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003768 (SFD)Building Address Owner Mailing Address City Palm Contractor Starr Address City State Lic. & Classif. "Arch., Engr.; Designer Address 715 Diaz 4 P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 No. 003763 %_114 oA_311=A.,_+z """''" . X�AA ' `"" BUILDING: -TYPE CONST. OCC: GRP. 247 E. TaY quits WaY #2 .. A.P: Numbe_ r 774- 111- O22 Zip Tel. ping$ .. 92262 1 322_.1020 Legal Description .. Project Description Single Fami2)' welling Consy ` p -- I Tel.. 387934 # Tel. 49s -Sq. Ft. 141.0 ASize. City(Zip I State Lic. # LICENSED.CONTRACTOR'S DECLARATION,,, I hereby affirm that I am licensed under provisions of Chapter 9 (comencing with Section 7000) of Division 3 of the Business.and Profession's Code, and"mylicense,is in full force and effect. ,f. '0", SIGNATURE 'DATE rf OWNER -BUILDER DECLARATION Vhereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec., 703 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 rile a signed statement that he is licensed pursuant to e4 the provisions of the Contractor's License law, Chapter 9 (commencing with Section 7000) of 'Division 3 orfhe'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 '($500).' - O I, as owner of the property, or my employees with wages as their sole compensation, will _ do the work, and the structure is not intended or offered for sale, (Sec. 7044, Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who . No. Stnripc No. Dw. Units New ❑ Add O Alter O Repair ❑ Demolition ❑ 1709 9 of 61 wood x"mance 428' Garaae Estimated Valuation PERMIT AMOUNT - Plan Chk. Dep.. A250AD Plan Chk. Bal.." 39.14 Const. 364.00 builds or improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building Mech. 33 {}} or improvement is sold within one year of completion, the owner -builder will have the burden Electrical - -1% 74 of proving that he did not build or improve for the purpose of sale.) O I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 1055 Al struct the project. (Sec.. 7044, Business and Professions Code:. The Contractor's License Law does .not apply to an owner of property who builds or improves thereon; and who contracts for S.M,j, . 55 36 such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading _ ❑ I am exempt under Sec. 6. 8 P.C. for this reason. a0 Driveway Enc. 20.00- 0.Q0.DateOwner Date—Owner Infrastructures-$ $ WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of4consentt self -insure, or a certificate ofs:a- Worker's Compensation Insurance, or a certiffed•copy'lhere`of. (Sec. 3800, Labor Code:),Oec - - Policy No. Company£ » _ 1, O Copy is filed with the city. O.C�fiw(copy is hereby furni hs ed>,4 - .... TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) _ - I certify that in the performance of thg work for which this permit is issued, I shall not. i J' "�7—` C1 employ any person in any manner sous to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT: If, after making this Certificate or Exemption you should become ZONE: BY:. subject to' the' Workers' Compensation provisions of the Labor Code, you must - forthwith comply with such provisions or this permit shall be deemed revoked. ' - Minimum Setback Distances: ' Front Setback from Center Line CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated,'and is subject to expiration if work thereunder is suspended for 180 days. ' I certify that I have read this application. and, state that the above information is correct. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip HARD COPY Rear Setback from Rear Prop. Line Side Street Setback from Center Line ' Side Setback from Property Line FINAL.DATE INSPECTOR Issued by: Date4f 4!8$ Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. @ $ UNITS A.C. UNIT COLL. AREA SLAB GRADE /� v YARD SPKLR SYSTEM 2ND FL. SO. FT. HEATING (ROUGH) MOBILEHOME SVC. BAR SINK POR. SQ. FT. @ ROUGH WIRING GAR. SQ. FT. @ POWER OUTLET I ROOF DRAINS // FOUND. REINF.gl . v _/ C/ AS (ROUGH) DRAINAGE PIPING CAR P. SQ. FT. @ HEATING (FINAL) WALL 50. FT. REINF. STEEL DRINKING FOUNTAIN SQ. FT. @ URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation SERVICE FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER $ GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LUMBER GR. LAUNDRY TRAY AIR HANDLING UNIT CFM FRAMING S `, ` 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. SQ. FT. @ c BATH TUB FIRE ZONE ROOFING SQ. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID @ 1+/4 c SEWAGE DISPOSAL SPARK ARRESTOR SQ.FT.GAR @ 3/ac HOUSE SEWER GAR. FIREWALL GAS PIPING PERMIT FEE LATHING r k MESH 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 PLUM ING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE /� v OUGH PLUMBS BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER O EPTIC A ROUGH WIRING DUCT WORK ROCK STORAGE // FOUND. REINF.gl . v _/ C/ AS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. 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 S `, ` INAL INSP. ROOFING D• "" �� /�/�� I X REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACEili'7'+�V/�e� SPARK ARRESTOR GAR. FIREWALL LATHING r k MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT,•/ OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS, GARDEN WALL FINAL P.O. BOX 1504 APPLICATION ONLY Building�� 78-105 CALLE ESTADO Address �-� �� Z LA QUINTA, CALIFORNIA 92253. Owner /� 00,4fH�LLA V,4L 1_C- L 1 C9 BUILDING: TYPE CONST. OCC. GRP. Mailing _ `/ �/ Address C-,?, K7 L— r _RyurZ q�WA r �� 7 A.P. Number 7-t Z Z. 9(y ( Zipp Tel. /0& 7 Z2 ? � 2 -/;c� z4r) Legal Description 4a7- /O .419j!!5e/5PIt U.y 9 Contractor \ Px? Iroject Description S/OGLE Ffi < L y ,�iu9�LLi� IV 4,1J1dV '29 �•� sN. .Pick S Y' �. L � �3z z — /o z State Lic. City �T & Classif. 