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04381 (SFD)T Buildin Address 53—$60 VallIA-10 Owner Coaahellia 'Fall Mailing Address 2147 E. Tahcruit CityZip Pain sl rinlm a 92262 Contractor ress T4ht 4 4 Q" Eland Starr Construction State Lic. %J17014A Citi & Classif. Lic. # Arch., Engr., Designer Address Tel. 04331 P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST. OCC. GRP. A.P. Number 774—n$13-006 Legal Description Project Description T_ 694 - - - Sq. Ft. No. No. Dw. Sized Stories Units CityI Zip I State �, 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 t'` 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, atter, 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). 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 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.) O 1, 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.) O 1 am exempt under Sec. B. ti P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent tossself-insure, ora certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sgc�3800,_,6bor Code.) Policy No. Company ... k—of-/K..✓ 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. New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ 4 301 Garage work for which this permit is issued. (Sec. 3097, Civil Code.) Side Setback from Property Line 1701 +61' Wood fence Lender's Address I FINAL DATE INSP,ECTO 1 P 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. 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. Estimated Valuation mentioned property for inspection purposes. Validated by: PERMIT AMOUNT Plan Chk. Dep. �50� Plan Chk. Bal. • Const. • U Mech. 3J*UV_ Electrical / fi s I t Plumbing • V5 S.M.I. 5 T+ Grading XV 0111JU . Driveway Enc. 4V+ Infrastructure�� •O TOTAL it 0�13t REMARKS 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 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.) Side Setback from Property Line Lender's Name Lender's Address I FINAL DATE INSP,ECTO 1 P 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. 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 WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE CONSTRUCTION ESTIMATL NO. ELECTRICAL FEES NO. PLUMBING FEES ISI FL SO FT y s UNITS SLAB GRADE ROUGH PLUMB? BONDING YARD SPKLR SYSTEM 2ND FL SO FT. 6 FORMS SEWER OR SEP IC ROUGH WIRING SVC. BAR SINK POR SO FT. CrMOBILEHOME GAS (ROUGH) METER LOOP HEATING (FINAL) OUTLET ROOF DRAINS GAR SO. FT. ftPOWER TEMP. POLE GROUT DRAINAGE PIPING CAR P. SO FT. � FINAL INSP. BOND BEAM WATER SYSTEM DRINKING FOUNTAIN WALL SO. FT. 0 =E LUMBER GR. FINAL INSP. URINAL SO. FT. (& ROOFING ESTIMATED CONSTRUCTION VALUATION S 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(AUTONDISH) APPLIANCE DRYER 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 SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID a IA c SEWAGE DISPOSAL k tFINAL INSPECTIONZ,_%S-- v� SO.FT.GAR 4a JVc HOUSE SEWER CERT. OCC. 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 8 AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB? BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEP IC ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. S -Plus-x$ =E LUMBER GR. FINAL INSP. LRAMING / - � � FINAL INSP. ROOFING J / L//►-- -I// REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING k tFINAL INSPECTIONZ,_%S-- v� CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESlINITIALS GARDEN WALL FINAL Building Address i' Owner c:o ; ",.Mailing Address City Contractor S7r,4/Q Address P.O. BOX 1504 APPLICATION ONLY 78-105 CALLE ESTADO i® LA QUINTA, CALIFORNIA 92253- ` t' L.4 7 F 7WW&06LiTL GV4w-!1.b Zip Tel. Z 7— Z. X22-/,aZ40 