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BPLB2019-0027D� VOICE (760) 777-7125 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 2/13/2019 Permit Type/Subtype: PLUMBING/ Owner: Application Number: BPLB2019-0027 NANCY SPURRIER Property Address: 78208 SAN TIMOTEO ST ST 78208 SAN TINOTEO APN: 646160019 LA QUINTA, CA 92253 Application Description: SPURRIER / INSTALLATION OF NEW SEPTIC SYSTEM Property Zoning: Application Valuation: $20,000.00 Applicant: Contractor: ALMS UNDERGROUND CONSTRUCTION INC P LLLiiI ALMS UNDERGROUND CONSTRUCTION INC 38703 VISTA DRIVE 38703 VISTA DRIVE CATHEDRAL CITY, CA 92234 FEB 13 2019D CATHEDRAL CITY, CA 92234 CITY OF LAOUINTA (760)324-1911 DESIGN & DEVELOPMENT DEPARTMENT Llc. No.: 482180 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 Dateoolll� Q 2,0. 19 Contractor -I!, W-W 00 OWNER -BUILDER DEC— RION 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 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 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. . B.&P.C. for this reason 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 Lender's 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 t e 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: ACE AMERICAN INSURANCE COMPANY Policy Number: RWCC65201240 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 t�hollse provisions. Date: 73 rea-201,/gApplicantagor L�,. Opp WARNING: FAILURE TO SECURE WORKERS' COMPENSATIO ERAGE 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. DW.-j4j�l9 Signature (Applicant orAg, ��Y.P_PM_ Application Number: BPLB2019-0027 Property Address: 78208 SAN TIMOTEO ST ST APN: 646160019 Application Description. SPURRIER / INSTALLATION OF NEW SEPTIC SYSTEM Property Zoning: Application Valuation: $20,000.00 Applicant: ALMS UNDERGROUND CONSTRUCTION INC 38703 VISTA DRIVE CATHEDRAL CITY, CA 92234 Date: 2/13/2019 Owner: NANCY SPURRIER 78208 SAN TINOTEO LA QUINTA, CA 92253 Contractor: ALMS UNDERGROUND CONSTRUCTION INC 38703 VISTA DRIVE CATHEDRAL CITY, CA 92234 (760)324-1911 Llc. No.: 482180 Detail: SEPTIC TANK MUST BE INSTALLED ON PROPERTY. 17.5 FEET NORTH FROM EDGE OF PAVEMENT PER 2016 CALIFORNIA BUILDING CODE. FINANCIAL DESCRIPTION ACCOUNT CITY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT QTY AMOUNT PERMIT ISSUANCE 101-0000-42404 0 $101.40 Total Paid for PERMIT ISSUANCE: $101.40 DESCRIPTION ACCOUNT QTY AMOUNT SEPTIC SYSTEM 101-0000-42401 0 $13.34 DESCRIPTION ACCOUNT QTY AMOUNT SEPTIC SYSTEM PC 101-0000-42600 0 $13.34 Total Paid for PLUMBING FEES: $26.68 DESCRIPTION ACCOUNT CITY AMOUNT RECORDS MANAGEMENT FEE 101-0000-42416 0 $10.00 Total Paid for RECORDS MANAGEMENT FEE: $10.00 DESCRIPTION ACCOUNT CITY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 0: RIVERSIDE C WIN0I0 FACILITY DEPT OF FNVIRilldMFNTAI WrAI TU C 7i CC 47950 ARABTA ST. STE# R County of Riverside EPARTMENT OF ENVIRONMENTAL HEALTH ,2/ 1 31/c 019 000001 www,rivcoeh.org 1107 10:46AN JOSIEO013 LAND USE APPLICATION 2060 $234- 00 OFFICE USE ONLY 034 00 • Riverside • CA • 92501- (951) 955-8980 PE CODE: -_�!'7" _L I FEE: 3'1 G u 742 A • Indio • CA 92201-(760) 863-7570 LAT: '3 3, Cq 2 L. LON.- _t { . 3coo HECK $234. O0 ❑WTS INFORMATION TR/PM LOT # APN c PRIMARY CONTACT Name E-mail PROPERTY Street Address 7i2 i�, 51+,^-' -I t���;LO Sr City L.