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353960, 360414, 387556, 391140, 003369 (SFD)BUILDING PERMIT PERMIT No.DEPARTMENT OF BUILDING 8 SAFETY - I FIELD sr, 3 5 3960 COUNTY•OF RIVERSIDE ` �,.4x„ v..,µM.r. .t. •.r<�^•iyt"•i}� N.`i..ri?fA••^""!a'r,a: vt...+ w/.y'i ..w.M-{•.«`•+r-..�•:?rntn.s� C� �4�wwA.li.+...#r}n_ y yfi,• :r :C TRUCTION I TE ;a NO. ELECTRICAL,FEES NO. PLUMBING FEES Co ,u Cly < s: s: 1 ( �r > I ST FL. f SQ. FT. @ ' UNITS Micro Film Fee _Cop $ rH Use of Prm ee it �. ^�/��/'. fir• iY ..' , J • J ,. ' , '._ . • .. 4tN •t r,�r:L Nw, (•,'w+e4'-;. ,v: ,. ,:` :.: SQ. FT. .•k-„b.:,,�. �.. .: .. '. ,..r«•, :•-h.r•«;, ..a .. :K%1RD'SPKLR SYSTEM`'✓ Mech. Fee Dbl Pl. Ck. Fee �'• $ ;et •Backd ..,, :' j .s 2ND. FL., • Construction. Fee Dbl $ SQ. FT. c”'• F S S _ <.• MOBILEHOME SVC.. BAR SINK 'G r FOR. / SQ. FT: •@ ` ... POWER OUTLET ., ROOF. DRAINS Plan Checker' Final ole' inspctor F e SQ. FT., '@ ' Sp. Insp. Fee '•7 $•8 De mol Fee $ DRAINAGE PIPING ' Supplimenlal PermN'Nu`rn ' �• K•f =° "'`s'r y' � ," ,.• :a.+'vrs.•+ Registr. Fee $ Mileage Fee g Address .. �X _ <Yt s t.• a::•F`.^r.�•+.,;i, ��Yiy� v�r',e�:.?!t Zip +. r w..«r•.oiw..4r+,v.4hes.n..xMwy.+41.r'rfIR,Y4t±. Owner/ ently f� 'JrJJ ��;%�J� < s•r'•if�r: :�'• .. (,,f+•/,x _ F ✓ Witness Fee $ Reinsp. Fee $ 1 L c %) Tor $ - 4 ol Fees Add s -•r. s „ � 0 1 _ «./ j 1 fir CiH / Zi p r ♦ ftf;.y fro • 's.. r; M.O. Ilp*. as Ch'ec Received by �'�'- Contractor rr - •Tel. " license# Trees required Sewoge System ' x/]13/'? ���J Address � . • � City _ Zip � C ` _ f 7 LL Pel .1 ,_ THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS.' CESSATION OF WORK verified by: L Ar _s Sewer District « ti. FOR•120 DAYS SHALLSO CAUSE; PERMIT JO, BECOME ID. -VO"-'" ' j:"' 4KnT "_%*A 1` I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH L } THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. � if 1 ^ �I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN { 1 ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA Form 284-208 (Rev.B/78) j �,.}S '�, • ..._� .__ .. _..-.--_ '14..x.:. -_._ ,L`'. ;,�,... a. .,-. ... ..... .•.t ..• e, ..-. �-_ _. _ ., :,. .. ... .i.. . ._. ,... ... NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back . 33 Ventilation System 2 Ftgs 8 Frms 34 Plenums 8 Ducts 2A Slab Grade 35 Furnace Comport. 3 Steel 36 Inlets & Outlets 4 Grout Blocks 37 Combustion Air 5 Bond Beams 38 Compressor 6 Roof Deck 39 Appl. Clearance 7 Framing 40 Fire Damper 8 Vents 41 Smoke Detection Device 9 Garage Fire Wall 42 Commercial Hood 10 Fireplace P. L. 43 Final 10A Fireplace T.O. No ADDITIONAL INFORMATION SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath 12 Internal Lath _ 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Walls (Batts) 12B Ceiling (Batts) 12C Ceiling (Blown) 14 Final PLUMBING APPROVALS 15 Ground Plumb 16 Water Piping 17 Rough Plumb 18 Vents 19 Sewage Disposal 20 Sewer 21 Water Heater 22 Water Softener 23 Water Service 24 Gas Test 25 Final Tank Pit L.Line REAR OF PROPERTY LINE ELECTRICAL APPROVALS P/L P/ 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final STREET NAME BUILDING PERMIT PERMIT NO. DEPARTMENTS OF BUILDING & SAFETY,, FIELD . " DST 3 COUNTY OF RIVERSIDE , CONSTRUCTION ESTIMATE '` `" •''' ' NO. ELECTRICAL FEES INO. PLUMBING FEES IST FL. :2ND. FL.' POR. ' y. -GAR. ti CAR, P. i u'•WP,LL -i 1T;" x ,r,m t ESTIMATED CONSTRUCTION SQ., FT.. @ 1 es� UNITS y SQ. FT. Q YARD SPKLR SYSTEM l.YJ%� MOBILEHOME SVC. SQ. FL '@ - .� BAR SINK SQ. F7• ® �� .' D POWER OUTLET ROOF DRAINS SQ. FT. @ DRAINAGE PIPING ,r'� ., s . w+ . _ . «, a,, ."4, r.. A`h, SQ. FT: DRINKING FOUNTAIN SQ. FT. @ F URINAL VALUATION $ 3 *"2i ;j WATER PIPING NOTE:,Not to be used as property tax valuation F. . . SWIM POOL, PVT, 'i FLOOR DRAIN MECHANICAL, FEES' ' SWIM POOL, COMM Y3 WATER SOFTENER VENT SYSTEM `' `'" ' "FAN' `, ''EVAP:"COOL `HOOD y SIGNSWASHER Mech. Fee � � ,. Dbl E j I&P (AUTO IH) APPLIANCE DRYER _ Y •' PI. Ck. Fe GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED ksT a LAUNDRY TRAY AIR HANDLING UNIT + CFM Construction Fee Dbl" E • IDLEMETER r,KITCHEN SINK /WATER ABSORPTION SYSTEM B.T.U. Zone.Restrictions TEMP USE PERMIT SVC Type of CLOSET COMPRESSOR _ HP SMI Fee POLE, TEMP/PERM .., _ LAVATORY HEATING SYSTEM'. j.FORCED GRAVITY ' ra AMPERES SERV ENT / SHOWER BOILER B.T.U.. Bond Amt. ' SQ. FT. @ c Plan Checker BATH TUB r ..-..3La+Rawtc•'*r'ct`"a~'r i-o-S..L ..w 'L�.'s."'�..•+..•.-._t'+,..�,:....+ n..:e..SQ..:FT;t�er..;�> :,t.;: ` WATER HEATER .SQ. FT. RESID @lt/.c E SEWAGE DISPOSAL �) f SQ. FT. GAR @ I/, c HOUSE SEWER Demol. Fee GAS PIPING PERMIT FEEPERMIT Supplimental '~ FEE PERMIT FEE fe DBL. TOTAL FEES,, MOB. HM. FEE MICRO FEE MECH. FE PL. CK. FEE CONST. FEE ELECT. FEE SMI FEE FEE. PLU B. FEE PERMIT NO. " "' '- ' '` `" •''' ' � dob'Address ..c.... a,;a. . , , . • +.-; . . r.'., a .. p,,,. r, -.Space Zip Owner 360414 _ Ile -v -� Community _ •.l�i"i �•s'i r'.� `* •} ` Valuation S.,rJ •Y.D Dote '7' 17 Dist. /-.1 Off. F. . . ' - MH.Permit Fee E Micro Film Fee Cop E Use of Permit •r Parcel No. Use/Case No. Ck. By C Mech. Fee � � ,. Dbl E j I&P PI. Ck. Fe E ksT a Lot Size ~ Construction Fee Dbl" E • legal Description / y s' + l' F S S t�r, ' .` R Electrical Fee Dbl E �C-' Zone.Restrictions Group Type SMI Fee E _ le Plumbing Plumbing FeeDb1 E Bond Amt. •Plan No. �q Plan Checker Date ft"' �� 7 / n Unit Sp. Insp. Fee E E �) f Demol. Fee E Const. Lender Branch - ?' Supplimental '~ Permit Numbers Registr. Fee E Mileage Fee E Address ! City Zip ,// f.l..+/,%.rr' Witness Fee E Reinsp. Fee E f�// Owner/ gpi lY�� f .»Y / fi",i / / C ! fl�i'�./ . rP :Tel. ;t Zip Total Fees r j S,• Address ". 2 7� City- Zip M.O. N.C. C.shEj heck•g Received by �• Contractor + ," rrw . «p �..+ e x Y . ..�: - r+. T.I. - 1z -`V . License# Trees' required .. « ... �„ .. ,..".a • .rr..w Sewage System - Address•City, + Zip T LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED. WITHIN 120 DAYS. CESSATION OF WORK 'Sewer District FOR 120 DAYS SHALL ALSO E PERMIT.TO BECOME VOID. ` ` C �^ - 7 . a": • — _ v`ro . . + +'x .. I HEREBY'AGREE THAT�ND Zees ITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH ' THE LAWS OF RIVERSIDE CO N'STATE OF CALIFORNIA.: Y _ I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANSkAND SPECIFICATIONS HAS DONE SO IN ACCORDANCE WITH SECTION '554T OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. Form 284-208 (Rev.8/78) .r r verified -by: NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPEC�,OR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Ftgs 8 Frms 34 Plenums 8 Ducts 2A blab Grade 35 Furnace Comport. 3 Steel 36 Inlets 8 Outlets 4 Grout Blocks 37 Combustion Air 5 Bond Beams 38 Compressor 6 Roof Deck 39 Appl. Clearance 7 Framing 40 Fire Damper 8 Vents 41 Smoke Detection Device 9 Garage Fire Wall 42 Commercial Hood 10 Fireplace P. L. 0 43 Final 10A Fireplace T.O. oo ADDITIONAL INFORMATION SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath 12 Internal Lath 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Walls (Batts) 128 Ceiling (Batts) 12C Ceiling (Blown) 14 Final PLUMBING APPROVALS 15 Ground Plumb 16 Water Piping 17 Rough Plumb 18 Vents 19 Sewage Disposal 20 Sewer 21 Water Heater 22 Water Softener 23 Water Service 24 Gas Test 25 Final Tank Pit L.Line REAR OF PROPERTY LINE ELECTRICAL APPROVALS PSL P/ 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final STREET NAME • 1 NOTICE: THIS IS NOT A BUILDING PERMIT APPLICATION TO CONSTRUCT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF -RIVERSIDE ti DISTRICT Permit No 284 199 9/74 CANARY—FILE, PINK—APPLICANT Owner �j�/� Architect Contractor :��A Address��"� Address Address_ City ll�A rA -City City - ity_Phone</' _�� /-///— '�, Phone Phone Phone oC cc I (we) the undersigned, hereby certify and acknowledge that I (we) have read the application and agree that if Curb and Gutter, and Z Paving, and/cr Dedication of right of,way-is required by the County of Riverside, the Riverside County Department of Building and Safety 3 shall not mala: a Final Inspection until said requirements have been met., 1 am also aware that no work is to be done within the County R/W O without an eicroachment permit. ' NOW, therefore, it is agreed that I (we) will not occupy said property and will not cause said property to be occupied until I (we) have complied with all off the of Riverside and the State of California governing said property. laws /County Jr/' `/%�'` DATE '� / ' % SIGNATURE OF OWNER AND/OR AGENT����" r o Approval by Signature fromtheFollowing Departments Listed Below Must Be Obtained Prior to the Issuing of a Construction Permit. I SPACE NO, t .i USE OF STRUCTURE r rs`+tL J,UBfAJDRESS- 1 _ r `r � �f„� (jr • /,��, 1 � SINGLE FAMILY N DUPLEX LEGAL>DES=RIPTION OF PROPERTY _ _� {fJ/� %r,t��T,T/1 Ar- �!