The URL can be used to link to this page

MISC (9512-043)P' N W O �/�J � r- W T n c Cs Z to P J W Co W U) Z LICENSED CONTRACTOR DECLARATION r I hereby. affirm 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. 629176 C;29 r 91.30195 ir License #_ Lic. Class Exp. Date Date2_rrr SignatureofContractor�r'' Jim vi OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's,AJc6fr Law for the following reason: () I, as o ner of the property, or my employees with wages as their sole compensati6n, 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:theproject (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. ( ) I have and will maintain workers' compensation insurance, as required by Section 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 *RE PUBIAC TN'ii. Policy No. 390982.8 (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,L6 or Code„d. shall forthwith comply with those provisions. ✓';, . Date: t'1. ° z. C c.._• Applicant ZZ;' % Warning -Failure to secure Workers' Compensation,coverage is unlawful and shall ,'.subject an, employer to criminal penalties andTcivil'ines 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 fora permit subject to the conditions and restrictions set forth on his application. 1 3Each 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 application agrees to, &shall, indemnify & hold harmless the City of. Indian Wells, 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) Date A"" _BUIL DING PERMIT PERMITi�,((I� DATE lI;YJ VALUATION LOT TRACT JOSITE ADDRESS 499 gl() rZkVt ti& Monfet* OWNER APN 64,6192005 CONTRACTOR ROBERT TAY MASONRY _ GEOFFREY G & BAIB.A WNI NEY 42200 BEACON Hlt.,L HA 4381.0.AVENID.fi MONTERO PALM DESERT CA 92260 LA QLJ1NTA CA 92.253 611917-VO12 CDL# 1246 DESIGNERIENGINEER USE OF PERMITS .t41. L. •', FEE DESCRIPTION FEES 6 FT. 'WALT. 121.00 LF LiSTIMKI O COST OF CONSTRUCTION 31625.00 I'i:iCd109IT .KEE SUMMARY ` SLID-TCYrAll, CONMUCTCON .AND PLAN CHECK i. $63.00 LESS PRE -PAID FEES $0.00 TOTAL YER10 IT VEWS DUE 'NOW $63.00 RECEIPT DATE BY DATE FINAL.ED 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 POOLS - SPAS steel Set Backs A Electric Bond Footings 2 / Main Drain Bond Beam Approval to Cover ill/U cW0 / / f Equipment Location Underground Electric Underground Pibg. 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: n Building Al .Sia Auewi D4 Address H0ntero T"r�' 4 4Q�u«fw The Rehm Family Trust Mailing Address 74818 Velie #10 City V. D. 7iP92260 Contractor Yea.ans & Kleine Address - 74818 Velie $10 City Zip P.D. 92260 State Lic. & Classif. 607379 Arch., Engr., Designer Address City of P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Tel. 773-0772 el.: 773-0772 Lic. # 1774 Tel. r Zip State Lic. # CONTRACTOR'S DECLARATION undeFprovisions of Chapter 9 (commencing with Section an'd Professions Code, and my license is in full force and 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, after, improve, demolish, or repair any structure, prior to its Issuance also requires the applicant for such permit to rile a signed statement that he Is licensed pursuant to the provisions or 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 or 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 or proving that he did not build or improve for. the purpose of sale.) O 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 contractorts) 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 ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATIONINSURANCE (This section need not be completed if the. permit Is for one hundred dollars ($100) valuation or less.) I