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06015 (SFD)t A Building Address 51-960ITerrers Hichac2 C. Read T4V1 4 4 a" P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Address 43576 Washington Sr. City Bermuda Dunes Zip 92201 1 Tel. owner/buil.dor City lZip State Lic. & Classif. b#448018 I City Lic. # Arch., Engr., Designer Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 70pp) of Division 3 of the Business and Professions Code, and my license is, in full force and effect. i / y 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, ager, kmrove, 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 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 app#=t to a civil penaltyof not more than five hundred dollars ($500). ❑ 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 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.) ❑ I, 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.) O 1 am exempt under Sec B. & P.C. for this reason Date Owner 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 ✓ O 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 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: n, 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 shalt 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.) Lenders Name Lender's Address 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 property for inspection purposes. Signature of applicant -Date- Mailing ateMailing Address City, State, zip No. 06015 BUILDING: TYPE CONST. OCC. GRP.- A.P. Number 773-173-811 Legal Description 'Project Description 15, 1). Sq. Ft. No. No. Dw. Size 1393 Stories 1 Units 1 New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ 1 Estimated Valuation 76.317.50 PERMIT AMOUNT Pian Chk. Dep. ' O0 Plan Chk. Bal. Const. 3 Mech. ' Electrical •�� Plumbing 172.3 S.M.I. '"y Grading Z0.03 Driveway Enc. ' 00 Infrastructure Y TOTAL REMARKS <..:�. a .R , x< , , „.•. �- .r„ :.ts. ,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 6-113-89 Issued by: Date Permit Validated Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING F€ES 1ST FL. SQ. FT. ® $ UNITS COLL. AREA &1 SLAB GRADE ROUGH PLUMB. YARD SPKLR SYSTEM 2ND FL. SQ. FT. HEATING (ROUGH) STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® DUCT WORK ROCK STORAGE GAR. SO. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) DRAINAGE PIPING CARP. SO. FT. ® GAS (FINAL) TEMP. POLE WALL SO. FT. DRINKING FOUNTAIN. SQ FT ® WATER HEATER URINAL ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation WATER SYSTEM FLOOR DRAIN MECHANICAL FEES GRADING cu. yd. $ plus x$ WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. f// 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11.4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/4c 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 171 STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR gv—SETBACK --/�_ GROUND 4U IN f^ UNDERGROUND A.C. UNIT COLL. AREA &1 SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR S ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) (/ / METER LOOP HEATING (FINAL) OTHER APPJEQUIP. 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. f// WOOFING. (/!