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RPL (9610-093)LICENSED CONTRACTOR 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 Professionals Code, and my License is in full force and effect. License # Lic. Class Exp. Dated 5 17170" BI ate Signatute of Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ( ) 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 & Professionals Code). ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals. Code). O I am exempt under Section B&P.C. for this reason Date Signature of Owner 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. VI have and will maintain workers' compensation insurance, as required by S, ion 3700 of the Labor Code, for the performance of the work for which this permit is issue;d: Mygwgrkers' compensation insurance cajr�%Ii&,;policy no. are: Carrier Policy No. (This section need not be completed if the permit valuation is for $100.00 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, and agree that if I should become subject to the workers' compensation provisions of Section 3700. of the Labor Code, I shall fortAwith comply with those provisions. (Date: a Applicant Warning Fa lure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,01)0, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building'and Safety for a permit subject to the conditions and restrictions set forth on his 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 applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 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 State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection purposes. Signature (Owner/Agent)--"`"r1'�'*'yam`'`'^? Date�� l BUILDING PERMIT PERMITk CONTROL# �E _q 6�,t�.>1 4266 D TE VALUATION S,f 4tjt),6(1 LOT TRACT ADDRESS 51-945 Ab'ENIDA All"E�1�IR OZA JOB SITE APN 773-181,024 OWNER CONTRACTOR / DESIGNER / ENGINEER :Fjt`�atir r cs*t,, ttwYGTUCG 5'URKCON S 11,Uvi'I-0. X1,985 AWNl.t A M11NDOY..A 3 % G—Ju kNO 08 I A, Q� 1i.hi` A, CA 9X2.•.53 PAW UEMU CA 9221.1 fiii�`'1.SVi•,9-:+57t4 s'fil.!>^i'iat�.�7;1 C13.€.fit %�i1 USE OF PERMIT ('+~.11X, AN1JIOR, SPA. P00L. At D AX7 1CfAO PATIO CONS T12WC.10N, 1140 j .OING 2WLi 5' }3T OMC WALL. ('t)t.rl_ A1ViWO*r. SPA. 8,1100,00 US f°0KC1A/1'1A'CI0 dF;B.tt?f St., 5 ,' i`, WALL :3.13+) Lill ESTIMATED COST Citi C0r°4P`.MP*,aJ'Q: iii' N ;y; 19i,:v{D:uel PIn;I0111' feCV, tirJ11311 ARV NiFtCHAN ICAC. - ER - Pom, 101-00"21-000 $24.00 h1JEC.t'1:1CAk.60 -.ix0e? C 1o1..I'�0..47,(3-,000 $45,00 +rIX,4iV"Ni`,I-T-E-- 000 101-000-11.9-000 527,00 VILM.d ti1'LTxd;.K FIX 1(3L-11�! �3.'.� ,;111 S€S1,!p4► '�--- ---'-� a: N:t7°Fit iC 1'(CrC.T 1 r is • (fi t �(i(Ml-�11:1f-0(?fi $124,00 l ;SUi AW.M, C0F+ .S1 WC -r N.A:ND ft'A'N C��1 14F!`C��yyli �3f?.1.4ti3 .1112-13S PIK, t L. c( UYVAL PERMIT FEES; MA, NOW $314.9$ {p� I RECEIPT DATE. BY % DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final BLOCKWALL APPROVALS steel POOLS - SPAS Set Backs Electric Bond Footings ?i L Main Drain Bond Beam / Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: wt 4 "� P.O. BOX 1504 No. 06764 Building 78-105 CALLE ESTADO Address 51m-985 indoza LA QUINTA, CALIFORNIA 92253 Owner frank Greco - - BUILDING: TYPE CONST. OCC: GRP. Address —380 .. t M01'lal A.P. Number 773-181-023 _ Legal Description Project Description $iCCk Wall City BerawdA Dwma Zip 92201 Tel. 343-4467 Contractor C. Address City Zip Tela State Lic. & Classif. City Lic. # Sq. Ft. No. No. Dw. Size Stories Units Arch., Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. city IZip I State Lic. # LICENSED CONTRACTOR'S DECLARATION ZI lexeby af(inn that I am licensed under provisions of Chapter 9 (commencing with Section 711 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 1 am exempt from the Contractors License Law for the following reason: (Sec- 7031-5,0usness and Professions Code: Any city or county which requires a pem* to construct, afar. rrprove, demolish, or repair any structure, prior to is issuance also requires the applicant for such permit to lie a signed statement that he is licensed pursuant to the provsions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Ofvisian 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exerrpfiarr. Any vbggion of Section 7031.5 by 'any applicant for a pent subjects the appilicarif to a cW penally of not more than five hundred dollars ($500). ❑ 1, as owner of the properly, 