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003845 (SFD)Building Address Owner Mailing Address City 1A 01 Contractor .4 I P.O. BOX 1504 No. 003845 78-105 CALLE ESTADO 78-740 Ta=ico LA QUINTA, CALIFORNIA 92253 Ron Phillips Zip Tel. • Address 77-635 Calle Madrid City. Zip . ... Tel...... Ira nuinta 92253 564-333] State Lic. City & Classif. Lic. # Arch., Engr.; ' •Designer Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION BUILDING: TYPE CONST: OCC: GRP. A.P. Number 71 9-077-010 Legal Description L- 7—. // d` Project Description'. �• Sq. Ft. 2:�4 No. No. Dw. Size - - Stories Units New ❑ Add ❑ Alter O Repair ❑ . Demolition ❑ I hereby affirm that I am,licensed under provisions of Chapter 9 (commencing with Section 7000) of Division,3 of the Business and Code, and my license is in full force and Ihereby affirm that there is a construction lending agency for the performance of the . effect _SIGNATURE= -+ DATE OWNER -BUILDER DECLARATION Estimated Valuation 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 Lender's Address FINAL DATE h C permto 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 PERMIT the provisions of the Contractor's License Law, Chapter9 *(commencing with Section. 7000) of expiration if work thereunder is suspended for 180 days.14! Division 3 of the'Business'and Professions Code, or that. he is exempt therefrom; and the basis 88 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 compensation, will do the work, and the structure is not intended or offered .for sale. (Sec. 7044, Buisness and COr1St. Professions Code: The Contractor's License Law does not apply to an owner of. property who mentioned property for inspection purposes. 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.) . O 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing struct the project.. (Sec.' 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property whobuilds or improves thereon, and who contracts for S.M.1. such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading ❑ I am .exempt under Sec: B. 8 P.C. for this reason Driveway Enc. 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.) 1.1 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 cf Exemption you 'should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shell be deemed revoked. - Infrastructure TOTAL 114,788 AMOUNT $250.00 +7 112 .50 468.00 36.00 93.40 103.00• g7�{.95 20.00 20.00 2,493.00. KLMARKS Pp l �,rs; i i t.YnL x ZONE: BY: 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 FINAL DATE - INSPECTOR 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.14! 88 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 and state laws 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 Mailing Address Validation: City, State, Zip HARD COPY y T CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ®. $ UNITS op ROUGH PLUMB. BONDING 2ND FL. SQ. FT. STORAGE TANK YARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ. FT. p POWER OUTLET ROOF DRAINS CARP. SQ. FT. REINF. STEEL DRAINAGE PIPING WALL SQ. FT. DRINKING FOUNTAIN SQ FT ® FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER SYSTEM WATER PIPING NOTE: Not to be used as property tax valuation LUMBER GR. FLOOR DRAIN MECHANICAL FEES INSP. 1 —$`6 WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER VENTILATION 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 cSEWAGE DISPOSAL SQ.