04873 (SFD)0481M
P.O. BOX 1504
Building84-120 Vista Grande 78-105 CALLE ESTADO
erI,4r eLA QUINTA, CALIFORNIA 92253
Owner
Doff Howard
Mailing
Address 79—S t l Country
City . Zip
ermuda Dec 92201
Contractor
Onrokee Homes
Aaaress
Same as above
City Izip
,
ub
Tel.
34S -622S -
State Lic. I City
& Classif. 476007 Lic. #
Arch., Engr.,
Designer
Address Tel.
Zip State
[Lic. #
r .r
LICENSED CONTRACTOR'S DECLARATION 1
I hereby affirm that I am licensed under provisions oVChapter 9 (commencing with Section
7000) of Divislon'3 of the Business and Professlons•Code, and my license is in full force and
effect.
^r
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, after, 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, 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 or Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penalty of 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 notiintended 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.)
O 1, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractors 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; DECLARATION
I hereby affirm that I have a certificate of co sentJvto self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof`(Sec. 3800, Labor Code.)
Policy No. A Company
❑ Copy is filed with the city. O 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) valuafbn
or less.)
I 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.
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.
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number 617-191-006
Legal Description
Project Description
4' 7Lrtii. i -Y 1 i tv I !V_ A 0VJ.9 , r U
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
I hereby affirm that there is a construction lending agency for the performance of the
Sq. Ft. 1709 No.
Size Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Lender's Address
FINAL DATE
INSPECTOR
This is a building permit when properly filled out, signed and validated, and is subject to
1 1 9
expiration if work thereunder is suspended for 180 days.
iG /
I certify that I 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 laws relating to building
Estimated Valuation
$94r814
construction, and hereby authorize representatives -of this city to enter the above-
PERMIT
AMOUNT
Plan Chk. Dep.
S250.00
Signature of applicant Date
Plan Chk. Bal.
104;.93
Const.
.418.00
Mech.
36,00
Electrical
95.23
Plumbing
103.40
S. M.I.
6.62
Grading
20,.44
Driveway Enc.
20'.00
Infrastructure
2s095.07
Fr_— a—T0eL%
L, zard. Fee
TOTAL
$3,28,5,9r3
,,n"' 1 .
REMARKS
'au Z�'a_ ' VCP
4' 7Lrtii. i -Y 1 i tv I !V_ A 0VJ.9 , r U
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
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.)
Side Setback from Property Line,
Lender's Name -
Lender's Address
FINAL DATE
INSPECTOR
This is a building permit when properly filled out, signed and validated, and is subject to
1 1 9
expiration if work thereunder is suspended for 180 days.
iG /
I certify that I 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 laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-
mentioned property for inspection purposes.
Validated by:
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE
CONSTRUCTION ESTIMATL
NO. ELECTRICAL FEES
NO. PLUMBING FEES
M
IST FL SO FT (p S
UNITS
GH PLUMB BONDING
HEATING (ROUGH)
STORAGE TANK
YARD SPKLR SYSTEM
2ND FL SO FT. M
DUCT WORK
ROCK STORAGE
FOUND. REINF.
MOBILEHOME SVC.
BAR SINK
POR SO FTm
REINF. STEEL
GAS (FINAL) TEMP. POLE
GARSO. FT. Cl
POWER OUTLET
ROOF DRAINS
WATER HEATER SERVICE
FINAL INSP.
DRAINAGE PIPING
CAR P. I SO FT. @
WATER SYSTEM
GRADING
CU. yd.
$ plus xS
WALL SO. FT. Q
LUBER GR.
DRINKING FOUNTAIN
SO. FT. (B
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION S
WATER PIPING
NOTE Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTOXDISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM E.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE,TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. @ c
BATH TUB
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT. B.T.U.
SO. FT. RESID @ I'A c
SEWAGE DISPOSAL
SO.FT.GAR @ Ai:c
HOUSE SEWER
FENCE FINAL
GAS PIPING
PERMIT FEE
INSPECTOR'S SIGNATURESIINITIALS
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
ETBACK
GROUND PLUMBINq)s V UNDERGROUND
A.C. UNIT
COLL. AREA
B GRADE /24
GH PLUMB BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
R SEP C T O WIRING(
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL
GAS (FINAL) TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
CU. yd.
$ plus xS
=S
LUBER GR.
FINAL INSP.,? G'�
NG
FINAL INSP.
�•
V7
t
L'
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
G W
LATHING
MESH
INSULATIONISOUNCy
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
' Desert Sands Unified School District
CERTIFICATION OF PAYMENT
OF
SCHOOL FACILITY FEES
NOTICE THIS DOCUMENT CANNOT—
TO: CityfEL0a 1OPL I A T E D,
I
Department of Community Development
78-105 Calle Estado
La Quinta, CA 92253
DATE:
LA
LA
This is to certify that P U VLEAI--'
developer of, which is
located at D — )ID -0 , within
this District, has paid school facility fees imposed pursuant to the
authority genera ed by overnment Code Section 53080 in the amo nt of
covering a total of iWb,square geet of ( ) residLJntial or
( ) industrial/commercial-development and that building permits for
this footage in this development may now be issued by your jurisdiction.
-Fo'709 x SUA% c=13G, '7 wl�
j OI
forLI69SERT SAND •UNIFIED SCHOOL DISTRICT
White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer
0007
20
COUNTY OF RIVERSIDE DEPARTMENT . OF HEALTH Assessors Parcel No.
