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003822 (SFD)Building. Address 51-395 Valle Owner P.O. BOX 1504 NO. 00.3822 78-105 CALLE ESTADO - LA QUINTA, CALIFORNIA 92253 Camp sem. `3 ws cv xawx.ca `'ax"r ."` BUILDING: TYPE CONST. - - -. ._ ». -0GG GRP. Address �A7 E.' ahqui z r+l�ay t� A.P. Number � 773-033-021 . City Zip ' Tela -Palm .�a;yl1"inc3 92262-�(j Legal Description l Project Description . y , .' ..... .• .» o . - Contractor- . - . ftarr 13F3StL1:C°� .i9:1< C.f2S tAsa?15/ _ Address.. City Zip _.. .. ..:. Tel.. _ State Lic. & Classif: 337934 City Lic. # 895 . , _. _ .. Sq. Ft. . 14101 «: No. No:.Dw. Size - Stories Units Arch.;-Engr., . - . .Designer New 0 Add ❑ Alter ❑. ..Repair ❑ Demolition ❑ Address Tel. 1701l of 6;. wood fence City Zip State Lic. # 4281 . Gar -acre ` t _ LICENSED CONTRACTOR'S DECLARATION. hereby.affiim that -t -am licensed under provisions of:Chapter 9 (commencing with Section 7000): of. Division 3 of the Business and'ProfessionsCode, and my license'is in full force and effect.. .. .. - ... SIGNATt1RE4'""' .. y. .,.;,. .. .. •:.c.•:� 4r DATE � OWNER -BUILDER DECLARATION Thereby 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 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 (5500).Chk: 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:+ 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 orthrough 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 . , or proving that he did not.build or improve for the purpose of sale.) - Estimated V81UatlOn .. ' � _4;11.9 - PERMIT - - AMOUNT - .. -• : Plad Chk. Dep. tAa S Plan Bal. .. _ ry COn'St. _- .. 364 Mech. . Electrical`' _ '74_ q' Plumbing - O 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 or 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 I am exempt under Sec. B. 8 P.C.- for this reason S.M;I: . _. . _ 5-146 Grading20.00 , - Driveway Enc. 20.00 Date owner 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_,_Ja°'^^s O Copy is filed with the city. . ❑Certified copy ishereby furnished. TOTAL REMARKS ' CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE . .• �Y.+yy,� ,�tyy, ¢Ys ^r ••x ,5h-....:'"�.:.ditiL 4 for (This, section need not be completed if the permit i§ for one hundred dollars ($100) valuation I certify that in the performance of the work for which this permit is issued, I shall not - employ any-Ferson in any manner so as to become subject to the Workers` Compensation Laws of Caliornia. Date " Owner' ' NOTICE TO APPLICANT: It, after making this. Certificate of Exemption you'shoiild 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. ZONE: - BY: ' M inimurn Setback Distances: :.. Front. Setback from Center Line Rear Setback from.Rear Prop. Line w CONSTRUCTION LENDING AGENCY 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.) . •, - . Side Street Setback from Center Line- Side Setback from Property Line - Lender's Name FINAL- DATE INSPECTOR 4/12/88- 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,l-have read this application and state that the above information is'correct. 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. '• Issued, by: - Validated by: Date Permit - " Signature of applicant Date Mailing Address Validation: City, State, Zip T HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ 2ND FL. S0. FT. POR. SO. FT. Qa GAR. SO. FT. ® CAR P. SO. FT. WALL SO. FT. SO FT ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER DUCT WORK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM HEATING (FINAL) 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 BOND BEAM SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL LUMBER GR. SO.FT.GAR ® 3/ac HOUSE SEWER FINAL INSP. ROOFING 0 GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE lv1ECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR 4 « �� SETBACK GRO Ui LUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ol ROU UMB- BONDING HEATING (ROUGH) STORAGE TANK FORMS EWER OR SEPTIC TANK UGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. S �� GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE y GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM FINAL INSP. GRADING cu. yd. $ plus x$ =$ LUMBER GR. FRAMING / /// FINAL INSP. ROOFING 0 D / REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING YJ 1 i t MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL Desert Sands Unified School District CERTIFICATION OF PAYMENT OF SCHOOL FACILITY FEES iv: t-ir-y or La �2uinta Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 NOTICE: DATE: THIS DOCUMENT CANNOT BE DUPLICATE®. This is to certify_ that / developer of , which is located at Via_Ji- Xwithin this District, has paid schoM facil t fees im osed pursuant to the authority generated by Government Code Se tion 5308,0 themount of covering a total of ,SL/p x" L� square feet of( residential or ( ) industrial/commercial development and that building permits for this footain this de,Yelo mentt. may now�)e issued by your jurisdiction. ;k'a 1Aa7/ for DESERT SANDS UNIFI D SCHOOL DISTRICT White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer Ci/� • ��`5 S (10)-37 S.1J THIS DOCUMENT CANNOT BE DUPLICATE®. This is to certify_ that / developer of , which is located at Via_Ji- Xwithin this District, has paid schoM facil t fees im osed pursuant to the authority generated by Government Code Se tion 5308,0 themount of covering a total of ,SL/p x" L� square feet of( residential or ( ) industrial/commercial development and that building permits for this footain this de,Yelo mentt. may now�)e issued by your jurisdiction. ;k'a 1Aa7/ for DESERT SANDS UNIFI D SCHOOL DISTRICT White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer Ci/� • ��`5 S (10)-37 N-144 ^'"i"""it'`i' ! ''",--y"a�ca�.�w�-x1" 'i" 'yam.,. ► rs�, ,+�'Mhl�'1vT-"ifit i'r`s( ' � •j=-- Vj sc1 'wy�.lp''�' �``t "�,T Yi'.tf .f y� + n.7 :'•�•�,Yvk i"'a}�+ .`,j✓tY�t';"�'i`�"F`f^F c� F: n Z O F- C) W U) W Z O U w U) Y Q W tr X Z O 1-- 0 W .) COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION ,�-� -����- •�i�� / 1 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 fee of $40 is required when the application is submitted. Check must be made payable to the County of Riverside. Building Department Application Log # Name (Owner. Agent. Contractor. Etc.) Mailing Address �Z �s71;0i .erra4-). 2yy L 7"A#Qa/rZ City State Zip Code Telephone f'�4MSP2 o eA fZ0- Z- 32 -/a za 'Job Property Address - ViaAe 'City or. Community /*4U/,J7'4 'Legal Description of Property. (Lot. PM. TR) u►1� s/ --3* 5 I o7- d.Z,Q/- 416 'Assessor's Parcel No 4VValer Agency or Well Lot Size 4. Use of Permit Planning Case M y7,3-r>33-G2-� ^�-Y�� SFO, MH Site Preparation Etc. Sign alu a of Applicant Dale 'The above information must be verified from Building Application STAFF USE — DO NOT WRITE BELOW THIS LINE Initial Date Certification of Existing S.D. System required. ❑ Yes No WOCB Clearance required. ❑ Yes D No �11 1r Soils feasibility report required. ❑ Yes No i r1 © Special feasibility boring report required. ❑ Yes No 1 ! i Detailed contour plot plans required. ❑ Yes LJ No Staff Specialist approval required. ❑ Yes No Lot Inspection Date Soils/boring report by Project # Date Soils Map Page `� Soil Type Approved by Date Type of System: No. of Bedrooms (1) Septic Tank Soil Rate Required ❑ Existing 151New 1:1Additional ❑ Replacement F \YL(,C N X ft U(-�Q Gals. �" } (2) Leach line sq. ft f Sidewall allowance Install Lines) Ft. Long, Leach bed Sq. (Bottom trench; area) s' ft.,rock/ Sq. Ft. Ft. wide within. inches i Ft. of bottom per running ft. ❑ N/A rock below dtain'lines area r Leach lines/bed-special design for slope: (3) Pit Diameter No�jl t&; �'Pit BI ! Seepage Pit total depth l J Applicable ❑ 5' Z'6' ` Max. allowable depth •N/A Overburden factor- actorX Y, t�-�,,,• �5 r �.�.t ('�•c�r �� l �.?c.� `�-�u�c->T`•f � tltC �n� `�;'`ii 1+�r', - • — v This application is approved/denied for the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements set fort in Section B above. 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 (2) Leach lines must be 100' min. from any wells including expansion area c- e x �(3)� Seepage 15 0' from including, pits must�be mi , ! any wells expansion area 44 Signature of Health Official ' Date"' RECEIPT NO. District: ❑ Riverside Indio ❑ Hemet Distribution: WHITE—Office file YELLOW—App DOH SAN 122 (Rev 8187) Issued by ('� t Date ti f 1 1 "6 ❑ Perris ❑ Rancho Calif. ❑ Blythe ;ant PINK—Bldg. Dept. GOLDENROD -Pending File M