3 9'7 9 Lic. # 7 Arch., Engr., Designer Address Tel. City( Zip ( State I Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby aff rY m that I am licensed underzprovlsionpof Chapter 9 (commencing with Section ' 000) of Division 3 of the Business and;Professlogs Code, and:mwrcense is in full force and OWNER -BUILDER DECLARATION 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, 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 the provisions of the ,Contractor's License Law, Chapter 9 (commencing with Section 7000) of- Division f-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). 01, 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.) ❑ 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.) ' ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARAT ON I hereby affirm that I have a certificate of,consent—to s If -insure, or a certificate of Worker's Compensation Insurance, or a ceitifiedreo y'(hereof! Sec. 3800, Labor Code.) Policy No.Company ❑ Copy is filed with the city. ❑/D Ce Me copy< s hereby fumished. CERTIFfCI ATE 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 if work thereunder is suspended for 180 days. I car illy, 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 BUILDING DIVISION Sq. Ft. Size / NewK No. Stories No. Dw. Add ❑ Alter ❑ Repair ❑ -Demolition ❑ i2/4"G E stimated Valuation -� St So PERMIT AMOUNT Plan Chk.,Dep.' Z j (j , o 0 Plan Chk. Bal. Const. bL4 , p O Mech. "3` pQ Electrical Z Plumbing S.M.I. 5, 3 (o Grading p Driveway Enc. _0 v e Infrastructure Q �6 -7- o v 9..53 TOTAL -7 REMARKS Q"JU4 IV .Y9Y_- V.9-47'-00 x1:J J.V Vr7,?YY 1 IV YY'IL 1 iY J's N� 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:_ CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SQ. FT. FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SO. FT. ® GAS (ROUGH) METER LOOP GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. SO. FT. ® GROUT WATER HEATER WALL SO. FT. ® FINAL INSP. DRINKING FOUNTAIN SQ FT ® WATER SYSTEM URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM FIRE ZONE ROOFING 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. SQ. FT. ® c BATH TUB LATHING SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1Va 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 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./EQUIP. 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 SIGNATURESIINITIALS GARDEN WALL FINAL 0 z O U W C0 z O H U UJ U) U) Y cr Q W cr 5 z O 1-- C) U W U) WA 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) -rincJ Mailing Address �Z t!� Z+"7 21 City State Zip Codde+ Z G r Telephone 43.2 /n Z C> 'Job Property Address 'City or. Community 'Legal Description of Property (Lot. PM. TR) /9 s.3 7Z S7 \22442 4,,q QZ11xJ_r4 A67lo Av"'4 /9z 'Assessors Parcel No Water Agency or Well (?egr4Cup (1,411, y use of Permit Planning Case # Lot Size a-14 `SFD. MH Site Preparation Etc Signature o>f p nl Date *The from above information must be verified Building Application STAFF USE — DO NOT WRITE BELOW THIS LINE Initial Date 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 0 No Lot Inspection Date Soils/boring report by Project # Date Soils Map Page Soil Type %^ / Approved by F Date Type of System:��,// No. of Bedrooms (1) Septic Tank Soil Rate Required EJ Existing 52'New ❑ Additional ❑ Replacement -3 r..' ' , / > I ) Gals. S `6 (2) Leach line sq. ft. Sidewall allowance Install Line(s)—Ft. Long, Leach bed Sq. (Bottom trench area) ft. rock/ Sq. Ft. Ft. wide with min. inches Ft. of bottom per running ft. /'❑ N/A rock below dra lines area Leach lines/bed•special design for slope: (3) Pit Diameter No. Pits Pit BI Seepage Pit total depth '' Applicable factor El 5' (P 6' o ^� ` / �/ Max. allowable depth -" N A Overburden 1 i^ • y i .-syr' .' A I-V' - r� �f+\//Jp Al / z.• 0 . �+.. v t" .j d L r r J This application is a6prov5)denied for the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements set forth in Section B'above. A building permit is necessary for the installation of the above -designed system. (S1)) Septic tank and sewer lines must be 50' from any wells (2) Leach lines must be 100' min. from any wells including expansion area C(3) Seepage pits must be 150' minfrom any wells including expansion area - 2 9 Signature of Health Official Date RECEIPT NO._ `4 Issued by �- "r Date -7 4 3 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 8187) OI f ICE OF AGRICUL1 URAL COMMISSIONER AND WEIGHTS &. MEASURES 49-613 Ilwy 86, Suite 8-12 CoacheJ.la, CA 92236 619-342-8291 E. LEON SPAUGY CO'•1"Is'-10"En JAMES 0 WALLACE ASSIS;A`t rO!.1MISSIONEP CLEMENT BENVENISTE SEALEA DATE CASE NO. R e ff /i± S O 3 2 ye DEVELOPER'S NAME: ADDRESS: 9-Y % i - TELEPHONE: ( 91 7) Dear Developer: 3 22--/0 -2- 4 Q,AA�/ c,,f 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 frau plc -lit material listed, this office must be notified_ iian2diately. Thank you for protecting and preserving the Coachella Valley's pest -free envirorunent. Agricultural Calmis rer's UEfice cc: cc: Indio and Riverside office