certify that in the performance, 64e"c;;wo7k for which this permit is issued, I shall not employ any person in any mannebos�bject.to the Wotkets Compensation Laws of California Date NOTICE TO TO APPLICANTi'-1l, jahe0makingithl9 Certificate of Exemption you should become subject to the Workers;a., pensatron -provisions of the Labor Code, you must forthwith comply with such provisions or this permif'sliall 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 applicant Date- Mailing Address 4 City, State, Zip No. 10675 BUILDING: TYPE CONST. OCC: GRP.- A.P. Number 617-442-039 Legal Description Project Description Pool & Spa J Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation 91999 PERMIT AMOUNT Plan Chk: Dep. .'., Plan Chk. Bal. r 76.05 Const. 117.00 Mech. 24.00 Electrical. , 45.00 Plumbing 27.00 S.M.I. 1.00 Grading Driveway Enc. Infrastructure A / t1 ]1 t v tr TOTAL _ X y REMARKS(") r ZONE: BY: ✓ Minimum S backDisla cn es: ErroVrlt 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 F,�ES ,. 1ST FL. SQ. FT. ® $ 2ND FL. SQ. FT. POR. SQ. FT. ® GAR. SQ. FT. ® CAR P. SQ. FT. WALL SQ. FT. ® SO FT ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN. URINAL WATER PIPING NOTE: Not to be used as property tax valuation BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENTSYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DIS H) APPLIANCE DRYER GAS (ROUGH)`2 3 Z GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEOUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM I I 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 FRAMING SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1% c SEWAGE DISPOSAL SQ.FT.GAR ® V4c 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 r PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR' SETBACK GROUND PLUMBING IOWUNDERGROUND C. UNIT COLL, AREA SLAB GRADE i ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING. DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH)`2 3 Z METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM FINAL INSP. ft 16/0/ z` 1 FINAL INSP. CL GRADING cu. yd. $ -Plus-X$-=$ LUMBER GR. FRAMING ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FI FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL a HOME BUILDERS 74-818 Valle Drive, Suite #10 • Palm Desert, CA 92260 • 619 773 0772 (FAX 619 779 0150)' tk--- B L%9 -8iQ A UEn�) D �4 P.O. BOX 1504 Building 78-105 CALLE ESTADO Address i 6 is Montero LA QUINTA, CALIFORNIA 92253 The Beam Family Trust Mailing Address 74818 Velie Suite 10 City Zip Tel. Palm Desert 92260 773-0772 Contractor Yeomans & Kleine 74818 Velie Suite 10 City Zip P. D. 92260 State Lic. & Classif. 607379 Arch., Engr., Designer Michael Yeomans Address same as above City .eZip I State Lic. # Tel.: 773-0772 City Lic. # 1774 No. 10274 BUILDING: TYPE CONST. OCC: GRP. A.P. Number 617-442-038 038 Legal Description Lot 45 Tract 3448 Project Description SVE D Sq. It- No. No. Size Stories No. Dw. New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Tel. Permit includes 245 lf of block wall DECLARATION Tr' C 1P apierg"('co :ode, and my lic Icing with Section is in full force and L Pool to be issued under separate permit 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,Business and Professions Code: Any city or county which requires a permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to rile a signed statement that he is licensed pursuant to. the provisions of the Contractor's license law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cade, 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 rive 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 or 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. t, however, the buildingMech. or improvement is sold within one year of completion, the owner -budder will have the burden of proving that he did not build or bnprove for the purpose of sale.) Estimated Valuation 226,471.70 PERMIT AMOUNT Plan Chk. Dep. 250 • 00 Plan Chk. Bal.. 640.23 Const.1084.00 t� ,t �t l� 10 8 4 • 0 0 89.50 Electrical.. 