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003426 (SFD)Building Address 54-245 Juarez Owner 4 P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Mailing Address I A1 v tpa,1106e1*1 4 wr t47>+•>? City Zip -7 BY: Palm Springs 9226.2 IT91. 322-342€ Contractor Starr Con6truction Address S=e City lZip Side Setback from Property Line Tel.' State Lic. I City & Classif. . 387934 Lic. # _895 Arch., Engr., - 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. + a ski _ ,:,, _ li' .:r'P� _f_r}f .rw!-. �.•(i' i SIGNATURE 1 _„ DATE OWNER -BUILDER DECLARATION 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 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 to the provisions o/ the Contractor's License Law, Chapter 9 .(commencing twith 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). ' ❑ 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, Buisness and Prolessions Code: The Contractor's License Law does not apply to an ownerofproperty 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 o/ proving that he did not build or improve lor,the purpose o/ sale.) - ❑ l,.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.) ❑ Lam exempt under Sec. B. & P.C. for this reason No. 00426 BUILDING: TYPE CONST. • .'OCC,. GRP A.P. Number 9IA-1 Q'}—>Fi 7 Legal Description ` Project Description Plan a Sinale Family i wo. Sq. Ft. 3 463 No. No. Dw. Size -. Stories • Units New ❑ Add ❑ Alter ❑ A75` Garage 3541 Fence itimated Valuation . PERMIT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. . Electrical Plumbing S.M.I. Grading Driveway Enc. Date Owner Infrastructure 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 i/ the permit is for one hundred dollars ($700) 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 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 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 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 HARD COPY TOTAL . Repair ❑ Demolition ❑ $75,565 t� AMOUNT - $25Q.a4 $ 59.89 361 � B0 X33.00 7 i5.til 09.00 5.63 24.00 20.40 �.���.�•4rJ REMARKS 11,y 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 1016%87Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ 2ND FL. SO. FT. POR. SO. FT. ® GAR. Sp, FT, ® CARP. SQ. FT. WALL SO. FT. ® Sp 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 ROUGH PLUMB. FLOOR DRAIN MECHANICAL FEES HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER DUCT WORK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GAS (ROUGH) LAUNDRY TRAY AIR HANDLING UNIT CFM HEATING (FINAL) 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 BOND BEAM SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL LUMBER GR. SO.FT.GAR ® 3/ac HOUSE SEWER ROOFING f7/ 8c^ VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING r� MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL 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 PLUMBIN UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SE I TAROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. �� Gy1 D GAS (ROUGH) LOOP HEATING (FINAL) OTHER APP.IEOUIP. REINF. STEEL GAS (FINAL) `METER / TEMP. POLE///� •�� r—SERVICE / GROUT WATER HEATER FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING f7/ 8c^ VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING r� MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL y / REMARKS: IUR'b swnAIUntbliNniALs. GARDEN WALL FINAL P.O. BOX 1504 APPLICATION ONLY Building-�- 7&105 CALLE ESTADO Address y-2ys �1/ {�,' QED LA QUINTA, CALIFORNIA 92253 Owner /i'Q ./ 42 C, Zip Tel. Contractor Address I 1247 State Lic. - City & Classif. A _ 3f7 93� Lic. # Arch., Engr., Designer Address Tel. CityI Zip I State I Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisib4s of Chapter (commencing with Section 7000) of Dlvlslonlp of the Business apppd Professions Code, rf my license is in full force and effect. / SIGNATURE DATE OWNER -BUILDER DECLARATION 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 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 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 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). ❑ 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, Buisness and Professions Code: The Contractor's License Law does not apply to an owner or 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 propertywhobuilds 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 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. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM 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 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 Callfornia. Date Owner NOTICE TO APPLICANT: If, alter 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 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 ateMailing Address City, State, Zip BUILDING DIVISION WING: TYPE CONST. OCC. GRP. A.P. Number "774- 66- b2y Legal Description L Project Description FLA A) ;F� Sq. Ft. Size �/�p No. No. Dw. Stories ( Units NewA_ Add ❑ Alter ❑ Repair ❑ 'Demolition ❑ 7 � G4 -1z- /L50 5 -0` %45AtcAF Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Z S o. o c� Plan Chk. Bal. S9. 8 Const. Mech. r7 O Electrical R.-7 Plumbing 00 S.M.I. Z Grading 0 A o u Driveway Enc. 2 O 00 Infrastructure TOTAL o t1 REMARKS 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. ® $ UNITS SLAB GRADE 2ND FL. SQ. FT. BONDING YARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CARP. SQ. FT. GAS (ROUGH) DRAINAGE PIPING WALL SQ. FT. OTHER APP./EOUIP. DRINKING FOUNTAIN SQ. FT. ® TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. 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, TEM/PERM 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/a c SEWAGE DISPOSAL GAR. FIREWALL SQ.FT.GAR ® 3/ac HOUSE SEWER LATHING 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. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRAD?NG -Cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL 0 Z O U IJP rn W Z O H U U-1 U) `1 Ir Q W Ir X Z O I— U W U) e } � RECEIPT NO. 6 —9 Issued by. 51 Date lo District: ❑ Riverside L l Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe o Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File DOH -SAN -122 (Rev. 6/86) 11 COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM Y, t 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•;$37i's required when the application is submitted. Check must be made payable to the County of Riverside. Aye Building Department Application Log # Name (Owner, Agent, Contractor, Etc.) - LLF �r� Mailing Address 2 X. V s c�Ju 2 City l.�IM j' l4L, State Zip Code Te ephone 32V Job Property Address / 5"�Si1�C`Z City ommuraity 7 t i.�l ia� Legal Description of Property. (Lot, PM, TR) <12. Lf.�T/2 �Ld -2.S' 'Assessor's Parcel No. titer Agency Well° � -n �)� �"' Use of Permi,blAgX2A) . �C4-fr,' �Pianning Case N Lot Size .�7�/ 7 ��� D 2 s SFD, MH Site Preparation Etc. Signatule-&Applicant //' 'The above information must be verified from Building Application STAFF USE — DO NOT WRITE BELOW THIS LINE Initial Date Certification of Existing S.D. System required. ❑ Yes WQCB Clearance required. ❑ Yes LJo a Soils feasibility report required. ❑ Yes N Detailed boring report required. ❑ Yes �LI�N0 Detailed contour plot plans required. ❑ Yes ❑ No' T Staff Specialist approval required. E] Yes 2No Lot Inspection Date Soils/boring report by / Project # Date Soils Map Page ► �M ( Soil Type C-11- Approved by /r (A -1J/ L Date—&-- Type of System: ❑ Existing OlNew ❑ Additional ❑ Replacement No. of Bedrooms (1) Septic Tank Soil Rate Required Gals.�� (2) Leach line sq. ft. trench Sidewall allowance ft. InstallLines) Ft. Long,Leach bed Sq. �F oftbottom (Bottom area) rock/ Sq. Ft. ft. 9�N/A Ft'dwide with min. inches per running rock below drain lines area Leach lines/bed-special design for slope: (3) Pit Diameter No. Pits Pit total depth_ � ljApplicable � urden factor ��N/A I 7,Seepage x. allowable depth V t n / o This application J, app d ;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 must b X50' from any wells;IIO'e, tC/r �jW k,.- MA. .,� (2 Leach lines must be 100' min. from any wells including exptanslon area 7 e�' s, < (3). Seepage pits must be 1:50' min. from any wel�ls including expansion area .�.•,��.,�6vi-•t,.+.o, sT� /J Signature of Health Official -" Date RECEIPT NO. 6 —9 Issued by. 51 Date lo District: ❑ Riverside L l Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe o Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File DOH -SAN -122 (Rev. 6/86) 11