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003587 (SFD)L Twit Qmkra P.O. BOX 1504 Building 78-105 CALLE ESTADO Address 53-300 Juarez LA QUINTA, CALIFORNIA 92253 Owner A_satArn Am�ric�en t' nrt'r>1>ir_>t~#, n Mailing Address City Zip ITel. Contractor 0. A.e olds constructi.6n Address ... ... .' . 0. BOx 807 City Zip Tela" Thousand Ptah s 92276 , 343-2671. State Lic. City & Classif. 4691657 Lic. # Arch.,•Engr-., Designer Address Tel No.. 003587 BUILDING: -TYPE CONST. OCC: GRP. A.P. Number T-ot 77" Rlock 19-1 Legal Description Project Description q$ ncrI a'.a . 1r'A7ntI1 V T)*rtst I in er Sq. Ft. 'PERMIT If Size 242'5 - New ❑ Add ❑ No. Stories City Zip State Wood fence IS Lic: # LICENSED CONTRACTOR'S DECLARATION T 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._ SIGNATURE DATE OWNER -BUILDER DECLARATION Estimated Valuation 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 No. Dw. Units Alter, ❑ Repair ❑ Demolition ❑ 5 . permit to construct, alter, Improve, demolish, or repair any structure, •prior to Its .Issuance also requires the applicant for such permit to Zile 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 3of 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 civil penalty'of not more 'thanrive hundred dollars ($500). . O 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 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. If, however, the building 'PERMIT If - AMOUNT" - -- - Plan Chk. Dep.,`'{„` ' Plan Chk. Bal. S 61 "73 Const.Professions Mech. 9 I�,eR 16 R b 0 Electrical '. or improvement is sold within one year of completion, the owner -builder will have. the burden of proving that he did, not build or,improve for the purpose of sale.) - .{ - Plumbingl " inn O 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 builds or improves thereon, and who contracts .for 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 S•M.I. _. ^• Grading2A AO Driveway Enc. 2n.00 Date Owner Infrastructure F� 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. O Certified copy is hereby furnished. TOTAL .d _ CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE REMARKS (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 thg work for which this permit is issued, I shall not - - employ any person in any mannerso 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 subject to the Workers' Compensation provisions of. the Labor code, you must forthwith comply with such provisions or this permit shall be deemed revoked. z ,., ~ 1'CSri} i ~'f•flTeli _ ZONE: - BY: Minimum Setback Distances: Front Setback from Cn t I 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 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 ateMailing Address City, State, Zip HARD COPY eer Ine Rear Setback from Rear Prop. Line_ Side Street Setback from Ceriter.Line Side Setback from•Property Line FINAL DATE INSPECTOR Issued by: Date 1/2810 Permit 5 Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBIN'4a FEES 1ST FL. SQ. FT. @ $ 2ND FL. SQ. FT. POR. SO. FT. @ GAR. SO. 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 FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER S (ROUGH) METER LOOP GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APP./EQUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM 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 FINAL INSP./v/ g SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID @ 1+/a c SEWAGE DISPOSAL REMARKS: SQ.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 GROUND ?rUMIA11 UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE lf'7 ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS EWER OR SEPTICC TA? 0 ROUGH WIRING DUCT WORK ROCK STORAGE / FOUND. REINF. ?j//' S (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./v/ g FRAMING ( AL INSP. ROOFING /Ira / ;l 5 fi P.9 V y,/J 0 O/ i IFINISH 1�4 fir', V REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHINGg4, VV MESH ( INSULATION/SOUND /(1171&i /7 & GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL i- V ��T._..Tj; <. r d..�..s..ay� �Yt� , v_t . �,�-:�Y . t r. r -I `/�c., fiN^rl:; A IY'i,J.!� . � � � 'i �•l � " I tj'� ,s.�, � ��reS: Y �F ew . � � ` �'� ; � � r ,ri 11 z O H U W U) "N z O U W U) 4 rn Y Q W W 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. V A non-refundable filing fee of $40 is required when the application is submitted. Check must be made payable to the County of Riverside. i Building Department Application Log # Name ( wrier. Agent. Contractor. Etc.) Mailing Address] Cay Slate A Zip Code ct "LZ 7 6 Telephone 'Job Pro n dreCdy or. muarly _ 'Legal Description M Property. (Lot. PM. TR) 'Assessor's Parcel No ' ater Agency well Use 01 Permd � I�nnmg Case M ' Lot Size Cr.. SFD, MH Site Preparation Etc. /('�' Q / �J — U ✓� attire of Applicant- Date ° a rilormau ve on must be verified from Building Application STAFF USE — DO NOT WRITE BELOW THIS LINE Initial Date D Certification of Existing S.D. System required. ❑ Yes L9 5N _' _� _ O WQCB Clearance required. ❑ Yes Soils feasibility report required. ❑ Yes Special feasibility boring report required. ❑ Yes o Detailed contour plot plans required. ❑ Yes LJ o Staff Specialist approval required. ❑ Yes No Lot Inspection Date Soils/boring rep/ort by Project # Date y Soils Map Pagel Soil Type Cd C Approved by Date/ --/J1- O Type of System: No. of Bedrooms (1) Septic Tank Soil Rate Required El Existing ❑'New ❑Additional ❑Replacement fi'� /Gals. (2)NLeach line sq. ft. Sidewall allowance Inst I Lines) Ft. Long, Le+acch be" Sq. (Bb om trench area) ft. rock/ Sq. Ft. running ft. /F, . . de with min. inches rock below drain lines Ft. oPb©tttm v$�� per area Leach lines/bed-special design for slope: • (3)'Pit•Diam=ter No. Pits Pit BI Seepage Pit total depth ! Applicable N/A Overburden factor 6' / ( Max. allowable depthd / APP d ;;This application is roved epied-for the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements s t forth in Section B above. A building permit is necessary for the install tion of the above -designed system. (1) Septic tank and sewer lines must be 50' from any wells �C to s (2) Leach lines must be 100' min. from any wells inclJding expa sl' area l ^/1—i Seepage pits /mustbe/150' min. from any'wells including expansi(o�n-aarea/0 J� O U / Signalure of Health Official - ' / • • - - / (� - i RECEIPT NO._ OO` �7 ssued by ��C�//4---y Date__ District:. ❑ Riverside ❑ Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe Distribution: WHITE—Office file YELLOW—Applicanr. PINK—Bldg. Dept. GOLDENROD—Pending File DOH SAN 122 (Rev 8/87) J i F w Qct Or ? 4 I \ J• 0 ,fes•." \Y 9, 1 8% DATE /- /5--- 99 DEVELOPER'S NAME: OFFICE OF AGRICULTURAL CONIMISSIONER AND WEIGHTS & MEASURES 49-613 Hwy 86, Suite B-12 Coachella, CA 92236 619-342-8291 ADDRESS: P..0 . 6e -G' 907 TELEPHONE: 16 / 9 ) 3 y Dear Developer: E. LEON SPAUGY COMMISSIONER JAMES 0. WALLACE ASS;STANE COMMISSIONER CLEMENT BENVENISTE SEALER CASE NO. R$SASO) /S Q'2276 267/ L, -t 242+ " 19 3 U­-� Qµ- a After reviewing your landscaping plans, all plant material listed is not in violation of quarantine laws governing the Coachella Valley. If substitutions do occur and they differ from plant material listed, this office must be notified inTr ediately. Thank you for protecting and preserving the Coachella Valley's pest -free environment. k,Ljk12Lz&= Agricultural Comms i ner's Office cc: Indio and Riverside Office