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003724 (SFD)Building Address 54-705 Carranza T lb 0 Oul 44f 4 QKWA P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Coachella Valley Land Co. Mailin Address 2417 E. Tah' quitz Slay #2 City Zip Tel. Palm Springs' - 922:52 1 322-1020 Contractor Address Zip State Lic. City & Classif. 387934 Lic. # 895 Arch., Engr., Designer Address Tel. City Zip State 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. G4,7 SIGNATUREF" i" .✓ `� DATE ,� OWNER -BUILDER DECLARATION Thereby 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 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 orimprovement 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.) ❑ 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. ❑ Certifiefd'c'opy 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 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 Dale Mailing Address City, State, Zip HARD COPY T No. 003724 BUILDING: TYPE CONST. OCC. GRP. A.P. Number. 774-274-021 Legal Description Project Description • E3 • Sq. Ft. 1410 No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ 170 0 of 6 • wood fence 428' Garage Estimated Valuation PERMIT -AMOUNT ' Plan Chk. Dep. $250.00. Plan.Chk. Bal. . 5 39.14. Const. 364.00 Mech. 33.00 Electrical 74.17 Plumbing 105,00 S.M.I. .. - 5.36 Grading 20.00 Driveway Enc. 20.00 Infrastructure 1.698.86 TOTAL S2„�03 /��e•++� REMARKS R o. 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 3/17/83 Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS A.C. UNIT COLL. AREA SLAB GRADE �7 (,, YARD SPKLR SYSTEM 2ND FL. SQ. FT. p BONDING HEATING (ROUGH) MOBILEHOME SVC. BAR SINK POR. SO. FT. ® SEWER OR SfPTIC1 AN(ROUGH WIRING GAR. SO. FT. ® POWER OUTLET ROOF DRAINS A v (ROUGH) DRAINAGE PIPING CAR P. I SQ. FT. ® HEATING (FINAL) OTHER APPJEQUIP. WALL SO. FT. ® DRINKING FOUNTAIN SQ. FT. ® URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation SERVICE FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GRADING cu. yd. plus x$ GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FINAL INSP. LAUNDRYTRAY AIR HANDLING UNIT CFM ROOFING y 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 FIREPLACE SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER LATHING4j / --j y GAS PIPING PERMIT FEE MESH 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�j GROUND PL M ING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE �7 (,, UGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SfPTIC1 AN(ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. A v (ROUGH) 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. FRAMING 527 FINAL INSP. ROOFING y i �/ REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING4j / --j y MESH INSULATIONISOUND. -20 ® FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS, GARDEN WALL FINAL ,. .•�, . }. ry R ct 1-m ,-'7 '. ��rir rt�^.Y� �%. lc' ��. i��'` � •.'_ `� .� r-T.,t �. r 't` y �. �.., ,� t� • / -,e ..>..• �., r'.- �''j 1. r1{ y�'fr �..rtr'+,� ALM.,.�s�,�nir �► r t z 0 H U W U) u z O U w U) V) Y tr Q W Ir Vf`z�y % i 0z;w U W Cn I t, LZ COUNTY FOF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION -77 —;27 Y — U a - 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.) �:o Mailing Address C,, // � � 6?-A,d,e �aaS1'Rc4�T'��v oZ`ii t 7_AH�Ju?Z WA Cdy 1041,* Sowess Slate ' -.4 G'� Zip Code Aja z 47-- 1 Telephone 3.72-/o z0 ,. 'Job Properly Address ,[J,/���DA '_CAy,oi••Commonoy 'Legal Description of Property (Lot. PM. TR)✓:�7 ;"`�"4 /i SY —7D_j- CAoev 4AIz /t' Q 141Ai7-,J 4a7' /O ,Q«30Q CLL1 T o4 dej 'Assessor's Parcel No Water�A a of;Well+. CSC gC�+ee//A ��.iL c �,,J ��11,,�,, � / FPe,miD L4 "PVu)1�----%-Pla�.ng case #7"•� Lot Size �/y 2 % /1 — v / �p � Jo e� ��J �+- Site Preparation EI Signature'OT Applicant Z Date 'The above information must be verified from Building Application STAFF USE — DO NOT WRITE BELOW THIS LINE /n Initials Date Nor Certification of Existing S.D. System required. ❑ Yes D WOCB Clearance required. ❑ Yes ❑O No Soils feasibility report required. ❑ Yes 0 N Special feasibility boring report required. ❑ Yes E No r l Detailed contour plot plans required. ❑ Yes © No 11 f r Staff Specialist approval required. ❑ Yes eNo Lot Inspection Date Soils/boring report by . /1 Project # Date Soils Map PagA r CVSoil Type( , Approved by / rte` Date f-- —1 -3 Type of System: (/ No. of Bedrooms (1) Septic Tank Soil Rate Required ❑ Existing ©'New ❑Additional O Replacement 3 f'%' 4�' W Gals. (2) Leach line tt. Sidewall allowance Install 1 Line(s) Ft. Long, — -de Leach bed Sq. bottom (Botto trench area) ft. rock/ Sq. Ft. F -with min. inches Ft. of 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 ^��n Applicable factor t.5' ©"6' ' / S/ Max. allowable depth /7 N/A Overburden '�/At ,� ./1 i� rn.r. r. - _ �i� /%t'7.' e,n. /J �r✓i%/ t-.�d..r-'?,-._ This applicationTis app vro ed/ niedFfor the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements forth in B above. A is for installation set Section building permit necessary the of the above -designed system. _ 1 Septic tank and sewer lines must,be 50' from any wells /(v (2) Leach lines must be 100' min. frm any wells including expans on area (3Seepage pits must be 150' min. from any wells including expansion area Signature of Health Official y G�, Date RECEIPT NO. 333,6 Issued by -1-S-A Date 3'�f-- Xr District: El Riverside ❑`( dio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe Distribution: WHITE -Office file YELLOW -Applicant PINK -Bldg. Dept. GOLDENROD -Pending File DOH SAN 122 (Rev 8187) r V44J OFFICE OF AGRICULTURAL CO3"A ISSIONER AND WEIGHTS b. MEASURES 49-613 Ilwy 86, Suite n-12 'Coachella, CA 92236 619-342-8291 E. LEON SPAUGY COMMWIONER JAMES 0 WALLACE ASSISTANT COMNUSS10%ER CLEMENT BENVENISTE SCALER DATE -L5' — /9gS' . CASE NO. S8/QS D 3/.�' B DEVELOPER'S NAME: ADDRESS: - 2 y-7—_ TELEPI [ONE: s q _2go Dear Developer: 40 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 Coamissioe 's Office cc: Indio and Riverside Office