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003106 (SFD)e t A'L c 44 P.O. BOX 1504 N o.• 003106 Building 78-105 CALLE ESTADO Address 46-175 Jefferson LA QUINTA, CALIFORNIA 92253 Owner Eucrene Peak BUILDING: TYPE CONST. OCC: GRP. Mailing, Address + A.P. Number. 0;1 7_111 —M -1 City Zip ITel, ' Legal Description Contractor , Project Description Single Family Dwelling Address _ City .. Zip Tel, State Lie. City & Classif. _ Lie. # Sq. Ft. No. No. Dw. • " . _ Size Stories Units - Arch., Engr.; Designer Bushman' s Drafting Co. New Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. Porch 320 sq. ft Setback Distances: _... 76-82-0 Florida 345--74129 Front Setback from Center Line "ft. CityZip .. . Palm Dere 't 92260. State Lie. # . - .. . GBraae 800 sa. work for which this permit is issued. (Sec. 3097, Civil Code.) LICENSED CQNTRACTOR'S DECLARATION . Side Setback from Property Line Lender's Name I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section _ 7000) Division 3 of the Business and Professions Code, and my license is in full force and Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE INSPECTOR tof . .. effec. .. 1 certify that I have read this application and state that the above information is correct. SIGNATURE DATE Date 1; !f,' /P7 Permit I agree to comply with all city and county ordinances and state laws relating to building _ ' OWNER -BUILDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractor's License law for the following Validated by: pya Saos ' . 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 V - Validation: requires the applicant for such permit to rile a signed statement .that he is licensed pursuant to PERMIT - AMOUNT the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) or HARD COPY _ ' 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.i�i�$ subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I, - Plan Chk. Bal. 63 . ❑ 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. . i8 sc3 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, Mech. �;�. 0Q _ 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 • �3 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- ' Plumbing 113.00 " struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds orimproves thereon, and who contracts for S.M,I. •� 7• such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading 213• f 0 :..67- 0 I am exempt under Sec. •. B. t> P.C. for this reason Driveway Enc. 20.00 i9ate�'+—owner Infrastructure 1635.09 -� ^� i'�t.'i6•r'I`1cai�tl 2 I 1.3 xr q�y 110 • 1,9' 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 " ❑ Copy is filed with the city. O Certified copy is hereby furnished. TOTAL S3119.2 1 $2869.21 CERTIFICATE OF EXEMPTION FROM REMARKS 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 . _. Owrier NOTICE TO APPLICANT: If, alter making this Certificate of Exemption you should become ' ZONE: ZOE:Minimum {r .0 l s . A i BY: -!ice jY subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 This is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE INSPECTOR expiration it work thereunder is suspended for 180 gays. 1 certify that I have read this application and state that the above information is correct. Issued by: Date 1; !f,' /P7 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- ateMailing MailingAddress Validation: City, State, Zip HARD COPY _ CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ .2ND FL. SO. FT. ® POR. 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 STORAGE TANK FLOOR DRAIN MECHANICAL FEES DUCT WORK WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER REINF. STEEL GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM FINAL INSP. 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. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL FIRE ZONE ROOFING SO.FT.GAR ® 3/4c HOUSE SEWER FIREPLACE 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 6ETBACK - OUND PLUM BIN. UNDERGROUND A.C. UNIT COLL. AREA GRADE5 =�—� ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK �gV_.1eSLAB �G&fIF0RMS SEWER OR S ROUGH WIRING 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$ c$ LUMBER GR. 14 CC(FINAL INSP. r' AMINGr�C/1 7(cs (,L,FINAL INSP.,F plc. ��' C��GO��OC /�� OOFINGD�-LIG l �% /! s /� 2�I W lf1C N n, L �./ L 2 �(`-► 1 REMARKS VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR FIREWALL // vvGAR. gt4ATHING MESH LINSULATION/SOUND(`JG FINISH GRADING 746 -FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL Building Address Owner it Mailing Address City Address ARROW PRINTING COMPANY. INDIO. CALIF. 260757•CE • Qstb& P.O. BOX 1504 APPLICATION ONLY 78-105 CALLE ESTADO /:�Sd i1i 15 % LA QUINTA, CALIFORNIA 92253 i✓� .77, ;c—E; <� Zip � City lZip I Tel. State Lic. (City & Classif. Lic. # Arcn., Lngr., Designer ALL%��L1AN Z>7AF�1. Ad rensp, Tel. 6 G Coa nItS- 75/ Z �it Zip State tm �GSE/t q2-Z�O Lic. # LICENSED CONTRACTOR'S DECLARATION I here Dy 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 effecI. 