ENVIRONMENTAL HEALTH SERVICES 7
NOT
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 speculations as indicated on the attached check list
A,nonrrefundable filing fee.(spe below) is required when the application is submitted. Check must be made payable to the County of
Riverside. Approval of this application shall remain valid for a period not to exceed one year from date of approval.
<
VERIFY ITEMS IN .SECTION A FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG'*
Z
DISTRICT:, 6
0
Agent Contractor, Contact rson
Phone
Address & Phone
WHITE - Office file- YELLOW' APp lickht • PINK - Bldg. Dept. GOLDENROD - Plans/Records
nAg, t9
.!t LU
0)
0 f,
A
Phone
Mailing Address
State
Z*
Job Property Address.
Legal Description (PM,'Tr`9' Lot)
4E: z7
Lot Sze
�. �ateggw 6
use Of Perm' P/P CU etc au,,V7A
64
Other,
0 s VS
Signature of Applicant
Date
CATEGORY:, RE:%�Conp FEE
CATEGORY: REV CODE FEE
®l` SUBSURFACE DISPOSAL 1238 o-05.00
o SITE EVALUATION UPON REQUEST 7349 $42.00
M
0 MULTIPLE PARCELS WITHIN SAME
(NO PLOT PLAN)
Z
LAND DIVISION
0 SEWER/SEPTIC VERIFICATION 7348 $11.00
0
a.' 1 at 4 Parr6els (Each) 1238 $45.00
(Less than 1 year)
b. Each Parcel after 4 7344 $16.00
0 PRELIMINARY ELECTIVE
W0
Rereview, (2nd review same parcel) 7344 $16.00
EVALUATION (Attach DOH SAN 53)
U)
0 SUO'Evaluabon in Conjuncfi6n with
0 HOLDING TANK 7351 .00
Critical Area7346 $86.00
0 ALTERNATIVE/EXPERIMENTAL 7345 $132O0
13 Site EvaluationLot Less than
SYSTEM
10,000 Sq. Ft. 7347 $86.00
/INrTIAL DATE
Holding"Tank Agreements Completed 0 YesWINo
Certification of Existing S.D. System Required 0 Yes
W0CB Clearance required.(Attach Form 0 Yes 0
DOH.'SAN 007,-Sarita Ana Region Only)
Soils Percolation Report Required. 0. Yes
-0
Spilk4afFeasibility Boring Report Required. 13 Yes PI
Detailed Contour. Mot Plans Required (1 to 5 It interval) 0 Yes
0 Yes
Staff $pecla]W Lot Inspection Required 0 Yes No
Lot inspection Date
Soils boring report by Project # Date
Soils Map Page Soil Approed
by Date
0
Z
No. of Systems
Yjpe of Sys"s)
❑1 Ing Tank 0 Existing
01
=New
No. Dwelling Units
Bedrooms, FUffUW01%
(1) Septic Tank
Soil Rate
Grease/Sand
Intop'
0
19 0 Replacement
Gal
LLJ
'(2) 6ach Line Sq. Ft
Bottom trench area
Sidewall'allowanoe
Inatell Lk ft. long 3 it wide with
Lkich. -Sed sq. ft.
c;.Z, oo 'ev.
It. rock/ sq. It.
per running ft.
min.rxmes rock below drainlines or
of botto'."'Irea
V
Lqachlihes/bed special design for slope:
Applicable
er
3) Pit Diameter
!�5
No Pits
Pit
IN
page Pit Total Depth
Other
Max. Allowable -Depth
-Depth
N/A Overburden factor
0 5 6
6
No. 2 System 777cz 3L6i,-_r_cp 72447>v.
p� 7
REMARKS -
A 41 1A
Ar
T=1 a PP !cation i _1f0f&D MED—for the.category checked in SECTION B above, regard
L<glhe design of a sqj�durfa(c'e disposal syste/as indicated
0
Z
on :the accompanied plot 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% ex
expansion area.
Septic tank and sewer lines be 50' minimum from any wells
Leach lin Ara b,
as must..
1 '00'.minimum from.any wells, including. expansion
3) Kb,
"Seepage pits.mus be 150 mini am from'ani w6lis,,including expansion /0
Si nature of.Health -.H6alth'Official'4
20
NOT
RECEIPT
y__
Issued B Date
DISTRICT:, 6
Riversi e 6.11i ndio
."
6Hemet 0 Perris 0 RanchdCalif0 Blythe
DOH SAN 122 (Rev."5/88) DISTRIBUTION:
WHITE - Office file- YELLOW' APp lickht • PINK - Bldg. Dept. GOLDENROD - Plans/Records
%
20
oa--r: R 1\� Of f ICE OF E. LEON SPAUGY
s AGRICu COMMISSIONER.
JAMES`0 WALU�CE
O 1 �I�, d Ay U ASS Sigvt C•), MISS,UNEP.
J;k J WEIGHTS. Fi MEASURES CLENIEv1 BEN
VE�ISTE
SEaIER
,`— 49=613 Ilwy 86, .Sulte II712
Coachella, 'CA. 92236
4,5 60-342-8291
DATE D y, /y'g CASE No: YS ids oa yC
DEVELOPER'S NAME,
ADDRESS: 7 7,— 8 11.
Ls u-�t 12c
2.•z0j
TELEPIIONE: (619) -3 yam= `6 2 Z
Dear Developer:
After reviewing your landscaping plans, x-111 plant mterial listed, is not in
violation of quarantine laws governing the'Coachella Valley. if substitutions
do occur and they, differ_fran plant material listed, this office.must be'notified
lnnediately.
Thank you for protecting and preserving the Coachella Valley's pest-free envirotimnt.
Agricultural Camu ssi i 's Off ice
ccs Indio and Riverside Office