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04641 (SFD)& Classif. ..• Arch., Engr.;' •, Designer LIc. # r Sq. Ft. ,No. No. Dw. , Size J1.533 - Stories Units " New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address t Tel. All �3 i•, ' City Zip _+ Lic. # '. 6, ' s i I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Divisionof the Business and Professions Code, and my license is in full force and ' Building'^ .3 effect. , t K - P.O. BOX 1504 ..s - 78-105CALLE ESTADO • • - Address Estimated Valuation yq� h $8 d.230 reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a LA QUINTA, CALIFORNIA 92253 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 Owner_ 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 f a ;;• subjects the applicant to a civil penalty of not more than five hundred dollars (8500). -owner , Plan Chk. Bal.: - y 84 ;. 34,. BUILDING: TYPE CONST. OCC, GRP. Mailing Address. , 52-42.5 Villa . ; - 173"213-01C Mech. • ` -16.00_ 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 � • w w y A.P. •Number- • Cit Y '" Plumbing ' ' 10.5 ..'00 •f,,,,,.. struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law ' does not to owner of who builds or improves thereon, and who contracts for Zip •' apply an property such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Tel. , to : nta Driveway Enc. .0.00. - " '92253 Infrastructure ���"-2714 �k Legal Description _ _ �,. _ Y:••• WORKERS' COMPENSATION DECLARATION, Contractor ,. 1{Ji�.�tlt I hereby affirm that I have a certificate of consent to self -insure, or a certificate of 1 Project Description . Address Policy No. Company " t - - TOTAL 02#90,33 E r rd.a, - •City- REMARKS WORKERS' COMPENSATION INSURANCE . Tel. (This section need not be completed if the.permit is for one hundred dollars ($100; valuation G, •'� or less.) . Zip. t State Lica - Laws of California. + Date- Owner ' ' NOTICE,TO APPLICANT: If, aftermaking this "Certificate of 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 `a ��. ?-a �._ • . x ys 1tt zieti ,?j.pt City & Classif. ..• Arch., Engr.;' •, Designer LIc. # r Sq. Ft. ,No. No. Dw. , Size J1.533 - Stories Units " New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address t Tel. City Zip State _+ Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Divisionof the Business and Professions Code, and my license is in full force and ' .3 effect. , ( SIGNATURE - - DATE- • • - ;• OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation yq� h $8 d.230 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 file 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) of - - - Division 3 of the Business and Professions Code, or thathe is exempt therefrom, and the basis 'Dep. - ' for,the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit Plan Chk: - G: J• V subjects the applicant to a civil penalty of not more than five hundred dollars (8500). -owner , Plan Chk. Bal.: - y 84 ;. 34,. ❑ I, as 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. •391 00'. 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. • ` -16.00_ 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 . 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 ' ' 10.5 ..'00 •f,,,,,.. struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law ' does not to owner of who builds or improves thereon, and who contracts for _ - - - S.M.L. apply an property such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) .5...99' Grading 2.0.00 ❑ 1 am exempt under Sec. B. & P.C. for this reason Driveway Enc. .0.00. Date k7.I.^Alrf owner rI"" Infrastructure 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 " t ❑ Copy is filed with the city.. O Certified copy is hereby furnished. TOTAL 02#90,33 E r rd.a, 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 t employ any person in any manner so as to become subject to the Workers' Compensation - Laws of California. + Date- Owner ' ' NOTICE,TO APPLICANT: If, aftermaking this "Certificate of 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 `a ��. ?-a �._ • . x ys 1tt zieti ,?j.pt Front Setback from Center LI_ntd ' Rea�,Si4tback;from Rear Prop Line I• CONSTRUCTION LEN DING AGENCY`. i r 4reby'affirm Side Street Setback from Center Line that there is a'construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code) - + x - • . • -"Side SetbaCk from Property Line ' 7 Lender's Name s' , • i rt ^ , fi : " Lender's Address FINAL DATE INSPECTOR 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 y „r, t t• + j. di , • : certify that 1. have.read. this application and state that the above information•is correct. ISSUed by. Date Permit + I agree to comply with all city and county ordinances and state jaws relating to building •'construction, and hereby authorize representatives of Ahis city to enter the above- mentioned property.for inspection purposes.f rt' , * Validated by: Signature of applicant z~' t Date M t t• t 5 ' ^ ; ,Mailing Addres _ alidation: Validation:- City, City, State,.Dp i' s y WHITE FINANCE PINK APPLICANT GREEN BUILDING, GOLDENROD - ASSESSORS OFFICE HARD COPY FILE - i � �. i. ,d.,• ae.t -.. a s..:1=••rt J,. ,..