lei /i4 v� -City Zip . Tel.: W ,�p2iA96s yzzc•z 322-/a2,0 State Lic. City & Classif. ��% ' .3 Lic. # gg3-- Arch., Engr., Designer BUILDING: TYPE CONST. _ OCC. GRP. A.P. Number % 7.f4- Legal Description_4v'r /Q 16L1e 2Zc' GG•rJ/r' 2 ,1 Project Description Sq. FL No. No. Dw. t ize / O Stories % Units ew%, Add ❑ - Alter O Repair ❑ ^ Demolition Address r s contractor's) Tel.AR. ,6 Driveway Enc. City - Zip State % as t G2 _. Lic. # s LICENSED CONTRACTOR'S DECLARATION. - I hereby affirm that I am licensed under,provisions of Chapter 9 (commencing with Section 7000) of Division 3 oflthe Business and Professions Code, and my license is in full force ' - fand effect:�1%����t te�.i�il� 7/�7t/l7X §LGI Af• " �/ DATE OWNER -BUILDER DECLARATION-- O Copy is filed with the city. ❑ Certified copy is hereby furnished. I hereby affirm that I am exempt from the Contractor's License Law for the.following Estimated Valuation ' 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 _ ... -: PERMIT. the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of _y '" ' �'." '° , , .yam �-t .t-7 - 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 Ch k. Bal. ' ❑ 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 Const. Professions Code: The Contractor's License Law does not apply to an owner,, of property who . - - CONSTRUCTION LENDING AGENCY `, builds or improves thereon and who does such work himself or through his own employees, . Mach. - - 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.) _ Plumbing ❑ 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. S.M:L"- - ' does not apply to an owner of property -who builds of improves thereon,•and who contracts for, • h rojects with a licensed ursuant to the Contractor's License Law) uc P P . O 1 am exempt under Sec. - B. & P:C. for this reason Grading Driveway Enc. Date Owner' Infrastructure WORKERS' COMPENSATION DECLARATION ,. I hereby'affinn'that I'have a certificate of consent,to self -insure or a certificate of.,, Worker's Compensation Insurance, ora certified copy they �of:'Sec13800, Labor Code.),,` _Policy No. Company � O Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL CERTIFICATE OF EXEMPTION FROM - WORKERS' COMPENSATION INSURANCE . REMARKS _y '" ' �'." '° , , .yam �-t .t-7 - (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 ,employ any parson in any manner so as to become subject to the Workers' Compensation Laws of California. _ 4 f7 � ix71'` k4 i y f 6 T & f yy7�3 . ©Q ' - ' Date Owner NOTICE -TO APPLICANT., if, altermaking this Certificate o/ `Exemption you should become subject to the Workers' Compensation provisions o/ the Labor Code, you 'must forthwith ti comply with such provisions or this permit shall be deemed revoked.. • ZONE: BY: f Minimum Setback Distances: •� Front Setback from Center Line _ Rear Setback from Rear Prop. Line — - - - CONSTRUCTION LENDING AGENCY `, Side Street Setback from'Ceiiter Line 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.) �� - 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 expiration if work thereunder is suspended for 180 days. I certify that I ,have read this application and state that the -above information incorrect. 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. FINAL DATE Issued by-- Validated. by: INSPECTOR -• - Date ~Permit' Signature of applicant ' Date .Mailing Address- Validation: t • City, State, Zip BUILDING DIVISION CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. @ $ UNITS SLAB GRADE 2ND FL. SO. FT. @ BONDING YARD SPKLR SYSTEM POR. SO. FT. @ MOBILEHOME SVC. BAR SINK GAR. SO. FT. @ POWER OUTLET ROOF DRAINS CAR P. SO. FT. @ GAS (ROUGH) DRAINAGE PIPING WALL SO. FT. @ OTHER APP./EOUIP. DRINKING FOUNTAIN SO. FT. @ TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM I 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 @ 11/4 c SEWAGE DISPOSAL GAR. FIREWALL SO.FT.GAR @ 3/ac HOUSE SEWER LATHING 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 0 z O F— C) W U) M z O P 0 w U) CO Y tr Q W / U OJ W .