Loading...
003540 (SFD)P.O. BOX 1504 Building 54-385 Vallejo.. 78-105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Owner Golden gest Homes Mailing Address P. ©. Box 2854 CityZip Tel. Palm Desert 92260 1 . • 7734424 Contractor . Address `. City Zip Tel.. . . ldvllwild 92374 714-659-9511 State Lic. City & Classif. Lic. # Arch., Engr., - Designer Address Tel. CityZip State - Lic. # _ LICENSED CONTRACTOR'S DECLARATION „ I 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. ✓ �•. ` i-'-dS� i .r. i i .,.F f r jam• _SIGNATURE - 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, alter, impiove, 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). ' ' 0 1, 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.) - 0. I, as owner of the property, am exclusively contracting with licerised contractors to con- .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 such projects with a•contractor(s) licensed pursuant to the Contractor's License Law.) . .O 1 am.exempt under Sec..B. B. t;. 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. . ❑ 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 the 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 -ofthis city to 'enter the above- mentioned property for inspection purposes. Signature of applicant Date Mailing Address No. 003540 BUILDING: TYPE CONST.- OCC: GRP. A.P. Number 774-244-01 8 Legal Description Project Description Single Ft mily Dwelling ZONE: BY: Minimum Setback. Distances: Front.Setback from Center Line Sq. Ft. 14$0 Size No. Stories- No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition 0 Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date 12/ ?9/?Permit Validated by: Validation: . Estimated Valuatiol :.78 s00 PERMIT AMOUNT Plan Chk. Dep.( _ (� Plan Chk. Bal. 11 69_55 . Const.. 370-01111 Mech. I If, .0n Electrical 74 _ nn Plumbing 1111- _ of S.M.I. 5_5f) Grading af}. 00 Driveway Enc. 20 _00. Infrastructure 1.72.5.00 TOTAL REMARKS 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 12/ ?9/?Permit Validated by: Validation: City, State, Zip HARD COPY :i T CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES r IST FL. SO. FT. @ $ UNITS COLL. AREA 2ND FL. SO. FT. ROUGH PLUMB. YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. I SO. FT. DUCT WORK DRAINAGE PIPING WALL SO. FT. (ROUGH) DRINKING FOUNTAIN SO FT ® HEATING (FINAL) URINAL ESTIMATED CONSTRUCTION VALUATION $ GAS (FINAL) WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER HEATER WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER WATER SYSTEM GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GRADING cu. yd. $ plus x$ LAUNDRY TRAY AIR HANDLING UNIT CFM FINAL INSP.-7 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 ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER 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 ROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE 2 / ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR E {ICT ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. l (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. $ plus x$ . g LUMBER GR. FINAL INSP.-7 C FRAMING'— / FINAL INSP. 0 ROOFING , ! A/A i / FJ `V' ` V/� 'l ( / ✓J (�ljG REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH 7��JfQSULATIONISOUND S �Y FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS. GARDEN WALL FINAL Desert Sands Unified School District CERTIFICATION OF PAYMENT OF tLA SCHOOL FACILITY FEES TO: City of La Quinta Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 IV - DATE: DATE: t)0Gk)t-'jV,1D- This is to certify thalt developer of which is located at within this District, has paid schooffa&lity fees imp,6sed pursuant to the authority q_enerated by Government Code S ctiott 53080 in the amoint of covering a total of 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 DESERT SANDS UNIFIAD SCHOOL DISTRICT White - Building Department • Yellow - Facilities Planning Pink - Accounting • Gold - Developer Ch- XJ -7 (10)-37 04 Z O U W U) M Z O F_ U w U) W `1 C1 Q W fr U W W F RIVERSIDE, PERMIT APPLICATION FOENVIRONMENTAL COUNTY PEO A SUBSUR ACE SEv GED SPO A DIVISION SYSTEM Applicant: Submit this form with four copies of a scaled plot plan (•-20 scale) drawn to County specifications required on the attached check list. A non-refundable filing fee of S40 is required when the application is submitted. Check must be made payable to the County of Riverside. 6 o l cle •, J P .S t- H Q Building Department Application Log # Name (Owner. Agent. Contractor. Etc.) �. Mailing Address City l �,r State Zip Code Telephone 'Job Property Address e,-6V&4_-,6rCt 'Cit. r-�'C: a nr'r 'Legal Description of Property, (Lot. PMTTR) lAl G' jk c /a/ % 2- P r 'Nd No 2 6 Q 'Assessor's Parcel No dbm„Lmlu� N r Agecy:w ' USE of PermitI�Plzr,,4 Case # Lot Size�_ SFC. MH Site Preparation Etc. r ✓� f �Q X TQC Signature of Applicant '1/ Date " '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 WQCB Clearance required. ❑ Yes © No f 1 F f Soils feasibility report required. ElYes No// !� Special feasibility boring report required. ❑Yes ®,��N6 l Detailed contour plot plans required. F-1YesU NNo' Staff Specialist approval required. Yes -eNo Lot Inspection Date %~ Project # Date Soils/boring report by �/14, Soils Map Pagell Soil Type u � Approved by 14 Ah'? Date 12- -17f I ' Type of System: U Nc of*Bedrooms (1) SeptticTannk Soil Rate Required ❑ Existing ("New ❑ Additional ❑ Replacement Gals. (2) Leach line sq. ft. Sidewall allowance ft. Sq. Ft. Install Lines) Ft. Long, Ft. inches r Leachch�bed Sq. Ft. (Bottor"ii'<t ench area) rock/ -� per running ft. OO�'N/A wid _with min. rock below drain lines of_bottorn area Leach lines/bed-special design for slope: (3) Pit Diameter / ^ No. Pits Pit BI Seepage Pit total depth '""'VefJ Applicable _­' N/A burden factor W1511 i Max. allowable depth U J i/"•"F+!! /i _,.•>°/Y✓Lv�.. Ale s- /')""� �.i-?7 7 J N '�� 1..+1.!„G%'G'i'�a.ii.4•+1. This application is�a p ed%zfenied for the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements A is for installation set forth in Section B'above. building permit necessary the of the above -designed system. (!) Septic tank and sewer lines must be,50from any wellsdll3 . r<.•-,•,tGE!� ter•: - / i". - (2) Leach lines must be 100' min. from any wells including expahsion area.. (3) Seepage pits must %be 150' min. from any wells in luding expansion area 11 p %� 3 � �, ,m< � �Sf /.1 1 �r/ l r/� , /-' /( �1 +/' e-r� 4c -174"9 " 1 G r° � ' rs' ,4e"-• Signature of Health Official / Date RECEIPT NO._ C-2 ?C2 6' Issued by S� //r Date r -12-F7 District: -10 Riverside ❑,Indio ❑ Hemet ❑ Perris :] Rancho Calif. ❑ Blythe Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD —Pending.File + y DOH SAN 122 (Rev 8187) • D r