04846 (SFD)Building
Address 52
Owner
r. t
Mailing
Address
Zip ITel.
L
city Zip Tela
Palm Slnrixtfts 92262 320-4638
State Lic. City
& Classif. I Lic. #
Arch., Engr.,
Designer
Address I Tel.
cityI Zip I State I
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section
7000) ofDivision 3 of the Business and Professions Code, and my license is in full force and
effect
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,13usiness and Professions Code: Any city or county which requires a
permit to construct, alter, irprove, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to Me a signed statement that he is licensed pursuant to
the provisions of the Contractors license law, Chapter 9 (commencing with Section 7000) or
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the alleged exetrpticn. Any violation of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penally of not more than rive hundred dollars ($500).
❑ 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 irproves thereon and who does such work himself or through his own employees,
provided that such onprovernents are riot intended or offered for safe. If, however, the building
or irprovement is solo within one year of completion, the owner -builder will have the burden
of proving Mat he did not build or aprove for the purpose of sale.)
❑ 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 apply to an owner of property who builds or improves thereon, and who contracts for
such projects wDh a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec B. & P.C. for this reason
Date f Owner
WORKERS' COMPENSATION DECLARATION
1 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 fumished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(firs section need not be completed it 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. H, after making this Certificate of Exemption you should become
subject to the Workers' Conpensagon 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.)
Lenders Name
Lenders Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 100 days.
I 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
JILDING: TYPE CONST.
P. Number 373-335-018
OCC. GRP. -
Description > 66_1G
Project Description
S.F.D.
Sq. Ft. 1348
Size
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑
Repair ❑ Demolition ❑
Estimated Valuation
S74. 18-3
PERMIT
AMOUNT
Plan Chk. Dep.
$250.00
Plan Chk. Bal.
$ 61.34
Const.
358..00
Mech.
33.00
Electrical
72.50
Plumbing
113.00
S.M.I.
5.22
Grading
20.00
Driveway Enc.
20.00
Infrastructure
1,633.74
TOTAL
S2.566.80
REMARKS
i o
s'rr,' t! h;e— v f -, 4-:1
t, J Gliati
1 t !f (rlL. 3 : I( r7 1SrJ
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
1218188
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
^�
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SO. FT. 0
BONDING
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK >r�
POR. SO, FT. ®
;ROUGH
EWER OR SE
ROUGH WIRING
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
AS (ROUGH) L/
_ (
METER LOOP
DRAINAGE PIPING
CAR P. SO. FT. ®
REINF. STEEL
WALL SO. FT. ®
TEMP. POLE
DRINKING FOUNTAIN,
URINAL
SO FT ®
WATER HEATER
SERVICE
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
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
V FRAMING ( _
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
ROOFING
LAUNDRY TRAY
AIR HANDLING UNIT CFM
G
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.
SO. FT. ®c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
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 PLUMBIN •��
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
;ROUGH
EWER OR SE
ROUGH WIRING
DUCT WORK
ROCKSTORAGE
FOUND. REINF.
AS (ROUGH) L/
_ (
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
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.
V FRAMING ( _
FINAL INSP.