/ I I9V As I0 (� REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL THING /� 5/�l7 MESH 0 ULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESlINITIALS GARDEN WALL FINAL:d 1 Desert Sands Unified School District CERTIFICATION OF PAYMENT OF SCHOOL FACILITY FEES NOTICE: THIS DOCUMENT CANNOT T0: City ofLaQu $ROCATED, Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 DATE: This is to ertify tha 14 , developer of which is located at WhA PA A within this District, has paid school facility fees imposed pursuant to the au orit}t, generate vernment Code ectio 530DO in the amou t ofd) p�'l�UZ7 55 , // covering a o al of G% square feet of (Y) resi ential or ( ) industrial/commercial development and that building permits for this footage in this development may now be issued by your jurisdiction. ILA L) for DESERT SAN S•UNIFIED SCHOOL DISTRICT White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer (10)-37 i RECEIPT NO. 15r3/ Issued By Date _57- o;;7 3 —00,F DISTRICT: ❑ Riverside, Q, ndio ❑ Hemet q Perris ❑ Rancho Calif. ❑ Blythe DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records MA COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH AssafO1° Parcel NO' ENVIRONMENTAL HEALTH SERVICES PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM y Applicant: Submit this form with four copies of a scaled plot pian (1-20 scale) drawn to County speci�lafr 'is indicated on the attached check list. G A non-refundable filing fee (see below) is required when the application Is submitted. Check must be made payable to the Cbunty of Riverside. Approval of this application shall remain valid for a period not to exceed'one year from date of approval. a Q ZI .t VERIFY ITEMS IN SECTION A FROM BUILDING Q SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG'tx A O Agent, Contractor, Contarson Phone Address 8 Phone ��� Phone � Mani �Addresa r ��... city State Zip Job Property Address escripf Prop. (PM, Tract, Lot) � c� r c.',� 27� 1 / , 1� 1 Lot Size ter A nc 1 Use of Permit P/P, CU, etc. a Other / � X/ a � I .elliiig, IH c. ( SET V"1 ' sig <Applicant - Date CATEGORY: REV CODE CATEGORY: REV CODE FEE 110 SUBSURFACE DISPOSAL 1238 $45.00 ❑ SITE EVALUATION UPON REOUEST 7349 $42.00 ❑ MULTIPLE PARCELS WITHIN SAME (NO PLOT PLAN) m Z LAND DIVISION ❑ SEWER/SEPTIC VERIFICATION 7348 $11.00 O a. 1 st 4 Parcels (Each) 1238 $45.00 (Less than 1 year) f` b. Each Parcel after 4 7344 $16.00 ❑ PRELIMINARY ELECTIVE 7352 $45.00 LU ❑' Rereview (2nd review same parcel) 7344 $16.00 EVALUATION (Attach DOH SAN 53) U) is O� Site Evaluation In Conjunction with t ❑ HOLDING TANK 7351 $45.00 Critical Area 7346 $86.00 ❑ ALTERNATIVE/EXPERIMENTAL 7345 $13200 ❑ Site Evaluation Lot Less than SYSTEM 101000 Sq. Ft. 7347 $86.00 NITIA DATE Holding Tank Agreements Completed ❑ Yes BgN2- 3 — Certification of Existing S.D. System Required ❑ Yes 0 No WQCB Clearanoe required. (Attach Form ❑ Yes 1744o DOH SAN 007, Santa Ana Region Only) Soils Percolation Report Required. ❑ Yes G) No Special Feasibility Boring Report Required. ❑ Yes Detailed Contour Plot Plans Required (1 to 5 ft, Interval) ❑ Yes � I Other ❑Yes Staff Specialist Lot Inspection Required 11 Yes fYNo Lot]LDate Sills boring report by l� Data �-- Soils Map Page r I Soil Type Approved by ''C.C/�.