07118 (SFD)Buildin
Address 53-760 Qbt e
Owner
��
Belai r Aeve
Address 34.116 Date Palm 0r. #6
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
City Zip Tel
Cathedral (i tat 92234 1 324»3767
Contractor
58.m
Tela
State Lic. City
& Classif. B2 558181 1 Lic. #
Arch., Engr.,
.Designer Design for Living
Address Tel.
Sam
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
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.
,- �GNATUfiE"-" DATE
OWNER -BUILDER DECLARATION
1 hereby affirm that 1 am exempt from the Contractor's License Law for the following
reaSOtK (Sec( 7031.5,Business and Professions Code: Any city or county which requires a
Permit to construct, alter, 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 Contractors License Law, Chapter 9 (commencing with Section 7000) of
OivLsfon 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the alleged exemption. Any vilolagon of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a chd penally of not more than five 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
bur72s of improves thereon and who does such work himself or through his own employees,
provided that such improvements are not' intended or offered for sale. ff, however, the building
or improvement is sold within one year of completion, the owner -budder will have the burden
of proving that he did not build or improve for the purpose of sale.)
❑ I, 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 comractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec B, 1£ P.C. for this reason
Date owner
WORKERS' COMPENSATION DECLARATION
hereby affirm that 1 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
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if Ne permit is for one hundred dollars (8100) valuation
or fess.)
1 certify that in the performance of the work for which this permit is issued, I shall not
employ arty person in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT., ff, after making this Certificate of Exemption you should become
subject to the workers' Corrpensation provisions of the Labor Code, you must forthwith
oompy wilh such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
1 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.)
Lendees Name
Lenders Address
This is t =permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
1 certify that 1 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 Add
City, State, ITP
No. 07118
BUILDING: TYPE CONST. OCC: GRP.-
A.P. Number. 374-155-032
Legal Description Lot 2, Bl k 203
Project Description S.F.D.
Sq. Ft. 1348 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation $75,855
PERMIT
AMOUNT
Plan Chk. Dep. $250.00
Plan Chk. Bal.
Lu • i
Const.
1. U
Mech.
53.50
Electrical
4015.36 -
Plumbing
0
S. M.I.
5.32 :
Grading
Z10. M
Driveway Enc.
Cu. rxu
Infrastructure
TOTAL
i /,
�s .
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: Dater' 90 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE fI/17/w �,f
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT. ®
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT. ®
OTHER APPJEOUIP.
DRINKING FOUNTAIN
SQ FT ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FRAMING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
REMARKS:
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEM/PERM
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.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR @ Vic
HOUSE SEWER
MESH
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 Yl;? 7 -4 `
y/I mw UMBIVOOi
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE fI/17/w �,f
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS,
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL% 7
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
GRADING
cu. yd.
10
$ Plus -x$-=$
LUMBER GR.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND O
FINISH GRADING
FINAL INSPECTION /
CERT. OCC.
FENCE FINAL
INSPECTOR'S SiGNATURES11NtT1ALS
GARDEN WALL FINAL
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COUNTY OF RIVERSIDE ENVIRONMENTAL ANO'
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 list.
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 #
Ag Pe
ddor,%Phone
I de�
—M:2.
dr s Firm
�
Owner
Phone
Mailing Address
City
State Zip
Job Property Address /
06114 .'V
Legal Description op. (PM, Traci
Zo-T o' 194/,� Z6 3
Lot Size Water A ell use of Permit P/P, CU, etc.
Other_
v Dwellin H Site Prep, etc.
A -9 49
/
t 1 / /� ! O
_
Signature of Applicant
Date
CATEGORY: REV CODE FEE
CATEGORY: REV CODE FEE
❑ 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
O ALTERNATIVE/EXPERIMENTAL 7345 $222.00
❑ She Evaluation Lot Less than
SYSTEM
10,000 Sq. Ft. 7347 $ 87.00
f
INITIAL DATE
Holding Tank Agreements Completed ❑ Yes - No TO /. S
Certification of Existing S.D. System Required ❑ Yes No
WQCB Clearance required. (Attach Form ❑ Yes No
DOH SAN 007, Santa Ana Region Only)
Sills Percolation Report Required. ❑ Yes No
Special Feasibilhy Boring Report Required. ❑ Yes No
Detailed Contour Plot Plans Required (1 to 5 ft. interval) ❑ Yes 11 No
Other ❑ Yes I I No
Staff Specialist Lot Inspection Required ❑ Yes No
Lot Inspection Date
Sills boring report by T" / Project if Date
Soils Map Page Sort Type Approved . by %/ !, Date
No. of Systems
Type of System(s)
No. Dwelling Units
(1) Septic Tank
Soil Rate
Grease
❑ Ing Tank ❑ Existing
New ❑ Replaoerrwnt
Bedrooms Flxture Units �/�
M 2 44#J
/,O
Z6
Grease
Gal
(2) Leech Line Sq. FL
Side rglLet
Install Line(s) ft long wide with
Leach Bed sq. it
Bottom trench area
R rock/ sq. 1L
per running ft
min. inches rods be nlines or
of bolt
❑ NA
—
Leachlines/bed special design for slope:
Applicable
N/A _X Overburden factor
(3) Pit Diameter
❑ 5 �6
No. Pits
Pit Belo`"
Inlet (BI)
�
14
(TD) SeePa9elry Depth
Other:
AI
Max.� Depth
No. 2 System
REMARKS:
This application isPPROVE /DENIED for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated
on the accompan lot n, 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 permit)ed in the required reserved 100% expansion area.
/(� Septic tank and sewer lines must be &.minimum from any wells
Leach lines must be 100' minimum from any wells, including expansion area
3)page pits must be 150' m' 'mum from any wells, including ex nsion area
Signature of Health Official Date
RECEIPT NO. A I H Issued By Date O
DISTRICT: ❑ Riverside, ❑ Indio ❑ Hemet 4 Perris ❑ Rancho lif. ❑ Blythe '
DOH -SAN -122 (Rev. 7/89) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. DepL GOLDENROD - Plans/Records
oo
OFFICE OF
AGRICULTURAL COMMISSIONER
AND
WEIGHTS & MEASURES CALVIN C. KAMINSKAS .
JAMES O. WALLACE 4080 LEMON STREET, ROOM 19 Assistant commissioner
AgrWhnot Commissioner RIVERSIDE, CALIFORNIA 92501 CLEMENT BENVENISTE :' .
Olrnctor of Welghts a Measures Seater
. (714) 787-2561 r,
49613 Highway 86, Suite B12
Coachella, Ca. 92236
(619) 342-8291 C
DATE j- I D CASE W. ` C, � S
DEVELOPER'S NAME: Q, A,;
Ca, 1
ADDRESS: Q2Z3�
TELEPHONE s ((v k j) 45-:)—f -% 7 (o :�
L_oc. ; Lo }- �� k 103C O%re�v�) �--0. Qu I `^�a
Dear Developers
After reviewing yourjandscaping plans, all plant material 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'''
immediately.
Thank you for protecting and preserving the Coachella Valley's pest -free environment.
;. ;.71
rl:.
American Engineering Laboratories, Inc.
58945 Business Center Dr., Unit A
Yucca Valley, CA 92284
Telephone (619) 228-1754
Fax '(619) 365-6908
San Diego o Modesto • Corona • Yucca Valley • Apple Valley • Palm Desert
April 24, 1990
Account No. 81015A
Belai-r Development
34-116 Date Palm Dr, Suite 6
Cathedral City,'CA 92234
ATTN: Brent.Lovett
Subject: In Place Density Testing
Single Family Residence
53-760 Avenida Obregon
La Quinta, California
On April 23, 1990 a representative of this company.visited
the above referenced project and performed in place density
tests.
The results of our testing indicate that the embankment
Placed as compacted fill was compacted to at least 90 percent
of maximum density at the locations tested.
The maximum density was determined per ASTM Test Method D1557
and the field density tests were performed in accordance with
ASTM D29.22.
Please -call this.office if you have.any:questions regarding
the above referenced project..
