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BPLB2015-013678-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T4ht 41wQ" COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT ' Application Number: BPLB2015-0136 Property Address: 78002 SAN TIMOTEO APN: 646160023 Application Description: MILLER / REPLACE SEPTIC TANK AND TWO SEEPAGE PITS, Property Zoning: 49792 COACHELLA DR Application Valuation: $14,000.00 Applicant: n ALMS UNDERGROUND CONSTRUCTION INC 38703 VISTA DRIVE CATHEDRAL CITY, CA 92234 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: C21. C42 License No.: 482180 Date: 11 Alm/1 Zb) 5 Contractor: OWNER -BUILDER DECLARA I N I hereby affirm under penalty of perjury that I am 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 fora permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (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.). U 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. . B.&P.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: 11111111111111.111111 10 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 (760)324-1911 Llc. No.: 482180 WORKERS 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 issued. (� 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: Policy Number: _ 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, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the labor Code, I shall forthwith comply with those provisions. Date: r' 9 N t. 2-0 (5 Applicant: f WARNING: FAILURE TO SECURE WORKERS' COMPENSJON COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES 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 Building Official 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 building construction, and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. Ll\ _ — --%n Date: % i 461/. 7_0 ! S' Signature (Applicant or Agent): / V Date: 11/19/2015 Owner: MILLER FAMILY TRUST 8 49792 COACHELLA DR �J LA QUINTA, CA 92253 n G9 Contractor: z i rN,) o ALMS UNDERGROUND CONSTRUCTION INC 38703 VISTA DRIVE c� CATHEDRAL CITY, CA 92234 (760)324-1911 Llc. No.: 482180 WORKERS 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 issued. (� 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: Policy Number: _ 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, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the labor Code, I shall forthwith comply with those provisions. Date: r' 9 N t. 2-0 (5 Applicant: f WARNING: FAILURE TO SECURE WORKERS' COMPENSJON COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES 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 Building Official 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 building construction, and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. Ll\ _ — --%n Date: % i 461/. 7_0 ! S' Signature (Applicant or Agent): / V 4 MIUOU N PAID�� -�:--?15ESCRIPTION BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 t PA I D. V -x rim.. Z4�r ", w 30 4Ex "Ed -k' ig 5's N . Total Paid for BUILDING STAN DARDSADM IN ISTRATION BSA: $1.00 .$0.001 =DESCRIPTIONEaM5 'C COUNT ;�4t*,t mlm ,-VAMOUNT41: �B, "PAIDe DATE r.y 34w,.A tN NPAIQ,�. . Tw PERMIT ISSUANCE 1011-0000-42404 0 $91.85 $0.00 P A I D, B Y 5j."N., j - 2ffig x} METHOD -Gh �'r,'NCHE( 1 K m, lil, Rm fil , 01UR"I 1-,Itt,�; MMM,1140m- R�y �ili-Y�"%-,.*"�l-l��'.,-.