180.109 Plumbing 193.50 O 1, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec: 7044, Business. and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. 8 P.C. for this reason S.M.I. 22.70 Grading 20.00 Driveway Enc. 20„00 Date Owner Infrastructure 4911.82 Arts in P-4ibli ; 316.18 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. n ' TOTAL ' V7728.62'r- ` 7728.62 7478.52 CERTIFICATE OF'EXEMPTION FROM WORKERS, COMPENSATION INSURANCE (This section need not be comple ed�rthe permit, s•lorroone hundred dollars (5100) vahration or less.) /`.. ,00",/t /�,,:..•" - I certify that in the performance: of-thgwork for which this permit is issued, I shall not employ any person in any me'6nek96 as to-'become•subject't6`thi3 Wrkei!' compehsation..._-, Laws of California j ` ^ i� r i`' Date Owner G r NOTICE TO APPLICANT, If, alter making this Certificate or 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. REMARR9 ��c, 11 N), ` f t /y ,/j a t j ttiii bi ` •�ytv 1 t "`��. kV l ; '`,fir A V,4 ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop: Line 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.) Side Street Setback from Center Line Side Setback from Property Line Lender's Name FINAL DATE INSPECTOR Issued by: Date Permit Validated by: 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 Validation: \ City, State, Zip / CONSTRUCTION ESTIMATE NO. I ELECTRICAL FEES, NO. PLUMBING FEE$ 1ST FL SO. FT. ® $ 2ND FL. SO. FT. ®` POR. SO. FT. ® GAR. SO. FT. ® CAR P. SO. Ff. WALL SO. FT. ® SO FT ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN. URINAL WATER PIPING NOTE: Not to be used as property tax valuation STORAGE TANK FLOOR DRAIN MECHANICAL FEES DUCT WORK WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER REINF. STEEL GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM FINAL INSP. 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. SO. FT. RESID ® 1 Vic SEWAGE DISPOSAL FIRE ZONE ROOFING SO.FT.GAR ® 3Ac HOUSE SEWER FIREPLACE GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PLCK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE / PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING,3,4�11 PZJQUNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE qV ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS J/ 2ffAJJ60R SEPTIC TANUGH WIRING. Klfilx� la 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. g �wFRAMING �t1 FINAL INSP. ROOFING:1 L 0- G `'IrJ 1 G l fl�i `n S g �a�5z I�Jp`�.� ` ll��Q� Vv�✓� l (� �� ` V // (P v St 0 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING l L,to MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION (� CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL Design 6 Production: Mark Palmer Design, 619-346.0772 eT H, E C T- Y 0 F. La u� .. 1982,= 1992 Ten.Canrat Decadeta b, vlh- August 19, ..1992.'. The Behm.Family Trust. 74818 Ve1ie,.Suite.10 Palm Desert,, CA 92260 -, TO WHOM "IT MAY CONCERN: J The property located. at 78-462 Montero - i n ;Montero _Estates in La Qui nta, A-.P-.N. 'is #617-442-1038, Lot 45', Tract 3448 has been re-addressed and now 49-810 Montero. If you have any questions, please feel free: to contact me; ` Sincerely, BUILDING AND SAFETY DEPARTMENT .