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12564 (PLBG)Building Address I 53-968 Cortez T441�p P.O. BOX 1504 78-105 CALLE ESTADO LA OUINTA, CALIFORNIA 92253 ".. Coachella Valley Lana Address 78-150 Calle Tampico #230 City Zip Tel. La Quinta, CA 92253 564-1155 Contractor Ed G. Wise AW150 Calle Tampico #238 - ity Zip Tel. C11 Quint�a, CAI 92253 1 564-1.377 & Classif. 664 238 LDING: TYPE CONST A.P. Number No. 12564 OCC: GRP. Legal Description Project Description Sewer Connect Lic. # 2851 I Sq. Ft. Size CityI Zip I State Lic. # ICE S D?CONTRACTOR'S DECLARATION I hereby affil t I am ensed�under provisions of Chapter 9 (cc 7000) of Divi / f the usiness and P rgYa Ions Code, and my IIc effect.!).: �°r� I hereby affirm.that I am exempt from the Contractors License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, after, 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 Me provisions or the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or thathe 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 Ove 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, Buisnass and 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, 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.) O -1, 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 w4h 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 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 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. Date Owner NOTICE TO APPLICANT. d, 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 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued..(Sec. 3087, 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, 21p I No. Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ (Estimated Valuation $1,500.00 PERMIT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS AMOUNT 30.00 ZONE: BY: Minimum Setback Distances: f Front Setback from Center Line Rear Setback from Rear Prop. Line 4ML-Mreel,gteJoack t4otn CejaLej Line FINAL DATEE- AI "W" Issued by: Date bb i Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. a $ UNITS SLAB GRADE 2ND FL. SQ. FT. @ BONDING Y ARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. I SQ. FT. ® GAS (ROUGH) DRAINAGE.PIPING WALL SO. F7. ® OTHER APPJEQUIP. DRINKING FOUNTAIN SO 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.COOL 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. SO. FT. ® c BATH TUB SQ. FT. ®.c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL GAR. FIREWALL SQ.FT.GAR ® 34c 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 S AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL, AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS EWERUGH WIRING DUCTWORK ROCKSTORAGE 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. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION Z CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL 71 COACHELLA VALLEY WATER DISTRICT CASH RECEIPT DETAIL Received From: C C= FSC_ /'� LC.��{ �/�► LG- 7_ •/ T !� I Address: '753 0 CA L.45 {. I C O S' Account No. Lot($) /O Service Add ❑ Meter(s) ❑ Servlce(s) ❑ Backflow(s) ❑ House Lateral(s) ❑ DetectorCheck(s) ❑ MeterSuroharge ❑ UP14flon Capacity. Charge 0/ �� S ElWS.B.F.C. ❑ Temporary Construction Meter ❑ Turnon'Charge ❑ Uncollected Account- Name ❑ Inspection Fee - Tract - Fee - ❑ Plan Check Fees Water I Sewer - Tract - ❑ Bond Payment - A.D. -_Bond_ Asamt= ❑ Customer Deposit ❑ Other re PLO 46117 . . �� _ so 3 " zEt� ZI In - COAL?4 Z a:A. Code Remarks: ❑Copy to: Cash Check Money Order D O pC TOTAL $ Water Service A3B(111a8) O pC TOTAL $ Water Service A3B(111a8) U W W m Z 0.1 U LLI m to Y m Q W m - COUNTY OF RIVERSIDE, DEPARTMENT OF HEALTH - 7 � _ SERVICES DIVISION 17 ENVIRONMENTAL HEALTH /I// 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 feeok�Pf Muired when the application is submitted. Check must be made payable to the County of Riverside. �'�6 Building Department Application Log 4 Name{Owner, Agent. Contractor. Etc.) Mailing Address City State zip Code Telephone .Job Property Address A/Eml�74 Gt CeR-ow- Legal. Description of Property (Lot. PAA S7394,f- ed�OT%e2 .LA►4 io Big Ife. —Lew.,- /9 'Assessor's Parcel No fWaier A ncN r Well Use Per u/ vtp¢�,nmg Case Lot Size A7 d ,P� : t/ 7 — �7� — 2 �l�.SYrrLIG"�' SFD. MH Site Preparation Etc ��� r SO )r/ vat Signature of Applicant Date 'The above information must be ver/Ned from Building Appficetbn STAFF USE — DO NOT WRITE BELOW THIS LINE /IInniitial Date ' "�^" ' Certification of Existing S.D. System required. ❑ Yes /I' r' �,i,__,i� WQCB Clearance required. ❑ Yes 2 il' it Ld Sods feasibility report requited. ❑ Yes Special feasibility boring report required. ❑ Yes Detailed contour plot plans required. ❑ Yes Staff Specialist approval required.. 10 Yes ONo Lot I spection Date "Soils/boring rennrtby Project p Date Soils Map Pag 4koil TypeOid Approved byZ:kAJ/1_ Date Type of System: No. of Bedrooms (1) Septic Tank Soil Rate Required / ❑ Existing LFJ^New ❑ Additional ❑ Replacement 3 1 Keq?C Ali Gals. Ile. ���j (2) ach line sq. ft. Sidewall allowance Long. Install Lines) Ft�Iines L bed Sq. (Sotto rich area) h; rock/ Sq, Ft. Finches Ft. of bo per running ft. C1;IQ%A rock below area Leach lines/bed-special design for slope: (3) Pit Diameter No. Pits Pit. BI Seepage Pit total depth N6�' Applicable N/A Overburden factor gK Max. allowable depth t4�' . �i �y This application ia roved or the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements .. set forth in Section a ove. A building permit is necessary for the installation of the above -designed system_ (1) Septic tank and sewer lines must be 50' from any wells ' 0 1'-t.a;� 1` * _&aA 4 � Leach lines must be 100' min. from any wells includinNexp nsiortarea 3) Seepage pits must be 150': min. from any wells including expansion area.(/ ^�� .411 Signature of Health 00aal i RECEIPT NO: Issued by I I -` Dat --// - PiP, District: ❑ Riverside ❑ I�o ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept., GOLDENROD—Pending File DOH.SAN-122 (Rev: 4188) Jr A F R 4 OF F ICE OF E. LEON SPAVGY � f �, AGRICULTURAL C.OMMISSIONL11 )AMES O'WALLACE o I ? b AND ASSIPAM rIMMISSIOW1 WEIGHITS & MEASURES CLE�IEyS(8 EgVEIrISiE . tit 4.9-613 Ilwy 86, 8uiite 0-12 'Coachells, CA 92236 MA r v. j6`11' 619-342-8291 DATE bcA I ��� CASE NO. MVEL OPER' S WHE s !3 T fi R R AuoREss i Z17 0 T..dNQ u I r z 2 • PALM SPIe I C -r 5 9 ZZ4..2, - TELEPIIONEs ( Lor/. ,dxe /fG Dear Developers 7-1-4-141-10 2-1 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 frun plant material listed, this office must be notified imnediately. Thank you Lor protecting mid preserving the Coachella Valley's pest -free environment. Alticultural Cannissioner's Office ccs Indio and Riverside Office r ..