Loading...
04552 (SFD)Building t3,46� Ve�.d soo Address Owner. mailing Address :79'•940 Horse6hoe City ,Zip Tel. ..*• Owner/Duilder S City Zip Tel. State Lic.. City & Classif. Lic. # Designer Address Tel. 4 P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 City ( Zip ( State I Lic. # LICENSED CONTRACTOR'S DECLARATION 1 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 `1 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 provisionsof 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 allegedrexemption. '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). O I, as owner of.tFie pi party, 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 of property who builds or, Improves .thereon and who does such work himself or through his own employees, provided Ahal -suchy improvements„ are not intended or offered for sale. If, however, the building or improve"rrient` is? sold within one year of completion, the owner -builder will have the burden of p(oving• that•he did not build or improve for the purpose of sale.) O 1; as•owrie cf�tha property, am exclusively contracting with licensed contractors to con- struct the,projeot. -(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.) O 1 am exempt under Sec. " B. & P.C. for this reason t �, - R qt 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 O Copy is filed with the city. O 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.) tis„` •••�:a 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. 54 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 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 ddress 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. ' BUILDING: TYPE CONST. OCC. GRP. A.P. Number, 774-054-021 Legal Description Project Description ° TS.P_111. r Sq. Ft. 120C) Size w No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $64,830 PERMIT Plan Chk. Dep. $250.00 Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure AMOUNT -36.89 .32 A 4 1'cT 0 26.00 6AA,s50 105.00 TOTALi�I REMARKS 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: Signature of applicant Date Mailing Address Validation: City, State, Zip ' WHITE FINANCE PINK - APPLICANT, GREEN -'BUILDING, GOLDENROD - ASSESSORS OFFICE, HARD COPY - FILE ._ .,...,a -r ....,.'� -.t`. .. .a,_..s?�,. - ..i w.:•.7..•v:?' 3'.. .Y>:.pu..... _ ......Oy. _ ...4., .. _ _.-•f:' _ _ .. .. CONSTRUCTION ESTIMATL NO. ELECTRICAL FEES NO. PLUMIJNG FEES IST FL SO Fl (42 1 UNITS UNDERGROUND A.C. UNIT YARD SPKLR SYSTEM 2ND FL SO FT. a ROUGH PLUMB 4A BONDING MOSILEHOME SVC. BAR SINK POR SO FT. a w4 SEWER OR ICT ROUGH WIRING POWER OUTLET ROOF DRAINS GAR SO. FT. Cl GAS (ROUGH) METER LOOP HEATING (FINAL) DRAINAGE PIPING CAR P. SO FT. tB GAS (FINAL) f/ rll MP. POLE16-11C-- 5: ,, YY DRINKING FOUNTAIN WALL SO. FT. @ WATER HEATER SERVICE FINAL INSP. URINAL SO. FT. a WATER SYSTEM ESTIMATED CONSTRUCTION VALUATION $ GRADING cu. yd. WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTONDISH) APPLIANCE DRYER REMARKS: GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM 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. SO. FT. RESID @ 1 I c SEWAGE DISPOSAL MESH 09 SO.FT.GAR @ 1:c HOUSE SEWER SULATI ONISOUN D,/?- GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE wtECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB FEE STRUCTURE PLUMBING ELECTRICAL HEATING 8 AIR COND. SOLAR g?,&TBACK P GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA a B GRADE _�G �� ROUGH PLUMB 4A BONDING HEATING (ROUGH) STORAGE TANK FORMS w4 SEWER OR ICT ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. REINF. STEEL GAS (FINAL) f/ rll MP. POLE16-11C-- 5: ,, YY GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. LUMBER GR. FINAL INSP. — — / FRAMING FINAL INSP. L$—PIUS—X$—=$ ROOFING � � � )�� - �(f �L' S (� / \/ REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR, GAR. FIREWALL THING MESH 09 SULATI ONISOUN D,/?