ROOFING
))f
�/ v •' 1
fr
r
P� I
�y
.•
G
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING 2
MESH
CATION/SOUND
FINISH GRADING
/
&INAL INSPECTION —G/—
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES11NITIALS
GARDEN WALL FINAL
RealQuest.com ® - Report
Page 1 of 2
Property Detail Report ReajQues Com
For Property Located At
52823 AVENIDA BERMUDAS, LA QUINTA CA 92253-3376
I Owner Information:
Owner Name: FLORES LEONEL & MAURA
` Mailing Address: 52823 AVENIDA BERMUDAS, LA QUINTA CA 92253-3376 H006
Phone Number:
Vesting Codes: SM / / JT
p Location Information:
I Legal Description: LOT 5 BLK 149 MB 018/092 SANTA CARMELITA VALE LA QUINTA UNIT
15
County: RIVERSIDE, CA
APN: 773-335-018
Census Tract / Block: 451.10/1
Alternate APN:
SANTA
Township -Range -Sect:
Subdivision: CARMELITA VALE
LA QUINTA UNIT
15
Legal Book/Page: 18-92
Map Reference: / 879-F2
Legal Lot: 5'
Tract #:
Legal Block: 149
School District: DESERT SANDS
INDIO U
Market Area:
Munic/Township:
i Neighbor Code:
Owner Transfer Information:
Recording/Sale Date: 08/31/2004 /08/2612004
Deed Type: GRANT DEED
Sale Price:
1 st Mtg Document #:
Document #: 693086
Last Market Sale Information:
Recording/Sale Date: 06/23/1995 /
1st Mtg Amount/Type: $69,600 / CONV
Sale Price: $88,000
1 st Mtg Int. Rate/Type: / ADJ
Sale Type: FULL
1 st Mtg Document #: 202546
Document #: 202545
2nd Mtg Amount/Type: /
Deed Type: GRANT DEED
2hd Mtg Int. Rate/Type: /
Transfer Document #:
Price Per SgFt: $64.14
New Construction:
Multi/Split Sale:
Title Company: FIDELITY NATIONAL TITLE
Lender: AMERICAN SVGS BK
Seller Name: EMC MTG
Prior Sale Information:
Prior Rec/Sale Date: 03/15/1994 /
Prior Lender:
Prior Sale Price: $70,000
Prior 1 st Mtg Amt/Type: /
Prior Doc Number: 108154
Prior 1st Mtg Rate/Type: /
Prior Deed Type: GRANT DEED
Property Characteristics:
Gross Area: 1,813 Parking Type:
GARAGE/ Construction:
CARPORT
I Living Area: 1,372 Garage Area:
441 Heat Type: CENTRAL
Tot Adj Area: 1,372 Garage Capacity:
Exterior wall:
Above Grade: Parking Spaces:
2 Porch Type:
Total Rooms: Basement Area:
Patio Type:
Bedrooms: 3 Finish Bsmnt Area: Pool:
Bath(F/H): 2/ Basement.Type:
Air Cond: CENTRAL
Year Built / Eff: 1989/ Roof Type:
Style:
Fireplace: Y / 1 Foundation:
Quality:
# of Stories: 1.00 Roof Material:
TILE Condition:
Other Improvements: ADDITION
Site Information:
Zoning: R1 Acres:
0.11 'County Use: R01
Flood Zone: X500 Lot Area:
4,792 State Use:
Flood Panel: 0607090005B Lot Width/Depth:
x Site Influence:
Flood Panel Date: 08/19/1991 Res/Comm Units:
1/ Sewer Type: NONE
Land Use: SFR
Water Type: TYPE
UNKNOWN
Tax Information:
Total Value: $193,008 Assessed Year: 2007 Property Tax: $2,635.32
Land Value: $61,951 Improve %: 068% Tax Area: 20104
Improvement Value: $131,057 Tax Year: 2006 Tax Exemption: HOMEOWNER
Total Taxable Value: $186,008
http://www.realquest.com/j sp/report. j sp?&client=&action=confirm&type=getreport&reco... 11/16/2007
RESULTS TO RIVERSIDE COUNTY GIS QUERY Page 1 of 1
Riverside County GIS
This information is made available through the Riverside County Geographic Information
System. This information is for reference purposes only. It is intended to be used as base level
information only and is not intended to replace any recorded documents or other public records.
Contact appropriate County Department or Agency if necessary. Reference to recorded
documents and public records may be necessary.
GIS inquiry for APN = 773335018 ... Request = OWNER
• parcel number : 773335018
• parcel—owner: FLORES LEONEL
• parcel _owner FLORES MAURA
• mail—to name :
• mail _to_street: 528.23 QVENIDA BERMUDAS
• mail _to_city: LA QUINTA CA.