�,�,�.,�'ll,��,_ Total Paid for PERMIT ISSUANCE: $91.85 $0.00 2 R W k 6 UI N @ DATE, tfl p g Pf 1 9, SEPTIC SYSTEM 101-0000-42401 0 $12.09 $0.00 IM RE PAIDI]BYrf�ij, WETHOW�'T,v MECEP E, 4- rDESCRIPTIONf,,gg �' ACCOUNT TY AMOUNT Vuft TV, PAID PAIDDATE.= ,= SEPTIC SYSTEM PC 101-0000-4260.01 0 $4.83 $0.00 t -BV METHOD` !� -ZRECEIPT #, PA% ,il tit T77 Total Paid for PLUMBING FEES: $16.92. $0.00 TOTALS:;' $000 Description: MILLER / REPLACE SEPTIC TANK AND TWO SEEPAGE PITS, Type: PLUMBING Subtype: Status: UNDER REVIEW Applied: 11/19/2015 SKH Approved: Parcel No: 646160023 Site Address: 78002 SAN TIMOTEO LA QUINTA,CA 92253 Subdivision: LA QUINTA GOLF ESTATES 2 Block: Lot: 30 Issued: Lot Sq Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $14,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: PLUMBING -INSTALL 2500 GALLON SEPTIC TANK AND TWO SEEPAGE PITS. 2013 CALIFORNIA BUILDING CODES. ADDITIONAL SITES Printed: Thursday, November 19, 2015 10:50:28 AM 1 of 2 C SYSTEMS CHRONOLOGY NAME TYPE NAME' ADDRESS1 CONDITIONS CONTACTS CITY STATE ZIP PHONE FAX EMAIL APPLICANT ALMS UNDERGROUND CONSTRUCTION INC 38703 VISTA DRIVE CATHEDRAL CITY CA 92234 CONTRACTOR ALMS UNDERGROUND CONSTRUCTION INC 38703 VISTA DRIVE CATHEDRAL CITY CA 92234 OWNER MILLER FAMILY TRUST 49792 COACHELLA DR LA QUINTA CA 92253 Printed: Thursday, November 19, 2015 10:50:28 AM 1 of 2 C SYSTEMS DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD .PAID BY CLTD BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid for BUILDING STANDARDS ADMINISTRATION* $1.00 $0.00 BSA: PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 SEPTIC SYSTEM 101-0000-42401 0 $12.09 $0.00 SEPTIC SYSTEM PC 101-0000-42600 0 $4.83 $0.00 Total Paid for PLUMBING FEES: $16.92 $0.00 0• 00 Printed: Thursday, November 19, 2015 10:50:28 AM 2 of 2 Or SYST[Ir1S p C' L l IL .... ..... . ALMS UNDERGROUND CONSTRUCTION, INC. 38703 Vista Drive; Cathedral City, CA 92234 760-324-1911 Office 760-324-9541 Fax 760-578-1510 Cell Almsunderground@gmail.com CA Lic. 482180 r 7gP n_ \ � er� r t/ 0 sD�o qve � O 6a.3 e CITY ®F QU DNTA. BUILDING & SAFE D APpRO FOR CONSTRUCTION DATE / 1 BY J 5 \ FY.pi�rfi�N` ` s' 1 �o /5�t d yti✓ell � Bin # City of La Quinta Building Sl Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit #f 0 Project Address:y90ZO 4e,.Ter1% ,wndr'sNamc: A. P. Number: G (� _ / 6 0 . 02-3 Address: L/ 9 7 0/ 2 a e, l� r Description: City, ST, Zip: G2— 2ContLegal Contractor: rac or. A /VW 3 a N Telephone: Address: —319703 vl s .d.,, b �, 4r4L ,) (-1 JL Project Description: /� `t � l 5 b o A:lo►, City, ST, Zip: 4.A keda6�X / Telephone:hone• 76 0 3z�/' I 19 - s 4S S e. Y+ti State Lic. City Lic. : 7 69 Arch., Gngr., Designer: 5 FTSr yJ K Address -0 City, ST, Zip: Telephone: <:_:::#::>;::`::?::::; Construction Type: Occupancy: State Lic. #: Add 'n Alter Repair ait Dem oProJecttYP Cc• cle Name of Contact Person: p� �M Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: 7 5 7? — / j / Estimated Value of Project: % d APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit Truss Cafes. Called Contact Person Plan Check Balance. Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. II.O.A. Approval Plans resubmitted Grading IN I40USE:- '"' Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees, Total Permit Fees 1 . HAERSIDFCTY/INDIO,FACILITY DEPT O' ENVIRONMENTALAALTH PA 42950 ARABIAwST ;; STE# :A• ' 5_17* I..'iZy.