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003824 (SFD)A 44 P.O. BOX 1504 NO. 003824 Building 78-105 CALLE ESTADO Address 52-R35 villla LA QUINTA, CALIFORNIA 92253 Owner Coachella vallpv Ted CIOnrip-my Mailing Address 247 E. Tvahquitz Way 02 City Tel. _Wy zip ilm Springs I92262 "I Contractor Staler Construction C&mpan Address. Sam City . . .. . City Zip Tel: LICENSED CONTRACTOR'S DECLARATION V 1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7 ) tot Division 3 of the Business and Professions poge,"and my license is in full force and effect... State Lic. City & Classif.38179 14 Estimated Valuation Lic. # .895-- Arch.,-Engr., AMOUNT Designer Plan Chk.,'Dep.' Address 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 9 subjects the applicant to acivil penalty of not more than five hundred'dollars ($500): 0 1, as owner of the prope!ty, or my.employees with wages as their sole compensation, will Tel. BUILDING: -TYPE CONST. A.P. Number - - 773-333-018 Legal Description Project Description S.F.DA Sq- Ft. 1410 No. Size Stories No. Dw. Units Demolition 0 New 0 Add 0 Alter 0. - Repair 0 1701 of 61 HARD COPY 428-4 Garaos City . . .. . Zip I .. ­ State tic. # LICENSED CONTRACTOR'S DECLARATION V 1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7 ) tot Division 3 of the Business and Professions poge,"and my license is in full force and effect... SIGNATURE' DATE OWNER -BUILDER DECLARATION F hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,B.,usiness And. Professions Code: Any city or countywhich. requires a Estimated Valuation 17 S C; in 9; PERMIT AMOUNT ,6, 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, Chapter9. (commencing with -Section 7000) of Plan Chk.,'Dep.' 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 9 subjects the applicant to acivil penalty of not more than five hundred'dollars ($500): 0 1, as owner of the prope!ty, or my.employees with wages as their sole compensation, will Plan Chk. Bal. S 3 9 .114 Const. 364 .0.0 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 Mech. 31 An 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 Electrical 74 -17 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 or sale.) Plumbing 0 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 S. M. 1. such -projects with a contractors) licensed pursuant to the Contractor's License Law.) 0 1 am exempt under Sec. B. & P.C. for this reason Grading Driveway Enc. Date -Owner Infrastructure WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a bertificate'of consentAo self -insure; or*a certificate of Worker's Compensation Insurance, or a certified copy'the'reof. (Sec. 3800, Labor Code.) Policy No. Company ❑ Copy is filed.with the city. 0 Certified copy is heret�qiu6shed. TOTAL REMARKS CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE 4 (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 thp work for which this permit is issued, I shall not employ anypersonin-any manner so as to become subject to the Workers' Compensation Laws of California. DateOwner 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. ZONE: BY: Minimum Setback Distances: Front Setback from Center -Line —Rear Setback from. Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line hereby affimn that there is a construction lending agency for the performance'of the wci� for which this permit is issued. (Sec. 3097, Civil Code:) Side Setback from Property. Line Lender's Name Lender's Address FINAL DATE INSPECTOR 4/12/8-S 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. .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 prop . erty I . for inspection purposes. Issubd:by: Validated by: Date Permit Signature of applicant Date Mailing Address jValidation: City, State, Zip HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ 2ND FL. SO. FT. POR. SQ. FT. ® GAR. SO. FT. ® CARP. SQ. FT. WALL SO. 