�- CiV�aT,� Zip Code 1, 2-2- 3 INFORMATION Water Agency/Well ivL b Lot Size Name �-lA-L itit PROPERTY OWNER Street Address MI City i L A Zip Code e' Z Phone E-mail Company Name �1 !"1 / 1 / lit n d G f it r1 Jk Contact A � 0 �-�- AGENT/ Mailing Street Address �8703 f <3+ Zip Code S 2� 3� CONTRACTOR t5 rail Phone 7KO zY 7 l 1 I E-mail / ll G��,ns under r u( i Owner/Representative Declaration: I certify that I have read the entire application and state that all the information is correct. I understand the amount of fees paid is based an my declaration armatian on this form, and that incorrect information is grounds for denial of the project. Signature (Applicant/Representative): _ Date: /3 Fe{ . 2-0 j 9 SUBMITAL CHECKLIST required at applicant's expense: ❑ Soils Percolation Report/Detailed Contour Plot Plan 0 Floor Plan andfor Plumbing Layout 0 Certification of Existing OWTS (C-42/A) ❑ WQCB Clearance 0 Special Feasibility Boring Report 0 Well Final Evaluation 0 Water Will Serve Letter ❑ Sewer Will Serve Letter Other: PAYMENT INFORMATION Receipt # Check it Credit Card ,Approval # OFFICE USE ONLY EPO-92 Wl/ 11/19) For our office locations call us at (888) 722-4234 or visit our website at www.rivcoeh.org County of Riverside DEPARTMENT OF ENVIRONMENTAL HEALTH www. rivcoeh. org CERTIFICATION OF EXISTING SUBSURFACE DISPOSAL SYSTEM ❑ 3880 Lemon Street • Suite 200 • Riverside • CA • 92501 - (951) 955-8980 ® 47-950 Arabia Street - Suite A • Indio • CA 92201 - (760) 863-7570 Property Information: APN: 6 k G - (- p t ci Date of Inspection: / / F�_; ,6 , Z -0 / ? 1. Owner: 4 A L a- 'kL �, T 'pvA' tLr- Address: -7 2-0';.5 Ae. T ,>1c>%t C T City: L,¢ L iil T-, t FAILURE TO PROVIDE ALL REQUIRED /NFORNIATION SHALL PREVENT OWNER FROM OBTAINING ENVIRONMENTAL HEALTH APPROVAL 2. Show design and location on a scale of 1:20 or 1:40 of the sewage disposal system and 100% expansion area in relation to dwellings, structures, wells, rock outcroppings, drainage, watercourses, etc. 3. a. I examined existing subsurface sewage disposal system at the above location on // Rk 2019 and determined that the tank capacity is/DDD gallons and that there is __ sq, ft. of leach line bottom area. There are 3 bedrooms in the dwelling and there are fixture units. b. There are leach line(s), each ft. long Depth ft. ❑ Rock ❑ Plastic Chamber c. There are / Seepage pit(s), each !C ft. in diameter, and z O ft. TD. /V ft. BI. d. The leach bed is ft. by ft., total sq. ft. of leached area. Depth is ft. 4. a. ConstruCiDrt of septic tank (Please check one of the Following): LrJ-✓Concrete ❑ Fiberglass ❑ Steel , ❑ Other: b. Internal dimensions of septic: Length V ft. Width 6 ft. Depth lam_ ft. c. Condition of tank (please check yes or no for each_question,: Inlet Tee present? ❑ Yes ❑ No Tank Structure deteriorated? ❑ Yes ZNo Outlet Tee present? ❑ Yes ❑ No Effluent Filter Present? ❑ Yes ❑ No Two compartments? ❑ Yes (J No d. Condition of D-Box: Level? ❑ Yes ❑ No Replaced? ❑ Yes ❑ No IA/ A 5, a. While pumping the tank, did effluent flow back into tank from absorption system? ❑ Yes ❑ No b. Prior to pumping, was the liquid level in the tank above the outlet tee? ❑ Yes ❑ No c. Was the area around the lids oxidized? ❑ Yes OrNo d. Is design of system gravity feed? aryes ❑ No e. Were well(s) observed on this or adjacent property? ❑ Yes 2No If