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06643 (SFD)B,ilde" 53-270 Juarax Sara Bre=er/Gerald Kat tilt3><t. Mailing • Address City Izip IT Contractor P.O. BOX 1504 78-105 CALLE ESTADO LA.QUINTA„CALIFQRNIA 92253 Address. ` P. 4.. Brix 1371 City Zip Tela . La Quiaea 92253 564-~3511 _ State Lic. City & Classif. 506667 Lic. # Arch., Engr., Designer Address Tel. City Zip State Lic. # * LICENSED CONTRACTOR'S DECLARATION b I hereby affirm that am licensed under provisions`of Chapter 9 (commencing with Section 7000) of Division 3 of )he Business and P,rofesio 7shs Code, and my license is 1n_fu11 fo ce a do effect �.--- (3 , f. / ” '' f 1 ;' .`: k. 1GNATl1RE w. �� DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors License Law for the following reason: (Sec. 7031.5.Busrress and Professions Code: Any city or county which requires a permit to construct, after, improve, darnoish. or repair any structure, prior to its issuance also requires the applicant for such:pennit to Oe a signed statement that he is licensed pursuant to the provisions of the Contractor's Licence Law, Chapter 9 (commencing 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 cid penally of rot more than five hundred dollars ($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 Lary 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 urprovmnerrts.are not intended or offered for sale. ff, however, the building or improvement is sold wiMrr one year of completion, the owner -budder will have the burden of proving that he did not build or improve for the purpose of safe.) ❑ 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 odds or improves thereon, and who contracts for such projects with a contractor(s) icensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sea a. & 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. C,onnpany ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be corrplcted 0 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 I <�qt • 1 ��. Date y i f Vit. Owner NOTICE TO APPLICANT: 8, after making this certd-cafe of Exemption -you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provs}ons or this pemxT 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, C" Code.) - -Lenders Name " ] v m- L-A Co i i rVGC :�i "'-.Q Lender's Address < C- h' rrt_c:. i r to. �y •xya 'r Tui 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. 1 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. w-^ Jam,. t :: . .. ,.� •_. .A t i `f Signature of applicant Date L V 1" ` Mailing Address '�` - a''�^ City,. State, Zip t t ,} i, . c, t r i„ L. No. 06643 BUILDING: -TYPE CONST: " OCC: GRP. 07/ A.P., Number 774-05-002 ,Legal Description r Project Description Si�i2 Sq. Ft. 1235 No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ 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 Estimated Valuation $90,292 Validated by: PERMIT AMOUNT Plan Chk. Dep. $250.00 Plan Chk. Bal. $ 259.56 Const. 399.00 Mech. 53.50 Electrical 114.12 Plumbing 157.50 S.M.I. 6.37 Grading 20.00 Driveway Enc. 20.00 Infrastructure 1,993.34 TOTAL $39"3-39 REMARKS ` 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 Issued by: - Date 11/13/89Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. F 1 +I 1ST FL. SQ. FT. ® $ UNITS ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK YARD SPKLR SYS 2 ND FL Sp. FT.' DUCT WORK ROCK STORAGE FOUND. REINF.///J /lf4. !1 11Y! MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® REINF. STEEL r GAR. SO. FT. ® POWER OUTLET IROOF DRAINS 1 WATER HEATER SERVICE FINAL INSP. �I DRAINAGE PIPING CAR P. SQ. FT. WATER SYSTEM FINAL INSP. 7 FINAL INSP. y GRADING cu. yd. plus x3 WALL SQ. FT. LUMBER GR. DRINKING FOUNTAIN SQ FT ® /A �`7/ IO jGG>ti ' -/" / I� I H URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation VENTILATION FLOOR DRAIN MECHANICAL FEES FIRE ZONE ROOFING WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTOXDISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1 Vi c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ic HOUSE SEWER FENCE FINAL 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 ; 1© w% In -3, OUND PLUMBING /�) UNDERGROUND A.C. UNIT COLL, AREA SLAB GRADE�0 ® ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF.///J /lf4. !1 11Y! GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) MP. POLE O GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM FINAL INSP. 7 FINAL INSP. y GRADING cu. yd. plus x3 =$ LUMBER GR. FRAMING 2/1ylea 17,4# ROOFING /✓7© /A �`7/ IO jGG>ti ' -/" / I� I H REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING /,,W.*V MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESlINITIALS GARDEN WALL FINAL �et: -' RECEIPT NO. / fJ Issued By AltmDate DISTRICT: ❑ Riverside, ©-"Indio ❑ Hemet q Perris ❑ Rancho Calif. ❑ Blythe DOH -SAN -122 (Rev. 7/89) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records M /1' 1 COUNTY OF RIVERSIDE ENVIRONMENTAL A""tO" ftroN NM 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 speculations as indicated on the attached check list , 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. f �Q ITEMS IN A FROM VERIFY SECTION BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG #� ^- Z �� Agent. Contractor, Contact Person . �T • Z4. Y� F-lrol.