%, i^p->'y f i>•••n'�"Gy._ ! yi `. �t .p.. COUNTY OF RIVERSIDE, DEPARTMENT OF HEALTH Y ENVIRONMENTAL HEALTH SERVICES DIVISIONS—v'3 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 o4aw2h is required when the application is submitted. Check must be made payable to the County of Riverside. it 47 Building Department Application Log N Name (Owner. Agent. Contractor. Etc.) S?4,9 0- Mailing Address A -r Z: K1/1 /J T . e AJ 5/7 44: City City AL s P ,� State Zip Code 7 z ~- Telephone nd zo Job Progeny Address /►,, i� . /' n� V /!f ! Gt �:Ctmmunny Legal Descriptiondof Properly (Lot. PM. TR) je�`V r+ 7?� <<.. •.>• i�1/4T 13-3.3(-o [ .I o XqQc�.v-ra ' L07' .�7 G/C Z Z.S Gi!V / 'Assessor's Parcel No Water A en rRwell `7 < � /J Pal nCg Case v Use of Perm i f Le/ l Lot Size ,/ �+' / 774 — b o — �� Gs I W p ,r,' / Y SFD. MH Site Preparation Etc Signature of Applicant Date 'The above information must be verified from Building Application STAFF USE — DO NOT WRITE BELOW THIS LINE f Initial Date ❑ Certification of Existing S.D. System required. Yes WOCB Clearance required. ❑ Yes (��Nol r Soils feasibility report required. ❑ Yes Special feasibility boring report required. ❑ Yes N6f Detailed contour plot plans required. ❑ Yes NO' Staff Specialist approval required. ❑ Yes lJ No Lot Inspection Date Soils/boring report by Project q Date Soils Map Page ``rSoil Type Approved Date !" 7-01 _f b Type of System: %� No. of Bedrooms �Tank (1) Septic � I Soil Rate Required ❑ Existing [g'New ❑ Additional ❑ Replacement W aw Gals. y " T / '� r �d��t; (2) each line sq. ft. (Bolt trench area) Sidewall allowance ft. rock/ Sq. Ft. Instal Line(s) Ft. Long. Ft. wl min. inches I Leach bed Sq. Ft. of`b'otto per running ft. ©-'N/A rock below drain line area Leach lines/bed-special design for slope: Applicable--fe (3) Pit Diameter No. Pits Pit BI Seepage Pit total depth � 0 19 9'6' J / Max. allowable depth Vo burden factor T �jN�/A G> c r.. ,,- fL("rr"Y,.. Z'� 1� ���� tJ �G�^--C��'a. �-'L-�t..�-!✓� �� ,,cf�-• /'z- l This application,C prMo�v ed/de ued for the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements set forth in Section a ove. A building permit is necessary for the installa ion of the above designed system. JL1 F M 1) Septic tank lines be 50'rfrom 10 and sewer must any wellsc (2 Leach lines must be 100' min. from any wells including exp a�'sio area „ Seepage pits must be 150'•min. from any wells including expansion are �� yL J r,� G ��•• Signal'ure of Health Official - ✓ Ie ' �- RECEIPT NO. JEW Issued by ��►� Date %-,2 7 (10 District: ❑ Riverside [E Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File DOH -SAN -122 (Rev. 4/88) OFFICE OF E. LEON SPAU,GY 1 s AGRICULTURAL COMMISSIONER CO"N15`1O LL O I ,Irl JAMES O WALLACE AND,, v ASSWAM COMMISSIONER "S ��� "' WEIGHTS & MEASURES CLEMENT BENVEINISTE SEALER }• 49-613 Ilwy. 86., Suite 8-12 ��\,���,o.•'� Coachella, CA 92236 q r 9, ti eq 619-342-8291 DATE 7 CASE DEVELOPER'S NAMES, ACS CJ 1� S+V' Li C' cy ADDRESS: L% ► L !� z I 4 U I-' bLl,'S ePA TELEPI ZONE s Dear Developers 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 inmediately. , Thank you for protecting and preserving the Coachella Valley's pest -free environment: Agricultural nnissioner's Office ccs Indio and Riverside Office