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003654 (SFD)1 C&tyl 44 P.O. BOX 1504 No. 003654 Building 78-105 CALLE ESTADO r Address 52-275 Valleic LA QUINTA, CALIFORNIA 92253 Owner r__n;xc c*_VUA Va lev L"- d Co. BUILDING: TYPE CONST. OCC: GRP. Mailing Address 247 E. Tahquitz Way 12 A.P. Number 773-262-012 City Zip Tel. Palm Springs 922'b2 ' _i22^1026 , _ Legal Description Contractor Project Description Singlo Family DwiMing Starr strueti.on Co. Address City' . _ State Lic. Cit & Classif. 387934 Arch., Engr., Designer Address Tel. Zip Tel. Licy# 89� .. Sq. Ft. .1410 Size 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,rand my license is i I full force and _effect. /�.7.,i �. _.-` •�. -% . �.f' - .!'�� /1 � _. �r"'� SIGNATURE - '"�' - i.Y ,,.-DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 703.1. 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 rile 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 o1 not more than.rive 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, 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 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 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 contractors) licensed pursuant to the Contractor's License raw.) ❑ 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 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..) 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. 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'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. Signature of applicant ---Date- Mailing aleMailing Address City, State, Zip HARD COPY New ❑ Add ❑ 17n of 6s No. No. Dw. Stories Units Alter ❑ Repai51Z ?eiClod f4?t4'ee 1 Demolition ❑ BY: Estimated Valuation A7K SOC PERMIT AMOUNT Plan Chk: Dep:arjl.' Rear Setback from Rear Prop. Line Zip Tel. Licy# 89� .. Sq. Ft. .1410 Size 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,rand my license is i I full force and _effect. /�.7.,i �. _.-` •�. -% . �.f' - .!'�� /1 � _. �r"'� SIGNATURE - '"�' - i.Y ,,.-DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 703.1. 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 rile 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 o1 not more than.rive 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, 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 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 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 contractors) licensed pursuant to the Contractor's License raw.) ❑ 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 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..) 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. 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'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. Signature of applicant ---Date- Mailing aleMailing Address City, State, Zip HARD COPY New ❑ Add ❑ 17n of 6s No. No. Dw. Stories Units Alter ❑ Repai51Z ?eiClod f4?t4'ee 1 Demolition ❑ ZONE: BY: Estimated Valuation A7K SOC PERMIT AMOUNT Plan Chk: Dep:arjl.' Rear Setback from Rear Prop. Line Plan Chk. Bal. S 59.19q Const. " 361.00 Mech. T3.. 0 Electrical 75LAI Plumbing 99.A0 S.M.I. S.%.9 Grading 7-0-00 Driveway Enc. 20 .. Aln Infrastructure TOTAL N7 0 oz7 41 REMARKS V f 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 2�17188Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ 2ND FL. SO. FT. POR. SO. FT. ® GAR. SO. FT. ® CARP. 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 BONDING HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER ROUGH WIRING DUCT WORK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM METER LOOP HEATING (FINAL) 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 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 INAL INSP. ROOFING GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEEELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLU UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE t ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER O �A ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE /L/f GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING FINAL INSP.tlj 5 cu. yd. $ plus x$ =$ LUMBER GR. FRAMING L INAL INSP. ROOFING (/ 41 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND L Z1 FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS, GARDEN WALL FINAL n[IC -PIA It411P11 Desert Sands Unified School District CERTIFICATION_OF.PAYMENT , Nw'OT TICE:"THIS D0CUMEWJ&C A'.1MGT-FEES BEDUPLICATED. T0: City of La Quinta r DATE: Department of Community Development 78-105 Calle Estado ti , La Quinta, CA 92253 �'• + This is to certify hat ! developer of which i located at Via4)���Q this'District, has paid school facility es imposed pursuant to the'� authority generated by Government Code Section 5308 n they amount of covering a total of - 9,9,�,� s' are feet of ) residential or ( ) industrial/commercial development and that building.permits for this footage,in this development may now be issued by your jurisdiction. (A- r `f 1047 / 1& (for D ERT SANDS UNIFIED SCHOOL DISTRICT 'Bu'ildln D artment • Yellow - Facilities Planning • Pink Accounting • Gold - Developer (10)-37 Z0 z 0 H U W t:n z O U w U) 0 Y Q W tr I— U W V) " +Fy^ •t te..«7'.. t+--r.�r, ti-� , .7 'ir �t� A ,.,z.�•;, . ; w .,ccy. ..,� �y d: ,r'+.' + ���� r� �).�">� �r�.�.t'...r pS „y-� i � �( ,1jJii'ti' �,rs .'N �hh""Xi+' )« rY+�,• COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION ' 7 7 3 -.2 PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM Applicant: Submit this form with four'copit?s 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.) - -SrX C'a.Aj s 7-4 �G rio,�J ' .Mailing Address - 7 • 7;� Afau, irz2 City A"4L ,7SPviAJ6S State . GA ` Z,p Code �� fG Z_. Telephone J2 �-ion � 'Job Property Address �� 52 - ,Z s V,4I L EJ© Q„oo�ommunny 'Legal Descnpuon of Progeny. (Lot. PM. TR)!� �^^C' 'Assessor's Parcel No !!Water �Ag.ency'di/-Weil CtP F !Ji<KiJ+ h - 1- Use of Permit-il�%Y°('1�/ 5Plannuig Case # Lot Size - .� SFD. MH Site Preparation Etc. +/ �r Signature of Applicants' Date ' from r;;;dhe:abovejplormauon must be verified Building Application STAFF USE — DO NOT WRITE BELOW THIS LINE /" Initial ' Date ,1;2- �( Certification of Existing S.D. System, required. El Yes Do � `' M WOCB Clearance required.. ❑ Yes Soils feasibility report required. ❑ Yes EO No Special feasibility boring report required. '• ❑ Yes Z Nox" f r No' Detailed contour plot plans required. ❑ Yes © Staff Specialist approval required. ❑ Yes ® No Lot Inspection Date Soils/boring report.by Project Date j Idc Soils Map Page Soil Typed 'Approved by / �r�--- Date -Type of System: No: of Bedrooms (1) Septic Tank SoilRate Required �, ❑ Existing ©'New ElAdditional ❑ Replacement �� i IVU Gals. (2) Leach line sq. ft. Botto(n trench ' Sidewall allowance ft. rock/ Sq. Ft. Install ' Line(s) Ft. Long, Ft. wide th,min. r inches Leach bed Sq. Ft. of bottom area) per.iunning,ft Gf+, ❑O-N9A rock below drain lines. "� area. Leach, lines/bed-special design for slope Applicable:.,." (3) Pit Diameters _• ' x No. Pits Pit BI f� Seepage Pit total depth ` N/A Overburden factor .,'l `D'S � 6' /!� .Max: allowable depth /,G�%/.c+��� .i'ir; /?-i ,..,.7 �.�_[..>.� %zr�i�•�"}—�l�i This application isa p eordl enied.for the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements set forthh in Section B above. A building permit necessary for the installation of the above -designed system. 0 ',, 1,ep, • 1 1)) Septic tank and sewer lines must be 50' from any wells^ _ p,- 0 . j ,r•.flit,' r 2) Leach lines must be 100' min from any wells including expansion area '" '- ' ` �'�` �- • • - A MIC -r -r (3) Seepage pits be' 50' rri&rom any wells }includingexpansion area c% �p f //J} �y 0_� X12 ��Y%�� m•ti !' +' ,r ,must �//Q�, ���r `� /�`•'�; / % d // ` G+e ." � f:.. f'/!` Z� V� •' �`..,�. Y�*yft..�J� . �O �''f ,� i, y i.+�"�'...,' ✓ � � .A1� I /r ri���f ,A .� Signature of Hearth Official - .;Jk;A�. • ` / _4,:? _ ' Dat �,�! r' RECEIPT NO. Issued by ��� Date-- �e9 District: ❑ Riverside D"Ind ❑ Hemet • ❑ Perris ❑ Rancho Calif. ❑ Blythe! Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File: DOH SAN 122 (Rev 8187) U Anr 4- J p 1WI; ,J �tKyt OF R A. �� . �! Of f ICE OF E. LEON SSPAE GY AGRICUU UfZI�L COti1h115510NER MMES 0 WALLACE +� r S, j "' WEIGHTS £� MEASURES CLEMENT BE`VENISTE t SEALER : it 49-613 Ilwy 86, Suite T3-12 ,�°�,�._•+'�Coachella, CA 92236 q r v, 1 e9 619-342-8"291 DATE 2- I- 8 CASE NO. DEVEIAPER' S NAME: ADDRESS: 2 y % "2- 9222 TELEPHONE: (6 /9) 32.2- /020 Dear Developer: 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 iim>ediately. Thank you for protecting and preserving the Coachella Valley's pest -free environment. "W4) 44 - Agricult al Coamis 'oner's Office cc: Indio and Riverside Office MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253