� Phone '--` '� Address & Firm ^� G/ •j ? (_'7dr,,/`7•j V C! 71'� �U�- („y t3 UJ Owner Phone Mailing Address City ' State Zip Job d?r p�pjA'dd' C, Rn, F Z Legal Description Prop. (PM, Tract, lot) c cc IC f 3 Lot Size VQter Agencr ell Use of Permit P/P, CU, etc lr2 o Other Dwelling ,etc. 7�. L• k, ray • Gam. ( \ Signature of Applicant \ 7 Date CATEGORY: REV CODE FEE„ _ CATEGORY: REV CODE FEE O' SUBSURFACE DISPOSAL 1238 $ 57.00 ❑ SITE EVALUATION UPON REQUEST 7349 $ 43.00 m ❑ MULTIPLE PARCELS WITHIN SAME (NO PLOT PLAN) LAND DIVISION ❑ SEWER/SEPTIC VERIFICATION 7348• $ 17.00 Z a. 1 st 4 Parcels (Each) 1238 $ '57.00 (Less than 1 year) b. Each Parcel after 4 7344 $ 24.00 ❑ PRELIMINARY ELECTIVE 7352 $ 23.00 W ❑ Rereview (2nd review same parcel) 7344 $ 24.00 EVALUATION (Attach DOH SAN 53) . Ing ❑ She Evaluation in Conjunction with ❑ HOLDING TANK 7351 $ 47.00 Critical Area 7346 $111.00 ❑ ALTERNATIVE/EXPERIMENTAL 7345 $222.00 ❑ She Evaluation Lot Less than SYSTEM 10,000 Sq. Ft. 7347 $ 87.00 INITIAL DATE G� " Holding Tank Agreements Completed ❑ Yes o"" Certlflcation of Existing S.D. System Required i ❑Yes No,`' - WOCB Clearance required. (Attach Form ❑ Yes E9 o DOH SAN 007, Santa Ana Region Only) Soils Percolation Report Required. ❑ Yes 7 No . Special Feasibiltty Boring Report Required. ❑ Yes ' Detailed Contour Plot Plans Required (1 to 5 ft interval) ❑ Yes �l��No OC►er ❑ Yes Staff Specialist Lot Inspection Required ❑ Yes ❑�No / Lot Inspection Date Soils boring report by Date y"'Project Soils Map Page t ` � / Q U Sort Type Approved by -*(.y Date r ` Z No. of Systema Tyf� of System(.) No. Dwelling Unita(i) (1) Septic Tank Soil Rate Grease/Sand 0 O Holding Tank ❑ Existing 8'hlew ❑ Replaoenwnt Bedrooma,-RxtuwWnts, , ,f �r W (2) Leech Line Sq. Ft \Bottom trench Sidewall allowance Installs ft wide with Line(s) ''�� ) 9 -m Leach Bed it area _ R rock/ sq. f< per running ft. min. incttea" -r�Okgebw drainlinea or ^� hof -bolt -me "��-me. daNA Leachlines/bed special design for slope: (3) Pit Diameter No. Pits Pit Below Seepage Pit_Total Depth Applicable I Inlet (BI) (TD) / N/A Overburden hector �CT'�5 �` JILI 7 Max. Allowable Depth € j No. 2 System Nlq REMARKS. / � IrG'�•�� /'1_. ��-Q.. i 'f�G�ii�.yGL},�f(it��f...-.- i �r — i'���Zz--- ' ��/ ti .sr/�r �.� This application it-tAPPROVED/L9ELIIED-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 Z above -designed system. No construction is permitted in the required reserved, 100% expansion, area. 0 (1 Septic tank and sewer lines must be 50' minimum from any wellsN (4 f) W Leach lines must be 100' minimum from any wells, including expansion a ea b(3) Seepage pits must ber,150' minimum from any wells, including expanslon�area A_ Signature of Health Official -' RECEIPT NO. / fJ Issued By AltmDate DISTRICT: ❑ Riverside, ©-"Indio ❑ Hemet q Perris ❑ Rancho Calif. ❑ Blythe DOH -SAN -122 (Rev. 7/89) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records M /1' 1 HEGUHU11YU HLUUESTtU BY AND WHEN RECORDED MAIL THIS DEED AND UNLESS OTHERWISE SHOWN BELOW MAIL TAX STATEMENT 70: Nam,Mark W. Katzman, Trustee Street 510 Flower Hill Lane _ Address • Palm Desert, Cal 92260 City a State MAIL TAX Name Street Address City & State TITLE ORDER NO. ESCROW NI.0418KK SPACE ABOVE THIS LINE FOR RECORDER'S USE GRANT DEED �7U- 0-7 i= 000-`6 THE UNDERSIGNED GRANTOR(S) DECLARE(S) DOCUMENTARY TRANSFER TAX IS $ 21.45 U computed on full value of property conveyed, or ❑ computed on full value less value of liens or encumbrances remaining at time of sale. ❑ unincorporated area ❑ city of AND FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, veret-t L. Aplet and Patricia Aplet, husband and wife as joint tenants �J hereby GRANT(s) to C`O Gerald Katzman an unmarried..man and:Sara;'Brennen an unmarried woman as tenants in common' —the following -des ribed•real•propertyin-the cttjwbf-*Ldi-Q irit � c� ,k•,q County of r iv e rs ide , State of California: ,ot 23 in Blo k 183 of Santa Carmelita at Vale La Quinta Unit #18 as per nap on fi.l.c iri Book 19, Page 31 of maps, records of` said County. Dated l Q Aug . 1.1, 1989 Everett L. Aplet STATE OF CALIFORNI COUNTYOF ._ CU --- SS„ Pa'tr cia_ ApTet ,,, On this da of .. war.::., Y in the year 19 before me, the undersigned, a tar u is in and for said Stat e o I pppeared �tf�G'ep �Z X1 personally known to me (or proved to me on the basis of satisfactory evidence) to be the �! _ OFFIOIAL SEAL person U� whose name _�.2 __ subscribed to the within ` ` PATRICIA SAL:'E11.1R': ft r instrument, and acknowledged to me that he executed it. ift..,ty Public -t r,lilarr,;�, ;iS:DE COUNTY r WITNESS my hand and official seal. j' Yy, ��a4, fo fir' I�ty Comm. Exp. hp.)* 1. 1W �`vC�CII� Signature N'.'T I'VBLk. IN AND FOR :AID STATE (Th -s area for ollicia, notarial seal) CO -441 (REV 4/85) MAIL TAX STATEMENTS AS DIRECTED ABOVE.