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10530 (SFD)T a 0 4tyl 4 4 QUM& P.O. BOX 1504 Building 78-105 CALLE ESTADO Arirlracs 51-946 Cortez LA QUINTA, CALIFORNIA 92253 Owner Luis & Sarah Bautista Mailing Address P. 0. Box 872 City Zip Tel. La Quinta 92253 564--53.29 Contractor Kaffit Construction Address P. Q. Box 304 Palm Desert 92251 State Lic. City & Classif. 403021 1 Lic. # 93 Designer Address Tel. CityI Zip I State I 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. . SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, alter, Improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to rile 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 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 civil penalty of not 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 Law does not apply to an owner of property who builds br 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 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.) Q I, as owner of the property, am exclusively contracting with licensed contractors to con- strudt'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.) ❑ 1 am exempt under Sec. B. & P.C. for,this reason J% Date Owner, !N 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 (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 for one hundred dollars ($100) valuation or less.) 1 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., 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. 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 Address City, State, Zip No. 10530 BUILDING: TYPE CONST. OCC. GRP. A.P. Number Legal Description Project Description Reconstruction of a ;fisting SFD Sq. Ft. 679 No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ pf-rm.it daps not include black walls or neral Estimated Valuation 44,872.50 PERMIT AMOUNT Plan Chk. Dep. 250.00 Plan Chk. Bal. !? q Const. W? ()n Mech. r%9; r n Electrical 9r, 1 A Plumbing i RA c (n S.M.I. so Grading Driveway Enc. Infrastructure TOTAL 907.56 REMARKS - r'i `' tr,.:N #' li rr•i i ,' �, 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 Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS ROUGH PLUMB. BONDING 2ND FL. S0. FT. STORAGE TANK YARD SPKLR SYSTEM POR. S0. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SO. FT. REINF. STEEL DRAINAGE PIPING WALL SO. FT. DRINKING FOUNTAIN. SO FT ® FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER SYSTEM WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. l/ g ll FLOOR DRAIN MECHANICAL FEES ROOFING � G,NJ � WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FIRE ZONE ROOFING: GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY 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 SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11% c SEWAGE DISPOSAL GARDEN WALL FINAL SO.FT.GAR ® 3/ec 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 PLUMBIN 3 e (I1NDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS -%I!7 SEPTIC TANKira R U H WIRING. DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) 0 1( 92 METER LOOP L •7 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. l/ g ll FRAMING K/ 3 Of�wo 000 FINAL INSP. 3� �j�� / ROOFING � G,NJ � � 12 � _��� Lo ��/( �StJ" N J� h �2g3h�� %,✓I/q{! �l Z 3 / % 3 L/ /118 C*vq�)-,e ,� k , -,2� REMARKS: VENTILATION FIRE ZONE ROOFING: FIREPLACE SPARK ARRESTOR GAR. FIREWALL RING E,2,& Z MESH INSULATION/SOUNDT FINISH GRADING FINAL INSPECTION 3 z CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESJINITIALS GARDEN WALL FINAL Certificate of Occupancy City of La Quinta Building and Safety Department This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code, certifying that, at the time of issuance, this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following: BUILDING ADDRESS: Use Classification: SFD 51-946 CORTEZ Occupancy Group: R-3 Type of Construction: VN Owner of Building: LUIS & SARAH BAUTISTA Building Official Bldg. Permit No.: Land Use Zone; 10530 RC Address: 51-946 CORTEZ City: LA QUINTA CA 92253 By: LONNIE DAY Date: 3/31/93 POST IN A CONSPICUOUS PLACE D - - — loo 429 ' 380 304, 414 v � ao 323 k .493 41.1 3o3 Hz3 CtwITrR CF STRf-S CCNTEM 0s= wolr 51946 AVENIDA CORTEZ LOTS.. 15 }lb 'Bi.