• Tom Hartung' Director of Building and'.Sa ty /l ec ' cc: Riverside County Assessor. GTE/Vicki McQueary Cityof.La Quintan ` Post Offc e Box 1504 ♦ •78-105 Calle Estado , -La Quinta, California 92253 Phone (61.9) 564-2246, Fax (619) 564-5617 Design 6 Production: Mark Palmer Design, 619-346.0772 T H E C I T Y 0 FJL� a ��uinta 1,981.- 1991 Ten Carat Decade February. 3, ; .1992 Mr.-Michael 'Yeomans. Subject: 74-_818 Velie, Suite 10 Setback Adjustment: 91-075 Palin Desert',`'CA -92260 Location:.78-442 Montero APN: 617-'442--037 Tract. Legal:. 3448 mot 45 Dear Mr'. Yeomans: This. letter. is to report approval' of your recent 'application fora setback adjustment, pursuant_ to,..Chapter.9.1.88 of the.City of La. Quinta Planning &,Zoning Regulations. '-.The following setback adjustment has' been approved subject -to-conditions and in accordance with attached Exhibit A. SETBACK ADJUSTMENT: +3 foot front yard encroachment (variable setback distance) FOR-:: Attached 2 1/2 .car garage fora single..family home., CONDITIONS• 1_.. The attached'-garage structure shall-not be any, closer than,:17 the westerly property line (see Exhibit A). All other-R-2 8,000 Zoning-:Code standards shall. be-'met.` 2. 'This approval shall expire,`within 6 months of: this letterunless used in conjunction with. the issuance of a building permit for the new home. Thereafter,\' the approval-shall remain in effect as long'as the building permit remains active. After-review it was determined'that: : l.' This adjustment is consistent with the intent and purpose.. of the Zoning Ordinance. City of La Quinta Post Office -Box 1504 • 78-105 Calle Estado _? La Quinta, California 92253 Phone (619) 564-2246, Fax (619) 564-5617" LTRGT. 0 6 6 / CS Palmer • Design 8 Proouc'?on: Mark DesrgAblT9.346 0772 CASITAS II HOMEOWNERS ASSOCIATION Post Office Box 116 La Quinta CA 92253 November 14, 1991 Department of Building and Permits CITY OF LA QUINTA .Post Office Box 1504 La Quinta CA , 92253 RE: .PROPOSED CONSTRUCTION Calle Orense' Gentlemen: Please be advised that. the Board of Directors/Architectural Committee of Casitas II Homeowners Association of the Montero Estates,.has reviewed the plans for referenced construction submitted by Yoemans & Kleine, Builders. The plans appear to meet all the necessary criteria setforth in our CC&R's and we feel the proposed residence will be aesthetically compatible with the surrounding homes. Mr. Yeomans has assured us the construction site will be kept clean and any damage which might be sustained during this construction phase will be righted upon completion. If you have any, questions, please contact our Association office at 564-2177. Yours truly, WAYNE GARDNER President WG/at i COUNTY OF RIVERSIDE -DEPARTMENT OF HEALTH-Asseessors Parcel No. 1,/7,— �/ Z. — 23 ENVIRONMENTAL HEALTH SERVICES PERMIT APPLICATION FOR. A SUBSURFACE SEWAGE DISPOSAL SYSTEM Appynt. 4'Submit`thls form with four copies of a scaled plot plan (1-20 scale) drawn to Countyspeculations as indicated on the attached check list. A non-refunbable filing fee (see below) is required when the application is submitted. Check must be made payable to the County of s O(.jiRiverside. Approval of this application shall remain valid for a period not to exceed one year from date of approval. VERIFY ITEMS IN SEC ION A FROM BUILDING 8 SAFETY -APPLICATION. BUII:DING DEPARTMENT APPLICATION LOG # Q Agent •Contractor, Contact eerson Phone Address ne 773 Owner M077Z 19'9. r C' ate Zip Job P o Adde sA /D�f Legal Descrip ion