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003528 (AC)P.O. BOX 1504 No.. 003528 136ildin ?$--��Ave+ dFi���� 78-105 CALLE ESTADO Address a , LA QUINTA, CALIFORNIA 92253 Owner La ouintea Arts IFo dation ' " - ' ' ` ' 13016DING: TYPE CONST. OCC: GRP. Mailing Address P. 0. Pox 777 A.P. Number City Zip Tel. T..'� .otlinta: .92253 - Legal Description Contractor Project Description rif f: rk a of natio caynr rinnell Company _ .Address Indiiin HMU3 Eli 34P City Zip Tela Mt. Center 92361 814-659-3962 State Lic. City & Classif.. 473969 Lic. # 994 Arch., E,ngr., Designer Address Tel. City Zip State '6 •handicap" hat ,room facility interior -partitions. Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition O WORKERS' COMPENSATION DECLARATION I hereby affirm that I'have a certificate of'conseht to self-insure,•or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Seca 3800, Labor Code.) 'Policy No. Company ❑ Copy is filed with the city. .0 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 it 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 Address City, State, Zip TOTAL I $201.43 I Iljr2Ci! .'!. REMARKS 4w;, f•Y_'.J. 4 f: 7413. 4.2-"9-ft7_ _ f t) Av, (wPMrt r. §,?srlL. [ vva. -su ZONE: BY: Ic. Front Setback from Center Line LICENSED CONTRACTOR'S DECLARATION Rear Setback from Rear Prop. Line hereby affirm that I am licensed under provisionsof Chapter 9 (commencing with Section Side Setback from Property Line 70 OO) of Division 3 of the Business and Professions Code, and my license is in full force and FINAL DATE INSPECTOR effect. Date 12/1$/ 84rmit Validated by: SIGNATURE DATE Validation: OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation .p 12 o/rJ1,i' f8ason: (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 AMOUNT the provisions or the Contractor's License Law, Chapter 9.(commencing with Section 7000) of •r Division 3 df the Business and Professions Code, or that he is exempt therefrom, -and The basis '• for the alleged Any Section 7031.5. by 'any for _. Plan Chk. Dep. - exemption. violation of applicant' a permit ' subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I, Plan Chk. Bal. $60.12 O 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 Const. _ CJ` 50 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, Mech. s �j P1 0 provided that such improvementsare not intended. or offered for sale. If, however, the. building • iD or improvement is sold within one year of completion, the owner -builder will have the burden Electrical •• !y of proving that he did not build or improve for the purpose, of sale.) .. _ d . ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing w 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 S.M•.I. f� rich projects -with a contractor(s) licensed pursuant to the Contractor's License Law.).- w Grading - O I am exempt under Sec. B. 8 P.C. for this reason • Driveway Enc. Date owner Infrastructure WORKERS' COMPENSATION DECLARATION I hereby affirm that I'have a certificate of'conseht to self-insure,•or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Seca 3800, Labor Code.) 'Policy No. Company ❑ Copy is filed with the city. .0 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 it 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 Address City, State, Zip TOTAL I $201.43 I Iljr2Ci! .'!. REMARKS 4w;, f•Y_'.J. 4 f: 7413. 4.2-"9-ft7_ _ f t) Av, (wPMrt r. §,?srlL. [ vva. -su ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback.from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date 12/1$/ 84rmit Validated by: Validation: HARD COPYI " CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ 2ND FL. SQ. FT. FOR. SQ. FT. ® GAR. SQ. FT. ® CAR P. SQ. FT. WALL SQ. FT. ® SQ 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 SLAB GRADE FLOOR DRAIN MECHANICAL FEES BONDING WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER SEWER OR SEPTIC TANK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED DUCT WORK LAUNDRY TRAY 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. SQ. FT. ®c BATH TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1114 c SEWAGE DISPOSAL BOND BEAM SQ.FT.GAR ® 3/4c 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 SETBACKROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE UGH PLUMB. /4 BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK WIRING A(r �4 f+ DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM $ GRADING cu. yd. plus x$ =$ LUMBER GR. t FINAL INSP. FRAMING / S A0 ! FINAL INSP. ROOFING / (/ �J REMARKS: VENTILATION FIRE ZONE ROOFING(///�/ FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING � MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS• GARDEN WALL FINAL M El Z O P U W Co Zt O U w U) U) Y Q w Ir U Z O U LLJ U) o��...P6 ' COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION 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 $40 is required when the application is submitted. Check must be made payable to the County of Riverside. Building Department Application Log # Name (Owner. Agent, Contractor Etc.) r // ,` Ff Z A n"` Marling Address V Vt%%!