+;xttic:, 'V114 :. x'... c.: x�tq; W ��F,.�a;�,�•� �'i• � y= a• .t..i J^s „'.`. . - .. :...y�,._ f''y5d_ COUNTY OF RIVERSIDE: RTMENT . OF'.. ENVIR-ONMENTAL'_ I R1 - T. H. LAND USE APPLICATION -' ()FFIfF IMF nN1 V erside -CA-§2501 = (951) 955 8980 _ �PE�C00E FEES y fsr 1 / 18/2011 5 000001 • CA 92201 - (760) 863-7570 1602 1:44PM SUSAN0001 LMS'#_: APN: 6 �../6th • p. 3. O I USE OF PERMIT: 22089 $464.00 3 0 �Pt �->`- r r -f7 y ' a ....�. �.IFt'e{,`�"z �u "FAF� =�A' ��& ��'�*• NI• -1 S P �''c �' -tom � �.�' � � J ^Lwtfk � 42 �`J 'S '� �t t� � � ,i 3i 122 T6 $9.28 �•.;:.�����,��+��+::,�---����;.����.��+ ���.�fi'-:�'.��.�u����� �'„ ���� 1539-Gc a z.;�M�� .;��_�E ll, P II P t-- ' • :HECK $473.28 ' 7 2 .:. i Phone Email. - any an Name ,7 A enUContractor. . AGENT/ CONTRACTOR: Mailing Addressr Phone 740 -3,Z/ Z I Email Imo. eri, .f 1, 72015. 1300n '. Signature Dat DZ 2 1 uit`'!i='• ' Site Address PROPERTY INFO: ' [Water 'iY Ag enc /Well 'V W ( :. Lot Size ; �a / 214/ .� Q . La C..V54. rd«`iq'. ' a t # F }.x Office Use,anl t 't � � .�::. ���• ��:r�v.., � �:<: CHECK BOX IF REQUIRED C riy9 . If any box is checked, this application shall be considered denied until the information is provided. ❑ Holding. Tank Agreements Required ❑ Floor Plan and/or Plumbing Layout Required -, ❑;Certificate of Existing' OWTS Required (C-42) ❑ Special Feasibility Boring Report Required=I'' ❑ WQCB Clearance Required ❑ Detailed Contour Plot Plan Required (1 to 5 foot intervals) ❑ Soils Percolation Report Required SITE EVALUATION INSPECTION REMARKS: lKu�e� - a .tt.L U t4icor ,F,07'C' 7 rh y�l1l Crt f -rp ,r Jt b''YCeT 'TI N� 1 r r L. r: ,,-.r fr L'1 rM I�-S'r ' c c 'f vc. • . K. i :O t'r f vtrt EHS INITIALS/DATE: A CG rncTe j4,4 /r v r �f A V'� C'CQ`S� t T- oL e .._. .. .... .. .•. �(i+�.:r "hYh, xi :2'e;J j?.4"F•.5' x .-.Y y.y', ..5„� #+:' Y Y +" +Yr �•' 'FY Y' }".'+,i �"." y -i -.'X+yam".;6^i"' ?.I'X'+f'. 1::.x ti:SE i r.i i:':i^% -: Fi'.t 'YS '�.: AS 4 �'��' 'x,4 £��� b�., `. �: �i�� 'q' '���ns"..� A��*��'Y,. X'�.AT.�iY�£.�.'•' �'. R4� e. k t_� ��: r .. +&�.. fi�+�4Y4'iY�i �� � ❑ NEW REPAIR / REPLACEMENT ❑ EXISTING ❑ PUMP 0 ATU ❑ CONNECT TO SEWER' FIXTURE UNITS # 1 BDRMS.# Soils Percolation/Boring Report By: Date: Project# C-42 Certification By: Date: License# Septic tank cap.: Soil Rate: Tested Depth: Max. trench depth:. _ Z _LaG Sq. Ft. Bottom Area: Total Linear Ft.: Line(s): Z• S + Length: feet • - Each 3 feet Wide ,. Sidewall Allowance: Ft. Rock/ Sq. ft. Running foot Rock below drain liner in.. or ' ❑ Plastic Chambers Leach Lines/bed special design for slope: ❑ WA O Overburden Factor: . Pit Diameter. No. pits: Depth below Inlet (bi):. Pit Total Depth: 7[Max.. allowable depth: CONSTRUCTION/INSTALLATION REMARKS: r ��..�; or L �. o f I A a N she ..... ... ..r is .Y .. �- . r MOAT`.- ,._.ice �2 h! k ..-iyTi" i +: ;� 3t +-$- �F. .ems". r .•. _ *'`rix' � _ :'A. 'ry b j w^ J - : Ta" s't,`xiE. avC '+C'. :.may .. .;� •.� a y . �¢,- ]. TP ' •;"tom`# `�' 'ak:f,A,” - rE-`-h';d. SECTION D x�:.� ��' 4�., ��E �E•. xT nMEN" This Application is is, Approved ❑ Denied regarding the design of the OWTS as indicated on the accompanied plot plan using the requirements set forth -in . Section Gabove. No constructiori ' permitted in the required reserved 100% Expansion.area. - EHS Signa e: Date: kr /J DEH -SV /�22 Rev: 10114 Distribution: WHITE - Office File; YELLOW -Bldg. Dept. PINK -Applicant a - COUNTY OF, RIVERSIDE DEPARTMENT.