003159 (SFD)•
444
P.O. BOX 1504 No. 003159
Building78-105 A LA QUINTACL CALIFORNIA 92253
Address ,G--�'(�� �,`t��afi€��� �t�$x�� '
Owner
James LaieY Trust BUILDING: TYPE CONST. OCC: GRP.
Mailing
Address P. 0. Box 6535 A.P. Number
City ZipTel.
Santa -Um .95406 707-944—IRAI Legal Description
Contractor Project Description Sinstie Fami.lm 1--veli.itig
Pine Creek Develo-nmentE
Address
53�►75 P„r� >icirr�;x
City... Zip Tela
Lia QUL 02253 564-0046
State Lic. City
& Classif. Lic. # S Ft. No. No. Dw.
399691 148 Size- - 1.453 Stories - Units
Arch., Engr., _
Designer New [4 Add ❑ Alter 01 Repair ❑ Demolition ❑.
Address Tel
City ]Zip State Wit+ tan
Lic. #
LICENSED CONTRACTOR'S DECLARATION •_, W
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. 1
SIGNATURE ” - - DATE _ - _ • - , , .
OWNER -BUILDER DECLARATION
Estimated V81UatlOfl
I hereby affirm that I am exempt from the Contractor's License Law for the following roro ,�
reason: (Sec. 7031,5,Busiless and Professions Code: Any city or county which requires $78.111.03permit 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'Iicensed pursuant to PERMIT - AMOUNT '
the provisions. of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of .=t
'Division 3 of'the Business and Professions Code, or thaChe'is exempt -therefrom, and the -basis '
for the alleged exemption. Any violation of Section 7031:5 by:.'any applicant fora permit PIan;Chk. Dep. :.e'i�'P►e`?_(ki
'subjects the applicant to a civil penalty of not more than five hundred dollars ($500). - - -
❑ 1, as owner of the property, or my employees with wages as their sole compensation,.will Plan Chk. Bal. _ A � ;
do the work, and the structure is not intended or offered for sale. (Sec: 7044, Buisness and COfISt
Professions Code: The Contractor's License Law does not apply to an owner of property. who. . 1_7n_(11(3
builds or improves thereon and who does such work himself or through his own employees, Mech. nn
... • provided that' such improvements are not intended or offered /or, sale: I/, however, the building
or improvement is sold within one year.o/ completion, the owner -builder will have the burden Electrical - 7C nP
o/ 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- 'Plumbing It's.G An
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 S:M.1. y Hifi '
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) . .
Grading 9!3 circ
❑ I am exempt under Sec.- B. 8 P.C. for this reason _
Driveway Enc. ifi On
Date owner Infrastructure 1 JAR_!
WORKERS' COMPENSATION DECLARATION
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 Np:'F Company - — 4
0^Copy is filed with the city. p Certified -furnished.
yfurnished.
_opyis hereb
TOTAL 47 nQ,r, I 1 !t 1 94% 91
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed i/ the permit is /or one hundred dollars ($100) valuation i.'* r:::,,G•;1
or less.) !.`,thsli $ -In fel 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
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 Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
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 Setback from Property Line '
Lender's Name
Lender's Address It I' ?
This is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE INSPECTOR
expiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct. ISSued'.by:- Date 6/16/87 Permit
agree to comply'with all city and county ordinance's and state'laws relating to building
construction, and hereby authorize representatives sof - this city to enter the above-. - -
mentioned property for inspection purposes. Validated by:
Signature of applicant Date
Mailing Address Validation:
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO, FT. ®
CAR P. SO. FT.
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
GH PLUMB.I —3 —
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GAS (ROUGH)
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
BOND BEAM
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR ® 3/ac
HOUSE SEWER
RAMING�5�� ,
FINAL INSVZ ;?-')- ,
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
V"vGRAND PL ING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
GH PLUMB.I —3 —
BONDING
HEATING (ROUGH)
STORAGE TANK
i
FORMS
SEWER OR SEPTIC TANK
OUGH WIRING
DUCT WORK
ROCKSTORAGE
FOUND. REINF. /�
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)MP.
POLY /
/
GROUT
WATER HEATER
SERVICE
1FINALINSP&Psi
BOND BEAM
WATER SYSTEM
$
GRADING
cu. yd.
plus x$
_$
LUMBER GR.
