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BPLB2019-003778-495 CALLE TAMPICO C& O D "i- QU&M LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Permit Type/Subtype: PLUMBING/ Application Number: BPLB2019-0037 Property Address: 81810 MOUNTAIN VIEW LN LN APN: 767480008 Application Description: WARNER / REPAIR SEPTIC Property Zoning: Application Valuation: $39,250.00 Applicant: D /,k SOUTHWEST PLUMBING INC �-' P 0 BOX 2006 MAR 15 2019 THOUSAND PALMS, CA 92276 CiTY DESIGN & TA DEVLOMSNT DEARTM ENS 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: C36 License No.: 731805 Date: / Contractor: OWNER-B ER DECLARATION 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 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 Add VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/15/2019 Owner: PETER WARNER 107 5300 HUSTON RD PEACHLAND BC CANADA VOH, X2 92253 Contractor: SOUTHWEST PLUMBING INC P 0 BOX 2006 THOUSAND PALMS, CA 92276 (760)343-2345 Llc. No.: 731805 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 issued. __5> 1 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 tN5URANCE CQMPANY Policy Number: C66007960 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, Applicant: s WARNING: FAILURE TO SECURE WORK ' COMPENSATION 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: Appiication is hereby made to the Building Official for a permit subject to the conditions and restrictions set forth on this application. I. 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, certify that I have read this application and state that the above information is correct. agree to comply with all city and county ordinances and state laws relating to building :onstruction, and hereby authorize representatives of this city to enter upon the above- nentioned property for inspection purposes. )ate: Signature (Applicant or Agent): Date: 3/15/2019 Application Number: BPLB2019-0037 Property Address: 81810 MOUNTAIN VIEW LN LN APN: 767480008 Application Description: WARNER / REPAIR SEPTIC Property Zoning: Application Valuation: $39,250.00 Applicant: SOUTHWEST PLUMBING INC P 0 BOX 2006 THOUSAND PALMS, CA 92276 Owner: PETER WARNER 107 5300 HUSTON RD PEACHLAND BC CANADA VOH, X2 92253 Contractor: SOUTHWEST PLUMBING INC P 0 BOX 2006 THOUSAND PALMS, CA 92276 (760)343-2345 Llc. No.: 731805 --------------------------------------------------------------------------------------------- Detail: PLUMBING - ABANDON LECH FIELD INSTALL NEW PUMP AND INFILT(iATOR SYSTEM- 2016 CALIFORNIA BUILDING CODE. DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $2.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $2.00 DESCRIPTION ACCOUNT QTY AMOUNT PERMIT ISSUANCE 101-0000-42404 0 $101.40 Total Paid for PERMIT ISSUANCE: $101.40 DESCRIPTION ACCOUNT CITY 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 QTY AMOUNT RECORDS MANAGEMENT FEE 101-0000-42416 0 $10.00 Total Paid for RECORDS MANAGEMENT FEE: $10.00 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 .•r�H. County of Riverside Vx DEPARTMENT OF ENVIRONMENTAL HEALTH www.rivcoeh.org �u �"Z Z ciZo LAND USE APPLICATION OFFICE USE ONLY ❑ 3880 Lemon Street • Suite 200 • Riverside • CA • 92501— (951) 955-8980 PE CODE: D —7,1 2 1 FEE: u 14 `(- of W 47-950 Arabia Street • Suite A • Indio • CA 92201— (760) 863-7570 LAT: ' ?