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 PLUM G UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE '`,/2 JIM op ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC A K ROUGH WIRING DUCT WORK ROCKSTORAGE 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. Ao"P. RAMING F_� —Si INSP. 1 —$`6 ROOFING � �^A �/)i , G (_ �/ /' / V� �, \ REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING L INSPECTION / ZC�Coll CERT. OCC. gdate�FINAL INSPECTOR'S SIGNATURES/INITIALS ,17 GARDEN WALL FINAL Desert Sands Unified School District CE�j�j ION OF PAYMENT NOTICE: THIS OCURAENT' CAR"' OF 'sd'� C'L'.'C ^4 Y ED. SCHOOL FACILITY FEES TO: City of La Quinta DATE: Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 r L1101 C(�7 tt\D /7 This This is to ce tify that r'�$-r(_L� developer ofwhich is located at a a� 19 t within this District, has paid school facility fees imposed pursuallnt to the authority generated, Governm t Code ectiof►- )080 in hhe. 4molAt of covering a total of ;?a4,CO square fe t of residential or ( ) industrial/commeLial development and that building permits for this footage in this development may now be issued by your jurisdiction. v_ for DESERT SANDS UN ED SC L DISTRICT White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer (10)-37 Z O H U U-1 W Z O U U.1 rn M ,Joh • Q W CC 7 OtAy U w U) :Y �fi �d 4+ v 0 - � , � + `fid' t r : . 4 r ' ` , Iii ,. rtife�•...«e►.ir�4 ' , $ ' "I1 ] 4 ; Name (Owner. Agent. Contractor. Etc.) Mailing Address -•' t Crty StateZip Code - Telephone 'JobProperty Address j-7u7 COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION . PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM - — • r 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 $40 is required when the application is submitted. Check must be made payable to the County of Riverside - h, � r".�_ 'S ,r''1 t(/",tip �)G! � 1�•f'• Building Department Application Log # Name (Owner. Agent. Contractor. Etc.) Mailing Address -•' t Crty StateZip Code - Telephone 'JobProperty Address j-7u7 `r,GommunM1y Description!yption of Properly. (Lot. PM. /T/R)�(]r it '/7-0,t ff Legal Description 1W/ t/ 'Assessor's Parcel No ` . Waie(Agenc orI �. n/1� Lot Size ,�1r'1t2Planning Case # Use of Per�T•l� - Use - • 1���-.� ��' SFD. MH Sne Preparation Etc. �Si§nature of -Applicant '„ „ r•,fy��✓� - , Date - • The above information must be verified from Building Application STAFF USE — DO NOT WRITE BELOW THIS LINE rA Initial Date Certification of Existing S.D. System required. f El Oo� WOCB Clearance required. r ❑ Yes Z Nom iit 1r ❑ [2 Soils feasibility report required. Yes N6 t 1 Special feasibility boring report required. ❑ Yes ®No' Detailed contour plot plans required. ❑ Yes Z�No' Staff Specialist approval required. ❑ Yes 121 No Lot Inspection Date Soils/boring report by + Projectf # Date Soils Map Page d Soil Type f; Approved by,Date Type of System: U No. of Bedrooms (1) Septic Tank Soil Rate Required ❑ Existing ' ©New El Additional ❑Replacement f y ,t,l -AX Gals. (2) Leach line sq. ft. / Sidewall allowance ' ft. 'Sq. Ft. Install +._ Line(s)—Ft. Long, Leach bed Sq. Ft. eiwith�min. inches F�bottorp (Bottom trench area) rock/ � - wl 'mow `� per running ft. [P N/A r rock below drain lines area Leach lines/bed-special design or slope: Applicable01 (3) Pit Diameter ' m No. Pits Pit 0 Seepage Pit total depth �Q " Max. allowable depth! N/A Overburden factor r - �`�,•- f V . , ,,,, f) / 91 ci . ✓Li2 C!1� /.r-'x.�' mow.-./•+.. �fiYt�-slQ �/��� /x�f�t-/��"y. X�.%�it� f �as7 ✓: ' Til //l . A +.IFo,( l�A --� .� i1 t�-iTil l.k1,4 This application is•approveqLenled 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 permmit�iisnecessary for the installation of the above -designed system. (1),� Septic tank and sewer lines must be 50' from any wells:,, /0 (2) ��� d Leach lines must be 100' mina from any wells including expansion ea 0(5)(3) Seepage pits must be 150', min from any wells including expansion area cig rY r Y�j S. naturE of HealthLOlhCial / " Date' �' �7 ql .moi eco ,.t �' ZLfAd RECEIPT NO.—� 3 Issued by�`� Date 4/- S' -•E �� District: El Riverside �❑ Indo • El Hemet El Perris El Rancho Calif. El Blythe Distribution: WHITE -Office file YELLOW 'Applicant PINK—Bldg. Dept. GOLDENROD—Pending File DOH SAN 122 (Rev 8187) G"