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 Contractors License Law does not apply to an owner of property who builds or irproves thereon and who does such work himself or through his own employees, Provided that Such irprovemenls are not intended or offered for sale. If, however, the building or rrprovament is sdd wW* one year of completion, the owner-buider will have the burden of prov i g that he did not buil or irprove 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 rot appy to an owner of property who builds or improves thereon, and who contracts for such projects with a con0acWs) 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 Workers 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 empleted it the permit is for one hundred dollars ($100) valuation or less-) I certify that in the performance of thF work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of CalifomLL Date Owner NOTICE TO APPIU ANT: f, after making this Certificate of Exemption you should become subject to the Workers' compensation provisions of the Labor Code, you must forthwith corrpy wfh 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 property 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 $3,750 PERMIT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL AMOUNT $63.00 .28 y REMARKS r.tss z . rk n=< 7K , •1. + fa. ;�v +h1 IV 04aii I 1t3#fit_ Y 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 12/19/83 Issued by: Date Permit Validated by: Validati CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ® $ UNITS COLL. AREA SLAB GRADE YARD SPKLR,SYSTEM 2ND FL SQ. FT. HEATING (ROUGH) STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® DUCT WORK ROCK STORAGE GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS METER LOOP HEATING (FINAL) DRAINAGE PIPING CAR P. I SQ. FT. ® GAS (FINAL) WALL SQ. FT. DRINKING FOUNTAIN. GROUT URINAL SQ FT ® FINAL INSP. ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation GRADING cu. yd. $ plus x$ 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, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. ® c BATH TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. Q. FT. RESID ® 1% c SEWAGE DISPOSAL SQ.FT.GAR ® Wic HOUSE SEWER MESH GAS PIPING PERMIT FEE PERMIT FEE tPL.CK.FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.F 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 APPJEQUIP. REINF. STEEL/ Z GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM A C WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING: FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS ' GARDEN WALL FINAL T4tyl 4 4 Q" Building Address 52-985 Mendoza Prank J. fteCi? Mailing Address 74-380 Part Fgya p City lZip ITel. City lZip Tel. State Lic. I City & Classif. 203493 Lic. # Arch., Engr., Designer Address Tel. P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 City( Zip ( State I 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 1 am exempt from the Contractors License Law for the following reason: (Sec. 7031.5,8usiness 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 Me 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 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 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. lf, 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 safe.) ❑ 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 contractors) 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 ❑ 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 the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of thg 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: ft, 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 property 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. Signature of applicant Date Mailing Address City, State, Zip No. LDING: TYPE CONST. OCC: GRP. P..Number 773-182--024 Description Project Description Skil 06562 Sq. Ft. 1442 No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ stimated Valuation $82,937 PERMIT AMOUNT Plan Chk. Dep. $250.00 Plan Chk. Bal. $ 230,05 Const. 668.50 Mech. 54.00 Electrical 208.37 Plumbing 160.50 S.M.I. 5.74 Grading 20.00 Driveway Enc. 20.00 Infrastructure 1,805. 