} G 5 G` �- ' LON: —(tL '3 Ig Use of Permit: LL Ac(.I 1 rtr. d ",MP . -' , PL ON: d 114 3 O1NTS INFORMATION TR/PM LOT # APN PRIMARY CONTACT I Name PROPERTY 1 Street Address cr� l INFORMATION Water Agency/Well Name \ NN PROPERTY , Street Address _ OWNER Phone n A ,% L/N. it iN Zip Code G l.Z S 3 C V rr Lot Size E-mail City �,, ,2 Zip Code Company Name Cyr, y{y � Contact r 'z 7Z- 9 Z G V' AGENT/ —MailingStreet Address CONTRACTOR 31410 Zip Code -� .Z Phone E-mail Aft 02 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 on my declaration of information on this form, and that incorrect information is grounds for denial of the project. 4 Signature (Applicant/Representative): Date:L(y OFFICE USE ONLY SUBMITAL CHECKLIST Re uired at applicant's expense: ❑ Soils Percolation Report/Detailed Contour Plot Plan ❑ Floor Plan and/or Plumbing Layout ❑ Certification of Existing OWTS (C-42/A) ❑ WQCB Clearance ❑ Special Feasibility Boring Report ❑ Well Final Evaluation ❑ Water Will Serve Letter ❑ Sewer Will Serve Letter ❑ Other: PAYMENT INFORMATION Receipt # Check # Credit Card Approval # ADDITIONAL NOTES/REMARKS For our office locations call us at (888) 722-4234 or visit our website at www.rivcoeh.org EPO-92 (REV 11/18) County of Riverside DEPARTMENT OF ENVIRONMENTAL HEALTH r www.rivcoeh.org LAND USE WORKSHEET ON: &- `f 43 1 B&S: I APN: -1 L4�C l G 61 .-0106 USE OF PERMIT: YO - LV'<tccf L (,-e5 .V fulA' TR/PM: I LOT: OWTS DESIGN ❑ New ® Repair/Replacement ❑ Modification ❑ Connect to Existing OWTS ❑ ATU ® Pump ❑ Connect to Sewer ❑ Septic Verification Fixture Units: Bedrooms: Soils Percolation/Boring Report By: Date: Project: C-42 Certification: 5' J- C fc /b� f y-d Date: f q License #: q 5­0`Z,-( ti Septic Tank Capacity: ( Stic; I Soil Rate: S Tested Depth: LEACH LINES ❑ Rock below drain line: in, I ® Plastic Chambers ❑ Other: Sidewall Allowance: ftZ/LF Sq. Ft. Bottom Area: L{ '�0 Total Linear Ft.: I Sj-C- # of Line(s): 3 Length: p Special Design: ❑ Yes ❑ No I Slope: ❑ N/A ❑ Overburden I Max Trench Depth: SEEPAGE PITS Pit Diameter: # of Pits: Depth Below Inlet (BI): Total Depth: Max Depth: ATU ❑ Groundwater: bgs ❑ Impermeable: bgs ❑ Other: Manufacturer: I Model: Rated Capacity: Tanks Required: ❑ Pretreatment ❑ Pump ❑ Other: Dispersal Field: ❑ Drip Dispersal Size: Emitters: Depth: ❑ Leach Lines ❑ Seepage Pits (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 CONSTRUCT1ON/lI USTALLATION REMARKS >�Uin�L�1 �-�rf;�►I �.+'} �-usrir5 i � (iMl' v.s�rs LICe't�sc-�j ,f'�1,,.�,e- Fj,'9c-�t2� . L-'1('16!vE'" orgy ,/-(-CA,C--icL 1.1.[ f t-l- C Ll-`A ,rv4%, (A L. 5t- IF3c qY 0�3Cf `1 L5L .svM a 4A- -T v 0,4L 3/k tt r t- btycv i 1-- L 70 pvm05 $ Yf -( L'r v3r rf, G1= t f N L 1t,^� —ylvr vMP rt� -(3�'� CSe r't✓J��� r�� SG�rEl9vLc LfGPV'C- -111JYA-LL V - c3u O/`- C,r C Krrr- n (A- t {A eat ' C [- ^ AV, jC�t ( C N -Tc P-A -Vo l�r PROJECT STATUS This application is ❑ 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 set forth in the Department's Local Agency Management Program (LAMP) and any applicable codes. REHS Signature: Date: ❑ Plan Check Only For our office locations call us at (888) 722-4234 or visit our website at www.rivcoeh.org EPO-91 (REV 11/18) County of Riverside 0 DEPARTMENT OF ENVIRONMENTAL HEALTH www.rivcooh.org CERTIFICATION OF EXISTING SUBSURFACE DISPOSAL SYSTEM ❑ 3880 Lemon Street • Suite 200 • Riverside • CA • 92501 - (951) 955-8980 4 47-950 Arabia Street • Suite A • Indio • CA 92201 - (760) 863-7570 Property Information: APN: -7.50a(-)- C. � Date of Inspection: 1. Owner: f-i i vw -✓ iA r Address:�� c��f` 1C kj Lr-City: FAILURE TO PROVIDE ALL REQUIRED INFORMATION SHALL PREVENT OWNER FROM OBTAINING ENVIRONMENTAL HiE:ALTHAPPROVAL 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. 