- OF ENV IRONMEN`T'AL HEALTH LAND USE APPLICATION . OFFICE USE ONLY 0 3880 Lemon Street • Suite 200'• Riverside • CA • 92501 - (951) 985-8980 '.E 47-950 Arabia Street • Suite A r Indio • CA 92201 - (760) 863-7570 C®DEFEE; EHS # LSo�u� ON #' LMS'# APN: ' 6 1.66.' 0 3. TR/PM L & "LGL t LOT # USE OF PERMIT: '. '`".: cN ;• sf'"' � �� .,� •�3r c . r S ' '. ,r:=+. ,..4y`n: � a;"�'t i .rte n, 'S't:s'�r :i - ts� '�: `sW e t4 . ':,'� .'� - v`� k:.;5' -:'�� .. �: �' .x' �<.. � te, - e -fig SECTIONYAtk:• arnx '' `�"�s=,ri...��,�;�,�+'�`�`��;�� tr���z��'"�`�''e �-�r��',��"���:�� 2, �.�r`�y��:�.r-"�"ks�'4�.� ������};��`�_,���` Name (LrlI i r OWNER: Address' Phone Email : Company Name : ,7 Agent/Contractor AGENT/ CONTRACTOR: Mailin Address 3 R�0 3- t Phone 74, 0.1 3_ / / Email Si nature a�� Dat .Site Address . y'� Li A ue r.Q n �� Lct . �/' 22 $ , PROPERTY INFO: ' Water A enc /Well � V CA/ ( Lot Size �. 0q Zy/ ! D , 7. a C � ��• . .'S...ECTION 1� VOR,M: Boass- 'CHECK BOX IF REQUIRED If any box is checked, this application shall be considered" denied until the information is provided. ❑ Holding Tank Agreements Required []..Certificate of Existing OWTS Required (C-42) ' ❑ WQCB Clearance Required ❑ Soils Percolation Report Required ❑ Floor Plan and/or Plumbing -Layout Required�, J• ❑ Special Feasibility Boring Report Required. H=U< . ❑ Detailed Contour. Plot Plan Required (1 to 5 foot intervals) SITE EVALUATION INSPECTION REMARKS: /Nv-e1 - a .;-c L o CA (Lor fP7''C -r /-( v.•.tT(4 1 t:a( j' t r'•-'Tce " Tr :NP E°rVL. L- T V(L-rt— 41-51r:''cc/111r Vi .d-t?.GY ->9u>< �fi f/T G'r" EHS INITIALS/DATE: CG rncTt //if®. P./T }Hv -1 114w` cCrCS,. f "h T F St^kv'Cfrj. "I - ,: . ua :SLs, s ai 3 Y` .rte 3 r'T ,.- c`a M' 'f' -SECTIO(�t Ct tt�. �g � z 011-15."Tw,r .flhi% k"Si-"-'..i,-,s "r.4 i�;=. s. W t.,._., .,..:,,. v -.!•'..Y.;.. :°i""'�,k'"4 xrn °r—z.9r''I`}'ti�"t �<` !i£� y ��S - '`"�<s� ':w't€5,-x'a«M.?rrY4s•. i".',:`.`r''*.bss�431-, ❑ NEW REPAIR / REPLACEMENT ❑EXISTING ❑ P.UMP ❑ ATU., ❑ CONNECT TO SEWER: ' FIXTURE UNITS# BDRMS:# Soils Percolation/Boring Report By: Date:Project# C-42 Certification By: Date: License# Septic tank cap.: Soil Rate: Tested Depth:' Max. trench depth: Sq. rt. Bottom Area: L� Total Linear Ft.: Line(s): Len the feet Each 3 feet wide Sidewall Allowance: Ft. Rock/ Sq. ft: Running foot Rock below drain line: in. '. or ❑ Plastic Chambers Leach Lines/bed special'design for slope: ❑ N/A ❑ Overburden Factor: " Pit Diameter: No. pits; Depth below Inlet (bi): ' Pit Total Depth: Max. allowable depth: CONSTRUCTION/INSTALLATION REMARKS: f-� ar LA f , -r- U3�C e—1 . '.' C' $ECTIONED z F4�•9f,� wig . .. .. +<'G.:.. .... t.. a:.4.. ..�..,C...'i.. "+•:M-,+Ik+v.ie'Y Y.sit... 4;.+MnT3i,.� +i'ss+?' .TP6,YT"cRi� .E<. s.iL.y'•:y'ai. T,E.v�.. $`.3'.: •w. {.t 3E:4.f..!. This Application istrApproved ❑ Denied regarding the design of the OWTS as indicated on the accompanied plotplan using the requirements set forth -in . . Section C -above. No construction • p rmitted in he required reserved 100% Expansion.area. EHS Signa e: Date: DEH -SA 2 Rev: 10/14 - - Distribution: WHITE — Office File; YELLOW —Bldg. Dept. PINK—Applicant