Loading...
PLBG (9912-179)LICENSED CONTRACTOR DECLARATION 11hereby 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. Date �-� 205214 C42 {3?J�fii 'Date ! A '� � Signature of Contractor OWNER -BUILDER DECLARATION ' I hereby affirm under penalty of perjury that I am exempt from the'Contr actor's License Law for the following reason: ( ) 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, Business & Professionals Code). ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). () 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. ( I have and will maintain workers' compensation insurance, as required by Se tion'3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier & policy no. are: Carrier t Policy No. S'Ckm, P, um 09 d5�•�J9 (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 notjemploy 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 Cppde, I shall forthwith comply with`those provisions". t5ate: / 1 Applicant �)7 Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $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. 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. Z. Any permit issued as a result of this application be 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 con4truction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspect -ion purposes. Signature (Owner/Agent) -''7�� Date n BUILDING PERMIT PERMIT# 9912-179 DATE 4119.�VALUATION S.1?goo.0 .LOTS.. TRACT JOB SITEY ADDRESS 52-35 F�1'��A.NIDA 1�'[RAN,'LD?17M APN I y OWNER f CONTRACTOR/DESIGNER/ENGINEER f f .Z' ` � l i `i}' J.V r) 1. ,,:i!'A%,t1"".) Ji , C i�l^ 14 CE..a�S."WiL � .1, IR"VAIr�1% 1.11 ',7 #39A AVENIDA IVIEN DOZA1681.9 LI7`CLENTIO.14.O1\GO'RUP.� ;'1 t" [ISNT '' CA 9'1 53 �Ul SCWr 1K)T S�' SNC,: CA moi` .10 - (160)329-6815 CB11 M6 ' USE OF P�RMIT SEPTIC AB.4N 0 , .^.'i5 ty{. RNT -C`'L r EgM1AUD) MST OF CONSTRIX.° ..i0 -N I,i3��.S1i3 FC:E SUA01-43re +1.1Jtt9l3ltsCi l- 3: -- $.eWER . 11014M -4194M Sf R-')TYT'A1. YMO N A NJ-) PLA M�V(7 $Y) 00 um $0.04) 'f!"4ii1AL P-CRt`+IFF DU NOW RECEIPT DATE BY - DATE FIN LED ,0Q 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 Wali Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final BLOCKWALL APPROVALS POOLS - SPAS Steel Set Backs Electric Bond Footings 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 O 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: COACHELLA VALLEY WATER DISTRICT c CASH RECEIPT DETAIL Q 41 . 76524 Received From: �� o epi �n r? $ `i I' c -e IJ C Date: ) 7 - 7 S Address: 1 (� — 91 `'r L Account No. -17 („_9'2 D 7 .Lot(s) ;7 Tract Service Address A L/ E.'A . An: -3 ,. , .,/� � Z � G.A. Code ❑ Meter(s) ❑ Service(s) ❑ Backflow(s) ❑ House Lateral(s) ❑ Detector Check(s) ❑ Meter Surcharge V,Sanitation Capacity Charge n WRRFr. ❑ Temporary Construction Meter ❑ Turn on Charoe ❑ Uncollected Account -Name ❑ Inspection Fee -Tract - Fee 7 Plan Check Fees Water / Sewer - Tract - ❑ Bond Payment - A.D. - Bond Assmt. ❑ Customer Deposit ❑ Other i f ) TOTAL $ Remarks: __1A I r L w. a. i� i q'CopY to: Cash Water Service Check 7 (r % Money Cashier e (✓� Order CVWD-438(11188) P.O. BOX 1504 Building.532~335 ��ondoze 78-105 CALLE ESTADO AddresLA QUINTA, CALIFORNIA 92253 Owner Joe SteVa-ar Mailing BUILDING: TYPE CONST. OCC. GRP. Address 79-940 Horseshoe A.P. Number 773-272-019 City Zip Tel. La Quinta 922,53 1342-3170 Legal Description Contractor Project Description .Single rttxrAIV Ih olliI g ress ity lZip I Tel. State Lic.I City & Classif. Lic. # Arcn., tngr., Designer Address I Tel. CityI Zip I 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., a, v i ✓ "4e � *'�• SIGNATURE - DATE 111' OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License law for the following reason: (Sec. 7031.5,Buslness 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 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 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, 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 improveme is are not intended or offered for sale. If, however, the building or improvement is sold within ane 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 