Prop. (PM, Tract, Lot) '• Lot Size. - &aLer Agency)W-511 Use of Permit P/P, CU, etc. Other Dwelling; Site Prep, etc. - Signa u of plicantf Date ' CATEGORY:, ' - REV CODE FEE CATEGORY: REV CODE FEE f9' SUBSURFACE DISPOSAL '' 1238 ❑. SITE. EVALUATION UPON REQUEST 7349 $42.00 ❑ MULTIPLE PARCELS WITHIN SAME (NO PLOT PLAN) LAND DIVISION ❑ SEWER/SEPTIC VERIFICATION 7348 $11.00 a. 1 st 4 Parcels (Each) 1238 $45.00 (Less than 1 year) b. Each Parcel after 4 7344 $16.00 ❑ PRELIMINARY ELECTIVE 7352. $45.00 O Rereview (2nd review same parcel) " 7344 $16.00 EVALUATION.(Attach DOH SAN 53) ❑ . 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 ITI DATE Holding Tank Agreements Completed ❑ Yes.- - 3- Certification of Existing.S.D. System Required ❑ Yes MN WQCB Clearance required. (Attach Form ❑ Yes MoNo DOH SAN 007, Santa Ana Region Only) Soils Percolation Report Required. T ` " ❑ Yes N Special Feasibility Boring Report. Required. ❑ Yes CSI Detailed. Contour Plot Plans Required (4 to -5 ft. interval) ❑ Yes - /1yo Other " ❑Yes i3�No Staff Specialist Lot Inspection Required ❑ Yes 0% Lot Inspection Date G Soils boring report by Project # Date-� _ " Soils Map . Page Soil Type Approved by Date No. of Systems/ : Type of System(s) ❑H��►di�Tank 0 -Existing No. Dwelling Units 0) (1) Septic Tank Soil Rate Grease/Sand dk'l ew ❑Replacement _ Bedrooms, Fixture, ttt; 3 BD J -78 D/Lirl • AJAX,, /�K d % �C�rease Intcp "ate Gal Gal Leach Line Sq. Ft. Sidewall allowance Vi Instals) ft long ft wide with t Bed sq. ft. Bo trench area ® {l ftrocW sq• ft• per running ft. � NA min. inc k below drainlines or ofbottom a Leachlines/bed special design for slope: (3) Pit Diameter . No. Pits _ Pit Below. Seepag�5t Ti j Depth �}}ll bt er. Applicable J Inlet (BI) . Max. Allowa Depth N/A- Overburden factor A y No. 2 System /.4 _ REMARKS: °� oo/ J �. ..P 7�D . . Th s applica ii is PROV E�11ED for. a category checked i ECTION B above, regarding the design.of. a subsurface disposal system as indicated oft the accompanied ploy the requirements set fort iaa permit is necessary for the installation of the ,# above -designed system. No construction is permitted in the required reserved 100% expansion area). Septic a �� _7LicQ,2o6.4Z(� tank and sewer lines must be 50' minimum from any wells . �2 Leach"lines must be 100' minimum from `any wells, including expansion ea --ll,, ' pits m (3) Seepage ust be 1 minimum froril any wells including expansion.area �'a' T:iQQ� q/ Si nature of'-Heatth_Official7. fate- -�-� d CALVIN C. KAMINSKAS Assblonl Commissioner (714) 215.3000 NS BY, ESNIERALINI us REV1810 c" a IN, 10 RLIJE JAI T RoWN 10 L" T z r'.w t + ROOMS DR IN' L4 p LA OUINFA :CWELLS W, 2 ouNrfty �.pl t - 11.o� , c a' cFN IF ty P, &V s III& sti YAVAP.AL, At p bl� MEID DL4jS PL c 01I 1— qp I IN I N'�, Co CAM A�7 p 7 A '01 WEL Ss 13 Y, G -50 U P 41). G k 7 TE� f I -oll 0 icv H w p - ffElqce LOT 44 F_ W, e�j 1, *, , 7615. tn 'A 71 -- W 4 A, t i3q AV� OLD LOT LINE 31 V" 65 0" t -Qu 0 1 T s + LA" I 14 TC) q ------- PRESENT LOT LINE EX. 6' GARDEN WALL TO ...... ... Cm N 8911'15* W 67.04# 19 s FL) 53. Z_ .5 1�1, I "! - , VIA �V,P, c 0 _6� 7 7.: I I I , , It., ,- �, -P, 3 1 sn, PS YA4ZD 77p EX- 'qoAjw� �J3 jA CIVINTA 30, SI + J/ AVAT� EX. 6' HIGH SHRUBS L > n r4 c�n cor4a ------ s, L -I NE 4 F-)41 Ls -ro x.% .. ns! C, U 9.S -J 6mUT 50 M' 7 .......... + e- ;Ooos .... ..... '0 A.V LeA I -A oulr.. > Tu X.: j cz> ".GA yr u) CIL .. ----- I— un, M _X > > CALIJE A )m A [CA, V. Ty F- r. A &r) JA_ 'o -ri Ncm cowc. c r -F& To 136 U, AVI m 0 r -x ws IZF-m O -E-0 To ALI-a7w F0 SPIRK TFT wz .......... 