10320 (SFD)Building
Address 52-110 Cortez
Owner
Expectations Constr
Mailing
Address 54360 Martinez
City Zip
.LaQuinta 92253
Contractor
Sante
P.O. BOX 1504 j
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
!tion BUILDING: TYPE CONST.
A.P. Number
Tel.
564-0.7133 Legal Description
Project Description
State Lic. City
& Classif. B 613406- Lic. # 0105
Arch., Engr.,
Designer
Address �, ITel.
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 -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, 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
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,- Suisness 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. ft, 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 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 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 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 the work for which this permit is issued, I'shall not
emplbyany person in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date . 2"770wner
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 of 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.)
Lenders 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.
1 certify that 1 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.
_
Signaturte of applicantDate
Mailing Address
City, State, Zip
No. 10320
OCC: GRP.
SFD
ZONE:
BY:
Minimum Setback Distances:
Sq. Ft. 1557
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑
Demolitiori ❑
does
not include clock
wall or
-Permit
pool
INSPECTOR
Issued by:
Date Permit -
fS
lr
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
.250.00
Plan Chk. Bal.
278.88
Const.
621.50
Mech.
49 .0 ()
Electrical
128.50
Plumbing
150.50
S.M.I.
9.60
Grading
20.00
Driveway Enc.
20.00
Infrastructure
2420.34
f
n
TOTAL
3558.32
3308.32 }
REMARKS
j
'
fh.^.Yi 4 •'yft'�:;'•• fi, Ci Al EZ•Y�.1 f _
rl ,L.`;{'i5fy 'yx /�'� 0 ..
fit`.-i'v!.
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. SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUM BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT.
FORMS
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. Q. FT.®
OTHER APPJEOUIP.
DRAINAGE PIPING
WALL SO. FT.
GAS (FINAL) TEMP. POLE
DRINKING FOUNTAIN.
SO FT ®
GROUT
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM. FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
SPARK ARRESTOR
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
SO. FT. ® c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1Y. c
SEWAGE DISPOSAL
SO.FT.GAR ® V c
HOUSE SEWER
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 / '�a►
!
GROUND PLUMBING // )f,"NDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUM BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEPTIC TANK ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
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. I Q/
FRAMING
FINAL INSP.
ROOFING k
VENTILATION
(Z for
/n
REMARKS:
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING A/ JX0f Ql
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION -t/1 Q Q
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESJINITIALS
GARDEN WALL FINAL
CALVIN C. KAMINSKAS DAN RILEY
Asslslonl Commissioner V Sealer. Weights &M9Osures
(714) 275-3000 (714) 275.3030 .
i'—.��s .
OFFICE OF .
AGRICULTURAL COMMISSIONER
JAMES O. WALLACE, Commissioner
83-612 Avenue 4.5 Suite 7
Indio, CA 92201
(619) 342-8291
DATE Q _ o2 � f 19 q I CASE Nle. P6 IgL6
DEVELOPER.' S NAME:
ADDRESS:
G f)- ck, 0
TELEPHONE: (6*) ,S
Lc/9 a0ock q IQ40
6Pxk 3.;2 quauz
Loi/8
9/ork3/ Ma*�to
Dear Developer:
td /7a -4 Gt& Lo .20 &ae4is?/ &Mauspa.
lot37 ai&k4I MaA40 Lol,3 &oc%is7 eaotiva
Ldl7 &,1 Lt7/ OW -Xy Ou"610
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 from plant material listed, this office must be notified
immediately.
Thank you for protecting and preserving the Coachella Valley's pest -free environment.
Agricultural Comnissio is Office
cc: Indio and Riverside
4080 LEMON STREET, ROOM 19, RIVERSIDE, CALIFORNIA 92501 — FAX (714) 215.3012
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 111/25/911 Type of Permit I La Quinta
No. 111016 Permit #
Log #
Owner Name Expectations Construction
No. 52110 street Cortez
city La Quinta zip Ca. Study Area 112
APN # I Tract # I Lot # Square Footage 11557
Type of Development IrTingle 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:
This certifies that school facility fees imposed pursuant to Government Code 53080
in the amount of 1.58 X 1557 or $ 2,460.06 have been paid to D.S.0 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 Expectations Construction Telephone
Name on the check
By James E. Lively
Assistant Superintendent, Business Services
Fee collected /exempted by Vickie J. Durrett
Payment Received
Signature � Check No. 0431
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
T
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COUNTY OF RIVERSIDE DEPARTMENT
Assessors Parcel No.
OF HEALTH
ENVIRONMENTAL SERVICES
PERMIT APPLICATION FOR A SUBSURFAfCE
DIVISION
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 Riverside.
Approval of this application shall remain valid for
a period not to exceed one year from date of approval.