�...... _3�4. `r`iJ-�i. ,.. >..t, .+a..l't.r .:�.:._. u.'z-.. .'�s. 'F` ••,. "3� .f.o-_..W..., •.ti',i.: 5+: s:.S+_,.,, ':.h`n . -'!. _ al .�tl�<. iY.. i b„Y � .. 'ry. - CONSTRUCTION ESTIMATL NO. ELECTRICAL FEES NO. PLUMBING FEES s IS7 FL SO FT W $ UNITS P/IVSLAB GRADED% y — ROUGH PLUMB BONDING YARD SPKLR SYSTEM 2ND FL SO FT. a FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR SQ FT, at GAS (ROUGH) METER LOOP GARSO. FT. POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. I SO FT. i Desert Sands Unified School District NOTICE: p CERTIFICATION OF.PAYMENT OF NOTICE: THIS�6d����S4�i00�F�CFi�. t�rtY�FEES i(ll.I R, BE DUPLICATED. TO: City of La Quinta DATE:. Department of Community Development 78-105 Calle Estado La Quinta,.CA 92253 This is tonnc,��e,Ar�_,tif tha (Y' C � developer of '� Vvc which is located at _— GLL % within this. District, has paid school facility fees imposed pu suant to the autho enerat d by Government ode S ction 53080 in the amoun of _1 covering a total of are feet of( ) residen •al or ( ) industrial/commercial development and that buil ing permits for this footage in this development may now be issued by your jurisdiction. `Lb! for DESERT SANDS • D , &lh'iq 0 UNIFIED SCHOOL, DISTRICT C Wh) Ouilding ite Department • Yellow -Facilities Planning • Pink - Accounting • Gold - Developer 0 007 t +41 t �i"r t; �:'?`•r�'!. +,...,yA;, f t '� 4iy�Y5.r'SFai .'J.. s ^F f �i1� 5 5 5 . i COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH Assessors Parcel No. . ENVIRONMENTAL HEALTH.SERVICES : -PERMIT APPLICATION FOR A SUBSURFACE,SEWAC E DISPOSAL SYSTEM s " 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 mt.st be made payable to the County of Riverside. Approval of this application shall remain valid for a period not to exceed one year fron date of approval. VERIFY ITEMS IN SECTION A FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATi.ON LOG' # : ` t.Agent Contractor, ntact Person Phone Address & Phone Owner'" _• . . ,, , Phone 6 y 27/, Mailing Add ss �. a - `l/a-, av-11, - City State Zip'Job Property Address ` Legal Description Prop. (PM T ct t� ( IT' u; . . c(�- U!/I Aur Lot. Size' afar Agenc /lhW Use of",,r�mR P/P, CU, etc. 4.� 6) V/ ✓T9 Othe w Dwelli H Sit( a Prep, etc. Signature of Applicant Date 'CATEGORY: REV CODE FEE CATEGORY: REV CODE FEE . SUBSURFACE DISPOSAL 1238 5.OQ . 11 ❑ SITE EVALUATION UPON REQUEST 7349 $42.00 ❑ `. MULTIPLE PARCELS WITHIN SAME (NO PLOT PLAN) LAND DIVISION ❑ SEWER/SEPTIC VERIFICATION 7348 $11.00 a.'' 1st.4 Parcels (Each) 1238 $45.00 (Less than 1 year) b. Each Parcel after 4 7344 $16.00 ❑ PRELIMINARY ELECTIVE 7352 $45.00 :.0 Rereview (2nd review same parcel) 7344 $16.00 EVALUATION (Attach DOH SAN 53) ❑ Site Evaluation in Conjunction with ❑ HOLDING TANK 7351 $45.00 Critical Area 7346 $86.00 ❑ ALTERNATIVE/EXPERIMENTAL 7345 $132.00 ❑ Site Evaluation Lot Less than SYSTEM 10;000 Sq. Ft. 7347 $86.00 r NO l��� — (DATE L Holding Tank Agreements Completed ❑ Yes 0- Certification of Existing S.D. System Required ❑ Yes ' 0;'No WQCB Clearance required. (Attach Form ❑ Yes Q" No DOH SAN 007, Santa Ana Region Only) Soils Percolation Report Required. ❑ Yes ®No' Special Feasibility Boring Report Required. ❑ Yes Detailed Contour Plot Plans Required (1 to 5 ft. interval) ❑ Yes P../ VN' ) Other- ❑ Yes Staff Specialist Lot Inspection Required ❑ Yes m No Lot Inspeti�tion Date Soils boring report by' # Date /)Project Soils, Page Soil Type ` �"�"� n p� .Map Approved by Date No: of Systems ype of System(s) No. Dwelling Units (1) (1) Septic Tank Soil Rate Grease/Sand ❑6lding Tank ❑ Existing Bedrooms, Fixture Units Grease Intcp New ❑Replacement 3 //,,Q�,,,�� T �� +� Gal Gal (2) Leach Line Sq. Ft Sidewall allowance Install s Line(s) ft long ft wide with Leach Bed sq. ft BoIbmarench area i ft rock/ sq. fL min. inches beb� rainlines a ofibotto area per running ft ®I -NA �1 Leachlines/bed special design for slope: (3) Pit Diameter No. Pits Pit Below Seepage Pit otal Depth Other. Applicable fops, 7 Inlet (BI) ./ } . N/A Overburden factor 6 J Ll Max. All gvyabig Depth' ; No. 2 System/A n= .,REMARKS: 4" This application iso PPROVED.DENIED•for the category checked in SECTION.B above, regarding the design of a:subsurface disposal system as indicated .on the . accompanie pot plan, using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the , above -designed system. No construction is permitted in the required reserved 100% expansion area. '¢ i) Septic tank and sewer lines must be 50' minimum from any wellscy /0 c Leach lines must be 100' minimum from any wells, including expansio ar a �+ 3) Seepage pits must be150' minimum from aqy wells, including expansion re nature of Health Official .RECEIPT NO. 7 �SO Issued By>� Data DISTRICT: ❑ Riverside, P Indio ❑ ! Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe JF DOH. SAN,122 (Rev. 5/88) DISTRIBUTION: WHITE Office file YELLOW -Applicant • PINK Bldg. Dept.GOLDENROD Plans/Records