07117 (SFD)Building
Address 53-340 Obreg
Owner
Belair €3eve1
Ti't,,, 4 4 4"
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Mailin
Address 34-115 Da$e Palo or. #6
City ZipTel.
Cathedral (ity 92234 324-7767
Contractor
Saiz
Address
City Zip Tel.:
State Lic. City
& Classif. 82 555181 Lic. # .
Arch., Engr.,
Designer Design for Living
Address Tel.
Same
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm 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.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,131usiness 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 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 applicant to a civilpenally of not more than rive hundred dollars ($500).
❑ 1, 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 intendeA or offered for sale. If, however, the building
or improvement -is sold wifirb one year of completion, the owner -builder will have the burden
of proving that he did not build or onprove for the purpose of sale.)
❑ 1, 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.)
❑ 1 am exempt under Sec B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
1 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 ff the permit is for one hundred dollars (S 100) valuation
or less.)
I certify that in the performance of thg work for which this permit is issued, I shall not
=any Person in any manner so as to become subject to the Workers' Compensation
Laws of California.
tate Owner
NOTICE TO APPLICANT: ff, 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.
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.) -
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
1 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 the above
mentioned property for inspection purposes.
Signature of applicant Date—
Mailing Address
City, State, Zip
No.
BUILDING: TYPE CONST. - OCC: GRP.
Number 774-075•-005
jai Description List 5, Bi k 187
)ject Description S.F.D.
07117
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
Issued by: Date 2/9/90_ Permit
Validated by:
Validation: .
Sq. Ft. 1348
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑
Demolition ❑
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
?bu. LIU
Plan Chk. Bal.
ZU9.11
Const.
"J-1. -"-`
Mech.
53..0
Electrical
105. 55
"~Plumbing
W .D
S.M.I.•
Grading
eu * UU
Driveway Enc.
ZU 4 UU
Infrastructure
Ilk 3ekiou • aU
TOTAL
REMARKS
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
Issued by: Date 2/9/90_ Permit
Validated by:
Validation: .
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEM
IST FL. SO. FT. ® $
UNITS
SLAB GRADE 7 !� Q
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM'
2ND FL SQ. FT.
FORMS
SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
TEMP. POLE
I
GROUT
DRAINAGE PIPING
CAR P. SO. FT. ®
FINAL INSP.
BOND BEAM
WATER SYSTEM
DRINKING FOUNTAIN.
WALL SQ. FT.
LUMBER GR.
FINAL INSP.
URINAL
SQ. FT.
ROOFING49/o,e U
ESTIMATED CONSTRUCTION VALUATION $
J ❑
Lj.►1 f o
0
a'
1 O
�I
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
VENTILATION
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FIREPLACE
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, 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 ® 1 Vi c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ic
HOUSE SEWER
CERT. OCC.
GAS PIPING
PERMIT FEE
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
SETBACK V11 21ep �j(�
y/fFtWAUMBINGOeW
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 7 !� Q
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.znlO�y�
'�7
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 6/r% 90
FINAL INSP.
ROOFING49/o,e U
PZe
J ❑
Lj.►1 f o
0
a'
1 O
�I
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
_
LATHINGf-a6'VAI 1 //%0
MESH
INSULATIONISOUND 7� Q
FINISH GRADING
Y
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
1
�=Sejsti{%+'�.�- -w. �'-�.}.�I'�^�°''�'-��.�Y�"�,;,��'-�'f`=�.�avy�G✓�.s�=�-r,'--`---+^�.r-l'"::-��.=�C��-'"`x✓-=-� � .f
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COUNTY OF RIVERSIDE ENVIRONMENTAL Asse"_O"_ftfam N''
<2
HEALTH SERVICES DIVISION
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 lief
A non-refundable filing fee (see 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 #
Tactor, Contact Pe rso �`
� ���i
ne Address & Fi m
-T� ..� //� D� 6 CC -
Owner
Prone Mailing Address
city
State Zip
Job Property Address
Prop. (PM, T Lot) /4
v
CD-esccription
Lot Size Water Age ell Use of Permit P/P, CU, etc.
Other
Lli �''v ih "w
U U ailing, H Site Prep, etc.