�j 1
WEI'NAL INSP`6 ��� I
RAMING�5�� ,
FINAL INSVZ ;?-')- ,
ROOFING
W (L N� ` EL If f 'i(��
/
att.LY�
1=0
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REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL�y
ATHING
MESH
//��
PteNSULATIONISOUND �-').- �"
''CC
GRADING
/FINISH
1` FINAL INSPECTION/4--
NSPECTION/G '0-
CERT.
CERT. OCC.
FENCE FINAL
IN5PhV1VK'S SIGNA1UNtS/INI11AL5_
GARDEN WALL FINAL
Jams G. Lai or" Sr.
P. 0'. Box 6835
Santa Rosaii- CA I5406.
C=6
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WA& %a STA"1011111" TO
r
Jamits G. * Lai ir, Sr..
P. 0. Box 6 835.
cft (A -,Santa,Rosa, CA' 95406
saw
L
THE UNUIERSIGNED GW ATOR(11 DECLAREW
DOCUMENTARY TRANSFER TAX,SS.None ---
M---.-uninctirporatedareas ,DCity'of
Parcel No.
0 corng-Aed on, lull value at property conveyed. Of
C3 computed on full valueless value of liens or encumbrances
remaining at time of We
By this instrument' dated -March 31- 1980 for a valuable consideration,
COOPER & TWERY DEVELOPMENT CO., a partnership. COIDOING DOING ENTERPRISES, a
Lalifornia corporation,'JAMES G. LAIER.- SR., and,KATHLEEN MATOVICH. as
Trustees under Trust Agreement dated July 1111.1973 for JARES'G. LAIER, SR.,
and JEFFERSON J.-DAVISS a married man as his sole and separate property,
all dba:, RIVERSIDE COUNTY PROPERTY, a Joint Venture
hereby GRANT to
JAMES G.'LAIER. SR., and KATHLEEN MATOVICH, as Trustees under.Trust
Agreement'dated July 1,1973 for JAMES.G. LAIER, SR.
.the following described real property in the Unincorporated Area
County of*Riverside, State of California:
As PerLegal-Descriptions attached - hereto and made a part hereof,
consisting of one page and marked EXHIBIT "A"
DATE , Na ch- 31. 1980
COOPER.$ TOWERY DEVELOPMENT CO..
his Attorney -In -Fact
CO I W7=ENTERP�RISES, A Cal '(1119irnia Corporation
.By.
(I%* iii,,eiii aw son
fide Ordff No Ewx" or Loan No.
aim iw(STA 11 1 11= AS DOW= APM
owe
7' -
Lots 12 and- 13, Block 83 of Santa Carmelite at Vale la Quints Unit No. 10,
es per sap racorded-in Book 18, -Page 70 of. Maps ,-Riverlide..County-Records.*
Lot 21.. Block 102 *of Santa Carmel i-ta" it -Vale La: Quinta -Unit No. 11; as = f
per sap recorded in Book 18, Paye 75 of Maps, Riverside County Records.
Lot 5, Block 1.79 of Santa Carmelite at Vale La Quinta Unit No. 18, as per
map recorded in Book 19, Pages 30 and 31 of Maps, Riverside County Records.
EXCEPT THEREFROM one -sixteenth of.all coal, oil, gas and other mineral
deposits in said land as reserved in.patent from the State of California,
J61y 26, 1934 in Book 182, Page 463, Riverside County Records.
Lot 3, Block 189 of Santa Carmelite at Vale La Quinta Unit No. 19, as
per map recorded in Book 0, Pages 33 and 34 of Maps, Riverside County
Records.
Lots 16 and 17, Block 190 of Santa Carmelite at Vale La Quinta Unit No. 19,
as per map recorded in Book 19, Pages 33 and 34 of Meps. Riverside County
Record,_
Lot 3, Block 212 of Santa Carmelita at Vale La Quinta Unit No. 20, as
per map recorded in Book 19, Page 38 of Maps, Riverside County Records.
Loi: 16, Block 231 of Santa Carmelita at Vale La Quinta Unit No. 22, as
per map recorded in Book 20, Page 24 of Maps, Kiverside County Records.
lot �reco
of Santa Carmelita at Vale La Quinta Unit No. 23, as
per in Book 20, Page25 of Maps, Riverside County Records.
Lot 16, Block 263 of Santa Carmelita at Vale La Quinta Unit No. 24, as
per map recorded in Book 19, Pages 44 and 45 of Maps, Riverside County
Records.
Lots 15 and 16, Block 277 of Santa Carmelita at Vale La Quinta Unit No. 25,
as per map recorded in Book 19, Pages 50 and 51 of Maps, Rivers'46e County
Records.
Lots 17 and 18, Block 277 of Sant} Carmelita at Vale La Quinta Unit No. 25,
as per map recorded in Book 19, Pages 50 and 51 of Maps, Riverside County
Records.
Lot 8, Block 278 of Santa Carmelita at Vale La Quinta Unit No. 25, as per
map recorded in Book 19, Pages 50 and 51 of Maps. Riverside County Records.
Lots 16, 17 and- 18, Block '289 of Santa Carmelita at Vale La. Quinta Unit
No. 26., as per map recorded in Book 20, Page 50 of Maps, Riverside County
Records.
Lots an lock 299 of Santa Carmelita at Vale La Quinta Unit No.
27. r map corded in Book 19, Page 82 of Maps, Riverside County
Records.
Lot 14, Block 300 of Santa Carmelite at Vale La Quinta Unit No. 27, as per
'map .recorded in Book 19, Page 82 of Maps, Riverside County Records.
t 5 Block 307 of Santa Carmelita at Vale La Quinta Unit No. 28, as per
sap records n Book 19, Pages. 59 and 60 of. Maps, Riverside County Records.
Lot 23,, Block 311 of.Santa Carmelite at Vale La Quinta Unit No. 28, as
per sap recorded in Book 19, Page 60 of Maps, Riverside County Records.
EXHIBIT "A"
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COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION7
—IN ' 75-
PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM v� Q1
Applicant: Submit thisJorm 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
c
-TS ` 'o \
City
State
Zip Code
Telephone
oo4
'Job Property Address
Cit c1m1u _
'Legal Description of Prope y. (Lot, P 7R)
307
'Assessor's Parcel No.
ater Agency, all,
' — '�
Use of Permit SFS— Planning Case N
Lot Size
G
O A
Z 0 \, ..
T
SFD, MH Site Preparation Etc.
5
es
"Signature of Applicant Date
- - ' 'The above information must be verified from Building Applicatlon
STAFF USE — DO NOT WRITE BELOW THIS LINE
Initial Date '
Certification of Existing S.D. System required. ❑ Yes
WQCB Clearance required. ❑ YesN�� '
Soils feasibility report required. ❑ Yes 2' e,
Detailed.boring report required. ❑ Yes Ff
Detailed contour plot plans required. ❑ YesL�J/No /
Staff Specialist approval required. El Yes Lif NO Lot Inspection Date
Soils/boring report by�+ � Project # Date
Soils Map Page Soil Type by16��"'' Dated 6�b
'/Approved ,
Type of System:
❑ ❑Additional ❑Replacement3
No. of Bedrooms
�'i^
(1) Septic Tank
Soil Rate Required
Existing New
Gals.
(2) each line sq. ft. I
Sidewall allowance
x' `
.Install Line(s) Ft. Long,
Leach bed Sq.
(Botto trench area)
ft. rock/ Sq.. Ft' '
funning ft. L9"N/A
Ft. wide in. inches
rock below drain lilies
Flo ottom .
per
areae
Leach lines/bed-special design for slope:
Applicable
(3) Pit Diameter
•�(
No. PitsPit
BI t
r
Seepage Pit total depth °V/I
Max.
N/A Overburden factor
/!
allowable depthV
G ,
14
This application i a pr&edh .ted►for the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements
tionof the above -designed system;
set forth in Section above. A building permit ivecessary for the in?i1ja.any
Septic tank and sewer lines must be -5;' from any wellsd /0-�j�
(2 Leach lines must be 100' min. from wells including exprea iy
1) RSeepage pits must be 150' min. from any wells including expansion area,/0 /% s-
Signature of Health Officia
RECEIPT NO. / Issued by e— Date
District: ❑ Riverside E 1 d ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe
Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File
DOH -SAN -122 (Rev. 6/86)
7