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05586 (SFD)Building 54-490 RUBIO Address Coachella Valley Land • 4 P.O. BOX 1504 78.105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Mailin Address 247 E. rllaliquitz Way #2 City ,� T 'Palm, S�3ia.I1LC� s Zip 922662 �39/322—" 020 Contractor Starr Construction Address. fii''t�'316 ' City lZip Tela State Lic. City & Classif- 387934 Lic. # 895 Designer Address CityI Zip I State 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 affirTn that 1 am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,6usimess 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 Qtiision 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 civilpenalty 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 appy 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 unprovement is sold within one year or completion, the owner -budder will have the burden of proving that he did not build or inprove for the purpose of sate.) 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 appy to an owner of property who bu dds 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 r' WORKERS' COMPENSATION DECLARATION,, I hereby affirm that I have a certificate of consent to self<in§ire, a certificate of Worker's Compensation Insurance, or a certified copy the[_eof. (Stec. 3800, Labor Code.) Policy No Company ❑ Copy is tiled with the city. ❑ Certified copy is hereby.fumished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed ff 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: ff, 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 Ihereby 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 No. 05586 BUILDING: TYPE CONST. - OCC: GRP.- A.P. Number 774-235-012 Legal Description Lot. 13 Blk 264 Unit 24 Project Description Sq. Ft. No. No. Dw. Size 1463 Stories I Units New70 Add ❑ Alter ❑ Repair ❑ Demolition ❑ 475 square feet garacre 170 feet 6 -foot wood, .fence Estimated Valuation $79,706,00 ,7,0C0® PERMITy AMOUNT Plan Chk. Dep. - •Gov • VV Plan Chk. Bal. 222.94 Const. �'_ _ _ U Mech. a �► Electrical 209.20 Plumbing S.M.I. • Grading • 01) Driveway Enc. Q+ 0 l;,( Infrastructure 2,755.14 " TOTAL REMARKS 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 3/31/89 Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ® $ UNITS A.C. UNIT 2ND FL SQ. FT. YARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. SEWER ORS IC',eAt DRAINAGE PIPING WALL SO. FT. DUCT WORK DRINKING FOUNTAIN. SQ FT ® URINAL ESTIMATED CONSTRUCTION VALUATION $ METER LOOP WATER PIPING NOTE: Not to be used as property tax valuation REINF. STEEL FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER WATER HEATER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FINAL INSP. LAUNDRYTRAY 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 ,C � L SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1% c SEWAGE DISPOSAL SQ.FT.GAR ® 3Vic HOUSE SEWER FIRE ZONE ROOFING ' 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 ROUND PLUMBIN UNDERGROUND A.C. UNIT COLL AREA RO QL B. 17 BONDINGnn HEATING (ROUGH) STORAGE TANK FORMS SEWER ORS IC',eAt ROUGH WIRINQ /J /I DUCT WORK ROCK STORAGE FOUND. REINF. GAS (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. /m FRAMING �-/--,7&' FINAL INSP. ROOFING 1 1 ,C � L I U� \y� REMARKS: VENTILATION FIRE ZONE ROOFING ' FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND (f FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS ' GARDEN WALL FINAL � y� y'Nj:; f " 9 f f 7 f '� it X 'i�'*'N '•d'P+ r ��� ,tF: F �; . ' Ja y,5/1w« ' T .•�,,...i, '' ,� - wi..ap fir, ` � �,J , r Z O U LU V) 7 C COUNTY OF RIVERSIDE. DEPARTMENT OF HEALTH _ Assea°Or' Pafcel No. .Z3-1� = © I Z 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 nom -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. VERIFY ITEMS IN SECTION A FROM BUILDING 8 SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG'* Agent, Contractor, Contact Person Phone Address•& Phone _57'4.4 .v-5 32-2•isas Owner Phone Mailing Address Z l.J City State Zip Job Property Address,Bya , �(� Legal Description Prop. (PM, Tract, Lot) '14 L .5 IA) 614 leaB/O 4py'/.9 .Ci6C .Z loy Wit Lot Size / YfjNell++-•' ` Use of Permit P/P, CU, etc.