I Zq0
_
nature of App cant.-
Date
CA ORY: REV CODE FEE
CATEGORY: REV CODE FEE
DC -SUBSURFACE DISPOSAL 1238 $ 57.00
❑ SITE EVALUATION UPON REQUEST 7349 $ 43.00
❑ MULTIPLE PARCELS WITHIN SAME
(NO PLOT PLAN)
LAND DIVISION
❑ SEWER/SEPTIC VERIFICATION 7348 $ 17.00
a. 1 at 4 Parcels (Each) 1238 $ 57.00
(Less than 1 year)
b. Each Parcel after 4 7344 $ 24.00
❑ PRELIMINARY ELECTIVE 7352 $ 23.00
❑ Rereview (2nd review same parcel) 7344 $ 24.00
EVALUATION (Attach DOH SAN 53)
❑ Site Evaluation in Conjunction with
❑ HOLDING TANK 7351 $ 47.00
Critical Area 7346 $111.00
❑ ALTERNATIVE/EXPERIMENTAL 7345 $222.00
❑ Site Evaluation Lot Less than
SYSTEM
10,000 Sq. Ft. 7347 $ 87.00
INITIAL DATE
r
Holding Tank Agreements Completed ❑ Yes C No 1 • T•
Certification of Existing S.D. System Required ❑ Yes No
WQCB Clearance required. (Attach Form ❑ Yes No
;DOH SAN 007, Santa Ana Region Only)
Solis Percolation Report Required. ❑ Yes No
Special Feasibility Boring Report Required. ❑ Yes No
Detailed Contour Pkn Plans Required (1 to 5 ft. interval) ❑ Yes No
Other ❑ Yes No
Staff Specialist Lot Inspection Required ❑ Yes No
Lot Inspection Date
Soils bioring report by (/� Project Date
Soils Map Page Sol. Type Approved by C ( Date
No. of Systems
Type of System(s)No.
Dwelling Unite
(1) Septic Tank
Soil Rate
Grease/Send
❑ Holding Tank ❑ Existing
Bedrooms, Fixture Unita
s o 2
Grease I
° R
3h�v/ti. zVia ,
IvooGa,
007
G�
(2) Laech Line Sq. Ft
Sidewall allowance r>stall Lines) n long a wide with
Bottom trench area
_ It. roG sq. n min. inches rock below draintines o
of bottom area
nrri
❑ NA
Leachlines/bed special design for slope:
(3) Pit Diameter
No. Pits
Pit Below
Seepage Pit TPtal Depth
Other.
Applicable
Inlet (BI)
(TD)
16
Max. AI, lois Depth
N/A -?—<-Overburden factor
❑ 5 6
f
►
No. 2 System
REMARKS:
This application istROVE/DENIED for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated
on the accompanlo Ian, 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 permittgd in the required reserved 100% expansion area.
(1) Septic tank and sewer lines must be SA:. minimum from any wells
Leach lines must be 100' minimum from any wells, including expansion area
3) Seepage pits must be 150' minimum from any wells, including expansion area
I A0
ate
—Signature of Health Official Date—
RECEIPT NO. /+ / t Issued By_� Date L�o
DISTRICT: ❑ Riverside, - ❑ Indio ❑ Hemel q Perris ❑ Rancho alit. ❑ Blythe
DOH -SAN -1.22 (Rev. 7/89) DISTRIBUTION: WHITE - Office file YELLOW . Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records
s
�4 o • r� u +..OFFICE OF l:
e AGRICULTURAL "COMMISSIQNER_.-
r.
ANDF
WEIGHTS &� MEASURES
• ��►�,•• CALVIN C. KAMINSKAS •"
JAMMO. WALLACE 4060 -LEMON STREET, ROOM `19 Assistant commissioner
Agricultural Commissioner RIVERSIDE, CALIFORNIA.92504. CLEMENT BENVENISTE
Director of Welphts & MeasuresSeater
(714); 787-2564
4.9613 Highway 86, Suite B12
"Coachella, Ca. 92236
(619)'342-.8291
DATE 1— 1 - oto CASE NO. C-
DEVELOPER'S NAMES Q ( /'1-�� �' yak ti�, P cti�4 v
II
ADDRESS:
'3 I ��o- 0.:� ►^4".1 �i y . G 22,3" y
TELEPHONE � ,�1� Z 6,-91 �.
A` CIL
Dear Developer: e to i 0 V P( 0 !.�
After reviewing your landscaping plans, .all plant material listed..is not in
violation of quarantine laws governing the Coachella Valley ' jf substitutions
do occur -and they differ.from•plant material "listed, "`this'office must.be notified {':
immediately.
Thank you for -protecting and preserving.the Coachella Valley's pest,_ -free environment.:
T
t
j'L.
_
AMERICAN ENGINEERING LABORATORIES
42240 Green Wey, Suite C
Palm Desert, CA 92260.
