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13-1517 (PLBG)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 13-00001517 Property Address: 78450 CALLE FELIPE APN: 646-192-017- - Application description: PLUMBING Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 6500 T4t!t 4 4 a" Applicant: Architect or Engineer: lie ------------------ LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of thesiness and Professionals Code, and my License is in full force and effect. Licen lass: C21 C42 Lc iseN 2180 ' Date• C AD I 3Contractor: • �. t..r NER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I a exempt from the Contractor's State License Law for the following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she 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).: 1 _ 1 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, Business and Professions Code: The' Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the 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 or she did not build or improve for the purpose of sale.). (_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_) I am exempt under Sec. , BAP.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: _ Lender's Address: LQPERMIT VOICE (760) 777-7012 li FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/02/13 Owner: WALKER WADE HAMPTON & JEAN 78450 CALLE FELIPE LA QUINTA, CA 92253 ( a Contractor: ALMS UNDERGROUND CO T INDFIC 38703 VISTA DRIVE CATHEDRAL CITY, CA 9 23 (;� 130 �P�• (760) 324-1911 Fj�ANC�� Lic. No.: 482180 ----------------------------------------------- WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is itssued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier BARRET BUS SRVC Policy Number 224'6 1 certify that, in the performance of the 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, and agree that, if hould become subject to the worker 'compensation provisions of Section . / 3700 of the Lab C e, I shall fort ith compl it ose provisions. Date) Qcto►3 Applicant: WARNING: FAILURE TO SECURE WORKER OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE ALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1 . Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. 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 buil In construction, and hereby authorize presentatives of itis county to enter u [he above-mentioned prope o spec[ion purposes. DDate:Z W signature (Applicant or Agent): K r Application Number . . . . . 13-00001517 Permit . . . PLUMBING 2013 Additional desc . Permit Fee . . . . 11.92 Plan Check Fee .00 Issue Date Valuation . . . . 0 Expiration Date 5/31/14 Qty Unit Charge Per -- Extension 1.00 11.9200 EA PLBG SEPTIC SYSTEM 11.92 -----------------------------------------------------------7---------------- Special Notes and Comments INSTALL 6FT.X16FT. SEEPAGE PIT PER v APPROVED COUNTY OF RIVERSIDE DEPARTMENT OF ENVIRONMENTAL HEALTH PLAN/PERMIT (ATTACHED). 2010 CALIFORNIA BUILDING CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 PERMIT ISSUANCE M/P/E 90.57 PLAN CHECK, PLUMBING 4.77 Fee summary Charged Paid Credited ------------------------------ Due. --------------------------- Permit Fee Total 11.92 .00 .00 11.92 Plan Check Total .00 .00 .00 .00 Other Fee Total 96.34 .00 .00 96.34 Grand Total 108.26 .00 .00 108.26 LQPERMIT Bin # City of La Q uin to Building 8r SafetyDivision P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: -7131150 all -r— r2 �. Owner's Name: a A. P. Number: Address: 781 c Legal Description: City, ST, Zip: L Contractor: ++ s e tti L CO � St' Telephone: <;<:x.:•.�. ;:..;:,<.,.}s Address: 38 7Q 3 L/,, s r Project Description: escron: �nll City, ST, Zip: C�Ce jf-t l Cl Z\ �i .. `-i 2,2- 3 q Telephone: Z _ -3// }:}: .;: ;'z:^ %'` y<:::.... State Lic. # : t 2 u City Lic. #•: 76 9 Arch., Engr., Designer: Address: City, ST, Zip: Telephone: <t>`::>;:;;;:}<:;:.;:::;:;;;; <:; ::};ry:<.