/ �C kwe t l�� (- l +T W a)TA / :� / 11(ffA�r !!-�4 �K � C,4 Z �6 / City A 01O CTA r 6 Slate Zip Code Telephone 'Job Pro dress 7$� ' /4X--1.41-- WD4 'Crty or. Communit9 Lk QL914s-A 'Legal Description of Property. (Lot. PM. TR) Assessor's Parcel No Water Agency or Well Lot Size use of Permit Planning Case # D SFD. MH Site Preparation Etc. rz.a 7 Signature of Applicant Date 'The above information must be verified from Building Application STAFF USE — DO NOT WRITE BELOW THIS LINE Initial tDate j Certification of Existing S.D. System required. ❑ Yes ❑ No WOCB Clearance required. ❑ Yes No Soils feasibility report required. ❑ Yes No Special feasibility boring report required. ❑ Yes No Detailed contour plot plans required. ❑ Yes No Staff Specialist approval required. ❑ Yes No Lot Inspection Date Soils/boring report by O Zt,'K,' Project # Date Soils Map Page Soil Type Approved by Date Type of System: No. of BedroomsY (1) Septic Tank Soil Rate Required ElExisting ❑ New E3 Additions X Replacement 7qt� `� �.S l�a�uJ►c3� anR 1c�C� Gals. t g4r T� (2) Leach line sq. ft/.% Sidewall allowance / Install Line(s) /^ Ft. Long, Leach bed Sq. (Bottom trent area) ft. rock/ �,/ Sq. Ft. Ft. wide with min inches Ft. of bottom per runni-ig ft. 2 N/A rock below drain lines area Leach lines/bed-special design ,for slope: (3) Pit Diameter � No. Pits Pit BI Seepage Pit total depth " Applicable// El5' 6' 1A Q Max. allowable depth N/A Overburden tactor C, �, u "G ""t"A 's, s� �. �^S p 'c � r (C.. L S -et S This application israpproved/denied for the Design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements set ffforthin 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 ((3') Seepage pitsnjust be°150' min. frDm any wells"including expansion area G',. ts"S- Signature of Health Official Date RECEIPT NO._ "? District: ❑ Riverside Windio C Hemet Distribution: WHITE—Office file YELLOW—App DOH SAN 122 (Rev 8/87) Issued by Date tz I %�J I ❑ Perris ❑ Rancho Calif. ❑ Blythe ;ant PINK—Bldg. Dept. GOLDENROD—Pending File t X000 P.O. Box 1504 APPLICATION ONLY Building 7&105 CALLE ESTADO Address $— Avenida La Fonda LA QUINTA, CALIFORNIA 92253 Owner La Quinta Arts Foundation Mailing BUILDING: TYPE CONST. OCC. GRP. Address P. 0'. Box 777 A.P. Number City Zip Tel. La Quinta 1 92253 Legal Description ContractorProject �'0'0 !�y � � r'47�� Cdt'✓�+f� Finnell Company Description Address iOU CA'P d�, r;.44 A9 Ak Indian Hills Box 34F ,�2,a2-�Teod,S Cmhn. Center zip 92361 Te714-659-3961 State Lic. #473969 Gen Bldg. City 990 A Classif. Lic. # Sq. Ft. No. No. Dw. Size Stories Units Arch., Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I he re tflVm t t I a ice e61r I nder provisions of Chapter 9 (commencing with Section 7000) ofviyio f the usin s d Prefeesions Code, and my license i in f fort effect.—gf SIGNATURE DATE OWNER -BUILDER DECLARATION 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 AMOUNT 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 thathe 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). ❑ I, Plan Chk. Bal. 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 Const. .�..Td 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 Mech. 0 Electrical D• o� 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.) Plumbing _ KO 04j 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 S.M.I. p O/ 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 Lew.) Grading ❑ I am exempt under Sec. B. 8 P.C. for this reason Driveway Enc. 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 Co oj�lj surance, or ayg % opy 1pe0m /Sec�n0, Leggrund Polis No. llJJ4 Compan l(i� p I' RCopy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL t7 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed N 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 s of employ any person in any manner so as to become subject to the Workers' Co nsatio Laws of California�,IersCona,,.nsamtion Date NOTICE TO APPLking th' ertificate of Exemption you esubject to the W provisions of the Labor Code, you m st forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 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.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration it work thereunder is suspended for 180 days. 1 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 j Date Mailing Address City, State, Zip FINANCE 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 Permit Validated by: Validation: