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12230 (SFD) + 3446 (SFD)
11111111IIIII III IIIII IIII 5° Building €(' /am Address ( • �� P.O. BOX 1504 APPLICATION ONLY /J 78-105 CALLE ESTADO Alvarado LA QUINTA, CALIFORNIA 92253 Owner 6ar-v Ake-rs Mailing Address Cityg 7 4b ' f -/z) !OV4d4,e l( mute- / Tel. 34/5-- — //OO ernl uh ilius Zip Contractor Sd 2 Address BUILDING: TYPE CONST.' OCC. GRP. A.P. Number Legal Description 77v- 0a - 016 7` 6 / /vc/< aS4/ 4,t gq Project Description City Zip Tel.. State Lic. r$ Y '4/3 GZ2 & Classif. T o City Lic.# 350 Arch., Engr.- Designer � £ �LJ�e+^ �(%u/.� Address -7 755- 5- dc/ o/<ee�P• Sq. Ft. j- pa. No. No. Dw. Size ..7 0 Stories Units New 0 Add 0 Alter 0 Repair 0 Demolition ❑' Tel. 365 af,6 city ViVCClc. Va//ey Zip ?,,2 , 34. 1 State Lic. # ).ae' 4/5-0 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 'n full force nd ( eftec 74•(A ✓— , 17Q 2'7 SIGNATURE�'" /7 / DATE IV/ OWNER -BUILDER DECLARATION • I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (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 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 f by'any applicant for a permit subjects the applicant to a civil penalty of not more than Ave 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, 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 Intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder wit 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 contractor(s) licensed pursuant to the Contractor's License Law.) ❑ I am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Workers Compensation Insurance, or a certified copy thereof,. Sec. 3890, Labor Code.) Policy No Company `E'Copy is filed with the city. 0 Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) 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. Date Owner NOTICE TO APPLICANT: If, 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 Lenders Address This is a building permit when properly filled out, signed and validated, and is subject to expiration it work thereunder is suspended for 180 days. 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 the above- mentioned property for inspectio%7purposes. Signature of applicant � v7lW'rL i ''Vj Dated Nailing Address Ur -5(/0` ' - „is/( ,11,.n City, State, Zip f1'o � %+r.� � . A' in l • � c. c r Cl' O !'11r2 1 BUILDING DIVISION Estimated Valuationle/7' 7 PERMIT AMOUNT Plan Chk. Dep. o 0 Plan Chk. Bal. (p/- 7/ Const. 3 s 90 Mech. So o 0 Electrical fs•y6 Plumbing /ate o S.M.I. 5.- :2-2 Grading o 00 Driveway Enc. ao- o� Infrastructure " 1;/7ian .,21v4'J /m 4i• '77 TOTAL 0e2 9. 6 4 REMARKS K7'il..7 Y O., ,L VC➢ C� ¢31 • " � J ty i i r. i n rAr1d r 4 Tr ill f ?7C . f1 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 Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES / 1ST FL. l ? SQ. FT. @ / (7 ( $4, a / �5- — STORAGE TANK UNITS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) 2ND FL. SO. FT. 4/.2 - GAS (FINAL) TEMP. POLE GROUT YARD SPKLR SYSTEM SERVICE FINAL INSP. ,J BOND BEAM WATER SYSTEM GRADING cu yd. MOBILEHOME SVC. LUMBER GR. FINAL INSP. BAR SINK FRAMING FINAL INSP. POR. SQ FT ® -7 YO S - POWER OUTLET VENTILATION ROOF DRAINS FIREPLACE GAR. SQ. FT. ® SPARK ARRESTOR GAR. FIREWALL LATHING DRAINAGE PIPING MESH CAR P. SO. FT. /749 d FINAL INSPECTION CERT. OCC. DRINKING FOUNTAIN INSPECTOR'S SIGNATURES/INITIALS WALL SO. FT. @ SQ. FT. ® URINAL ESTIMATED CONSTRUCTION VALUATION �7 $ / 3 tcO - WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER 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, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. 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 @ 14c HOUSE SEWER 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 GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE 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 APP./EQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu yd. _$ LUMBER GR. FINAL INSP. $ plus x$ FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL SECTION A SECTION B Cc 2 w Ir SECTION C -t ,.. -t. .. ,ii. ^ ---,......-;•-- • MINI IIIIIIIIIIII 51 IE I COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM ,` 77T -ZOO- — 0/ Applicant: Submit this form with four copies of a scaled plot plan (1-20 scale) drawn to County specifications required on the attached check list. A non-refundable filing fee of $37^is required when the application is submitted. Check must be made payable to the County of Riverside. 0 Building Department Application Log # Name (Owner, Agent, Contractor, Etc.) 6 Qi -v S. / kers Mailing Address y/ 7410 //7/ 4'c City / germLtia 0441 es- State C4 Zip Code q..20 t Telephone 3/S-//oo, , 'Job Property Address ti vr_ A /vlGlra�v "City o C-ommunity (4)4«t ,. 'Legal Description of Property. (Lot, PM, TR) "Oa... ',• �''" Los- 7 , Bloc, 'y, n,7`y , 'Assessor's Parcel No. 77q -,,?0,- 0/7- 6 Watei"Agenc orwWell' -..-•- w D. �' - , n�� /% Q, ,,r�" Use of Perm .i/�f`GC! w/ f /"""pl n'g Case it Lot Size t I x /0) SFD, MH Site Preparation I SFIO Al- l q, 2-S 19 Signature of pp Ica Date / . 'The above information must be verified from Building Application STAFF USE — DO NOT WRITE BELOW THIS LINE Initial Date Certification of Existing S.D. System required. ❑Yes ©NoV/ 6?— ,7•-tr-P WQCB Clearance required. ❑ Yes <o/" f Soils feasibility report required. ❑ Yes ❑ o" i Detailed boring report required. 1=1/" Yes No./- • It Detailed contour plot plans required. ❑ Yes o• I f I Staff Specialist approval required. ❑ Yes LTJ No Lot Inspection iDate . Project # Date Soils/boring reportby�j // Soils Map Page I/ if Soil TypeCi(_-. Approved by A-•4-14--.. Date9 ' 2--f -p 7 Type of System: V y ❑ Existing Plfew ❑ Additional ❑ Replacement No. of Bedrooms 3 %'N,i ' (1) Septic Tank /avre Gals. Soil Rate Required V•9-1(17171,9;147 (2) beach line sq. ft. (Bo otr ch area) Sidewall allowance ft. rock/ Sq. Ft. Gf Install Line(s) Ft. Long, r Leach bed Sq. Ft:afAbottom • area �' Ft.' w de, th min inches per running ft. CiN/A _ rock below drain lines Leach lines/bed-special design for slope: Applicable -� (3) Pit Diameter/ 5' 6' No. Pits Pit BI /[L T Seepage Pit total dep h--'�''7e Max. allowable depth YO N/A L.--0`..."-Overburden factor .,..ka_..,„, ,,,— .-2.4r .4 SSD 4,�,,.._4+ ...� . / , This application is aS pproved'.denied-for the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements set forth in Section B above. A building permit �snecessary for the installationll1of the above -designed system. /� 41» Septic tank and sewer lines must be 50' from any wells -T/ /0 of .Z; Le 3. � � -g-e,-,4?--,�/ i G�r (2) Leach lines must be 100' min. from any wells including expansion area -,'s1 ' including expansion areap , )9-....e.t.a.,-per`�,�_ S (3) Seepage pits must be 150' min. from any wells ).,/ / p,.,,,, / Signature of Health Official- / /, ,s %r Dale , j P if e / / 06, RECEIPT NO District: ❑ Riverside ©`Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File DOH -SAN -122 (Rev. 6/86) Issued by 5 1 Date OFFICE OF AGRICULTURAL COMMISSIONER 4080 LEMON STREET, ROOM 19 RIVERSIDE. CALIFORNIA 92501 1714) 787.2561 49-613 Hwy 86, Suite B-12 Coachella, CA 92236 (619) 342-8291 1-1111111-11p111 52 E. LEON SPAUGY COMMISSIONER JAMES O. WALLACE ASSISTANT COMMISSIONER Dear Developer/Landscaper: Thank you for inquiring with the Agricultural Commissioner's Office regarding local quarantine laws. Any diseases or insects associated with the plants/landscaping material presented on your landscaping plans do not pose a threat to the Coachella Valley Citrus, Date, Grape, Vegetable, or Field Crop industry. We therefore approve your landscaping plans. If however, any substitutions of plants/landscaping materials within your plans occurs between now and the actual planting date, you must contact this office within 48 hours before delivery into the Coachella Valley. Also, the substituted plants/landscaping material must be held for inspection upon arrival. Any sub- stituted landscaping material found infected/infested with quarantine pests will be immediately treated or shipped out of the Coachella Valley at the discretion of the Agricultural Commissioner's Office. Under penalty of perjury, I the undersigned will comply with the above. Authorized Agent: Name Signature /4keirs afge64 Permit Number(s) R s7R.S 25 -A - Date 2 ,$.A-.- - J?, 6 a-../7 i/, ' 2S Gt 2 Developer 6LALmv,._ Address AGRICULTURAL COMMISSIONER'S APPROVAL Date 9 - Authority cited: Agricultural Code; Sections 6301, 6461, 6462, 6464, 6501, 6521- 6524 cc: 2 Plan Check, Indio Office, Riverside Office tJ•stic 201c1"b3rzc P.O. Box 1108 Yucca Valley, California 92284 365-6383 1900 Sc Ft-. X 3w/sQ•Fr. ...y200 w 1%4 300c e 1007. Remainder P� 5S% - ,Ctr'C. 0 1 SOO 1,J ea . I - Gcx Pb • 0;T.F. , . e., l 000 vu I _ • Cfr .-. @, 1 GOOW I- W' H. Circ . `15oOw L.CuPACI i s rG . e.,15 0 0 W 1- Dry.er Ctrs. @� SO oQ w 1 Ray - .e. Grc • e gOcxDw a.-ec,.44A Hrt - 125 -Ow cc. • 1- 3%Z +oh A/c Corp• 753(0 I- Airy Ho, -,d).. C. FSI ` (No ►te„� S.frIs) 240 = 1 5 $ 0.,"%:, 1 Use 00awsT Ser -vie -e. z. 1111111141111 53 3000►. Li zo �,.. 3000u lopow 1500 1.. `15oov 1500w 5 oopk, OQOH ZSOOw 17 53Co $1 w 3x11992• oo 110319 111 54 IE Desert Sands Unified School District CERTIFICATION OF PAYMENT OF SCHOOL FACILITY FEES TO: City of La Quinta Department of Community 78-105 Calle Estado La Quinta, CA 92253 CD DATE: / U�l/e% Fiat tertTHIS DOCUMENT CANNOT BE DUPLICATED. R a Y 399 / 9 7 /if" This is to certify that developer of c:2 „444/ located at -,1-4/-//,.5-1- (at..A6x_ this District, has paid school facility fees imposed pursu.)nt to the authority enerate• by Go ernment Code .ectio�t 5 08t in he ;u•..n $ 4; /4/4 ( //L t -4../..L..,.I.... f uk ' V.iA_/ i ! %/. /Qi)2l% covering a total of ,4 2F,2 x a_ square feet o ( residential or ( ) industrial/commercial development and that building permits for this footage in this development may now be issued by your jurisdiction. which is , within for DESERT SANDS UNIF ED SCHOOL DISTRICT White - Building Department • Yellow - Facilities Planning • Pjnk - Accounting • Gold - Developer 5-65 (10)-37 Phone (619) 568-3627 eYe/le 52 (t£CI'9W- C70: For the Finest in Escrow Service Jackie Phillips Escrow Officer WC c W 11 1 44-900 San Pablo Avenue Palm Desert, CA 92260-3537 ucevat•,. Wim.• &(JW 60: 44-900 SAN PABLO AVENUE • PALM DESERT, CA 92260-3537 (619) 568-3627 our execution of these instructions, the sum of $500.00, and will further deposit an additional amount of $16,500.00, plus closing costs, in the form of a cashiers check, just prior to close of escrow; and will deliver to you any instruments which this escrow requires shall be executed by me. all of which you are Instructed to use provided on or before October 6, 1987 you hold a policy of title insurance with the usual title company's exceptions, with a liability equal to the total considerations herein covering Lots 6 & 7, Block 254, of Santa Carmelita at Vale La Quinta, Unit 11111111111111111111111 55 10-1419 • Escrow Number August 7,1987 Date Paid outside of Escrow Cash through Escrow Encumbrances of Record Encumbrances of Record New Encumbrances Total Consideration 17,000 30. 17,000 ' DO 24 As per map recorded in book 19 page(s) 44&45 of maps in the office of the County Recorder of Riverside (Memo: Property Address: Vacant Land — refer to legal description above, showing title vested in: GARY S. AKERS and LYNDA P. AKERS, husband and wife, as Joint Tenants County, Calif. FREE FROM ENCUMBRANCES EXCEPT ONLY THE ITEMS NUMBERED BELOW: (1) General and Special taxes for the fiscal year 19 87 19 88 , which are not delinquent as of close of escrow (2) The lien of supplemental taxes, if any, assessed pursuant to Chapter 498, Statutes of 1983. of the State of California (3) Bonds/Assessments: None (4) Covenants, conditions, restrictions, reservations, rights, rights of way, easements, and the EXCEPTION OR RESERVATION OF WATER, OIL, GAS, MINERALS, CARBONS, HYDROCARBONS OR KINDRED SUBSTANCES ON OR UNDER SAID LAND, now of record, If any. . INSTRUCTIONS: (A) This escrow is subject to the Buyers approval of a copy of the Preliminary Title Report and C.C. & R.'s within 7 days of Buyers receipt of same. No written disapproval to escrow holder within said time period shall be deemed Buyers approval as to this condition. (B) This escrow is subject to the Buyers obtaining the necessary approval to construct a single family residence on each of the aforementioned lots. All parties signing this agreement hereby acknowledge receipt of a copy of these instructions. Prorate taxes based on latest available tax bill as of Close of escrow Prorate insurance handed you as of or buyer will hand you new insurance at his option. Prorate Homeowner's Association dues as of r N/A • Prorate interest on loans of record as of N/A Prorate rents and adjust deposits as of . based on rent statements handed you. Any rents in arrears are to be disregarded in your prorations. Credit seller. and debit buyer the amount of impounds, if any, as disclosed by beneficiary statements from the holders of the loans of record. I/We agree to pay escrow tees and charges as charged. • N/A N/A EACH PARTY SIGNING THESE INSTRUCTIONS HAS READ THE ADDITIONAL ESCROW CONDITIONS AND INSTRUCTIONS ON THE REVERSE SIDE HEREOF AND APPROVES, ACCEPTS AND AGREES TO BE BOUND THEREBY AS THOUGH THE REVERSE SIDE HEREOF APPEARED OVER THEIR SIGNATURES. vBuyer's Signature ��-• R pBuyer's Signature . Gary. S.•Akers . Lynda P. Akers Address Phone The foregoing terms, provisions, conditions and instructions, and those on the reverse side hereof are hereby approved and accepted in (heir entirety and concurred in by me. I will hand you necessary documents called for on my part to cause title to be shown as above, which you are authorized to deliver when you hold or have caused to be applied funds set forth above within the lime as above provided. Pay your escrow charges. my recording fees, charges for evidence of title as called for whether or not this.escrow. is consummated, except those the buyer agreed to pay. You are hereby authorized to pay bonds, assessments. taxes, and any liens of record, including prepayment penalties;. if any, to show title as called for. Pay Documentary transfer taxon deed as required .• Pay commission as follows $ to $ to Seller's Signature...- -----.–.----._ ..._ Seller's Signature Margaret Y. Chan • Address— --..._—.—. PD 12/86 Building Address Tat, 44thirad P.O. BOX 1504 78-105 CALLE ESTADO •to_A LA QUINTA, CALIFORNIA 92253 Owner Gary S. Akers Mailing Address City A1.x'7Ail Met,. Zip A't 1 Aireoln 1r Bermuda Dunet i 92201 Tel. 345-1100 Contractor Same Address 1111111IIPIII 56 No. 003446 BUILDING: TYPE CONST. • OCC. GRP. A.P. Number 774 —202 —01fi Legal Description Project Description Single Family Dwelling City Zip Tel. State Lic. & Classif. 484382 City Lic. # 350 Arch., Engr., Designer Sq. Ft. Size 1382 No. • Stories No. Dw. Units New ❑ Add ❑ Alter 0 Repair 0 . Demolition 0 Address Tel. Rene 200' City Zip State Lic. # Garage 450' 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 intuit force and effect. __41 -__41 -,to.,. .✓f,✓r,� DATE tLi`l 1Gr -7 SIGNATURE CJ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (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 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 civil penalty of not more than live hundred dollars ($500). O 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, 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 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 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 contractor(s) licensed pursuant to the Contractor's License Law.) IJ I am exempt under Sec B & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I 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 ' ,41'r Ea Copy is filed with the city. 0 Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) 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. Date Owner NOTICE TO APPLICANT: If, 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 ,'✓l.f-.t 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. 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 the above- mentioned property for inspection purposes. // I Signature of applicant --+ -r 'f4 '' . (C. :A (4, Date �'/ ' Mailing Address "•' -• City, State Zip HARD COPY Estimated Valuation $74,484 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 61 71 Const. 15L.nn Mech. n -on Electrical 04 Plumbing li17-nn S.M.I. C 22 Grading t) _ f:f1 Driveway Enc. 2n. t1f9 Infrastructure 1.091.77 TOTAL 20-“ REMARKS r#"?t'`stet 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 10/9iRlPermit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL SO. FT. SO. FT. SQ FT so. FT. SQ. FT. SO. FT. SQ. FT. VALUATION @ $ STORAGE TANK FORMS UNITS ,OUGH WIRING 9)77 DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP 2ND FL. OTHER APP./EQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE /l/3/? ,,.2 / GROUT WATER HEATER YARD SPKLR SYSTEM FINAL INSP. POR. ® GRADING Cu yd MOBILEHOME SVC. FINAL INSP. plus x$ BAR SINK FINAL INSP. GAR. @ ,. /v / //��!/ll[[//� X --7-.--ii. /D/�✓ e 2 ' 05 y REMARKS: VENTILATION`'I�'/�y POWER OUTLET FIRE ZONE ROOFING ROOF DRAINS SPARK ARRESTOR CAR P. GAR. FIREWALL (J� LATHING{-J�� , 3417 MESH DRAINAGE PIPING FINISH GRADING WALL @ FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS. DRINKING FOUNTAIN @ URINAL ESTIMATED CONSTRUCTION $ WATER PIPING 1I NOTE: Not to be used as property tax valuation FLOOR DRAIN ! !!!! MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER 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, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. @ c BATH TUB SQ. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID @ 11/4 c SEWAGE DISPOSAL SQ.FT.GAR @ 3/ac HOUSE SEWER 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 /2 , GROUND PLU BI G � UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE 4 'ROUGH PLUMB BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR S IC ,OUGH WIRING 9)77 DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE /l/3/? ,,.2 / GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING Cu yd LUMBER GR. FINAL INSP. plus x$ n , i' /CFRAMING7-) / , [y FINAL INSP. ROOFINGS./5- — 17 ,. /v / //��!/ll[[//� X --7-.--ii. /D/�✓ e 2 ' 05 y REMARKS: VENTILATION`'I�'/�y FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL (J� LATHING{-J�� , 3417 MESH INSULATION/SOUND 3 (Z4 (go FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS. GARDEN WALL FINAL SECTION A SECTION B SECTION C COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM 1 10111114111 11111 ffj 64 IE Applicant: Submit this form with four copies of a scaled plot plan (1-20 scale) drawn to County specifications required on the attached check list. A non-refundable filing fee of$37 is required when the application is submitted. Check must be made payable to the County of Riverside. Building Department Application Log # Name (Owner, Agent, Contractor, Etc.) Mailing Address City State Zip Code Telephone 'Job Property Address 'Assessor's Parcel No. 'City gr aernedi Water Agenc ;onoMell "Legal Description of Property. (Lot, PM, TR) Use of Perm' 'Planning Case # SFD, MH Site Preparation Etc Lot Size Signature of'dpplict *The above information must be verified from Building Application Date STAFF USE — DO NOT WRITE BELOW THIS LINE Certification of Existing S.D. System required. WQCB Clearance required, Soils feasibility report required. Detailed boring report required. Detailed contour plot plans required, Staff Specialist approval required. ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes Initial Lot Inspection Date Date Soils/boring report by Project # Soils Map Page Soil Type Date Approved by Date Type of System: ❑ Existing la -New ❑ Additional ❑ Replacement No. of Bedrooms (1) Septic Tank Gals, Soil Rate Required (2) Leach line sq. ft. (Bbttpm trench area) Sidewall allowance ft rock/ per running ft. ❑ N/A Sq Ft Install Line(s) Ft Long, Ft wide-wt((t min inches rock below drain lines Leach bed Sq. Ft. ofi bottom area Leach lines/bed-special design for slope: Applicable N/A Overburden factor (3) Pit Diameter No, Pits Pit BI Seepage Pit total dep h Max. allowable depth t This application is"approved/djnied-for the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements set forth in Section B above. A building permit is necessary for the installation of the above -designed system. (1); Septic tank and sewer lines must bei,50' from any wells (2) Leach lines must be 100' min. from any wets including expansion area (3) Seepage pits must be 150' min. from any wells including expansion area Signature of Health Official RECEIPT NO. Issued by_ Date District: ❑ Riverside Di Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File DOH -SAN -122 (Rev. 6/86)