�j! 4�!/r �C APARTMENTS AGRIC. f �' O N N r f/,i3� COMMERCIAL INDUSTRIAL o Z COMMUNITY. ALTERATIONS ❑ ~� '11,K127-r,� N0. OF SUBMITTED PLANS - USE OF PERMIT .���— CASE NO. p Z NO. OF - ES REQUIRED ^NO. OF BUILDINGS NOW EXISTING Q Y -t- . ZONE rP l SETBACKS: FRONT L SIDE '� REAR J m _ GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE ~� SETBACK ORDINANCE # _— OF FEET REQUIRED ONl STREET r DATE �" SIGNATURE OF LAND USE OFFICIAL DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET- ` --z CURB ANG GUTTER REQUIRED: YES, ❑ NO ❑ � STREET W ' CAN CAN CURE AND. GUTTER FEASIBLY BE INSTALLED? YES ❑ • NO ❑ HAS AN ACCEPT BLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR' DRIVE Y AND STREET �- YES °L IMPROVEMEE4T? NO ❑ DATE SIGNATURE OF ROAD DEPT. OFFICIAL4 73— /J- -77 r SEWAGE DISPOSAL / 10 _ d"-�`�/ W F T- _ WATER POLLUTION REMARKS 12 FLOOD CONTROL at W AIR POLLUTION W DIV OF HW! 0 a YOUR PROPERTY MAY BE SUBJECT TO( — c FLOOD. RIVERSIDE COUNTY ASSUME.S *--- NO RESPONSIBILITY IN EVENT OF FLOOD. 284 199 9/74 CANARY—FILE, PINK—APPLICANT a UA z 3 O o� CL -O Qjj K0 0> -Z I.- sLL J Q N m 06 .a6 t: o a _z ui z 0 z O J O IL W e APPLICATION FOR TREE PLANTING I (Va9), the undersi.geed, hereby certify and acknowledge that I (we) have read the application and agree that if trees are required°under River- side County Ordinance No. 457, the applicant agrees to install said trees prior to final' inspection. It is understood that no final inspection ;will be given until said requirements have been met or exception has=been granted by the County. Now, therefore, it is agreed that the prop- erty owner shall cause the property lines to be surveyed in the event no survey stokes can be found. Further, it is agreed that the County of Riverside shall ossune Z'no` � responsibility should trees have to be removed due to lot line errors. ��0� / Owner's Name ��� 42 Building Permit No. !/ Meiling Address - .79 6-61452 /KS City r XRT State 4;4Z_ Zip Z�T Job Address ` Obs -5- // BPo°tGe� Z Community Legal Description 314 3/4' S411,3 44A44Z/T.4 Vii`y✓3LE 2 Assessor's Map, Book & Page -7 ? 57 jO &X, Type Structure Type of Soil �Ih� Is water available Road Dept. Plot Plan No. Type of existing tre6s in road right-of-way Trees preferred by applicant (1) OW/8 (2) A4 LL (3) Date Owner's Signature Planning Commissicn Case No. ROAD DEPARTMENT APPROVAL Approved species`e Washingtonia robusta (Mexican fan palm) Number of trees` Spacing of tr'roes Distance from lot lines: Front.2' in R/W Side Additional requirements Ppr plot plan nn rpvprgp- Date Building and Safety notified 5/79 Signature REQUEST FOR EXCEPTION Reason (attach additional page if necessary) Request for hearing: YES ❑ Owner's Signature ' (Forward application to Planning Dept. if exception requested) Planning Dept. Concur ❑ D ate NO REQUEST FOR HEARING Non -concur ❑ Explanation Signature Road Dept. Concur .❑ Non -Concur ❑ Date Signature A. REQUEST FOR HEARING AND COMMITTEE DECISION Date hearing established Date hearing notice mailed to owner Approved ❑ [Disapproved ❑ Date Owner notified of decision y Date Building & Safety notified Signature APPROVAL BY BUILDING INSPECTOR Final Date Inspector Building Permit No. Job Address Community Requirements for tree planting complied with 'Remarks (Detach and forward above information to Rood Department Riverside) 284-230, REV. 1/74 APRT 3 0}'1979 . .. . , _ . . fit. • .. r r 1 Oct DEPARTMENT OF BUILDING AND SAFETY r. COUNTY 'OF . RIVERSIDE CLAIM OF; DATE: ADDRESS: 4,fe- %/3 P& cIz 14�� R ,CITY AND°STATE ON THE TREASURER OF THE COUNTY OF RIVERSIDE, STATE OF CALIFORNIA y' Instructions: Permittee will furnish the following information: (1) Permit Number (2) . Date Issued Tlz/L 71-0 �l . =v. (3) Total Fees Paid -`(4) Reason for Refund I CERTIFY THAT THIS CLAIM IS TRUE AND CORRECT, AND THAT NO PART HEREOF HAS BEEN PREVIOUSLY PAID BY THECOUNTY OF RIVERSIDE. Claimant's Signature (:Do not write below this line), Dat • General Fund: 1001-28441231 FROM:. 'DEPARTMENT OF. BUILDING AND SAFETY TO': AUDITOR -CONTROLLER, COUNTY. OF°RIVERSIDE Please issue to the above indicated claimant a refund of on'.the' above permit deposited under Treasurer's Receipt No97!69 , dated 444-49 AUTHORITY: Ordinance No. 457.,. Section 7, Subsection E Approk00;-, —,s4pP oyed for the following reason: (strike out words not applicable) BDILDINLi PC11CF111 PERMIT NO. DEPARTMENT OF BUILDING & SAFETY Dsr 38755-6 1. COUNTY OF RIVERSIDE FIELD i10 CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES :Ji " IST FL. ` 2ND. FL. POR. GAR. CAR P. WALL ESTIMATED CONSTRUCTION -< -'T$ 1. e ( UNITS SQ. FT. @ Community i Z�•^ �•�' _..• i1 SQ. FT. @ YARD SPKLR SYSTEM SQ. FT. @ s MOBILEHOME SVC. BAR SINK SQ. FT. @ E!.,,rl. 6 , - POWER OUTLET ROOF DRAINS SQ. FT. @ DRAINAGE PIPING SQ. FT. @ DRINKING FOUNTAIN SQ. FT. @ 7 �� URINAL qq VALUATION r'�jtVl 1`�� a ��~ WATER PIPING NOTE: Not to be used as property tax valuation SWIM POOL, PVT FLOOR DRAIN MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER VENT SYSTEM FAN EVAP. COOL HOOD SIGN WASHER (AUTO)(DISH) APPLIANCE DRYER Bond Amt. $ GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED Final Date LAUNDRY TRAY AIR HANDLING UNIT CFM' IDLE METER KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR . -HP POLE,TEMP/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. @ c BATH TUB y, City- Zip �.•`"'�•-"`"' t SQ. FT. @ c WATER HEATER Contractor` �,..e SQ. FT. RESID @lt/.c SEWAGE DISPOSAL Trees required SQ. FT. GAR @ 'r. c HOUSE SEWER - GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL. TOTAL FEES MOB. HM. FEE MICRO FEE MECH. FEE PL. CK. F€�' LC 0 CONST. FEE EIECT. TIEFE SMI FEE FEE PLUMB. FEE _PERMIT NNOO. 13875561- Job/Adress.�. - � space AP - Owner) - _ Community i Z�•^ �•�' _..• i1 Valuation Date `te- Y _ Dist. ,Off.. FC � .. CX ' MH.PermitFee $ Micro Film Fee Cop $ Us "of Permit �...� 'u f, 1 fi '�r'v�` Zt— ...r --. tF '� `{p t��C Y--'N f ��f�� L1• '•r Parcel No. { )l.4 .t( ..• ✓ I Use/Case No. y� .,} 1 �f'•6 C% •�J C1k. By .' Mech. Fee. Dbl b ' Pl. Ck. Fee $ ir.-� . '+ Set Backs j Lot Size - r^ '`� r w ' Construction Fee Dbl $ Legal Descrjption ti -., . �j. �N� ( (� J I'..t t ' «T' ...,.5� 41,:•1?.4--� F r` S S "�"" S t1 'i••� .� '� Electrical Fee Dbl $ Zone Restrictions Gro p Typ SMI Fee $ Plumbing Fee Dbl $ Bond Amt. $ Plan NT. 0 -w �J er Final Date Inspector Unit _ Sp. Insp. Fee $ Demol. Fee $ Const. Lender Branch _ Suppli ent Permit Numbers Registr. Fee $ Mileage Fee $ Address '.� 'r0ty .` } Zip r" �''� '��/f•t� Witness Fee E// Reinsp. Fee $ OwnerAgent ,{1 �•i Zip Total Fees $r,V Address] i L J i 'C.,��.AC./-'�-�i' City- Zip �.•`"'�•-"`"' t M.O: . 1`4.C. C] Cash Check Received by 1"`'j i' Contractor` �,..e Tel. _ .. - Licensee �"^ . Trees required SewageSystem Address .. City p - T LL P THIS PERMIT SHALL BECOME VOID IF WORK 1$ NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by: Sewer District FOR 120 DAYS SHALL ALSO CAUSE'PERMIT TO BECOME VOID. HEREBY AGREE THAT ALC WORK I CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH rt THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. I HEREBY CERTIFY THAT THE, INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. 'Form 284 208 (Rev 8/78) as �. NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Ftgs 8 Frms 34 Plenums & Ducts 2A Slab Grade 35 Furnace Comport. 3 Steel 36 Inlets 6 Outlets 4 Grout Blocks 37 Combustion Air 5 Bond Beams 38 Compressor 6 Roof Deck 39 Appl. Clearance 7 Framing 40 Fire Damper 8 Vents 41 Smoke Detection Device 9 Garage Fire Wall 42 Commercial Hood 10 Fireplace P. L. ❑ 43 Final IDA Fireplace T.O.OP'N ❑ NO. ADDITIONAL INFORMATION SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath 12 Internal Lath 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Walls (Batts) 12B Ceiling (Batts) 12C Ceiling (Blown) 14 Final PLUMBING APPROVALS 15 Ground Plumb 16 Water Piping 17 Rough Plumb 18 Vents 19 Sewage Disposal 20 Sewer 21 Water Heater 22 Water Softener 23 Water Service 24 Gas Test 25 Final Tank Pit L.Line REAR OF PROPERTY LINE P/L P/ ELECTRICAL APPROVALS 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final STREET NAME over PERMIT NO. 1387556 DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE Dsr COUNTY OF RIVERSIDE 1.'1 1 CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL.� 2ND. FL. SQ. FT. @ 1 "'��� / UNITS Di I. SQ. FT. @ YARD SPKLR SYSTEM FOR. GAR. t-� ° CAR P. WALL SQ. FT. @ Use Permit "yC y� .�,�rtg,,. , l �% .j V `{ v�, sL�t (a ---o 4� 1 �..e-+'T/y\. ' •„Js`� MOBILEHOME SVC. BAR SINK SQ. FT. @ POWER OUTLET ROOF DRAINS SQ. FT. @ DRAINAGE PIPING SQ. FT. @ DRINKING FOUNTAIN . SQ. FT. @t-� URINAL ESTIMATED CONSTRUCTION VALUATION $, I �%� "° G'Ovpw,S •Ty`q� WATER PIPING NOTE: Not to be used as property tax valuation Plumbing Fee Dbl $ SWIM POOL, PVT FLOOR DRAIN MECHANICAL FEES Final Date Z'-'11 ' SWIM POOL, COMM WATER SOFTENER VENT SYSTEM FAN EVAP. COOL HOOD Dental. Fee $ SIGN WASHER (AUTO)(DISH) APPLIANCE DRYER Mileage Fee $ Address. I Zip GARBAGE DISPOSAL,,' FURNACE UNIT WALL FLOOR SUSPENDED Ownef/A'gent Zip Total Fees $ kn' 'Address yy t� C�ty-. -. Zip M. 0. N.C. Cash Q Check Received by '; Contractor Tel. LicenseX Trees required Sewage System Address City Zip 4 T LL P Sewer District 01 �� Form 284-208 (Rev.8/78) @s THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by: FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. BUILDING PERMIT PERMIT NO. DEPARTMENT OF BUILDING & SAFETY DST 3911401 COUNTY OF RIVERSIDE FIELD (ZQtNSTR ESTIMAT NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. 2ND. Fl. POR. '� SQ. FT. @ UNITS � • SQ. FT. @ - YARD SPKLR SYSTEM o r..�'r MOBILEHOME SVC. SQ. FT. @ BAR SINK GAR. CAR P. WALL SQ. FT. @ u POWER OUTLET ROOF DRAINS SQ. FT. @ DRAINAGE PIPING SQ. FT. @ DRINKING FOUNTAIN SQ. FT. @ ESTIMATED CONSTRUCTION VALUATION $ _ a j '� URINAL WATER PIPING NOTE: Not to be used as property tax valuation SWIM POOL, PVT FLOOR DRAIN MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER VENT SYSTEM FAN EVAP. COOL -. HOOD SIGN WASHER (AUTO)(DISH) APPLIANCE DRYER .^`� ` /� 5 ! GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED Electrical Fee - Dbl 8 LAUNDRY TRAY AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR _ HP POLE,TEMP/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY_- • AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. @ c BATH TUB 4 SQ. FT. @ c WATER HEATER $ SQ. FT. RESID @11/4c .SEWAGE DISPOSAL Sup SQ. FT. GAR @ '/. c HOUSE SEWER Registr. Fee § ,Mileage Fee $ GAS PIPING PERMIT FEE Reinsp. Fee PERMIT FEE PERMIT FEE DBL.' TCqf MOB. HM. FEE MICRO FEE MECH. FEE Pl.%C E2 . CONST. FEE ELECT. FEE SMI FEE FEE PLUMB. FEE T t PERMIT NO. 4 Job ddress ..A .,^r^ ILZ ekn rzte,:2- Space P Zi •'. p Owner � � 1 ! � • Community t f`{ �) { f Valuation Dote Dist. �.J i Off. —4 F,C.C, ,dL' MH.Permit Fee $ ,Micro Film fee Cap $-,� Use of er t �- ,r' +- i ^,� ` 1' �j , �,��.,T y (0- •v Parcel No. .�„ I !,d' � : �r ,Use/Case No. Ck. By p j, Mach. Fee Dbl $ rPl. Ck. Fee $ Set Backs Lot Size �,onstruction Fee Dbl $ ,C Legal Description .^`� ` /� 5 ! F 4`r S S / �� ` R -�'+•-• Electrical Fee - Dbl 8 Zone Resjins TTl! Group Type SMI Fee $ Plumbing Fee Dbl $ Bond Amt. $ Plan o..la ker Final Date �— Inspector Unit Sp. Insp'. Fee $ Demol. Fee $ Const. Lender Branch Sup I Permit Numbers / Registr. Fee § ,Mileage Fee $ Address City Zip r i_'J�i' .` f, ,�%'• �,+,: /-r's`.•P- Witness Fee $ Reinsp. Fee $ Owner/Agent r Tel. Zip Total Fees $ - / Address r, `. N r,' City/ r ? r' zip % M.O. Q, N.C. sh ;Ch.CkpReceived by �%"Contractor Tel. � .r � LicenseN Trees required Sewage System Address City Zip T LL P -Sewer District r jForm 284-208 (Rev.8/78) ©s THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by: FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. 1 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN / ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Ftgs 8 Frms 34 Plenums 8 Ducts 2A Slab Grade 35 Furnace Comport. 