-- Data 3 r r U No. of System �{ Tyle of Systeme) ❑�I Olding Tenk ❑Existing No. Dwelling Units BedroomstmertlnNs (1) Septic Tank Soil RateGresse/Send (f �/p old) Inicp O f J_ m J New O Reptaoeer►t 1341hQ�'y � �Gaf Gal U 12) Leach Line Sq. Ft Sidewall allowance Install une(s) R long _fit wide with Leach Bed sq. It. trench arm ft rook/ sq. It. min. Diib>rod{4bebw drafnlines or ofbal area per running iL NA —� Leachlinea/bed special design for slope: (3) Pit Diameter No. Pita PR Below Seepage Pit TC0 Depth Otfrer. Q<a Apple / L�7 6 Inlet (BI)/ N a Max. Allow le�Depth N/A te�_ O.burn factor NO.2 System A114 D ��p�• REMARKS: This application ' PPROVE ENIED for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated on the accompariied p using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the Z above -designed system. No construction is permitted in the required reserved 100% expansion area. WLeach Septic tank and sewer lines must be 50' minimum from any wells L1 f O i (P,, 1,,,_a,,,, e� lines must be 100' minimum from any wells, including expansion 16a eo 4 1 e.J_t, � t, Seepage pits must�/be 150' minimum from any wells,,, including expansion area � to ,(¢ /�.k,_ ' V •� uL � �. e p i_ MVV � r Si nature of Health Offician; "''• L L /f'J 0 KC ,6, 4 Date RECEIPT NO. 15r3/ Issued By Date _57- o;;7 3 —00,F DISTRICT: ❑ Riverside, Q, ndio ❑ Hemet q Perris ❑ Rancho Calif. ❑ Blythe DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records MA Buena Engineers, Inc. - ~� 79-811 Country Club Drive, Suite 4 Bermuda Dunes, CA 92201 • (619) 345-1588 / 328-9131 Client Name Client Client Phone DATE AUG . t4 $9 JOB NO. 6-7 � (62G 1 PROJECT s1 A LOCATION / CONTRACTOR tA • 4 -FAT::) OWNER WEATHER C-�r—AIiZ7– TEMP. oat AM 0 a PM PRESENT AT SITE OPTIMUM MOISTURE CONTENT % N2� i ST I �'3 TEST NUMBER TEST LOCATION ' LOT NO. ELEVATION FIELD TESTING REFERENCE CURVE MOISTURE CONTENT % DRY DENSITY lbs./Cu. ft. MAXIMUM DRY DENSITY % MAXIMUM DRY DENSITY lbs./cu. ft. OPTIMUM MOISTURE CONTENT % N2� i ST I �'3 10-L1 (0-7. PF- I t . < (C8 r REMARKS: MT=- A -et -A . AS.SUM 10 F c2� E U t UUS *TE Ran( 7"9-GTC�E-E i E S f -t- c Q U 1 t2C M i A -j TS FIELD REPORT TECHNICIANS SIGNATURE. %n'.'�.v..ir Lc� xs�l3:t.:L.`.'x..x'�'k�i4_X-i'•.v.,..y�>w... �.:.+4r,±d.a �� ,.:..>,E+o;.�Y.��1- j {�.� R;#�u:�.r,�6:, �-.y-�w��v ���^ r"� .- `� '�Y'�r�'.t.-rs'Y-.:.,i�,r°w,..:w,.�y.,.r.^-y1rY,.r.,.;rrv�-�o�v-�"`s�-�✓• ) .. r• •w -v-.- � %---t,. .,. Buena Engineers, Inc. ~� 79-811 Country Club Drive, Suite 4 Bermuda Dunes, CA 92201 • (619) 345-1588 / 328-9131 Client Client Address Client Phone DATE 3bL`( Z 1 ►.qct JOB NO. (- 1 �>R P PROJECT ELEVATION LOCATION LA 0-,,j 1 tv`r-A CONTRACTOR MICt4AEL F+A1 OWNER WEATHER Cc : A IZ OPTIMUM MOISTURE CONTENT % TEMP. o at AM ° at PM PRESENT AT SITE 1 Z4 ani ICS,3 TEST NUMBER TEST LOCATION ) 000 --SE- PAC) LOT NO. ELEVATION FIELD TESTING REFERENCE CURVE MOISTURE CONTENT % DRY DENSITY lbs./Cu. ft. MAXIMUM DRY DENSITY % MAXIMUM DRY DENSITY Ibslcu.ft. OPTIMUM MOISTURE CONTENT % 1 PEE- PLAt.J 1 Z4 ani ICS,3 2 F R CO. -7 3 ,.. FP -,3 i 114.4 EKISTI IJG NOME St .. .�s : � .,.. .. - :.� .�-fix K =^� •-. a T - I 3 --..�:�,� �� ._.,.�_� _ _ .. .. _ _ V ACAnjT U �, a �5 •qhc�- ,�,: .�,. •(�. _ a rF_ �,T .Lac -�t-r o S - 2 VACANT . 4 C (-� L L. E OU A tJ C -,<p REMARKS: PE F-FC}� M E 3 �j ON) USF` PACS A -2E A, �jv F 1 LL. . PO'3J A 2F-1 UArL HEST AA L F CT- LCJT W A 6E t fJ C -r WAT-E [Z�E D. TESTS A SD z3 A'e1` LOCATT� C3J W'E�T �14CF . /ASS,U to (,\J & A M CT -F (20 F14%LE Tp M SET C> -r-:- NisIn 12E (2E tit E TEST COC Aa -F7 0-tJ CAST N A L E� Ae 1, SOME C.J'! 447f— U iZ \ L (Z AQ � FA lLt 7 E-T- SOIL- SUIL S A to P L E j'A V --E tJ P-crcz T -CE- s-" IV G . 6646 CLIENT REPRESENTATIVE SIGNATURE FIELD REPORT TECHNICIANS SIGNATURE