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06214 (SFD)Building Address 53-060 RaMIX09 P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 i Chariac Tme. Mailing Address Fs �� BOX 59 City Zip Tel. !La -Quiuta 97253 56471486 Contractor General Contract Hana.nez$ant Address State Lic. City & Classif. 524325 Lic. # 1235 Arch., Engr., Designer Address I Tel. City( Zip ( State I Lic. # _ r r LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 700 of Division 3 of the Business and Professions Code, and my license is in full force and effect. _SIGNATURE DATE OWNER -BUILDER DECLARATION 1 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, pdor 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 (commenclmg 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 dagars (S500). ❑ 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. If, however, the building or improvement is sold within one year of completion, the owner -budder wig have the burden of proving that he did not build or knprove 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.) O 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' COMPENSATION INSURANCE (This section need not be completed i1 the permit is for one hundred dollars (5100) 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 aliforniaDateOwner 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 car ity 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. 05214 JILDING: TYPE CONST. .P.11.- OCC: GRP. P. Number 774-052--003 Legal Description Project.Description �•'�•• Sq. Ft. 1485 Size No. Stories - No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $81,952 PERMIT AMOUNT Plan Chk. Dep. �2 Plan Chk. Bal. S 230.24 Const. � g5j ,50A Mech. 60.00 Electrical 109.12 Plumbing 154.5G S.M.I. 5.74 Grading 20.00 Driveway Enc. 20.00 Infrastructure 1,805.67 17 TOTAL $3,.213.77 --��� r �9` +fes REMARKS R,r, .x an ti 44 •i n b e -112—nr� d +i 1 11,1 f AL 1 zyitfi ,7 . r f 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 024/89 Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ 2ND FL. SQ. FT. POR. SQ. FT. ® GAR. SQ. FT. ® CAR P. I SQ. FT. WALL SQ. FT. 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 VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEQUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM rl(REINF. MP. POLE !0 CIS - 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 FINAL INSP. 12---Plus—x$—=$ SQ. FT. ®c IWATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/. c SEWAGE DISPOSAL SQ.FT.GAR ® 3/4c 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 PLUMBIf/ UNDERGROUND A.C. UNIT COLL. AREA V SLAB GRADE —� ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS EPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP/0—A0 HEATING (FINAL) OTHER APPJEQUIP. STEEL GAS (FINAL) rl(REINF. MP. POLE !0 CIS - GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. 12---Plus—x$—=$ FRAMING /2& Q FINAL INSP. ROOFING&4 _ /l ry � 7 (vry,11" 5' U fj REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL L /)y, LATHING 'I DW4 I /'o MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS ' GARDEN WALL FINAL ) q.w n t S�i"%i 'L` • T S.! i 7' c�. F' w' 9l!^�:?Yip�i' y„eT �ap, p . d^ �WI� 5..