3 Steel 36 Inlets 8 Outlets 4 Grout Blocks 37 Combustion Air 5 Bond Beams 38 Compressor 6 Roof Deck 39 Appl. Clearance 7 Framing 40 Fire Damper 8 Vents 41 Smoke Detection Device 9 Garage Fire Wall 42 Commercial Hood 10 Fireplace P. L. E 43 Final IDA Fireplace T. 0. Cj NO. ADDITIONAL INFORMATION SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath r 12 Internal Lath 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Walls (Batts) 12B Ceiling (Botts) 12C Ceiling (Blown) 14 Final PLUMBING APPROVALS 15 Ground Plumb 16 Water Piping 17 Rough Plumb 18 Vents 19 Sewage Disposal 20 Sewer 21 Water Heater 22 Water Softener 23 Water Service 24 Gas Test 25 Final Tank Pit L.Line PSL REAR OF PROPERTY LINE ELECTRICAL APPROVALS P/ 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final STREET NAME BUILDING PERMIT PERMIT NO. DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE q�T '9 1:1 COUNTY OF RIVERSIDE (� (;QrN9STRUCTION a I ST FL.—," ' 2ND. FL. FOR. �. GAR. "-,.. ?• WALL ESTIMATED. CONSTRUCTION ESTIMATf SQ. FT. @ NO. ELECTRICAL FEES IR UNITS � NO. PLUMB G FEES SO. FT. @ nnYARD SPKLR SYSTEM " ✓" MOBILEHOME SVC. SQ. FT. @ BAR SINK SQ. FT. @ POWER OUTLET ROOF DRAINS SQ. FT. @ DRAINAGE PIPING SQ. FT. @ DRINKING FOUNTAIN SQ. FT. @ URINAL VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation SWIM POOL, PVT FLOOR DRAIN. MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER VENT SYSTEM FAN EVAP. COOL HOOD SIGN f WASHER (AUTO)(DISH) APPLIANCE DRYER Type GARBAGE DISPOSAL FURNACE UNIT 'WALL FLOOR SUSPENDED Bond Amt. $ LAUNDRY TRAY AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK ABSORPTION SYSTEM 1 B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR 'HP POLE,TEMP/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. @ c BATH TUB is SQ. FT. @ c WATER HEATER Cityj�" t Zip�a Jr•: ,� �.-� f"� .:J f� Xi SQ. FT. RESID @ 1114 c SEWAGE DISPOSAL Contractor SQ. FT. GAR @ �/A c HOUSE SEWER r" Sewage System • • i T U. - P GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE 1 DBL. k T • V E/aJJ MOB.HM.FEE MICRO FEE MECH. FEE PL. JCIj/ CONST. FEE ELECT. FEE �Lr/ SMI FEE FEE PLUMB. FEE I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. Form 284-208 (Rev.8/78) as Job ddress Space •�� �, At&Z-2 - p �'f Owner t ' i-'�. 9" PERMIT NO. `391140 Community , rRI T�.� Valuation $ Dote Dist. F C.C. MH.Permit Fee $ Micro Film Fee Cop $pJ Use of t © _ / tiijl �. �" „/',��/�.4v I C% J t...'�" Parcel No. Use/Gose No. f J Ck. By _ Mech. Fee Dbl $ tiPl. Ck.' Fee $ Set Backs Lot Size _ Construction Fee Dbl $ Legal Description F �, �% h. <�. ��,� S /� ,i S i'"'' R;,__a_ Y Electrical Fee Dbl $ Zone ResVrct,hns - Group Type SMI Fee $ Plumbing Fee Dbl $ Bond Amt. $ Plan o. Pl'a/�,�/h/ec/kerma ��(/(7 /��. Final Date ev Inspector Unit . SP. Insp. Fee $ s Demo[. Fee is Const. Lender Branch • - Supplimentol Permit Numbers r Registr. Fee $ {Mileage Fee $ Address City Zip/^ c p /� f l/ Y✓ !.r d•' Witness Fee E Rt:iasp. Fee $ Owner/Agents jF( -rf (-{i/per}' ,. tr r p u' t- y- •1i Tel. Zip is Total Fees - $ _ Address rr„" r.. { eu f"� tMr G�' •f..r (fi' eic Cityj�" t Zip�a Jr•: ,� �.-� f"� .:J f� Xi ` M. 0. N.C. s Check Received by`.\-5QW61DI4 Contractor TAI. eft / ""` r f ' `✓ License# Trees required - Sewage System • • i T U. - P Addresar CitY Zip THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by: FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. I HEREBY AGREE'THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. Sewer District ^ i/ Jae, I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. Form 284-208 (Rev.8/78) as Building Address Alco Develo Mailing. ' Address � 730 B i nh City Zip Contractor _ P1 S' Address 4 P.O. BOX 1504 No. 003369 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 A -r !meil BUILDING:- TYPE CONST. OCC: GRP., f v 111. A.P. Number 774.236. 01` — Tel. §227-0 32 -RaFt4 Legal Description Project Description S� L Diel l i ng 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 it work thereunder is suspended for 180 days. I certify that I have read this application and state lhat'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 .ofthis city to enter the above- mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip HARD COPY Rear Setback from.Rear Prop. Line Side Street Setback.from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date .9 `15 B Permit Validated by: Validation: City . Zip Tel.. State Lic. & Classif.:- 387296 City Lic,. # SiSq. Size . Ft..1414Stories