LOG # VERIFY ITEMS IN SECTION
A FROM A NON -FEE BUILDING & SAFETY (goldenrod) APPLICATION
Agent, Contractor, Contact Person
Phone
Address City State Zip
Owner
Phone
Address City State Zip
Job Property,Address
City
State
Zip
Legal Description Prop. (PM, Tract, Lot)
MowI've Z_
(fitl►1�o(
Lot Size
Water Agency/Well
Use of
Permit P/P, CU, etc.
Other 5�,40 C&O-p-o FrJ A h f- (Affe
(DwellingH
Site Prep, etc.
L u
Signature of Applicant
Date
CATEGORY REV CODE
FEE
CATEGORY REV CODE FEE
SUBSURFACE DISPOSAL (per system) 1238
$153.00
❑ SITE EVALUATION UPON REQUEST 7349 $120.00
(NO PLOT PLAN)
❑ MULTIPLE PARCELS WITHIN SAME LAND DIVISION
❑ SEWER/SEPTIC VERIFICATION 7348 $ 58.00
a. 1st 4 Parcels (Each) 1238
$153.00
❑ PRELIMINARY ELECTIVE EVALUATION
b. Each Parcel after 4 7344
$ 55.00
(Attach DOH -SAN -53) 7352 $ 69.00
❑ REREVIEW (2nd review same parcel) 7344
$ 55.00
❑ HOLDING TANK 7351 $119.00
❑ SITE EVALUATION In Conjuction with Critical Area •7346
$197.00
0. ALTERNATIVE EXPERIMENTAL SYSTEM 7345 $656.00
❑ GRADING PLAN REVIEW DETAILED 1238 $104.00
❑ SITE EVALUATION Lot Less than 10,000 Sq. Ft. 7347
$172.00
❑ GRADING PLAN REVIEW CURSORY 1238 $ 55.00
❑ SECOND FIELD VISIT (SITE EVALUATION) 7346
$ 65.00
❑ COPIES (LAND USE) 7786-81 $ 50
INITIAL DATE
Holding Tank Agreements Completed
❑ Yes D No
Certification of Existing S.D. System Required
❑ Yes No
WQCB Clearance Required
❑ Yes J No
(Attach Form DOH SAN 007, Santa Ana Region Only)
Soils Percolation Report Required
❑ Yes No
Special Feasibility Boring Report Required
❑ Yes No
Detailed Contour Plot Plans Required (1 to 5 ft. interval)
❑ Yes No
Grading Handout Provided
❑ Yes No
Staff Specialist Lot Inspection Required
❑ Yes No
Maintenance Booklet Provided
❑ Yes No Lot Inspection Date Initials
/
C/42 / Soils Percolation Boring Report by !
t Q Lic/Project # Date
Soils Map Page Soil Type
Approved By Date
No. of Systems
Type of System(s)
No. Dwelling Units
(1) Septic Tank
Soil Rate
Grease/sand
❑ Holding Tank ❑Replacement
❑Addition
Bedroo s, Fixture U I
?�
/ 0yU
�t
Grease Intcp/Unt Trap
�j Existing
n'Exis
� r/ �� �
Gal.
Gal.
r
Sq. Ft.
Total Linear
Sidewall Allowance
0
Leagh.,13e sd� q ft
Bottom Area
Ft.Install
n. r�ocw��,,, �+.,. .per running ft.
Line(s) ft. long ft. wide with.
of
Bottom Area
I Jested' ept6 h
(] NA
min. inches rock bel _ drainlines or
Proposed Bottom Tested Depth
Leachiines/bed special design for slope:
(3) Pit Diameter
No. Pits
Pit Below
Seepage Pit Tonal Depth
Other:
Inlet (BI)
(TD) '
Applicably
❑ 5
6 , ''
Max. Allele Depth
N / A —,F Overburden Factor
Well Review Approved: Signature
Date Well Drilling Permit #
Grading Plan Approved: Signature
I Date
REMARKS:
This application is APPROVED/�NIED for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated
on the accompani lot pl �Gsing the requirements set forth
in SECTION C above. A building permit is necessary for the installation of the above -designed
syste Nn cnnstruction is nermitted in the required reserved
100% expansion area.
(1 Septic tank must be 100' minimum from any wells
Leach lines must be 100' minimum from any wells,
including expansion area
Seepage pits must be 150' .minimum from any wells, including expansion area
63)
Signature of Health Official
Date
RECEIPT NO. 1
DISTRICT: ❑ Riverside
V I ❑ CASH (CHECK NO.
Issued By i f I r U✓ Date-
0
ate ❑ Indio ❑ Hemet O Perris ❑ Rancho Calif. ❑ Blythe
DOH -SAN -122 (Rev 6/91) DISTP: '-0 oe_fda— - — -- Records