- FINISH GRADING Ft AL INSPECTION l ? lU�l ' CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINiT1AL5 GARDEN WALL FINAL Building _ Address Owner Mailing Address Contra'`cto? Address J�j j'' v L iS tJ P.O. BOX 1504 - APPLICATION ONLY / 78-105 CALLE ESTADO , LA QUINTA, CALIFORNIA 92253 ` BUILDING: TYPE CONST. OCC. GRP., �/ 7 94 a HoaC A.P. Number -7-71/_., 7i7 ~ d 5 �•- r7 Z� ZIPr . Tel. Legal Description Project Description f� -y Zip e. ' State Lic. City & Classif. Lic. # Sq. Ft. 7. U 0 No. No. Dw. ' /Arch., Engr., Size • - stories Units Designer y - New ❑ Add ❑ Alter ❑' Repair ❑ -Demolition ❑ Address a Tel. - _ -- - City - Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION , I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, license Is in full ; and my force and effect. » - SIGNATURE - DATE OWNER -BUILDER DECLARATION--- ES11fT1ated Valuation " I hereby affirm that I am exempt from the Contractor's License Law for. the following reason: (Sec. 7031.5,Buslness 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 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. - .. subjects the applicant to'a civil penalty of not more than five hundred dollars ($500). Plan Chk. Bal. O I, as owner of the property,.or my employees with wages as their sole,cpmpensation, will do the work, and the structure is not Intended or offered for sale. (Sec. 7044, Buisness and ',Const. .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. - - - - 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 ' Electrical- _ 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- Plumbing strucl 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. -- - w -. • - - such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading .. " p , , - O I am exempt under Sec. B. 8 P.C. for this reason ' / Driveway Enc. - `Date owner l A 10l4 --r.; . a.� 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 O Copy is filed with the city.. ❑ Certified copy is hereby furnished. TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (This section need not -be completed if the permit is for one hundred dollars ($100) valuation OM82 10 1636,08r23-88 or less.) I certify that in the performance of tha work for which this permit is issued, I shall not XQ t.H.3H 1 I U I HL 1 c i �, VV 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 ZONE: _ - BY: subject to the Workers' Compensation provisions of the Labor .Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Minimum Setback Distances: - Front Setback from Center. Line `. Rear Setback from Rear Prop. Line• - �. - CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line 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.) Side Setback from Property Line .Lender's: Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject -to FINAL DATE INSPECTOR 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. ISSued:by: Date Permit' - I'agree to comply with all city and county ordinances arid state iaws.relating to building -construction, and hereby authorize representatives -of this city to enter the above -.- mentioned property for inspection purposes. Validated by: Signature of applicant Date' - -Wailing Address= - - Validation: - State., Zip -City, BUILDING DIVISION CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBIALG FEES 1ST FL. SQ. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SQ. FT. FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® GAS (ROUGH) METER LOOP GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. SQ. FT. ® GROUT WATER HEATER WALL SQ. FT. ® FINAL INSP. DRINKING FOUNTAIN SQ. FT. ® WATER SYSTEM URINAL ESTIMATED CONSTRUCTION VALUATION $ =$ WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. 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 FIRE ZONE ROOFING 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 LATHING SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/. c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER FINISH GRADING 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 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 INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL Desert Sands Unified School District CERTIFICATION OF PAYMENT OF k(.A SCHOOL FA Y FEES tW NOTICE: THIS ®C►CU e t BE DUPLICATED.88 TO: City of La Quinta DATE: Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 