Units Arch., Engr., - Designer New ❑ Add ❑ Alter ❑ Repair ❑. -Demolition ❑ Address Tel. GAR 4401 Part h 329; 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. . a ' SIGNATURE+' ✓' `'' `�' DATE OWNER -BUILDER DECLARATION 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'cfty or county •whfch.requires. a • -permit fo construct, alter, improve, demolish, or repair anystructure, prior to its -issuance also requires the applicant /or 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 o/ the Business and Professions Code, or that. he is exempt therefrom; and the basfs /or 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 doflars-($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. I/, however, the building or improvement is sold within one year of completion, the owner -builder .will have the burden o/ proving that he. did not build or improve for the purpose o/ 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 o/ property who builds or improvesthereon, and who.contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ I am exempt undecSec. Sec..B. & P.C. for this, reason _ Estimated Valuation d q tfig+�e� 0 I ., _ 4 `' PERMIT • ' . - �, ' •"AMOUNT r • - Plan Chk. Dep. .. J I W) Plan Chk. Bal.. - 49.41 1 .Cof1St. -- .36x100 ' Mech. �s 3 6 AG L Electrical - - r°` 7 A - tx Plumbing•_) S•M';I.. , .• - tf`,y A Grading 2P? on Driveway Enc. Date owner Infrastructure1 A44. 18 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 O Copy, is filed with the city. ❑ Certified copy is.hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit Is /or one hundred dollars ($100) valuation ' or less.) 1 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: I/, after making this Certificate of Exemption you should ' become 'subject to the Workers' Compensation provisions o/ the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. - TOTAL L)A1%_0-9 t ;ld A7 REMARKS ti V _ ... ZONE: BY: _ Minimum Setback Distances: - Front Setback from Center Line 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 it work thereunder is suspended for 180 days. I certify that I have read this application and state lhat'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 .ofthis city to enter the above- mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip HARD COPY Rear Setback from.Rear Prop. Line Side Street Setback.from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date .9 `15 B Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES' 1ST FL. SQ. FT. ® $ UNITS COLL. AREA 2ND FL. SQ. FT. ® ROUGH PLUMB. YARD SPKLR SYSTEM POR. SQ. FT. p MOBILEHOME SVC. BAR SINK GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. ® DUCT WORK DRAINAGE PIPING WALL SO. FT. ® GAS (ROUGH) DRINKING FOUNTAIN SO. FT. ® HEATING (FINAL) URINAL ESTIMATED CONSTRUCTION VALUATION $ GAS (FINAL) TEMP. POLE WATER PIPING NOTE: Not to be used as property tax valuation WATER HEATER SERVICE FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FINAL INSP. LAUNDRY TRAY AIR HANDLING UNIT CFM C� 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/a c SEWAGE DISPOSAL GAR. FIREWALL SO.FT.GAR ® 3/ac HOUSE SEWER LATHING Z �� 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 W-11/SETBACK q_30-5 OUND PLUMBIN X UNDERGROUND A.C. UNIT COLL. AREA LAB GRADE 4?— 3Q ROUGH PLUMB. LdBONDING ,, HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. 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. p FRAMING FINAL INSP. � ROOFING /. �.. ✓� C� REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING Z �� MESH INSULATIONISOUND r FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL Desert Sands Unified School District CERTIFICATION OF PAYMENT OF SCHOOL FACILITY FEES (ty TO: City of La Quinta DATE: /-71JV, Department of Community Development 78-105 Calle Estado �yp� w p La Quinta, CA 92q�253 B�1iJ: I HIS DOCUMENT CANNOT BE DUPLICATED. This As to certift"at I developer of which is located at SS/- 6 `' within this District, has paia school fk6ility fees imposed pursuant to the authority 9enerated by Government Code Section 53080 in the amount of �J covering a total of square feet of (l-Y—residential or ( ) industrial/comme cir al development and that building permits for this