'Y �%MF-0#4,H .. ..... "S" P14Z I v F_ WA- ... .... x. -*i 4 u - It PRI VE: Hc�y is . .. ... . . . . . ........ .. . N EW 6,2Nc-, .. ....... X . ........ �GENERAL NOTES X. APPROACH FIE�� CIT-( 77 - LA. QUI N-11,06. 5Tj*PAIZPS THE G .. .... ......... SIMI 'AND SITE CONDITIONSBEFORE STARTING WORK. CONTRACTOR SHALL VERIFY ALL DIMENSIONS _X -xi: Is .. .... . . ....... .......... L18 % 00 DIMENSIONS SHALL TAKE PRECEDENCE OVER SCALES SHOWN PGE ....... . .... ON DRAWINGS. . ............................ .. ......... L 3. ALL WORK SHALL CONFORM TO THE MINIMUM STANDARDS OF THE . ........... LATEST EDITIONiOF THE UNIFORM BUILDING CODE AND ANY OTHM ct� x, ..... . ..... .. ........... 'REGULATIONS OVER MY PORTION OF THE WORK, INCLUDING THE �s E�INF_ STATE OF - CALIFORNIA DIVISION OF INDUSTRIAL SAFETY. ^gcf4 14AY. xix- .. ...... . *T ENTKY 10 -Z F _t4f, . . . . . . .. . . . :z . . . . . . . . . . . . 4 x.., CONTRACTOR SHALL VERIFY ALL DIMENSIONS ONJOB ......... ---------- :- :-:i*x. .. - :. * * ... :* ... (51.6 SITE WHICH AFFECT HIS WORK. EACH CONTRACTOR SHALL BE T -M ------ WORK RESPONSIBLE FOR FURNISHING MATERIAL AND PERFORMING R, .. .. .. .. .. p PER MANUFACTURES SPECIFICATIONS.— tj ..... Q 0. - T . L9 ..... .... i FZA- I IS 1- 0 THE CONTRACTOR SHALL PROVIDE ALL MEASURES NECESSARY . . ..... ---- OL 77- -ITF ...... ... .... . . . .... .. ....... . TO PROTECT THE STRUCTURE DURING CONSTRUCTION. SUCH .... .... . .. ... ... ... MEASURES SHALL INCLUDE BUT NOT BE LIMITED TO BRACING SHOR- .. ....... .. ... . . ...... ...... Q 'ING FC1R,, LOADS DUE TO CONSTRUCTION EQUIPTMENT, ETC. (Tj4r.) ...... 6' S ........... CONSTRUCTION MATERIALS, HALL BE SPREAD OUT'JF�PLACED . . ......... .. .. ..... ExCEED THE ....... 6N-hwm b -8ijIfIt NOT LOA FLOORS OR ROOF .... ......... . ....... . . . IGN LIVE LOAD PER sQuARE FOOT. PROVIDE z ADBQUATE Dt§ -AND/OR BRACING WHERE STRUCTURE HAS NOT TT .... ...... . SHORING A. AINED 4V SPIRK %A DE�IGN STRENGTH. ......... .............. ....... v .... ..... ....... ....... ......... 0 .......... . .......... (52-60 TC) . . . .... ... i ..... ..... . FL) (52.32 . ... I. ...... Xe. .... .. ... ... TET, r- o N C, Fz E T E 13L(P- PLAN X MANT EX p4&LL- A� sm-oTH rINISH 100 C-1 j:5 b .......... C, (52.84� at . ... . . ... A. . .... .... . ......... < ...... x::j: ..... ..... . fr LIA Lo sl :ix Y :-xiii �s' .............. r EX. Ir ..... 5, -LT F1 A I'SH 14 + ........... ...... . '5d 1 LP I �G /,k 1`2�� R OCK,.j 17 00 5-rE:pnNc;., -STONES (F W - -d FZF 0 ?T Z I C, PF Ip -DIU5 -3 -y .. ... ...... M X r X% - 3' < X ST SIG GTE EASEMENT LLJ AO' G v. J:3 3 Up k� 3 TNAc-7 �3"` '^S,5H0\VN bq 1� S r20 ^.,L -2 L root_ p. 1*1 - fWEIVIS1 VE c1:00 RTY I - — , I = 15� 0 WIPE 17 - ++12 - 0�6 -SrA 0 1.4) fZ&I-SEP STIN.' , WATER METERS U) SPZ) Soup 75. 0 '70 6' C, 15- J, 6, L=6.06' 4r - � r 'S I TE V N/1, 4 MA., JW -IN re;vl_ 77 F)zOf'E4ZTY I— I N FE: (-ttirx) I Site Plan SPRK 8 121zoPER-TY, LINE M (0 71- 2 Fou dati'n Plan and 1) tails GAS 0 R e SP K 0 CONPENSIP4CI UNIT ON PA4> To Ew- .3 Floor Plan cc*c CoW -TE 5L01 14 1G47F_ WA4-L K�A m1m. 31, A450ve cqg,%pE smroTH FiNi5 H E�,<TF_124 OF, PLb,5TF_rz *I ON _Fit ei TA -4 I- CAZ k E, 0 Lu 4. Elevations `ttttt`tt"t`10=rR4AW IN ,,�E e or JV S4. C§ - 0, Z _R__ 3-0 I 5 Ou ildi ng Sections Lx gy DATE nd 6 Building Sections, Doo 1? Window Schedules. 81CALE 1A, ------------ Plan Roof Framing JOE NO. -,2 4 c. oA& T rLI16,NCE CEIRTI f 1(=��TES IIIIHIRET BIT IBIT EXH E Eledrical Plan 6 �75 ASE s�, M Me c chni al Plan APP GVE ING DIVISION Y PLANK, 48 .19 Z__ L d �lan an scape L/A4 Y& % PRINTED ON CLEARPRINT 1000H 4