}.,::.:: y: }::}'lyy:;lr+:i �'•i:4:ii:;Ly%nYiJ�4 :. Co nstiuction Type: Occupancy: State Lic. #: Project type circle one): New Add'n Alter Repair Demo Name of Contact Person: ) oz1 1 ,,, .5 Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: J�C-DD APPLICANT: DO NOT WRITE BELOW THIS LINE ii Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 14 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 21d Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review, ready for correctionsfissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees ALMS UNDERGROUND CONSTRUCTION, INC. 38703 VISTA DRIVE CATHEDRAL CITY, CA. 92234 Ca. Lic. 482180 A1msUnderground(igmail.com 760 -324 -1911 -Phone; 760-578-1510 Cell; 760 -324 -9541 -Fa' x -70 q�-O 4�f;U"' f QWJ.- �l 12/ CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION DAT E�Z Z ?7 BY � Propvse� loo, THIS APPROVAL GRANTED BY THE DEPARTMENT OF ENVIRONMENTAL HEALTH !s VALID FOR ONE (1) YEAR FROM DATE . -OF APPROVAL. COUNTY OF RIVERSIDE • COMMUNITY HEALTH AGENCY DEPARTMENT OF ENVIRONMENTAL HEALTH - - TIZt Lot N APN: ESSORR'S A CEL NUI G- / �'� �/ LAND USE APPLICATION ,7r/y� -#.5�7 - ON# IN# LMS# EHS # `SECTIOWA4 ': i �, a ^tc4' c. .s. 1�`- ,� ,:i��. ti� - -ryr , �,; s �. .... •h °. r rt '�' 1 _ r w:, ` a L.� _ay,?ifv i4»-. ,! r i _�.:..,`.'" _ •^ �( TCITY AGENT, CONTRACTOR. ADDRESS TELEPHONE # At,, 5 Undes" r-,N,1J 3-(o03 V;,`�a �r, 32 y ._ /9'l/ OWNER ADDRESS — / CITY Fe TELEPHONE # .7cazt� ,.ltUo..l1 Gr 791-/.S Caitc 1' JOB PROPERTY ADDRESS CITY Thomas Brothers © Map # 7ggs0 etre Wil; fie LOT SIZE WATERAGENCY/WELL USE OF PERMIT C vw� �'_S.ECTIOW'131 k * FINANCIAL RESPONSIBILITY NOTE: Pertaining to Deposit -Based fee Payments - Fees placed on deposit are intended to pay for System review including approval and installation. The project owner or applicant named in Section B will be subject to billing requests for additional monies should fees deposited to that point be insufficient. At final approval, the project owner or applicant named will receive a final statement and notice of any final fees due or refunds due (as applicable). ROP. Fees: For Alternate Systems, renewable operating permit (ROP) fees will be due upon finalization of the project. ROP fees will be issued to the project owner or applicant named in Section B. SEND ALL BILLING MATTERS TO THE CLIENT OR ENTITY LISTED BELOW: RESPONSIBLE CLIENT/ ENTITY NAME ltr< Upidergv'otA `ci L-orJ . MAILING ADDRESS CITY/STATE ZIP TELEPHONE # / 3f'7 03 U. <�a. r Ca. 0.��a1 C AT4 5 2-2-,3y 3 Zly / l !'cant Signae: aie: Below — For Office Use Only SECTIONfC,,f-=�t, ;:rti p CHECK BOX IF REQUIRED If any box is checked„this application shall be considered rejected until the information is provided and the fees paid. Re -submittals later than 90 days after date noted below may require repayment of fees. ❑ Holding Tank Agreements Required ❑ Floor Plan and/or Plumbing Layout Required ❑ Certificate of Existing OWTS Required ❑ Special Feasibility Boring Report Required ❑ WQCB Clearance Required ❑ Detailed Contour Plot Plan Required (1 to 5 foot intervals) ❑ Soils Percolation Report Required PRE SITE INSPECTION REMARKS INITIALS & DATES SECTION D-.- * Soils Percolation/Boring report byF Project # Date Type of System: ❑ New ❑ Replacement ❑ Existing # Fixture units Septic tank Cap. / Soilate, f Ad ❑ Pump d[]Connect ❑ ATU Connect to Sewer # Bdrmsp� Sq. Ft. Bottom Area Total Linear Ft. 1; Sidewall allowance ft Rock/ sq ft runnirigioot=5..f'2 9`8 130131a #14f3l611 4.'-'24 'S wr°IKNGt; Tested Depth Maximum Trench Depth ,,, 772210 $1 Install Lines ft.long ft wide with min. inches rock below drain line, or ❑ Plastic Chamb Cs •-"_,-A —`,• i:2 . T Leach Lines/bedspecial design for slope Applicable ❑ N/A ❑ CHECK $Overburden Factor: 6 •-• Pit Diameter i No. Pits ' Pit below Injpy(Bl�- Pit Totalepth LNOAllowable Depth ' e. Well Review Approved by: (Signature) CONSTRUCTION / INSTALLATION% w / INITIAL DATES NJ o” ' d 7kk ♦ V l� NO ! • 'I , i"� d &•.- F- C, YY iSECTION'E�:�•"� n :ry ,.;,�as4_.s..i -: .. ;��°G" :'• � �`: ".^r .; , :ix �.�i°'<<}'r��. _ „ a,, �.� � ,.