002783 (SFD)P.O. BOX 1504: No. 002783
Building
Address _94^5210 AVOU& R8MLA QUINTA, CALIFORNIA 92253
Owner
BUILDING: -TYPE CONST. OCC: GRP.,
Mailing
Address A.P. Number 774--24-1-001 & 002
City Zip Tel.
pa1iu Dosext 922 346— SW Legal Description lots 23 I .24 *raar SWXni . )
Contractor
� •fit �. Project -Description fandiy
Address. .
74--990 VelieV�
City .. Zip Tela
palm 9226 346-$864
State Lic. City DOG 1974 FERM 250
& Classif. 35739 Lic. # Sq. Ft. No. No. Dw.
Size Stories -Units
' Arch., Engr., sxz
Designer New QZ Ah"O Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lic: #
LICENSED CONTRACTOR'S DECLARATION '
hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000).of�Dyivisiioonn 3.0f the Busiyness�a✓nd,P7ofes'sions Code; and my license -is -in -full force and
effect. k f0�.1.�fCef.•
• .SIGNATURE` " ' r q.O DATE
v
-OWN ER-BUILDER'D'ECLARATION
Estimated Valuation
s7�.�
- 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, 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 • • PERMIT - AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section .7000) of
'DiNsion'3 of the .Business and Piolessions 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, Plan Chk. Dep. - 250.00
subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ',t s -
D I, as owner of the property, or my employees wijh wages. as their sole compensation, will,. Plan Chk. Bal. X1:46.65
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 Const. 460.50 not apply,to an owner of property who - 6
-builds o7 improves thereon and who does such work himself or through his own employees, McCh
provided, that su. BiGsid{;
ch improvements are not intended or offered for sale. It, however, the building.
or improvement is sold within one year of completion, the owner -builder. will have the burden 10.491'
of proving that he did not build or improve for the purpose of sale.). EIeCtrlCdl
❑ I, as owner of the property, am exclusively contracting with licensed' contractors to con- Plumbing- 124.00
struct the -project. (Sec. 7044, Business -and Professions Code: The Contractoi's`License Law _
does not apply to an owner of property who builds or improves thereon, and who°contracts for S.M:I: 7.74
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) • -
O I am exempt under Sec. B. 8 P.C. for this reason Grading 20.013
Driveway Eno. 20.00
Date owner Infrastructure��.7
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. -O Certified copy is ,hereby furnished.
TOTAL 2,$03.09 a°2®553.0
CERTIFICATE OF EXEMPTION FROM REMARKS .
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 ZONE: BY:
subject'to'the- Workers' 'Compensation provisions of 'the Labor Code, you must°•forthwith Minimum Setback Distances: '
comply with such provisions or this permit shall be deemed revoked -
Front Se.tback.from Center.Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
Ihereby affirm that there is a construction lending agency for the performance of the
work for which this. permit is issued. (Seca 3097, Civil Code.) Side Setback from Property Line
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE INSPECTOR
expiration if work thereunder is suspended for 180 days. ..
I certify that 1 have read this application and state that the above information is correct. Issued by: Date y �2-29-86Permit
1'agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of7t.his city to enter the above-.
mentioned property for inspection p[uTrpose)s. t ff Validated by:
Signature of applicant, /S'L Al r, Date
Mailing Addres V�v Validation:
City, State, Zip i `•
A 6 9 8 1 12 29 255 U9 U
HARD COPY `.
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. IN PLUMBING FEES
IST FL. SQ. FT. @ $
2ND FL. SQ. FT.
POR. SQ. FT. @
GAR. SQ. FT. @
CAR P. SQ. FT.
WALL SQ. FT. @
SQ 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
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
SLAB GRADE
LAUNDRY TRAY
AIR HANDLING UNIT CFM
BONDING
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
METER LOOP
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
GAS (FINAL)
SO.FT.GAR @ 3/ac
HOUSE SEWER
GROUT
GAS PIPING
PERMIT FEE
ERVICE
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
{(�GSETBACK l2`
`4 /
ROUND PLUMBING3
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
OUGH PLUMB. (i L ,a
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
EWER OR SF '�
�LfiOUGH WIRING L/ ��/,��
DUCT WORK
ROCK STORAGE
FOUND. REINF.
