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05696 (SFD)Building 52_760 DIM Address D12411S RICifMERG P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Mailing Address City Zip Tel. Contractor Address Tela State Lic. I City & Classif. 453778 Lic. # 620 Arch., Engr., Designer Address Tel. City ZipI State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7(100) of Division 3 of the Business and Professions Code, and my license is in full force and effect. 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, after, Improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to Me a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Divfsion 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis for the alreged exemption. Any violation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars (5500). ❑ 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 impmves thereon and who does such work himself or through his own employees, provided that such krprovements are not intended or offered for sale. 0, 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 buil 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 braids or improves thereon, and who contracts for such projects with a contractof(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec B. & P.C. for this reason w � I Date 1 Owner %.rl, N .y. 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. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed If the pemnit is for one hundred dollars ($100) valuation or less.) I certify that in the performanceof thg work for which this permit is issued, I shall not employ anyperson in any manner so as,to-become subject to the Workers' Compensation Laws of California I� Date Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become subject to the Workers' Compensation provfskms of the Labor Code, you must forthwith comply with such provisions of this pemtit 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, Cirri Code.) Lender's Name Lender's Address This isa 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 Address City, State, Zip No. 11LDING: TYPE CONST. OCC. GRP.: P. Number 773-312-002 Description Project Description 45696 LOT 25 — BLK 170 — WIT 17 SPD 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 3I��� OR Issued by: Date Permit Validated by: Validation: Sq:- Ft. 1640 Size No. 1 Stories No. Dw. Units NewX Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $90,178.00 PERMIT AMOUNT Plan Chk. Dep. 250.00 Plan Chk. Bal. OL • Const. 00 Mech. J3..50 Electrical 12132 Plumbing 160.50 S.M.I. 13.65 Grading 20.00 Driveway Enc. 20.00 Infrastructure 1,990.75 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 3I��� OR Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SO. FT. FORMS SEWER OR SEPTIC TANK ROUGH WIRING. MOBILEHOME SVC. BAR SINK POR. gp, FT. ® GAS (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR. SO. FT. ® TEMP. POLE GROUT DRAINAGE PIPING CAR P. I SO. FT. FINAL INSP. WALL SO. FT. WATER SYSTEM DRINKING FOUNTAIN. DING cu. yd. $ —plus—x$—=$ LUMBER GR.// URINAL Sp FT ® FINAL INSP. ` W(I(ROOFING 7—1 �—� ESTIMATED CONSTRUCTION VALUATION $ REMARKS: WATER PIPING NOTE: Not to be used as property tax valuation FIRE ZONE ROOFING FLOOR DRAIN MECHANICAL FEES SPARK ARRESTOR WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER MESH GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM 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 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 PLUM BI116 /3 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 APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM /� r% �/� 9G/ FINAL INSP DING cu. yd. $ —plus—x$—=$ LUMBER GR.// FRAMING X '. FINAL INSP. ` W(I(ROOFING 7—1 �—� //fJ /,(,// 0 r ` " V - �-4� ry (- t4./ �.✓/ ( 14 Cc���U�Uti V N`-� � � I/ /d� p^ ( �f -�� /� �COQ cr�� / / REMARKS: VENTILATION FIRE ZONE ROOFING . 91 FIREPLACE SPARK ARRESTOR GAR. FIREWALL A)L,4ATHING/ MESH /�NSULATION/SOUNq /6- FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATUREWINITIALS GARDEN WALL FINAL 1 Desert Sands Unified School District T ^ CERTIFICATION OF PAYMENT OF NOTICE: 1 141,S DCCJME .