�?. This Application is'V pproved ❑ Denied regarding the/design of the OWTS as indicated on the accomaa ied plot plan using the requirements set forth in Section D above. A building permit is necessary for the construction of the above designed system. No construction is permitted in the required reserved 100% Expansion area. (1) Septic tank must be 100' minimum from any wells. (2) Leach lines must be 100' minimum from any wells including expansion area. (3) Sewer lines must be 50' minimum from any wells. (4) Seepage pits must.be 150' minimum from any wells including expansion areas. f EHS Signature: /X� Date: Environmental Resources Management Office Locations Environmental Health - ERM Division Environmental Health - ERM Division Riverside Permit Assistance Center Palm Desert Permit Assistance Center 4080 Lemon Street, 2ntl Floor 38686 EI Cerrito Road Riverside, CA 92501 Palm Desert, CA 92211 RIVERSIDE 951 955-8980 PALM DESERT 760 393-3390 DEH -SAN -122 Rev: 1/09 • • Distribution: WHITE — Office File: YELLOW — ADolicant: PINK — Bldo. Deot.: GOLDENROD — Plans/Record: e County of Riverside Community Health Agency Department of Environmental Health 4080 Lemon Street, 2nd Floor P.O. Box 1206 Riverside, CA 92502 (951) 955-8980 1, Certification of Existing Subsurface Sewage Disposal System-. Date of Inspection: 255 Ahv. ZpO I 78y50 Ca He Ge' Ii'oc Lok (2), +a- Wodk,cr (Property Address) _ (Owner's Name) (Legal Description and APN) FAILURE TO PROVIDE ALL REQUIRED INFORMATION SHALL PREVENT OWNER FROM OBTAINING ENVIRONMENTAL HEALTH SERVICES APPROVAL. 2. Show design and location on, a scale of 1" = 10' to 1" = 40' of the sewage disposal system and 100% expansion area in relation to attached dwellings, structures, wells, rocks, watercourses, etc. on required plot plan. 3. a. I examined the existing subsurface sewage disposal system at the above location on (dace) 2.5' rN o V. x D 13 date and determined that the septic tank capacity is o. ; t,;', ;) gallons and that there is -- sq. ft. of leachline bottom area: There are 7 bedrooms in the dwelling. There are fixture units. b. There are leachline(s), each ft. long. c. There are plastic chamber(s), each ft. long. d. There are seepage pit(s), each F4 in diameter, /-4/ ft. deep. e. The leach bed is ft. by ft., total sq. ft. of leachbed area. 4, a. Construction of septic tank (please check one of the following): concrete ❑ fiberglass ❑ steel ❑ other: b. internal dimensions of septic (length ft., width_, depth ft.) c. Condition of tank (please answer yes or no for each question): Yes No Inlet Tee present? ❑ ❑ Outlet Tee present? ❑ ❑ Two compartments? ❑ ❑ Tank structure deteriorated?* ❑ ❑ *If yes; briefly explain and indicate appropriate correction suggested: d. Condition. of D -Box (if needed) Level ❑ Yes ❑ No replaced ❑ Yes ❑ No full of septic effluent ❑ Yes ❑ No 5, a. While pumping the tank, did effluent flow back into tank from the absorption system? aYes ❑ No b. Prior to pumping,.was the liquid level in the tank abpve the outlet tee?. (Yes ❑ No c. Was the area around the lids oxidized? ❑ Yes 0 No d. Is design of system gravity feed? Uj- Yes ❑ No e. Were wells) observed on this or adjacent property? ❑ Yes 2/No If yes, indicate distance of well from: Septic Tank ft. Leachlines / ft. Seepage Pits ft. f. Distance from springs, lakes Septic Tank ft. and natural drainage courses: Leachlines ft. (circle appropriate item) _ Seepage Pits ft. g. Sewer is within 200 ft. of system and abuts property line. /❑ Yes No ADDITIONAL COMMENTS: h. How long has dwelling been vacant? (if applicable) months weeks N/A (9 6a. ❑ It is my opinion that the system appears to be in good working order and can be expected to function properly with proper maintenance. No repairs are necessary at this time. 6b.ris my opinion that the system is not in good working order and will not function properly without the following repairs: r .. . I - ify under p nalty of pe rju ?t the foregoing is true and correct: Signature C-42 State License Number xplralion Date Print Name Name of Pumper Company and Receipt Number/Name of Company Holding C-42 License Address I Phone Number The Department$of Environmental Healt has evi �nred and approved this certification: r / / T invironmental Health Specialist Date btW, A'W;, 84-(Jev 6/04) Distribution: WHITE—Office; PINK—Contractor; YELLOW—Applicant