• mail to_zip : 92253
For further information or questions, please contact ...
Riverside County Assessors Office
(909) 955 - 6200
4080 Lemon Street
Riverside, CA. 92501
http://www.tlma.co.riverside.ca.us/cgi-bin/gisquery3.cgi?APN=77333 5018&REQUEST=... 11/16/2007
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CD
COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH Assessors Parcel No.
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 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, Contact Person
Phone
Address & Phone
Owner
Phone
K4aifing Address
City
State
Zip
Job Property Address
L6gal Descrn Prop. (PM, Tract, Lot)
'r
F'
r '
r � r
,,- ,- �i �� / 'rl
Lot Size
a�r�Anc all.
of Permit P/P, CU, etc. (�} [i�cr N s;;
Other
�Use
'6 / % J
,f
Dwelling, MH Site Prep, etc.
Signature of Applicant
Date
CATEGORY: REV CODE FEE
CATEGORY: REV CODE FEE
SUBSURFACE DISPOSAL 1238 (-$45.00 )
`; ~
❑ SITE EVALUATION UPON REQUEST 7349 $42.00
❑ MULTIPLE PARCELS WITHIN SAME '""
(NO PLOT PLAN)
LAND DIVISION
❑ SEWER/SEPTIC VERIFICATION 7348 $11.00
a. 1 st 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
❑ Site Evaluation Lot Less than
SYSTEM
10,000 Sq. Ft. 7347 $86.00
INITIAL / DATE
Holding Tank Agreements Completed ❑ Yest o _ ? /rte_ `� / u k
Certification of Existing S.D. System Required ❑ Yes Y" 0 I
WQCB Clearance required. (Attach Form ❑ Yes 0
DOH SAN 007, Santa Ana Region Only)
Zo,
Soils Percolation Report Required. ❑ Yes
Special Feasibility Boring Report Required. ❑ Yes
Detailed Contour Plot Plans Required (1 to 5 ft. interval) ❑ Yes N
Other ❑ Yesf {N6
Staff Specialist Lot Inspection Required ❑ Yes No
jrT
Lot Inspection Date
Soils boring report by Project # Date
Soils Map Page r1 Soil Type �� Approved by = Id Jr-' Date
No. of Systemsype
of System(s)
No. Dwelling Units //
(1) Septic Tank
Soil Rate
Grease/Sand
❑ mg Tank ❑Existing
ew ❑ Replacement/,�,��.
Bedrooms, Fixture Unit
'r
Grease Intcp
A
14 /
".4 x
-/40—Gal
(2) LeachLine Sq. Ft
Sidewall allowance
Install Line(s) n long a wide with
Leach Bed sq. n
om bench are
n rock/a sq.i
min. iriohe&�w drainlines or
oT?r�a
per running ft.
Leachlines/bed special design for slope:
(3) Pit Diameter
No. Pits
Pit Below
Seepage Pit Total Depth
Other*
Applicable
4 '//�
Inlet (BI)
f
-Vll
Max. AllowableDepth
N/A �_�Overtwrden factor
No. 2 System
REMARKS:
This application is.APPROVEO/DEULED.,for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated
on the accompahltitr�, '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.
.�
Septic tank and sewer lines must be 50' minimum from any wells 16 -�-r • f .! _'r_ ^ {�=> -
Leach lines be 100' from including 'A Je
must minimum any wells, expansion Jarea/' fir-. �. rt ��
Seepage pits must be 150' minimum from any wells, including expansion areq y�//Q
Si nature of Health Official '' r /1 Dat
I r/ -,If/r
/ // . V L
RECEIPT NO. 9 l Issued By ( .112._ Date-
DISTRICT:
ate DISTRICT: ❑ Riverside, ndio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe
DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept. GOLDENROD - Plans/Records
W