3 TOTAL s2 + J r.1 1011 REMARKS fk!ST'!f'' P 40 0'".17t( <()-_ U t.f^t l t'1 3 I if I Mt_ I ."0 '. `I 7 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 NSP9C10..R 789 Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ® $ UNITS SLAB GRADE A/Z(J d 2ND FL SQ. FT. YARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS FOUND. REINF. GAS (ROUGH) ��j/y�` METER LOOP DRAINAGE PIPING CAR P. I SO. FT. ® OTHER APPJEQUIP. REINF. STEEL WALL SQ. FT. DRINKING FOUNTAIN FT ® GROUT URINAL ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation WATER SYSTEM FLOOR DRAIN MECHANICAL FEES =$ WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER % / �l a l GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM VENTILATION 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. SQ. FT. ® c BATH TUB GAR. FIREWALL SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® I V. c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ec 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 �� (� ROUND PLUMBING�1 1Y/8 UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE A/Z(J d ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS ROUGH WIRING / SEPTICft DUCTWORK ROCKSTORAGE FOUND. REINF. GAS (ROUGH) ��j/y�` 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. 3 7 o FRAMING / FINAL INSP. / ROOFING /w7/,?P/} % / �l a l REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACEIISe SPARK ARRESTOR GAR. FIREWALL LATHING r/Qw/r / MESH INSULATIONISOUND f Ptop FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL N ow LW - a� RECEIPT NO. Issued By j"" Date DISTRICT:' ❑ Riverside, 9 Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept. GOLDENROD - Plans/Records 1 COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH Assessors Parcel No. ENVIRONMENTAL HEALTH SERVICES — — 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 checklist. 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. Q VERIFY ITEMS IN SECTION A FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG Z f 0 Agent, Contractor, Contact Person Phone Address & Phone WOwner U) FRAkl <;RE4�D Phone 1W -!5446 Mailing Address 7Y -.&O l- ,P7" oy G 4b�, C'State �Z��lz,�iJ� t� uN1s l.:A , Zip 901 Job PropertyAddress `�i Legalpescription Prop. (PM, Tract, Lot) T'"`ia ,131,x, ,//8 uU? �/ QL Lot Size Ae�V7811 Use of Permit P/P, CU, etc.- -P Other rte` f Qrlox/" (�J/f ��f// ff_i�r d7, ,V I W, D r �, ,J� _--- :ia(,J�+� )r--, , 6/2 -o 1Jwellin ,.MH, it& a Prep, etc. Signature of Applicant Date CATEGORY: REV CODE FEE CATEGORY: REV CODE FEE SUBSURFACE DISPOSAL 1238?, U ❑ SITE EVALUATION UPON REQUEST 7349 $42.00 m ❑ MULTIPLE PARCELS WITHIN SAME (NO PLOT PLAN) Z LAND DIVISION ❑ SEWER/SEPTIC VERIFICATION 7348 $11.00 0 a. 1 st 4 Parcels (Each) 1238 $45.00 (Less than 1 year) H b. Each Parcel after 4 7344 $16.00 ❑ PRELIMINARY ELECTIVE 7352 $45.00 W ❑ Rereview (2nd review same parcel) 7344 $16.00 EVALUATION (Attach DOH SAN 53) U) ❑ Site Evaluation in Conjunction with ❑ HOLDING TANK 7351 $45.00 Critical Area 7346 $86.00 ❑ ALTERNATIVE/EXPERIMENTAL 7345 $132.00 ❑ Site Evaluation Lot Less than SYSTEM 10,000 Sq. Ft. 7347 $86.00 Holding Tank Agreements Completed ❑ Yes 8<0""", INITIALrDATEC� Certification of Existing S.D. System Required ❑ Yes J N _ . WQCB Clearance required. (Attach Form ❑ Yes DOH SAN 007, Santa Ana Region Only) Soils Percolation Report Required. ❑ Yes P.NP.:1 "�'r�Special Feasibility Boring Report Required. ❑ Yes Detailed Contour Plot Plans Required (1 to 5 ft. interval) ❑ Yes ,1 Other ❑ Yes Staff Specialist Lot Inspection Required ❑ Yes PI No Lot Inspection Date Soils boring report by Project # Date f q G+ Soils Map Page ! °� ! Soil Type Approved byDate U Z No. of Systems Ue of System(s) ❑ Hplding Tank ❑ Existing No. Dwelling Unitsrl % Bedrooms, FixtMOT iflt5 (1) Septic Tank Soil Rate Grease/Sand 0 B'New ❑ Replacement QQ� /L1�! �(• � d �/ °`� "� Gal LUU Leach Line Sq. Ft. Sidewall allowance In�WLine(s) ft long ft wide with teach Bed sq. ft. Bo m trench area ft rock/_sq. ft. min. orches eb drainlines or of 0 bo per running ft. �- L`J" NA Leachlines/bed special design for slope: (3) Pit Diameter No. Pits Pit Below Seepage Pit Total Qepth �c , her: Applicably j�a�r °ON'5" L� 6 Inlet (BI f� Max. Allowgb N/A Overburden factor (Q ((� [depth T No. 2 System i V IA REMARKS:-�,`l.