yes, indicate distance of well from: Septic tank eft Leach lines Seepage Pits f. Distance from springs, lakes, and natural water courses chr�k all that apply): ❑ Septic Tank �❑ Leach lines ft. ❑ Seepage Pits g. Is sewer within 200 ft. of structure and abuts property line? ❑ Yes Ca No Additional Comments: a f'r c '4an e4 5 _frnwit n 4 n a�a h. How long has dwelling been vacant? (if applicable) weeks ❑ N/A ft. ft. 6. a. ❑ 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. b. It is my opinion that the system is not in good working order and will not function properly without the following repairs: S„c'l a-* . r.. ; 4-L - J - _ _ C _ A - - - ! certifj under malty of perjury that the foregoing is true and correct. J Signature: es+�- Print Name: Contractor License No.: `� ($ Q -Expiration mate: ❑ Pumper Co.; Phone Number: 73 2 Address: 397 3 I/" City Ci4eafraf 424 Zip: 9 E?0-31 ;RO/93/16) County of Riverside DEPARTMENT OF ENVIRONMENTAL HEALTH wtivw.rivcoeh.arg ....,.': LAND USE WORKSHEET ON: I B&S: APN: S 4 c — '' USE OF PERMIT: _ (�U �G i �[ `f } Z r�� c� .� r Tg1PM: 1�0 LF 9; �*res z LOT: i �r LEACH LINES ❑ Rock below drain line: in. ❑ Plastic Chambers ❑Other: Sidewall Allowancz: ftZ/LF Sq. Ft. Bottom Area: Total Linear Ft.: # of Line(s); Length: Special Design: ❑ Yes ❑ No Slope: ❑ N/A ❑ Overburden Max Trench Depth: SEEPAGE PITS Pit Diameter: G # of Pits: ( Depth Below Inlet (BI): Total Depth: /c max Depth: ATU ❑ Groundwater: bgs ❑ Impermeable: bgs ❑ Other: Manufacturer: Model: Rated Capacity: Tanks Required: ❑ Pretreatment ❑ Pump ❑ Other: Dispersal Field: Cl Drip Dispersal ❑ Leach Lines ❑ Seepage Pits Size: Emitters: Depth: (fill out above) (fill out above) In addition to the above, provide the following prior to Final: ❑ Engineer Clearance Letter ❑ Service Agreement ❑ Recordation document ❑ ROP Permit CONSTRUCTION/INSTALLATION REMARKS f' R G P a2 bK � t 5 �d Y PTi c t i pG�y L' • y�G %u f t_ 6C,6,cl9 fc v- 6e c rN .-jLL uEG �.4LC dT w �"rtf P- 37C'h 5 it G"� ✓CLt.T ►� c L=,�� P (r _ pl/-t PROJECT STATUS This application is M. Approved ❑ Denied regarding the design of the OWTS as indicated on the accompanied plot plan using the requirements set forth above. No construction is permitted in the required, reserved 100% expansion area. System must meet requirements s t forth in the Department's Local .Agency IVlana. ernent Program (LAMP) and any applicable codes. REHS Signature: Plan �4 Only For our office locations call us at (888) 722-4234 or visit our website at www.rivcoeh.org =on-ai ani i i i � ai c4a Qazofra Project Address: $' 2 a E T,'w.a�� p APN #: 6 Y 6 ' / 40 • 0 / Applicant Name: Address: City, ST, Zip: Telephone: Email: PERMIT # 0027 PLAN LOCATION: Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech ZT,v':600-n2w Sv s4,2, »-, i �l�ghdo►�ex��'"i�q sep�i� sys-�ew. Valuation of Project 78495 CALLE TAMPICO LA QU I NTA, CA 92253 760-777-7000 mi .- < to ClfA V ai pvs C6AlClIr ZA k A.),ql i I 1 JAccuZ,-t �jt DEPAR7MEEN Ppovi.„ CITY 4F LA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION DATE - / I B Co m9 �r)/r PLqA4CP- 1e J k A�sFD dOM PJAM46R, • 7'a ik r,-_ 1,4 - --�-- i e pP, )F4cN G7 3- e, 4k5 7$20S Sad G?6a-=n-tL Y GAte Al f, N 8� am N Q /i0 N 71 ►%0 HiGIM 1D3HlS �- L 110 0 > ov 70 M a W 30 a r j .. J 0 o pay r� V w rti r7 s o g r 9�F � 05 0 0 0 r r1