}.�A Othercr &.IIing,!"M.'H-aA �i �Ye �;., Site Prep, etc. crate Signature of Applicant CATEGORY f J�j• REV CODE FEE t MI' SUBSURFACE'DISPOSAL / 1238 � $45.00 CATEGORY: REV CODE FEE ❑ SITE EVALUATION UPON REQUEST 7349 $42.00 -`❑ MULTIPLE PARCELS WITHINSAME (NO -PLOT PLAN) LAND DIVISION , - _t. .' ❑ SEWER/SEPTIC VERIFICM10N 7348 $11.00 a. 1 st 4 Parcels (Each) , ..G '1238 - $4500 i#�q ' (Less than 1 year) b. Each Parcel after 4 ..' • T344 �':$1 t3 00 ❑ PRELIMINARY ELECTIVE 7352 $45.00 ❑ Rereview (2nd review some parcel) x,7344 $16*00 EVALUATION (Attach.DOH SAN 53) �t ❑ 'Site Evaluation InConjuncti�n with'. ❑ HOLDING TANK - 7351 $45.00 Q tical`Area. 7346'.`. ,'$86.00 ❑ ALTERNATIVE/EXPERIMEIWTAL 7345 $13200 ❑ Site Evaluation Lot Less than 1 , ,, ~• SYSTEM 10,000 Sq. Ft. ., -,7347. '- $86.00 > ,._ (�J, INRWL DATE 7X 9 Hddl yTank Agreements Completed ' ❑Yes Ja- No +'� ng Certification of Existing S.D. System Required' I ❑ Yes ❑�o - 1 /J WQCB Clearance required. (Attach Form t ❑Yes 'sO" No a DOH SAN 007, Santa Ana Region Only) Sills Percolation Report Required. 11 Yes No,A Special Feasibility Boring Report Required. ❑ Yes , . ©'RNs - -. Detailed:CoMoiu Piot,Plans Required.,(I to,5;fL,intery i).-• .,,,�� .},„._ _, µ� .Yes -_ ..,la p � !. Other ❑ Yes. Staff Specialist Lot Inspection Required ❑ Yes 17 No I •Y Lot Inspection Date Sills boring report by ' �3 r /l `Project # ; Date 1441 ! Approved by Dame -12 y -. � j Soils Map Page Sop Type ( No. of Sysler6 Typej& System(.) No. Dwelling Unita 0) (1) Septic: Tank 'c,y� Soil Rate Grease/Sand � �eG Intcp ❑ Holding Tank' 0 Existing O Replacement�i/�'�• Bedrooms. F,ixhaeo ft. t ��� /�/>SLi.f• /(/ �t/Gal'S°,i'/�� I (2) Leach tine Sq. Ft EL "' Sidewall allowance Ir ll � Lines) R long $wide with Leach Bed aq. ft. Bottom trench R rocW ' sq. R per running ft min.rock below drainlines or. °f`�Orn- . Leachlines/bed special design for slope: (3) Pit Diameter No.'Pits Pit Below Seepage Pit Total Depth ''©then: • Applicable „/ .r Inlet (BI) ..Jd� Max.'_!Ilowable Depth N/A Overburden tactor + - T No. 2 System REMARKS:5/`Y(i& Y'ti=`Gt •t- �Oc, :� �!"L ' ?. /v a 'P ---a ,` c.�- Gk' .il/rf'f' /.d•4/1 may%-etX�iC.�••� ..✓.+ c<.�l�ri' ��-o—•^ YLv� � . .•FSU Y'�•C..G. This application i PROVE /DENIED for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated t on the accompan`; d' Prot pan, using the requirements set fotth in SECTION C above. A building permit is necessary for the installation of the above -designed system. No construction is permitted in the required reserved 100% expansion area. Septic tank lines be 50''`minimum from a.e;29t wells�`trJ0 ` ,' %.fr'44 ((1) and sewer must any from area �11 Leach lines must be 100' minimum any wells, including expansion i / )��� (3)� Seepage pits must he 150' minimum from,any wells, including expansion area 1 - //' ii. r ! 0 - - �•.� � T -•+„(„(°'J . (.� yy. 20...,0 S 6� Si nature of Health Officials •i3 .! w. �C r- iIEJ qcle RECEIPT NO. `-© ;2. 4 Issued By Date DISTRICT: ❑ Riverside, 9-oo Indio ❑ Hemet q Perris ❑ . Rancho Calif. ❑ Blythe DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records �{ o ' Pis, E Of F ICE OF E lEory SPnt;GY ? P 1 s AGRICULTURAL COMMISSIONERI � - ,� � Jn.•IESCO%rnSSO�En 0 wnILACE O , d AND �SS,'STANI rf)MMISSlo-'En " ; S • t-,! WEIGHTS & M.EASURES. CLE�IEvsEs EgVEM51E 49—.613 Ilwy 86, Suite D-12 '�,.� ,,,,e•'7 'Coachella, CA 92236 Mq r q, 1 e9 619-342-829.1 DATE • M A�,`G� e2q CASE NO. DEVELOPER'S NAME:,.S%R �.2 CB ,cJ 3 r2ya ri o,•J ADDRESS i -2 y 7 TELEPHONEs ( Giq) 32. z - /.0 -T_ p Dear Developer: After reviewing your landscaping plans, • all plant material listed is not in violation of quarantine laws governing the Coachella Valley. I IF substitution�s' do occur and they differ frun plant material listed, this-office must be notified imnediately. Thank you for protecting and preserving .the Coachella Valley's pest-free envir,inment. Agr ultuial Candy-sioner's Office cci Indio and Riverside office . -1 W4 4 27 77- •�7�- �/0