G
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)
POLE 7/r /J'
vv. v
GROUT
WATER HEATER
ERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
$
GRADING
cu. yd.
plus x$
_$
LUMBER GR.
FINAL INSP.
^
at/_FRAMING — G b ' I
INAL INSP.
ROOFING
OK To wic^P
LO�Nr^
1
'
rIC
PIP
—' DEC 1
.{
A,4Af
Q
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
4 INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATUREWINITIALS
GARDEN WALL FINAL
COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION q
F-7 -��/,�%
PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM /0e, 1;
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 $37 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 / ^
City_ �—State
Zip Code
Telephone /
C�ob Propeity, AddPe
d 5'tZ d -lir RAF•.. frr Z y �9c c 11r'Y,
!City or Oommonity ''
n ._-._
Legal Description of Property. (Lot, PM, TR
�,•, 34
//"
^, /C(th-
'Assessor's Parcel No.---'�'""' Water Agency orgV..JeIL l
'�'� 0._ �� wC %
Use of Permit F- A,,egl r•"jl • ! Planning Case #
'Lot`Size`''
/ ,;2 ?'6 Cha / q00,:X
SFD, MH Site Preparation Etc(. �
Me 11( tot
n
f ignature of plican Date
/ 'The above information must be verified from Building Application
c f STAFF USE — DO NOT WRITE BELOW THIS LINE
y
l Initial Date
Certification of'Existing S.D. System required. ❑ Yes 2'-No_,1' t`�� Id -,
WQCB Clearance quired. E) Yes ,2 No ;
r
Soils feasibility#iepgyt required. El Yes I� o !ft
El 2
Detailed boring report required. Yes No t
'
� Elf
Detailed contour plot plans required. Yes •D No
i
Staff 6cialist,approval required. ❑ Yes 0 -No Lot Inspection Date
Soils/boring report by ` Project # Date
Soils Map Page R Soil Type Approvedtbye6w, L Date/f4
4
�'►
Type of,System:R -`
-No. of Bedrooms
(it) Septic Tank
Soil Rate Required
El Existing (]'New El Additional El Replacement
/ (� v
04 Gals.
"�/ "�.1 ,f�L✓G�
r
! rG'7 ;
(2) Leach line sq. ft.
Sidewall allowance
Ft.
Instal� Lines) Ft. Long,
Leach bed Sq.
'bottom
(Bot�O,, trench area)
ft. rock/ Sq.
O'N/A
Ft'"Wid.., we i� th min. inches
Ft. f
per running ft.
rock below drain lines
area
Leach -lines .ed 'al `design for slope:
App lic /
(3) Pit Diameter
No. Pits
Pit BI
Seepage Pit total depth —ei? U
N/A rburden factor
Max. allowable depth V U
1,
� �-/ C �f�z-rL=.�-•'�Y r�'�v o• ��F,P.� ice!' '1.�. e'fCx? c.� �,ti, � �F'it? %-e..�?�r�� �-r./
�. �•t-C�,.o%l.0 � � .d= -y' t �t�'� �^zc.� ,�- .l..ra..a-G-r-.r-�.-i22�?,-t,�,c�n_ ,. � ...c�_.�-cP
This a lication ovv d denied for`the desi
pp % pp grl�of a subsurface disposal system as indicated on a accompanied plot �n using the requirements
set forth in Section B above. A building permit°is necessary for the installation of the above -designed tep?, ._
11c G
(1)Sep c tank and sewer lines must be/50' from any wells `! / bY+- tF�r✓ Il it t
/
+J21 Leach lines must.,be 100' min. from any wells including expansion area _
!( (3 Seepage pits muist be 150' min. from any wells including` expansion area -1/0
Signature of Health Official�c: * ` .b"— :�! - Date
RECEIPT NO. ) -5 Issued by SV—.Date l - �-
District: ❑ Riverside [P -M55" o ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe
Distribution: WHITE -Office file YELLOW -Applicant PINK -Bldg. Dept. GOLDENROD -Pending File
DOH -SAN -122 (Rev. 6/86)
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..... 132 a
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T EMP
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/, 's.T..... ^ 'A.?.f....r'
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COOLING
00
DOXT,
AREA
Eis aS± ' ',` .. :......;
W S 7e , r, , .: R E i.::: P•,_.. %:.:t F ... ,.....:I 3.95ISsa
'
A R .