Sincerely,
AM J CAN EN INEERING LABORATORIES, INC.
Q
Pau oersti
ViceP �-ident; e ert Division
cc: Brent ovett 2).
PRH/kc
AMERICAN ENGINEERING LABORATORIES, INC.
❑ 7940 Arjons Drive, Suite A ❑ 1490 Rincon Street, Unit Z ❑ 515 Galaxy Way 58945 Business Center Dr., Unit A
San Diego, CA 92126 Corona, CA 91720 Modesto, CA 95356 X Yucca Valley, CA 92284
(619)695-3730 (714)272-4230 (209)576-0813
(619)228-1754
CLIENT: _ PROJECT: 53 _ -� DATE:
I.D. NO.:
NU tw PROJECT NO.:
REPORT OF FIELD COMPACTION TEST
TEST N
LOCATION OF TEST
�— O G \,
OPTIMUM
MOISTURE
%
FIELD
DRY DENSITY
P.C.F.
MAXIMUM
DRY DENSITY
FIELD
MOISTURE
%
OPTIMUM
MOISTURE
%
FIELD
DRY DENSITY
P.C.F.
MAXIMUM
DRY DENSITY
PERCENT
RELATIVE
COMPACTION
PERCENT
REL COMP.
REQUIRED
FIELD
MOISTURE
OPTIMUM
MOISTURE
FIELD
DRY DENSITY
MAXIMUM
--DRY DENSITY
PERCENT
RELATIVE
PERCENT
REL COMP.
REMARKS:
Prt
—'%
%
P.C.F.
COMPACTION
REOUIRED
COMPACTION
REOUIRED
�
a.5
��v•5
�5
TEST p
LOCATION OF TEST
�— O G \,
FIELD
MOISTURE
%
OPTIMUM
MOISTURE
%
FIELD
DRY DENSITY
P.C.F.
MAXIMUM
DRY DENSITY
FIELD
MOISTURE
%
OPTIMUM
MOISTURE
%
FIELD
DRY DENSITY
P.C.F.
MAXIMUM
DRY DENSITY
PERCENT
RELATIVE
COMPACTION
PERCENT
REL COMP.
REQUIRED
REMARKS: e
l/.tl
FIELD
MOISTURE
OPTIMUM
MOISTURE
FIELD
DRY DENSITY
MAXIMUM
DRY DENSITY
PERCENT
RELATIVE
PERCENT
REL COMP.
REMARKS: /0/�
�iy1Pv'
%%
P.C.F.
COMPACTION
REOUIRED
�
a.5
��v•5
�5
�'
TEST r
LocAnow of TEST
FIELD
MOISTURE
%
OPTIMUM
MOISTURE
%
FIELD
DRY DENSITY
P.C.F.
MAXIMUM
DRY DENSITY
FIELD
MOISTURE
%
OPTIMUM
MOISTURE
%
FIELD
DRY DENSITY
P.C.F.
MAXIMUM
DRY DENSITY
PERCENT
RELATIVE
COMPACTION
PERCENT
REL COMP.
REQUIRED
REMARKS: e
l/.tl
8 51c�
9 g
-5
9 a
TEST p
LOCATION OF TEST
FIELD
MOISTURE
%
OPTIMUM
MOISTURE
%
FIELD
DRY DENSITY
P.C.F.
MAXIMUM
DRY DENSITY
FIELD
MOISTURE
OPTIMUM
MOISTURE
FIELD MAXIMUM
DRY DENSITY DRY DENSITY
P.C.F.
I PERCENT
RELATIVE
COMPACTION
PERCENT
REL COMP.
REOUIRED
REMARKS:
✓'�7, ,!" \
!l,
b 5OZ511
I.3.5
9 g
is
TEST S
LOCATION OF TEST
FIELD
MOISTURE
%
OPTIMUM
MOISTURE
%
FIELD
DRY DENSITY
P.C.F.
MAXIMUM
DRY DENSITY
PERCENT
RELATIVE
COMPACTION
PERCENT
REL COMP.
REOUIREO
REMARKS:
�a