-aCi< 30 SANTA C KRMKLITA .LA QU INTA CA APM. 773-1.53-02-5 k t f t i r Y� .�.i:�Rr �.�j^'^: ;!C�e;:��r-rr�+Y.�'..;•_-YF. �";�+•�„Ti�..�..�... .. �� .—r -y; .�-.ter-""_, _. .. ..... .._ ._�..- ... -v .-. - .. .. � _ .. �...�� .I': io (0 G rsscc wholesale electric corporation headquarters Box U 1811 Industrial Blvd. Lake Havasu City Arizona 86403 ANAHEIM 1161 North Kraemer Anaheim, California 92806 INDIO 83-852 Avenue 45 Indio, California 92201 LAS VEGAS P.O. Box 14337 Las Vegas, Nevada 89114 GLENDALE .6710 West Belmont, Ave. Glendale, Arizona 85303 CHANDLER 42 W. Boxelder Place Chandler, Arizona 85224 SIERRA VISTA P.O. Box 2900 Sierra Vista, Arizona 85636 LAKE HAVASU CITY 1811 Industrial Blvd. Lake Havasu City, Arizona 86403 KINGMAN 3555 N. Essco Kingman, Arizona 86401 BULLHEAD 2816 Hwy. 95 Riviera, Arizona 86442 MJF C�Q..,aaclfL `l` ltP�\Z�OtA PCZ Ck.*,�� ..� . ►��1AMOND �►_.% wiRe & cABLe co. NM -B 90°C. NON-METALLIC SHEATH UL FILE NUMBER E 10816 Diamond's Type NM -B Cable with a PVC (Polyvinyl -Chloride) Jacket is designed to provide superior abrasion resistance, low temperature properties, flame retardant and crush resistant. Type NM -13 Cable is designed specifically for use as an internal building wire, above ground and in dry locations only. (tach finished package displays the Underwriters Laboratories Label indicating list- ing under the non-metallic standard. conductors........... COPPER insulation ............ POLYVINYL CHLORIDE ground conductor ..... COPPER separator ............ IMPREGNATED PAPER serve ................ IMPREGNATED PAPER jacket ............... POLYVINYL CHLORIDE The insulation of each conductor meets or exceeds the requirements of Underwriters Laboratories Type THH. The jacket compound com- plies with the requirements of the Underwriters Laboratories standard for non-metallic sheathed cable. The copper conductors meet the requirements of ASTM -13-3 if solid and ASTM -B-8 if stranded. Diamond NM -B also meets the specific requirements of Federal gov- ernment specification J -C -30A for Type NM Cable. Number G' "d- :.,;- �� Size of - Wire Ampacity, Approx Welght APProi<:�"00 Feokege Strands a Size 30°C (86 ) Per 10WFt. Inches - 14/2 Solid — 15 58 19X:39 250'Ft Ctn.' 12/2 Solid — 20 76; 21X,42 250,1 Ctn: 10/2 Solid — 30 105 :23X:46 ` 250" Ft. Ctn. 14/3 Solid =; .. 15 88 41 . 250, Ft Ctn. 12/3 Solid — _ 20 118 45 250 Ft Ctn. 10/3 Solid' —" 30 161 SQ 250 Ft Ctn.,tt 8/3 7 — 40 278 70.. 125 Ft, Coil " 1 6/3 7 - 55 422 .85 '125 Ft. Coil` '14/2 thru 10/3 Available on 1000 Ft. Reels "8/2 thru 2/3 Available on 500 Ft. and 1000 Fl. Reels 14/2 thru 10/2 Available on 5000 Ft. Reels. WITH GROUND WIRE '14/2 Solid 14 16 69' 19x39 , 250:Ft Ctn: '12/2 Solid 12- 20 96 .21X.45 250 Ft.'Ctn. , •10/2 Solid 10 30 137 23x.50 250'Ft. Ctn. 8/2 7 10 40 215 .30x.63 200 Ft. Ctn. 6/2 7 10 55 313 - .37x.78 • 125 Ft: Coil: '14/3 Solid 14 15 100 41 250.F1. Ctn. '12/3 Solid 12 20 137 :45 250 Ft. Ctn. '10/3 Solid 10 30 192 .51 250 Ft: On:, j 8/3 7, 10 40 305 .68 125 Ft. Coil 6/3 7 10 55 450 .84 125 Ft. -Coil:, . " 4/3 7 8 " 70 664.94 125 Ft. Coil " 2/3 7 8 95 930 1.01 125 Ft. Coil '14/2 thru 10/3 Available on 1000 Ft. Reels "8/2 thru 2/3 Available on 500 Ft. and 1000 Fl. Reels 14/2 thru 10/2 Available on 5000 Ft. Reels. 07/22/92 14:39 SMAK July 28, 1992 ESSEX GROUP APIA. 002 Esstx Gr6up, Ino. Wire. & Cable Div e;pn 1? 