�.J...'t d { This application is�lYPPR60�V eNiEWfor the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated t❑ on the accompanied plot plan, using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the Z aboyezdesigned system. No construction is permitted in the required reserved 100% expansion area. W2a Septic tank and sewer lines must be 50' minimum from any wells'4 /9 Leach lines must be 100' minimum from any wells, including expansio 'area (3 Seepage pits must be 50' minimum from any wells, including expansion area�f �U . ,��'� "3 1� lr G`� 't'iN C`9 J �� Signature of Health Official cam• � DateC;9' _ 0 RECEIPT NO. Issued By j"" Date DISTRICT:' ❑ Riverside, 9 Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept. GOLDENROD - Plans/Records 1 RECORDING REQUESTED BY OI, ANUE COAST TITLE CO. RT �] AND WHEN RECORDED MAIL TO `_ NAME Frank J. Greco, etux ADDReas 79380 Port Royal CITY d STATE L-sermuda Dunes, CA 92201 MAIL TAX STATEMENT11 TO 1 NAME ADOREEe SAME AS ABOVE CITY & STATE L 11 ' ps 00 Wj N n dc CL LC 0 W 1, W 1.0 AL SPACE ABOVE THIS LINE FOR RECORDER'S USE Documentary transfer tax3_11-55 .............................. ® Comj'uted' on full value of property conveyed, or ❑ Computed on full value less liens 8 encumhrcinces re ain. g thereon at time • le. ,.�........... t?..ie . ,. &A Signature of declarant or agent determining tax firm name ❑ Uriincorporated. area City of. La.•,Q� }n .......... I Grant Deed L This form furnished by Orange Coast Title Company PARCEL NO 773-181-023-(D FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, JAMES L. MONTGOMERY, Trustee of James L. Montgomery Trust, dated March '18, 1980 hereby GRANT(S) to FRANK J. GRECO and NANCY C. GRECO, Husband and Wife as Joint Tenants the following described real property in the City of La Quinta county of Riverside state of California: Lot 11 of Block 118 of Santa Carmelita at Vale La Quinta, Unit No. 12 as pera�ecoraed in Book; 18 pages 79 an-d-So—o�7a-ps--sn- ' of the County Recorder of said County Dated September 8, 1988 aures L. Montgomkoler , Trus ee STATE QF.CAWO,RNIK 0 — COUNTY OF f On —Q ! _ SS J V � Aw W appeared_ `- A�yUa C 10 (y7 W U- V W a� J Y lei subscribed to the within " OFFICIAL: SEAL 3 V I-� JAMIE WARDING W (Ti ' ps 00 Wj N n dc CL LC 0 W 1, W 1.0 AL SPACE ABOVE THIS LINE FOR RECORDER'S USE Documentary transfer tax3_11-55 .............................. ® Comj'uted' on full value of property conveyed, or ❑ Computed on full value less liens 8 encumhrcinces re ain. g thereon at time • le. ,.�........... t?..ie . ,. &A Signature of declarant or agent determining tax firm name ❑ Uriincorporated. area City of. La.•,Q� }n .......... I Grant Deed L This form furnished by Orange Coast Title Company PARCEL NO 773-181-023-(D FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, JAMES L. MONTGOMERY, Trustee of James L. Montgomery Trust, dated March '18, 1980 hereby GRANT(S) to FRANK J. GRECO and NANCY C. GRECO, Husband and Wife as Joint Tenants the following described real property in the City of La Quinta county of Riverside state of California: Lot 11 of Block 118 of Santa Carmelita at Vale La Quinta, Unit No. 12 as pera�ecoraed in Book; 18 pages 79 an-d-So—o�7a-ps--sn- ' of the County Recorder of said County Dated September 8, 1988 aures L. Montgomkoler , Trus ee STATE QF.CAWO,RNIK COUNTY OF f On —Q ! _ SS —before me, the under. -� - signed, a Notary Public in and for said _ County and State, personally appeared_ `- - NOTARY SEAL OR STAMP known to me to he th erson_—_.whose name ( subscribed to the within " OFFICIAL: SEAL instru nt and acknowledged that executed the same. I-� JAMIE WARDING of N NOTARY PUBLIC • CALIFORNIA PRINCIPAL OFFICE IN RIVERSIDE COUNTY Aly Commission Exp. Sept 1, 1991 Name (Typed or Printed) of Notary Title Order No. Escrow No. MAIL TAX STATEMENTS AS DIRECTED ABOVE a • Of ''�,. OFFICE OF �AGRICULTURAL COMMISSIONER v � AND WEIGHTS & MEASURES CALVIN C. w4MlNswas JAMES O. WALLACE 4080 LEMON STREET. ROOM 19 Assistant Commissioner Agricultural Commissioner RIVERSIDE, CALIFORNIA 92501 CLEMENT BENVENISTE Drector of weights R Measures (714) 787-2561 Sealer 49613 Highway 86, Suite B12 Coachella, Ca. 92236 (619) 342-8291 Q :Er 2 9 DATE %r _ % CASE ND. %� 9 %� 5 DEVELOPER'S NAME : lz-� ADDRESS : 71 - 3 8D 6tl— TELE$HONE: (4(1?) 3Y5— Y Y % 1-0 ZL 4 Dear Developer: After reviewing your landscaping plans, all plant material listed is not in violation of quarantine laws governing the Coachella Valley. If substitutions do occur and they differ frau plant material listed, this office must be notified immediately. Thank you for protecting and preserving the Coachella Valley's pest -free environment. Agricultural CamLissioner' O fice cc: Indio and Riverside Office rr 4