Code Telephone pO � � (� I 22 -7 (=, -J --� -f 3 - 2 -w 'Job Properly Address 3 'City or C:)mmunity� �.- Z14- `'Legal Description of Property. (Lolr•PM; TR)---^•••�.._,.,.,,__ /tel` .36/0 L /J//C /o3 0"1 4- 8 'Assessor's Parcel No water Agency or well \ �7hin. '6.g1, t.w,,A, t I 1 I- *11 Lot Size use of Permit Planning Case a ` , f SFD. MH Site Preparation Etc. /Signature of Appli nt Date 'The above information must be verified from Building Application Z STAFF USE — DO NOT WRITE BELOW THIS LINE pp 11 Initial \ Date Certification of Existing S.D. System required. ❑ Yes © No WOCB Clearance required. ❑ Yes m No Soils feasibility report required. ❑ Yes No Special feasibility boring report required. ❑ Yes No Detailed contour plot plans required. ❑ Yes No t Staff Specialist approval required. El Yes No Lot Inspection Date / b Soils/boring report by Y\ Project N Date Soils Map Page Soil Type Approved by Date Type of System: No.of Bedrooms (1) Septic Tank Soil Rate Required ? El Existing (YNew El Additional El Replacement ` "V-Q.Q,._ r�t:� \ 00 0 Gals. !L-` 5v 1 (2) Leach line sq�ft. Sidewall allowance / Install Lines) Ft. Long, Leach bed Sq.* (Bottom Iren1/ch area) ft. rock/ q. Ft. Ft. wide with p inches Ft.'of bottom per running ft. ❑ N/A rock below drain lines area �1 Leach lines/bed-special design for slope: (3) Pit Diameter No. Pits Pit BI , Seepage Pit total depth Applicable � ElLN5' 6' ( Max. allowable depth N/A Overburden factor 1 1%No( , � il c\ k 0 O i. X �C1 NS f6,'1 a This application is. pproved_/denied.for.the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements "set fo5rt Section B above. A building permit is necessary for the installation of the above -designed system. �(i)/Septic tank and sewer lines must be 50' from any wells (2) Leach lines must be 100' min. from any wells including expansion area rSee a e its must ,pe 150' mi . from we (s including expansion area �'ti" `^ t () p9 P Y �, 9 P Signature of Health Official '` Dale r RECEIPT NO. bb6cN 2 0Issued by \-,l,1, \, �—\ Date 2- t i ► ' %.d f District: ❑ Riverside Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File DOH SAN 122 (Rev 8187) Oce ► l�f t c9A L =vr �N ♦M�.��r (A C, It tvefqP y vvh-TL �� IN FIELf� p'L UNp q& 0 A 0 opoNil - ' L J-1• �• ll'b "APProval of these plans by the Department of Pub& Health of Riverside County does not relieve the End• ser or Architect of the responsibility for d6XagftVft bw or Architectural deaixn,'t,y vI 9 I S twMa" Of 1 4VII&O iMd,EWAL HEALTH Food Establis litnen4 $owe nit Trailer ParkJ�p., 3Sit7►h ir�x Motel, Apt_, Hotel �. Ft, of L Lok% k Dwelling 1 - b t �— swpw pii* Qi. Commercial Building' Pmt ti0F1 toS@W'ts- Swimm`ng Pool No on-site regenerating wa!er s�_f cn-ng devices maybe discharged Into th@ individual g wan dtsit• %; systp Wafer <_u?a y ,s.rv.n lu:. yj ra;:a`icn must be f:orn an apprcv.d s:xvr:c. . v • , ►�D� All sewage dis�;sa.t.;.;'_ -7, must conform with requ r;:mznts of eu rent Uniform Plumbing Co&. Any cutting, g;ac;ng, x filing in excess of four (4) faet wdi nullify stwage disposal approval. Approval has been obtained from the Regional Water Quality Control Board for Installation of the ,Y age disposal system. r t! F y tha ncy, construction ,)r installation the 1terg, -ec a above, a:1- n"r. 1 212`x'/ Q.: uucLk . A! a MAIN-Ui �3-3yv jvA2�Z sane.. MItI. 1a0' FR0k1 ANY WELL. i ANY LARC:;_ I R; V- ' a p t-� H ir.liq. ;'A sou U5 WERIAL CAN BE S -i ORED OR GENERATED AT THIS E— ryl rDEPARTMENT APPROVAL PUBLIC I��AI,Ta OF ALID FORONE (1) YEA:DATE.--APPROVAL, Gm - 1 -GAL. t:-vEEhl _.3Nj�Ll1�s AT. C4 /C (Tyr). - ,4• -r*! OOOM -4- r-IH. colic. WALl'. 1 + Inti ASIDE 00&/ APPROVED y E: �, - � 9 ua 0 "UhAL DD` r _ m IM 411111 I- W^T. LINE, •- =VTC.^r , rs� , 1 ♦ 1 1 _� w � L l� 1 1 1 r� t I n T �' -; - r' '$+t r.•>?�r`� ��w OFFICE OF AGRICULTURAL CONIMISSIONER AND WEIGHTS & MEASURES 49-613 Ilwy 86, Suite B-12 'Coachella, CA 92236 619-342-8291 E. LEON SPAUGY CO%tuKaONER JAMES WALLACE WALLACE ASS:S"A%t COMMISSIONER. CLEMENT BENVENISTE SEALER DATE 1.2- — 2- i- cS' 2 CASE NO. R 8 7 2 S / i 2 9 A DEVEDOPER' S NAME: V�/ -L.v, CP,•-Y.o•�,c erg ADDRESS: P-0. dd X g 7 TELEPHONE: (6 / y) 3 Y3_ 2 ,1( 7 s 3- 3 Y U���' 3� 3 3 i Dear Developer: S y- 4 s''s- f c a� 5 3- C -s` 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 fran plant material listed, this office must be notified immediately. Thank you for protecting and preserving the Coachella Valley's pest -free environment. Agricultural . Commis inner' s Office cc: Indio and Riverside Office