Telephone (619).;341=5790
Taz {619) 341,5794
Yucca Valley • Apple Valley; San Diego
Corona ' Moaesto`i`Pa1m: Desert *.- Watertown'* Hammonton
April 17, 1990
Account No. 81015
Belair Development
34-116 Date Palm Dr, Su-ite `6
Cathedral City, CA. 92234
ATTN: Brent'Lovett
Subject: In -Place Density Testing
Single Family Resider'tce
53=340'Avenida:Obregon
La Qu inta, California
On April 16,, 1990 a,>representative'of this company visited
the above' referenced p-roject..and performed in place density
tests.
The results. -of .our. testing. indicate tha.,t the embankment.
placed 'as compa,c.ted fill w.as, oropact-e&.,to at least 90 percent
of maximum density at the lacation:s: tested.
The maximum density was de;te,rmined per ASTM Test Method D1557
and the, f ield.. density tests,'-we�re,' performed in"accordance with
ASTM D2922:
Please cal:d this office if.you have any questions regarding
the above ref.eren`c.ed p.roj ect ,.
Sincerely,
AM ICAN Er INEERING LABORAT.O„RIES, . INC.
Pau Hoers g
.Vice ide.n T. 'sert Division
cc: Brent Love'tt 2)
PRH/kc
AMERICAN ENGINEERiN:G LABORATORIES, INC.
P
❑ 7940 Arions Dr., Suite A ❑ 350 S. Maple SL, Unit K O 515'Galaxy Way ❑ 58945 Business Center Dr., Unit A
San Diego, CA 92126 Corona. CA 91720 Modesto, CA 95356 Yucca Valley, CA 92284
(619)695-3730— (714)272-4230 (209)576-0813'
(619) 228-1754
CLIENT: Jn7 PROJECT: tJ3''.'34O DATE: / x/14 w
_
V v 1 y ,
U �Q.�(�•� N I.D. NO.:
PROJECT NO.:
REPORT OF 'FIEL=D COMPAC,TIO:N TEST
TEST I
LOCATION OF TEST
' -�' - -
` •�� J
FIELD
MOISTURE
%
OPTIMUM
MOISTURE
%
"FIELD
• ORY.DENSITY
P.C.F..'.
MAXIMUM •
DRY DENSITY
PERCENT;
'RELATIVE°
COMPACTION
"PERCENT;
REL- COMP..
• REQUIRED'
.REMARKS: -
I
FIELD
MOISTURE
OPTIMUM
MOISTURE
FIELD
DAY DENSITY;
TEST 0
LOCATION OF TEST
CEN'�6� or
CJ
• FIELD
'. MOISTURE
%
OPTIMUM
MOISTURE
%
FIELD
DRY DENSITY
P.C.F.
MAXIMUM
DRY DENSITY
-
PERCENT
RELATIVE
COMPACTIONS
PERCENT •-
CI°
rRE.COMP.
- REOUiRED
REMARKS: '
I
FIELD
MOISTURE
OPTIMUM
MOISTURE
FIELD
DAY DENSITY;
TEST I
LOCATION OF TEST
CEN'�6� or
aJ
FIELD
MOISTURE
%%
OPTIMUM
MOISTURE
FIELD
ORY DENSITY
P.C.F
-. MAXIMUM,.
.,DRY DENSITY
PERCENT'
RELATIVE.I
COMPACTION
"
REMARKS: ,/'' '
Y1� R'
I
FIELD
MOISTURE
OPTIMUM
MOISTURE
FIELD
DAY DENSITY;
_ MAXIMUM
DRY DENSITY
-
_ PERCENT
RELATIVE:.
-
REL"}COMV.
/fi� 7�
l~
%
%
P.C.F.
COMPACTION'
• REQUIRED...
'
/2�
TEST I
LOCATION OF TEST
CEN'�6� or
aJ
FIELD
MOISTURE
%%
OPTIMUM
MOISTURE
FIELD
ORY DENSITY
P.C.F
-. MAXIMUM,.
.,DRY DENSITY
PERCENT'
RELATIVE.I
COMPACTION
PERCENT. -
REL;COMP. `
.AEOUIRED-.
REMARKS: ,/'' '
Y1� R'
o.
.
4
TEST I LOCATION OF TEST•
t
FIELD OPTIMUM FIELD MAXIMUM. •PERCENT PERCENT REMARKS:
MOISTURE MOISTURE DRY DENSITY DRY DENSITY. RELATIVE. ,REL]`COMP.
% % P.C. i. ^' 'COMPACTION ' REQUIRED.