This is to certify that I -1l VV -u developer which is located a ,— , within this District, has paid school fa c lily fees imposed pursuant to the authority ge erated by Governmente Sec ion 53080 'n the amount o5 o $ ( -f -h ouo ficm 2 h //U� covering a total of 1 square feet of ( residential or ( ) industrial/commercial development and that building permits for this footage in this development may now be issued by your jurisdiction. for ERT�SA�-� FIE SCHOOL DISTRICT S White - Building Department 40 Yellow - Facilities Planning • Pink - Accounting 0 Goold - Developer i b -r 5g 0 ire 00t 1 �o A- SO </d � �'-ng` b - 50,aCC (10)-37' . '�. .Y.. -+r •j.r _l.y.. Vii..•-r.,�;�-•r tiq� �.-.�-... .- ^�_'�.r� ..� �:.`�„a;�,.�� �; 2 Z 0 U W M Z O U W Z 0 W CD W COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH Assessors Parcel No. ENVIRONMENTAL HEALTH SERVICES -05 - OR,/ 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 speculations as indicated on the attached checklist. 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. VERIFY ITEMS IN SECTION A FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG # Agent, Contractor, Contact Person Phone Address & Phone Owner __J 0C' x�V e � � Phone � � `� v!' U Mailing Add . ss l R /h J � City 11! Slate Zip �� Job Property Address Legal Description Prop. (PM, Tract, Lot) 4� L.07--2 3 ted- 13 a4113 P?- 0 Lot Size'r Water Agency{,/Well Use of Perm@ P/P, CU, etc. Other / Dwelling, MH Site Prep, etc. 41 \)Ale, Signature of Applicant ,� Date CATEGORY: REV CODE FEE CATEGORY: REV CODE FEE P7 SUBSURFACE DISPOSAL ,.t f 1238$45.00 ❑ SITE EVALUATION UPON REQUEST 7349 $42.00 ❑ MULTIPLE PARCELS WITHIN SAME (NO PLOT PLAN) LAND DIVISION, f ❑'-,.SEWER/SEPTIC VERIFICATION 7348 $11.00 a.` 1 st 4 Parcels (Each) ti ; ' r x " ' 1238 $45.00 (Less than 1 year) b. Each Parcel after 4 7344 $16.00 ❑ PRELIMINARY ELECTIVE 7352 $45.00 ❑ Rereview (2nd review same parcel) 7344 $16.00 EVALUATION (Attach DOH SAN 53) ❑ Site Evaluation in Conjunction with ❑_. , HOLDING TANK 7351 $45.00 Critical Area` 7346 $86.00 -OALTERNATIVE/.EXPERIMENTAL 7345 $132.00 ❑ Site Evaluation Lot Less than SYSTEM 10,000 Sq. Ft. 7347 $86.00 - ,—INITIAL DATE Holding Tank Agreements Completed ❑ Yes No V'1oZ'- Certification of Existing S.D. System Required ❑ Yes No WQCB Clearance required. (Attach Form ❑ Yes No p4 DOH SAN 007, Santa Ana Region Only) Soils Percolation Report Required. ❑ .Yes No lNo Special Feasibility Boring Report Required. ❑ Yes No Detailed Contour Plot Plans Required (1 to 5 ft. interval) ❑ Yes l Other - " ❑ Yes 11 No Staff Specialist Lot Inspection Required ❑ Yes II No Lot Inspection Date s Soils boring report by 6,011 .r t Project # Date Soils Map Page Soil Type Approved by Date No. of Systems Type of System(s)elling Units (1) Septic Tank Soil Rate Grease /Sand Q Holding Tank ❑ Existing edrooms fixture Units Yk.e Greasentcp 11mew ❑ Replacement q l/ U al �� Gal (2) Leach Line Sq. Ft. Bottom trench are Sidewall allowance sq. ft. ft roc Install Li s) ft. long ft wide with Leach Bed sg14 per ruga ing ft. ❑ NA min. i es rock below drainlines or of bottom, area / Leachlines/bed special `cjesign for slope: (3) Pit Diameter No. Pits Pit Below Seepage Pit Total Depth Other: Applicable - Inlet (BI) 1 Max. Allowable Depth N/A Overburden factor � ❑ 5 T' 6 No. 2 System REMARKS:1 This applicatio 'sA PROV /D NIED for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated on the accompanied plot plan, using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the above -designed system. No construction is permitted in the required reserved 100% expansion area. (1 Septic tank and er li es -m it be 50' minimum from any wells (2 Leach lines must001 from minimum any wells, including expansion area Re 3) Seepage pits my 1 0' minim m from any w IIs, i cluding expansion area e ` Signature of Health Official -1 Date V r'a RECEIPT No. �C�� '/ % }% lssuedE DISTRICT: Q Riverside, ❑ _ Indio ❑ Hemet ❑ DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file Date 121'" v ❑ Rancho Calif. V❑ Blythe Applicant PINK - Bldg. Dept. GOLDENROD - Plans/Records