footage in this development may%now be issued by your jurisdiction. for DESERT SANDS•UN FIED SCHOOL DISTRICT White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer (10)-37 z O f— U W U) :s U) `1 Lr Q W Ir LN Z O H U W Cn IWW Nwr 7 COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION 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 $37 is required when the application is submitted. Check must be made payable to the County of Riverside. �C o l /e %,+OIPVw c4 Building Department App ication Log # Name (Owner, Agent, Conttrractt, Etc.) ` Ale. fj Mailing Address t ng 15Q 071 vr_Ir��e-A 4, b t-1 city J Z 1 ' Stated (%�ajr l � Zip Code l j v ---- 1 \fM/1� , v ✓q� C L 'Job Property Address I 6 �MI�2CZ_ -City or Community f . LA 0U,WA � 'Legal Description of Property. (Lot, PM, TR) I-�,-1 31C 'Assessor's Parcel No. Water Agency or Well -",---------------- –L-ot"Size An"4 Use of Permit _ Planning Case N 60A too SFD, MH Site Preparation Etc. Signature of Applicant Date The above information must be verified from Building Application STAFF USE — DO NOT WRITE BELOW THIS LINE Initial Date Certification of Existing S.D. System required. ❑ Yes ❑t No``=f w WQCB Clearance required. ❑ Yes No ,fi�t,, Soils feasibility report dequired. El Yes L} No ©�eFale5'lb�onnCgi6r1ebporeyquired. 1:1 Yes 4 No Detailed contour plot plans required. ❑ Yes ED No Staff Specialist approval required. ❑ Yes ❑ No Lct Inspection Date Soils/boring report by C '^ Project # Date Soils Map Page Soil Type Approved by Date Type of System: No. of Bedrooms (1) Septic Tank Soil Rate Required ❑ Existing ❑ New ❑ Additional ❑ Replacement it t tT_ OU L) Gals. (2) Leach line sq. ft. ` Sidewall allowanceZ Install Line(s) Ft. Long, Leach bed Sq. (Bottom trendarea) ft. rock/ Sq. Ft. Ft. wide with min. inches Ft. of bottom 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 } ApplicableI N/A Overburden factoor El 5' D'6' ` I y, Max. allowable depth This application iapproved/denied for the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements set forth in Section B"•above. A building permit is necessary for the installation of the above -designed system. iv_(1•) Septic tank and sewer lines must be 50' from any wells (2) Leach lines must be 100' min. from any wells including expansion area ) Seepage pits must be 150' min. from any wells including expansion area I" t " "' �d " `�-"' °' ' �.r Signature of Health Official Date RECEIPT NO. District: ❑ Riverside Q`ndio Distribution: WHITE—Office file DOH -SAN -122 (Rev. 6/86) Issued by ' 'r Date 0 ( `( I ._`.'7 ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pendine File 4b{ .1 .: N { OFFICE OF 0 a AGRICULTURAL COMMISSIONER E. LEON SPAUGY " j 4080 LEMON STREET, ROOM 19 COMMISSIONER RIVERSIDE, CALIFORNIA 92501 JAMES O. WALLACE ASSISTANT COMMISSIONER +\. 1714) 787.2561 . qr9, �e9 49-613 Hwy 86, Suite B-12 " Coachella, CA 92236 (619) 342-8291 " Dear Developer/Landscaper: Thank you for inquiring with the "Agricultural Commissioner's Office regarding, local quarantine laws. Any diseases oriinsects associated with the plants/landscaping material presented on your_landscapi'ng plans do not pose a threat to the Coachella"Valley Citrus, Date, Grape, Vegetable, or Field Crop"industry. We therefore ar-prove your, landscaping plans. If.however, any substitutions of plants/landscaping materials within your plans occurs between now and the actual planting date, you.must contact this office within 48 hours before delivery into the Coachella Valley. Alsc,ethe substituted plants/landscaping material` must be held for inspection upon arrival. Any sub= stituted landscaping material -found infected/infested with'quarantine pests will. be immediately treated or shipped out of the Coachella Valley at the discretion of the Agricultural Commissioner's Office. Under penalty of perjury, I the undersigned will comply with -the above. Authorized Agent:. Name ,d. t Date Signature Permit Number(a) 6 f7lt,5O90YA Developer &n=;,9e t Address 6 9 73a /y4wUI6/4.1 AGRICULTURAL COMMISSIONER' S APPROVAL. lam/ � Date_7 -1-f2 -Authority cited: Agricultural Code; Sections 6301, 6461, 6462,;6464, 6501, 6521- 6524 cc:. 2 Plan Check, Indio Office, Riverside Office