contractoris)-licensed pursuant to the Contractor's License Law.) ❑ 1 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 - ' ! / 1! e I✓ :• t . ' ,. , r� 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 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: 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 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 inspection purposes. Signature of applicant Date Mailing Address City, State, Zip WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE Sq. Ft. 1200 Size No. - No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $64,830 PERMIT AMOUNT Plan Chk. Dep. 8350.00 Plan Chk. Bal. Const. 3lu . 00 Mech. 2b s uo Electrical 68.50 Plumbing 105.00 S.M.I. 52 Grading(}„�b Driveway Enc. 20.00 Infrastructure 1#416.60 TOTAL .!JU .2 6 REMARKS itt►� tjj"' 10 VP41 'it; tV 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 7/19/80 Issued by: Date Permit Validated by: Validation: WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES ISI FL SO F1 !p $ UNITS COLL. AREA SLAB GRADE �/ SPKLR SYSTEM 2ND FL SO FT. grYARD HEATING (ROUGH) STORAGE TANK MOBILEHOME SVC. BAR SINK POR SO FT. ar I ROCK STORAGE GAR SO. FT. Qr POWER OUTLET ROOF DRAINS METER LOOP HEATING (FINAL) DRAINAGE PIPING CARP. SO FT. a REINF. STEEL GAS (FINAL) WALL SO. FT. (a DRINKING FOUNTAIN SO. FT. a GROUT URINAL ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. , WATER PIPING NOTE: Not to be used as property tax valuation BOND BEAM FLOOR DRAIN MECHANICAL FEES GRADING cu.yd. $ plus x$ WATER SOFTENER VENT SYSTEM FAN EVAP.COOL MOOD SIGN WASHER AUTOXOISHI APPLIANCE _ DRYER I VVV GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED 12 _ r /� �,�J 1l f� c� LAUNDRYTRAY 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 SPARK ARRESTOR SO. FT. c WATER HEATER MAX. HEATER OUTPUT. B.T.U. SO. FT. RESID 14: c SEWAGE DISPOSAL I C LATHING — 2 SO.FT.GAR V4c MOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE I L.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB FEE STRUCTURE PLUMBING ELECTRICAL HEATING 8 AIR COND. SOLAR i f SETBACK GROUND PLUMBIN /DERGROUND A.C. UNIT COLL. AREA SLAB GRADE �/ GH 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.IEOUIP. REINF. STEEL GAS (FINAL) MP. POLE —/d — v— GROUT WATER HEATER SERVICE FINAL INSP. , BOND BEAM WATER SYSTEM GRADING cu.yd. $ plus x$ = $ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. I VVV ROOFING �) k,-), 12 _ r /� �,�J 1l f� c� REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR, FIREWALL I C LATHING — 2 MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS , GARDEN WALL FINAL itit 7 4 P.O. BOX 1504 APPLICATION ONLY Building ��� �� Q � � 78-105 CALLS Address 7 LA QUINTA, CALIFORNIAORNIA 92253 Owner „y ss Z fi ` Addre City Zipc Tel. ress Tel.. State Lic.I City & Classif. Lic. # Arch., Engr., Designer Address I Tel. CityI Zip I 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 I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Buslness 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 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, 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, asowner 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.) 0 1 am exempt under Sec. B. & P.C. for this reason Date w Ownar 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 ❑ 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 parson 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 or 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. 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 Mailing Addi City, state, BUILDING DIVISION BUILDING: TYPE CONST. OCC. GRP. Number �7 �2'% — 0 Legal Description Project Description Sq. Ft. Size New ❑ -� No. V Stories No. Dw. Add ❑ Alter ❑ Repair ❑ . -Demolition ❑ Estimateo Valuation PERMIT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS AMOUNT a n#1cA cnn 4 n nrat7 A7_4 7_-QQ 47 W -CAN CASH i. ' TOTAL f 275.00 ZONE: BY: ` Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line r 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. SO. FT. ® $ UNITS SLAB GRADE 2ND FL. S0. FT. BONDING YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SO. FT. GAS (ROUGH) DRAINAGE PIPING WALL SO. FT. OTHER APPJEOUIP. DRINKING FOUNTAIN SO. 