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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 Z O U W W Z O U UJ W r.. 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