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 FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APP./EQUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE 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 FINAL INSP.9 P—si SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER VENTILATION GAS PIPING PERMIT FEE FIRE ZONE ROOFING 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 P MB UNDERGROUND A.C. UNIT COLL. AREA C SLAB GRADE / 6 ROUGH PLUM'BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER 0 E 1 ✓OUGH WIRING 7AL DUCT WORK ROCK STORAGE FOUND. REINF. S/b / O GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM i WATER SYSTEM - GRADING cu. yd. $ plus x$ -$ LUMBER GR. FINAL INSP.9 P—si FRAMING FINAL INSP. &ROOFING —�� O ]/ �^ �J UU v 612,,110 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING v % i L MESH INSULATION/SOUND / FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL �11��'u+^*r�r-'}�r�'�.,..•..4,1..,; � �'a�+� t�=� Vii' �„�; `1h12""' � .yr, x_ ^_'Yi f f+"'� �7�b'..�:�+"�+ �.� El Z O_ t— O W U) M Z O F_ U' W U) Z O U W U) COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION - � _ ^ 5 - O ( 3 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.) S _ e o Mailing Address Z 5�i .--i • f/t Le � T� (AU City State Zip Code • 26 z, Telephone 3z Z '/d a_® -Job Property Address 'City or. Community 'Legal Description of Property. (Lot. PM. TR) A 4Vu iN TA G © s" .C'L.e 'Assessor's Parcel No Water Agency or Well ce Use of Permit Planning Case N Lot Size �� _ z� _ ©'Q faJ ' oA�l�r�� K/ SFO. MH Site Preparation Etc. Sign j� Applicant '—T Date 'The above information must be verified from Building Application t/ STAFF USE — DO NOT WHITE BELOW THIS LINE Initial*,,', t Date leu C` Lt Certification of Existing S.D. System required ❑ Yes El No WOCB Clearance required. ❑ Yes D No Soils feasibility report required. ❑ Yes ❑ No Special feasibility boring report required. ❑ Yes ❑No Detailed contour plot plans required. ED Yes El No Staff Specialist approval required. ❑ Yes ❑ o Lot Inspection Date ( Soils/boring report by �� �'� t �Project # Date Soils Map Page Soil Type Approved by Date Type of System: No. of Bedrooms (1) Septic Tank Soil Rate Required ILI / ❑Existing New ❑Additional El Replacement "'�' �, W `s1 +�e.4. , k 000 Gals. (2) Leach line sq. ft. Sidewall allowance% Install—Line(s) Ft. Long, �L/each bed Sq. (Bottom trench area) ft. rock/ Sq. Ft. Ft. wide witIl min. inches '' Ft. of bottom per running ft. / ❑ 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 i ❑ 5' E-6' , , � Max. allowable depth N/A Overburden`i �vfactor 1i.'1�,i,�L�^�\ tij � �Jv / �� �� �J��t `► U,`LQ � ' W �'11,,� 1M �"'^�� ivV.�v � v(11)L �.1•' � � ,J,l � ..�+�'i.tSr.� � d,, \,��, . ��s��tr-,��„ drl- 2�( �-�.�. =.�,_ c�(,,�OV to wwts• ILC f• A- otS r This application is approved/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. f0)) Septic tank and sewer lines must be 50' from any wells (2) Leach lines must be 100' min. from any wells including expansion area ti 1 \��v , t(! \�r.*n Cu- �@�, �' Lut•,rV r. rpt �1 �3),? Seepage pits rriu`st• bebe t�n. from any wells including expansion area y l 1L - - \ x o,o� p� �l Signature of Heatlh Off�cral✓' Date RECEIPT NO. District: ❑ Riverside ® Indio Distribution: WHITE—Office file DOH SAN 122 (Rev 8187) Issued by Date k I ( I J ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File Of WE OF E. LEON SPAUGY VM . - �Q\ AGRICUL'I URAL COMMISSIONER co��s iq•EP JAMES 0 WALLACE AND V V A S;S iANT r9..-.1Icclo`EP. 2 WEIGHTS & MEASURES CLENIENT BENVE`IST E SEALER - 49-613 ,11wy 86, Sulte 11-12 Coachella, CA 92236 Mq y`9` 9� 619-342-8'L91 DATE . CASE NO. S .0 y 0,6 F DEVELOPER'S NAME:. AUDRZESS : y 7 TELEPI(ONE: Dear Developer: 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 Fran plant nviterial listed:, this office must be notified i nmedia tely . Thank you: for protecting ana preserving the Coachella -Valley's pest=free .environment: AgricUltufal Colmiissi ) is Office cc: Indio and Riverside Office