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 WASH ER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. 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 ® 11/4 c SEWAGE DISPOSAL GAR. FIREWALL SO.FT.GAR ® 3/ac HOUSE SEWER LATHING 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 APPJEOUIP. 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 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 SIGNATURESIINITIALS GARDEN WALL FINAL Desert Sands Unified School District CERTIFICATION OF PAYMENT ®TICE: THIS DOCUMENT C A OTF BE DUPLICATED. SCH CILITY FEES W V � TO: City of La Quinta DATE: Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 This is to ce tify that ✓�` �r , developer of which is located at s tma, within this District, has paid school Acility fees imposed pursuant to the authority generatby Governme t Cod Sectiost 53080 in the amount of covering a total o fa square feet of( ) residential or ( ) industrial/commercial development and that building permits for this footage in this development may now be issued by your jurisdiction. for DESERT SANDS j 61IFIED�CHOOL DISTRICT White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer 0007 04 Z O U W Un .. Z O U w U) U) Y Q LU fY X Z O H U W 0 COUNTY OF RIVERSIDE, DEPARTMENT OF HEALTH ENVIRONMENTAL 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 specifications required on the attached check list. A non-refundable filing fee of S40 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 j City State Zip Code Telephone 'Job Properi Address 'City or Community 'Legal Description of Property (Lot. PM. TR) +� 'Assessors Parcel No Water Agency or Well n�6ewl l,44 Use of Permit Planning Case # Lot �ze SV. iVU —� �— / Y� K�• SFD. MH Site Preparation Etc 9gnalure`.of Applicant Date 'The above information must be venlied from Building Application STAFF USE — DO NOT WRITE BELOW THIS LINE Date (Initial Certification of Existing S.D. System required. ❑ Yes No V� — WOCB Clearance required. ❑ Yes No Soils feasibility report required. ❑ Yes UL1 No Special feasibility boring report required. ❑ Yes No Detailed contour plot plans required. ❑ Yes No PO Staff Specialist approval required. ❑ Yes No Lot Inspection Date Soils/boring report by Q A) 1-1 Project # Date Soils Map Page Soil Type Approved by Date Type of System: No. of Bedrooms (1) Septic Tank Soil Rate Required ❑ Existing New ❑ Additional ❑ Replacement 3- LO-UaGals. 14 L �..., (2) Leach line sq. ft. Sidewall allowance Install Lines) Ft. Long, Leach bed Sq. (Bottom trench area) ft. rock/ Sq. Ft. Ft. wide with min. inches Ft. of bottom per running ft. ❑ N/A rock below drain lines area Leach lines/bed-special design for slope: (3) Pit Diameter No. Pits Pit BI Seepage Pit total depth Applicable ❑ 5' 6' Max. allowable depth N/A Overburden factor M �✓ / iv► t%1�t14 P v . L G st r 1i- Ll% )OXAMvivii 10' i was 5?e Sem 1--ghvc�-- c 4 ll/ This application is approved/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 is necessary for the installation of the above -designed system. (1) Septic tank and sewer lines must be 50' from any wells (2) Leach lin must be 100' min. from any wells including expansion area Seepage pi must 6e 150' n. from any wells including expansion area 66 SignaWrebf Flea n OHicral Date RECE14 NO. 3� 1.5 Issued by Date District: ❑ Riverside ❑ Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File DOH -SAN -122 (Rev. 4/88) •° I R of f ICE OF E. LEON SPAGGY A .°" ' e; CO%tuISSIO`�EA s AGRICULTURAL COti1N115SIONER )ARIES O WALLACE J �1 AND ASS:S;A.%r COMMISSIU%EP d CLE�1E.4 1 BE`VENIS1E E° WEIGHTS & MEASURES SEALER 49-613 Hwy 86, Suite B-12 'Coachella, CA 92236 619-342-8291 \ 9 1 DATE %- 2 CASE DEVELOPER'S NAME,6t S -E- c P-^ '— E r - ADDRESS s 7 9 gs� __ S ko z TELEPHONES. Q2 - 3 /,-7b �f -7 6toe.k-16u u,. fi l S►4,�4.A C' Aral,-t.� Dear Developers 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. Agricul al Camissioner's O fAe ccs Indio and Riverside Office