... , , . ,...
,, , ., t.... c: AREA 1.60074
ART& .
:..:. WEST W
1.1"1 i .A .::: 56 SO.FV PERCEMT...., OREA
t n t ,
[,�TNDOWS
AREA 308 EUXT. PERCENT Or AREP
15.6028c+
SIN3LE PANE.'
t
THIS
EIALDINU
,
TKIT
rnyvAL S.C.
OF' THE WINDOWS IS
130Li T L..,
,_.+''•:fit.:..%',±..1;..::r,i':T
� ..
iEpl
0.012)-
......
FTM3vTY&3
,. DESEA
LOSSES
... 9360.15 BTU
,
KFILTRATION
LOSSES....
8,92.432 BTU
.r;
ENOS
:...
-
t
`.... '. -
r r
r
PAD.
C17 F113PLE.
, ,
4 COOL!
r: •
�LAB Gi` ]iD, `
�EILIK� lN5ULArl��i,
AlTlC,
NORTH HIN�JWS GLAZI�G
EAST W[N�[`�/S C�AZiNG
SO|�TH WlNDJ�S GL��ING
�E5| WI��OWS 5LAZI��
SKYLIGHT G|'AZTN-'
EAST SHADING CEEFFlClENT
SOUTH SHADING COEFFICIENT
WEST SHADING COEFFICIENT
NORTH SHADING COEFFICIENT
�
SKYLIGHT SHADING COEFFICIENT
IHF[LTR4TIOh
'
THERM4L MASS 425 SQ.FT.
SOUTH UVERHAUG
^ - -- -
-3 Pl I�/TS
' -1 POINTS
^ 1 poll NlS
' � FOINrS
O 76 BE AND REFRIGERATION COO�IN�
-2 POINTS
0 POI11TS
-1 POINTS
^ 3 POINTS
<} PQATS
1 POINTS
'
8 FOINTS
0 POI%TS
VE
EER OF THE COOLI10
2YSTEM 19 8.7
6 POINTS
114.
vAlAWAhCE POINT?
P��.R AB 163 LS -4 FOR THIS
OREA 15
THE
TOTAL PDlNT3 ARE
2 `
THE
FOL1.0010 MAVDATORY
FEA7URFA/DEyILES APE
REDUIRED PERM
TITLE 24
�
[NSULPTFICN
AB SPECIFIED;
PER NA�|UFACTURES
LAOLQ:
,
INFILTRATION
CONTROL.
1OURS, UJINDOuS RDLLY
WEATERSTRlPFED`
GPEN}NGS
CAULKED AND
SEALED AROUND JOINTS
IN
ELECTRIC
5UTLET GASKETS
ON ALL EXTERIORWALLS
KP!/L|FACTURED
ROCRS 04wL
MEET OPpLlCABLn STANDARDS
SACK
DRAFT DAMPERS ON
EXHAUST FAN
FlREPLACET
rUET H*»E
T13HT FIrTIMG, ULb5AVLE
DUGPS COVERImD
�
F7REP5X
PRDVlDE
��ONBUSTIO�! AIR
INTAKE DUCTS (6-80.
JN.,
Wl`�H TIGHT
� FIF'lKG �4K�ER
0TYS;
PUILT PER EHAP[ER
1) U.M.E.
3I7ED 10
1.2 DESIGN LOGS 10
BTLH
PER Sp.F7.
OR +5,000 BY!-,
S�T9*�.�
T�ERhUST�'S ��AiL
H�V� AU70�1ATIC SETBACK
CAPABILITY
/Y PERIODS PER 24 0.:
:A7ER
1104ER Q VA./[
R-12 INCULATION WRAPPING,
AND R-3 ON
FIRST 5`OF PIPE
SH�L'-
NiF NYE C141. OLRNIPG
PlOL7S
LI6H!
5�! �4[TCHE,i ��r!C
�,``
8&T�� FO BE�ri'�br��C�NT,
`
'E���EPT BAli|
HlPPUR, PIT AINK,
C��RTlF!Eb
Dy -......
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