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, atter, 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 Me 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). ❑ 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, Bulsness 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 contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. 8 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 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: It, 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 petrrfit�ssued. (Sec. 3097, Civil Code.) Lenders Name GLL RAS( b -INK Lender's AddressZSd Ab / S -5;4, .r3 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 ins ction purpos s. // Signature of applic n Datey 29 �7 .Mailing Address City, state, Zlp BUILDING: TYPE CONST. OCC. GRP. A.P. Number a /% — l Z-/ r -Z— Legal Legal Description %, dT 2.Z �l4Q_1 v?/90 Project Description PAA,_gC .4J7- /Z f -Q, / 3 Y Sq. Ft. f Size �G No. No. Dw. Stories Units 1 New ❑ Add ❑ Alter ❑ Repair ❑ 'Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep.�-S Ge p C) Plan Chk. Bal. Const. Mech.' Electrical Plumbing S.M.I. Grading Driveway Enc. I of rastructu re 1Z a 9 7d TOTAL7 5 : U O 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: Desert Sands Unified School District CERTIFICATION OF PAYMENT. OF SCHOOL FACILITY FEES TO: City of La Quinta DATE: Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 This is to certify that- developer hat developer of which is located at -175-t within this District, has lVaff school facility fees imposed pursuant to the authority enerated by Government Code Section 53080 in the amount of co ering 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 UNIFIED SCHOOL DISTRICT White - uil ing Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer 41 C� 0 Z O U w U) m Z O U W U) X Z O F- 0 W U) i♦ Ah COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION ��7 - �o�l 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-r-7efun-dable filing fee of $37 is required when the application is submitted. Check must be made payable to the County of Riverside. � ` F .�. u(-- r NE ! Ea r K Building Department Application Log # Name (Owner, Agent, Contractor, Etc.) Mailing Address City State Zip Code Telephone Job Property Address /' _City or•Gommunity--�- •Legal Description of Property. (Lot, PM, TR) IL4 *Assessor's Parcel No.- j/ / V1/ Water Agency or. Wel b j�r Use of Perm, r!t.� �+ �u� `5a'PfV&g Case # Lot Size �^1 // 07 - / � v - � � � j1% D /� n ® �r' �D ^ /60 X SFO. MH Site Preparation Etc. Y Signature of Applicant N Date *The information above must be verified from Building Application STAFF USE — DO NOT WRITE BELOW THIS LINE rInitiall Date r; Certification of Existing S.D. System required. ❑ Yes 2 No"r �,�-�`C y 1- r1 -,� WQCB Clearance required. ❑ Yes 171� No Soils feasibility report required. ❑ Yes ©No, % 1 j Detailed boring report required. ❑ Yes D`NO � r Detailed contour plot plans required. ❑ Yes Q No Staff Specialist approval required. ❑ Yes E] No Lot Inspection Date Soils/boring report by / / } f Project # Date[ Soils Map Page 11(9 Soil Type /Q'/ Approved by f' Date/ �" q "%{ 7 tl Type of System: ❑ Existing P°New ❑ Additional ❑ Replacement No. of Bedrooms (4/oa L,1,r� A (1) Septic Tank Soil Rate Required (2)sLeach line sq. ft. Sidewall allowance r Install+�Line(s) Ft. Long, "Ft. ed Sq. Lea'bottom- (Botto trench area) ft. rock/ Sq. Ft. running ft. O /N A wfde+w.'. min. inches below drain lines Ft. of bottom per per rock area Leach lines/bed-special design for slope: - Applicable (3) Pit Diameter / No. Pits Pit BI Seepage Pit total depth r . N/A N/A Overburden factor -1 �l Com/ Max. allowable depth—7 �' .�-7% � i'f-.l-7��--•-.�A'`1'%' f r z... <rc-rrl /,/ 4+�.: f�'•''Gs�..rh-c'L.. ?//11`.1r �.7.•"?• ,�,/. c:.:�%'1 ��E�.t r ft'.1,.0 f�l.�--� �eti'....-r r✓ /1 a,.�->^-C(' /r.... �d�_ � fir .r� ,,mayy .�' ./�^'�1�.. r• . s� 12_� X �J ��t .. /L ,. i /.� �s o .i .... rt .,�►.rr . G�� at --s-=+ /mss %l� :7 6 fi This application i appro d/' enied•for the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements set forth in Section B a ove. A building permit is necessary for the installation of the above -designed system. Septic tank and sewer lines must bre�50' from any wells(/� r, ���� :- /ct'.'A.' (2 Leach lines must be 100' min. from any wells including expansion area r!. / 3' Seepage pits must be 150' min. from any wells including expansion area, �" r [ !J , JAV f��'�.l-tn-�{ii [ifl..+,!_ �'�'✓_.,,n L...I••.� % �, Signature of Health Official / I ( i, De, _fy �• f, • -� RECEIPT NO. District: ❑ Riverside O'Indio Distribution: WHITE -Office file DOH -SAN -122 (Rev. 6186) Issued by Date ❑ Hemet ❑ Per -is ❑ Rancho Calif. ❑ Blythe YELLOW -Applicant PINK -Bldg. Dept. GOLDENROD -Pending File '0."