� _ , . - . � .. A non-refundable filing fee (see below) is required when the application is submitted. Check must be made payable to the County of , � .. • F VERIFY .ITEMS IN SECTION A FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG '# Agent, Contractor, Con ct Person Phone Address & Phone Owner ' 'I COUNTY OF RIVERSIDE DEPARTMENT OF.HEALTH Assessors Parcel No. ENVIRONMENTAL HEALTH SERVICES 7711 xv 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 indicatk 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. VERIFY .ITEMS IN SECTION A FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG '# Agent, Contractor, Con ct Person Phone Address & Phone Owner ' 'I Phop Mailing Address City V S to Zip Job Property Address , Legal Description Flop. (PM, Tract, Lot) Rr !, Lot Size;' Agency/Well Use of Permit P/P, CU, etc. Other -,f// JWa'ter ` "Jo Dwelling, MH Site Prep, etc. Signature of Applicant Y Date CATEGORY: REV CODE FEE r v CATEGORY: REV CODE FEE �1 .SUBSURFACE DISPOSAL f 1238 445.o6",, -i "' �❑• SITE EVALUATION UPON REQUEST 7349 $42.00 <3 . MULTIPLE PARCELS WITHIN SAME f (NO PLOT PLAN) LAND DIVISION 1 ❑ SEWER/SEPTIC VERIFICATION 7348 $11.00. a., 1st 4 Parcels (Each) 1238 $45.00 (Less than 1 year) b. ,:Each Parcel after 4 7344 $16.00 ❑ PRELIMINARY ELECTIVE 7352 $45.00 ❑ 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 'GI Site Evaluation Lot Less than SYSTEM 10,000 Sq. Ft. 7347 $86.00 r INITI L v ATE ' Holding Tank Agreements Completed _ "" ❑ Yes No�: ' Certification of Existing S.D. System Required ❑Yes No WQCB Clearance required. (Attach Form ❑ Yes No DOH SAN 007, Santa Ana Region Only) Soils Percolation Report Required. ❑ Yes No Special Feasibility Boring Report Required. ❑ Yes C No „Detailed Contour Plot Plans Required (1 to 5 ft. interval) ❑ Yes C No \ Other ❑ Yes I No StaffSpecialist Lot Inspection Required ❑ Yes I No �.. Lot Inspection Date by-��' Soils boring repo y Project # Date '` Soils Map Page Soil Type Approved by Date No. of Systems Type of Systems) No. Dwelling Units (1) Septic Tank Sal Rate Grease Sand ❑ Holding Tank,, ❑ Existing `-❑ Bedrooms, Fixture Units G W60,, / New Replacement. �A rttfi n,ak c, Gal Gal 4t (2) Leach Line . Ft.`-� Bottom trench rea Sidewall allowance .. -- 1•` ft rocW� sq. ft:– ,, Install Line(s) long ft wide with min. inches rock below drainlines or Leach Bed sq. ft1 of bottom area Kiingf ❑ NA / � Leachlines/bed special desig/for slope: Pit Diameter No. Pits Pit Below Seepage Pit Total Depth Other. Applicable "b 'N'%16 Inlet (BI) t ❑ 5 ` ' I Max. Allowable. Depth N/A Overburden factor No. 2 System REMARKS: V\n0.+H�G This application i`APP� ED/DENIED for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated on the accompanied plot plan, using the requirements set forth 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. (Ll)) Septic tank and sewer lines must be 50' l minimum from any wells (2) Mach lines must be 100' minimum from any wells, including expansion area � F1 � 1,., ZZs. `amu,, _AA J . n.d•. (3 Seepage pits must be 1`50'' minimum from any well •including expansion area S (, T C4ku std' U Signature of Health Officiate-- G Date RECEIPT NO. �' 2 Issued By C Date— DISTRICT: ate DISTRICT: ❑ Riverside, IX Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe { DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept. GOLDENROD - Plans/Records Al A eaarrar, <<� 1 11 u;E t)t E. EEW SPnt;r,Y co .rn�ao .tn nGlKUL I URAL COMMISSIWt" )AMES 1) V1M.UACF AN 0 CIEMEN 1 F.14VEN151E WI.1611 I'S b. MEASURES suattn 49-613 Iluy 06, Suite 11-12 M,I Y v. 1'eq� G 19-342-5'l91 c CASS 10- DUE IU.Ul1l' bEVELOPER' S I'IN E Gia-Po�aL ADDRESSt Q r 53-060 Aoe, L)ear Vevelopers lifter reviewing your 1a11c SC0111.1KI 1110113; tali 1110"1 11HtValle lis Jed substitutliolls. violation of yuaralltine MWS klOvel-11111y th'e Coachella Y do occur 011c1 they cliE[er [resn 1110111 1 1>:lterial listed, 11113 o[[ice must be ilotiEied isnlp-diately. , ilc you for prvtectilly and 1lteservilly the Coachella Valley's fest-[ree eilvirotellent. Thal y n cultural Cuxultl a61erjs UL E ice ccs 111dio Euld Riverside U[[ice