—SMQ04UANN OOL FAC LITY FEES � BE DUPLICATED, OT s' TO: City of La Quints DATE: -%Q Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 This is to c rtify t at developer of i c h is located at within this District, has paid school fa ity fees imposed pursuant to the aut ity g rate by G vernment Code Sectio5� 3080 i the amount of b ( �-o - > covering a total of square feet of �) residential or ( ) industrial/commercial development and that buil8ing permits for this footage in this development may now be issued by your jurisdiction. ovaj. 0 for DESERT SANDY UNIFIED SCHOOL DISTRICT 01-) g epartment • YelloWF 1, Me, PIanning 0 Pink - Accounting • Gold - Developer (10)-37 V� A Lug RECEIPT NO. ` Issued By 5k Q e DISTRICT: ❑ Riverside, ❑-Indio❑ Hemet q Perris ❑ Rancho Calif. ❑ Blythe DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records L z COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH Afassssors Parcel No. ENVIRONMENTAL HEALTH SERVICES k73 -:�3lZ —CMZ 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 speculations as indicated on the attached check list A non-refundable filing fee (see below) is required when the application is submitted. Check must be made payable to the County of Riverside. Approval of this application shall remain valid for a period not to exceed one year from date of approval. Q Z VERIFY ITEMS IN SECTION A FROM BUILDING 8 SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG' I O`" Contractor, Contact Pelson Phone Address & Phoeee , W U) Owner Phone Mailing Address .,. Jbb,Prope dress / Z_ Legal Description Prop. (PM, Tract, Lot) �L� G .i, L A-17 Lot Size r Water Agency . t r� Use of Permit P/P, CU, etc. k `�Q u.� s. �. �nA �irs Other /j C,C:gLf `��r� C/N� ��11 X /0 r. , t E✓i ! G (/ .r_ «C (X .�� �D~wel , SR4 Prep, etc. 1 J �j�" 5 Signature of Applicant a ' Date CATEGORY: REV CODE FEE . - � CATEGORY: REV CODE FEE ©SUBSURFACE DISPOSAL 1238 $4 ❑ SITE EVALUATION UPON REQUEST 7349 $42.00 m ❑ MULTIPLE PARCELS WITHIN SAME (NO PLOT PLAN) Z LAND DIVISION ❑ SEWER/SEPTIC VERIFICATION 7348 $11.00 O a. 1 st 4 Parcels (Each) 1238 $45.00 (Less than 1 yeah F b. Each Parcel after 4 7344 $16.00 ❑ PRELIMINARY ELECTIVE 7352 $45.00 W ❑ Rereview (2nd review same parcel) 7344 $16.00 EVALUATION (Attach DOH SAN 53) U) ❑ Site Evaluation In Conjunction with ❑ HOLDING TANK 7351 $45.00 Critical Area 7346 $86.00 ❑ ALTERNATIVE/EXPERIMENTAL 7345 $13200 ❑ Site Evaluation Lot Less than SYSTEM 10,000 Sq. Ft. 7347 $88.00 NrTDATE / Odd Holding Tank Agreements Completed ❑ Yes Certification of Existing S.D. System Required ❑ Yes Neoe- WOCB Clearance required. (Attach Form ❑ Yes CIO DOH SAN 007, Santa Ana Region Only) Soils Percolation Report Required. ❑ Yes Special Feasibility Boring Report Required. ❑ Yes Detailed Contour Plot Plans Required (1 to 5 ft interval) ❑ Yes C�' ,No Other ❑ Yes Staff Specialist lot Inspection Required ❑ Yes No lot inspection Date Soils boring report by Project Date /,, Soils Map Page Soil Type Approved �✓� Date y - . , U No. of Syslems Type System(.) ❑ding Tank ❑ Existing No. Dwelling Units f 1 Bedrooms, . (1) Septic Tank Soil Rate _ rease/Send G Inlcp O�t O Replacement 3 /,9 4,1 <h . 1;14Y �1 f (! v v / /sr F G� Gal W -(2j Lech Line Sq. Ft. 9ottorn french area Sidewall allowance R fL Instal ve - _ Line(s) It. long R wide with -Leach Bed sq. ft. ��ktol:.rea rock/ sq. per running ft min. inches ��ebw drahilines w -�,,,�M If "x'►.,,,,,,, K �Leachlines/bed special design for slope: (3) Pit Diameter No. Pits Pit Below Seepage � Depth Applicable f �/I aa*" e6 / Inlet(BI) l Max. All 1� Depth N/A i" Overburden factor T No. 2 System IV14 REMARKS: � � i/3---C-�%,c: J../f .t /1 �-7'^x.._ I/r��/ A✓r�,��',i-�1-c..,r�,.. mit ���) �o 4_d_-,_ _ ,F ! t �. !�T �!✓ . ,�' -, 7t ilf G+' ' C � lCw� r / .✓ .2 r �n c This application 'st APPROVEu/yENIED for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated on the accompan tot -p n, using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the 0 above -designed system. No construction is permitted in the required reserved 100% expansion area. � H- 1) Septic tank and sewer lines must be 50' minimum from anyw ells /0 Y_ Leach lines must be 100' minimum from any wells, including expansionjarea � c 3 Seepage pits must be 150' minimum from any wells, including, expansion aread U) % tok _Si nature of Health Official't�ciiti Lug RECEIPT NO. ` Issued By 5k Q e DISTRICT: ❑ Riverside, ❑-Indio❑ Hemet q Perris ❑ Rancho Calif. ❑ Blythe DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records L z �� �eaarr.a: •)"t � 4-W \►'v, lei UNFE UEVELOPUR' S IWIE r 1\UUIIESS i Of I III of E. LEON SVAUGY AGRI :UL i URAL CO;MMISSIONLit )AMES o U:ALIACE WE1611I'S b. MEASURES CLEMEyi 9ENVENISiE SLAM 49-613 Ilwy 06, 9111te II -12 'Concl►e) ln, CA 92236 619-341-OZ91 C11SC IIU. TELU1110M 1.061-- 2-5 -�31 K 1-7n Dear Developers Uter reviewing your landsctil hig plans, till 111tint material listed is not iii violative of quarantine laws tjoveming the Coachella Valley. if substitutlons do occur rind they dliter [rein plait nriterial llsted, this of -lice iirusl be mulled hin ed-latelt'. '1'hwk you Lor puutecting and pleserving' tate Coachella Valley's pest -tree enviroteinnt. -- Auri -� I- -- — Agr culC'aIII veer s UL E ice ccl Indio and Riverside (A-0ce