1 examined existing subsurface sewage disposal system at the above location on °�� and determined that the tank capacity is r �.�> gallons and that there is sq. ft. of leach line bottom area. There are bedrooms in the dwelling and there are fixture un its. b. There are leach lina(s), each ft. long Depth ft. ❑ Rock ❑ Plastic Chamber c. There are - Seepage pit(s), each ft. In diameter, and ft. TD, ft. BI. d. The leach bed is ft. by ft„ total le sq. ft. of leached area. Depth is ft, 4. a. Construction of septic tank (Please check one of the following): A Concrete ❑ Fiberglass ❑ Steel ❑ Other: b. Internal dimensions of septic: Length ft. Width 4{ ft. Depth c. Condition of tank (please check yes or no for each question): Inlet Tee present? Yes ❑ No Tank Structure deteriorated? ❑ Yes A No Outlet Tee present? 0 Yes ❑ No Effluent Filter Present? ❑ Yes 0 No Two compartments? C@'Yes ❑ No d. Condition of D-Box: Level? ❑ Yes ❑ No Replaced? ❑ Yes ❑ No 5. a. While pumping the tank, did effluent flow back into tank from absorption system? 91 Yes ❑ No b. Prior to pumping, was the liquid level in the �t-aynk above the outlet tee? Yes ❑ No c. Was the area around the lids oxidized? 161)Yes ❑ No d. Is design of system gravity feed? O,Yes ❑ No e. Were well(s) observed on this or adjacent property? ❑ Yes Q No If yes, indicate distance of well from: Septic tank ft. Leach lines Seepage Pits ft, f. Distance from springs, lakes, and natural water courses (check all that apply): ❑ Septic Tank ft. ❑ Leach lines ft. ❑ Seepage Pits ft. g, Is sewer within 200 ft. of structure and abuts property line? ❑ Yes Q No Additional Comments: h. How long has dwelling been vacant? (if applicable) months weeks ❑ N/A 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: I certify under penalty of per that the foregoing is true and correct Signature: _� Print Name: Contractor License No.: �.�s_�f Expiration Date:-�� Pumper Co.: j Address: Phone Number: � I f City: 12 duZip: EPO-91 (REV 03/16) LL :5eOVS—c V,.cr4r 1-fzGt� urveL c5*5t COUNTY OF RIVERSIDE DEPARTMENT OF ENVIRONMENTAL HEALTH ONSITE WASTEWATER TREATMENT SYSTEM IDwellin9 t5_ Gal. Septic Tar* nk r S , (/ s Co mmer� 5 7- Sq. Ft. of Leach Line Seepage Pits No. Dia 81 TD ME) Connect to Sewer _..__ Concrete Pump CharriDer Conned to Existing • Installation of leach lines are not to exceed y'{ k in de" • Install risers to grade. leaving lids accessible for cleaning. Gh ,� Larger tanks (2000 gallons or greater] require 2 rism to apr� r. Approved cleanaicle effluent filters must be installed to facrltMe serves • No on-sRe water softening devices shall be discharged into the septic sygm. m aA clearance from the California Regional Water Quality Control Board. • Installation shall conform to the current UPC: �grading in the area of Proposed drip lines shall require new op"M by this Date: i� EHS: I�� Q 47 94 Feet Map My County Map Los AtigAes �_ --•--ter - � :�� - — -- . � -- 'IMPORTANT' Maps and data are to be used for reference purposes only. Map Features are approximate, and are not necessarily accurate 10 surveying or engineering standards. The County of Riverside makes no warranty or guarantee as to the content (the source is often third party), accuracy, timeliness, or completeness of any of the data provided, and Assumes no legal responsibility for the information contained on this map, Any use of this product with respect to accuracy and precision shall be the sole responsibility of the user. REPORT PRINTED ON.-. 3/13/2019 8:27:19 AM © Riverside Countv GIR I ;Vk Map '��uana _M�xlev4 1 ;00 ti .00 A. 0 d