1,0 W1111 stroei P C. Bnx 1 110 I�crt Wayne, Indiana 4680 1 - I i t C 219/461-4= Fax; 219/4.01-4j545 I LAQuinta Elecrric P.0- Box 1.504 LaQuinta, CA 92253 Subject: 1-YPe NM -8 Cable File E10816 Gentlemen: 18-M resppnding relative to a situation reported to us 7regal:ding some non-motallio sheAthed cable, Type N -M -E cable, purchased. from Essex Group,, lrnt. It is my understanding the print legend is either iltegi�le or non -existing. Essex Type NM -B sable is manufactured to comply with t17B Platipn�l.1 Electrical Code and the Underwriters' Laboratories Standard #719, and we warrant the cable tO meet these requirements with this one exception. If there are further questions, please contact me at the above address or by phone. Sincerely yours, INC. [Fire .h (;able Division 0 Jose c. Holloway Sr. Product Engineer JCH:� CC: John Bridgeman - Antahetm,.CA 0 X00' 39t1d w1 3Hvmv of 7 - �i' : 2z -mr "V - �i' : 2z -mr .4 u�itrGv . P.O. BOX 1504 No. 10026 Building 78.105 CALLE ESTADO Address 51-946 Cortez LA QUINTA, CALIFORNIA 92253 Owner Luis and Sarah Bautista Y BUILDING: TYPE CONST. OCC. GRP. Address P. O. Box 872 City Zip Tel. La Quinta 92253 564-5129 Contractor Tel.: & Classif. B 347810 ' I Lic. # 1375 Deslgnera Address Tel. City* IZip I State I Lic. # LICENSED CONTRACTOR'S DECLARATION 1 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 I hereby affirm tit i 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 requies a permit 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 licensed pursuant to the provisions of the Contractor's license 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 peanut subjects the applicant to a civil penalty of not more than five hundred doltars (5500). ❑ I, as owner of the property, or my employees with we as their sole compensation, will do the work, and the structure Is not intended or offered for sale. (Sec. 7044, Busness and Professions Code: The Contractor's License Law does not appy to an owner or property who bulbs or improves thereon and who does such work himself or through his own enpbyess, provided that such improvements are not intended or offered for sale. ff, however, the briding Of improvement is sold within one year of completion. the owner -budder will have the burden of proving that he did not build or improve 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 Contractors License Law does not appy to an owner of property who buDds or improves thereon, and who oartracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. R. d 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 Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) PoliNo. Company &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 for one hundred dollars ($100) valuation or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT: ff, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that there Is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3087, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and Is subject to expiration if work thereunder is suspended for 100 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and slate laws relating to building construction, and hereby authorize representatives -of this city to enter the above- mentioned property for inspection purposes. Signature of applicant -Date- Mailing ateMailing Address City, State, Zip FINANCE Number .egal Description AUC lroject Description IZeCsi' SFD L rxisro -►5 . C714INL I.,tVI i:��ir4� P2 I�/����tar-IyEnrlar to il4 Sq. Ft- 2650 No. Size Stories No. Dw. New ❑ Add'❑ Alter Repair ❑ Demolition ❑ Permit does not include block wall or POO 1, Ac- tAAI 4dt4,}to4 o't Ityt'4$ s,Aee T S 1n l q . ?_9 so } A, c. f;a (tc t{ O to'c 4 P_514 stimated Valuation 148,182.00 PERMIT AMOUNT Plan Chk. Dep. .250.00 Plan Chk. Bal. 429.66 Const. 811.00.- 11.00•- Mech. Mech. 55.50 4 Electrical 165.14 Plumbing 178.50- 78.50S.M.I. S.M.I. 1.4 3_6C Grading Driveway Enc. Infrastructure Arts in PublLc 1 TOTAL 5319:74 5069.74 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 Permit Validated by: Validation: CITY OF LA QUINTA PLANNING DIVISION 1) PROVIDE SCHOOL MITIGATION IMPACT LETTER. THIS IS IN REFERENCE TO THE HOUSE I'M ATTEMPTING TO BUILD AT 51-946 AVENIDA CORTEZ, CITY OF LA QUINTA. I WON A DOUBLE LOT AND HAVE AN EXISTING HOUSE AT THE MENTIONED ADDRESS. THE HOUSE SETS ON THE SOUTH SIDE OF THE LOT LEAVING THE NORTH SIDE VACANT.THIS IS WHERE I INTEND TO BLUID THE NEW HOUSE. THE NEW HOUSE WILL HAVE FOUR BEDROOMS,LIVINGROOM,KITCHEN AND DININGROOM.THE SQUARE FOOTAGE OF THE RESIDENCE IS 2491'. THE GARAGE WILL BE WHERE THE OLD HOUSE STANDS NOW. THE FRONT PORTION OF THE HOUSE WILL BE REMODELED TO MAKE THE GARAGE.THE EXIST- ING LIVINGROOM WILL BE THE GARAGE. WHAT IMPACT THIS NEW HOUSE WILL HAVE ON THE COMMUNITY OF LA QUINTA I DON'T KNOW. PERSONS LIVING IN THE NEW HOUSE WILL BE MY WIFE AND THREE CHILDREN. WE HAVE NO PLANS FOR OTHER CHILDREN. 2) ROOF TILE: LIGHT RED, STUCCO BIEGE IN COLOR WITH WOOD TRIM. 3) NEW HOME WILL NOT HAVE A PATIO.DISTANCE FROM NEW HOME TO GARAGE WILL BE OVER TEN FEET. TVBA 0 OR YO R TIME: L STA JR. 10-22-91 4) ON THE NORTHEAST AND SOUTH PORTION OF THE PROPERTY A SIX FOOT WOODEN FENCE EXIST. I PLAN TO BUILD A SIX FOOT STUCCO FENCE ON THE WEST END OF THE PROPERTY. 80' STUCCO FENCE MINUS THE 20' FOR THE DRIVEWAY. DIAGRAM IS ATTACHED TO THIS REQUEST BY THE PLANNING DEPT. NOTE: PLANS SUBMITTED TO THE PLANNING DIVISION HAVE ALREADY BEEN STAMPED BY THE AG. DEPT. DESERT SANDS UNIFIED SCHOOL DISTRICT 82-879 Highway 111 NOTICE: Indio, CA 92201 Document Cannot Be Duplicated (619) 347-8631 Date 5/12/92 1 Type of Permit I La Quinta No. 111381 Permit # Owner Name Luis & Sarah Bautista Log # No. 51946 street Cortez city La Quinta zip 92253 study Area 113 APN # Tract # Lot # Square Footage 1679 Type of Development Residential Addition No. of units Comments At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 500 square feet, detached accessory structures or replacement mobilehomes. It has been determined the above-named owner is exempt from paying school fees at this time due to the following reason: EXEMPTION NOT APPLICABLE Tlris certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 11.58 1 X ® or $ .1,072.82 have been paid to D.S.0 S.D. for the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued. Fees Paid By Cash Telepliore, Name on the check - q By James E. Lively v - Assistant Superintendent, Business Services d :; L . Fee collected /exempted by Vickie J. Durrett Payment Received Signature � ��'� Check No. Cash Collector: Attach a copy of county or city plan check application form to district copy for all waivers. Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting 0<0 Z _O b W U) I COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH Ass"alM 10111111,00 No. . ENVIRONMENTAL SERVICES DIVISION ??3 ^ 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 IIvL 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. ERIFY�TEMS IN SECTION�APFROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG #� Agent, Contractor, Contact Person Address & Firm owner City State Zip Job Props Address Legal Description Prop. (P ,Tract Lot) LC_f /'a % ey.. q z i53 s/-94 Drs Ir a (o �oc rk.30 Lot Sizeter Agency l• Use of Permit P/P, CU, etc. Other �A k i T"fF f4% elli rep, C. nature of Applicant Data CATEGORY: REV CODE FEE CATEGORY: REV CODE - FEE O1 SUBSURFACE DISPOSAL 1238 ls'j❑ SITE EVALUATION UPON REQUEST 7349 $ 43.00 m ❑ MULTIPLE PARCELS WITHIN SAME (NO PLOT PLAN) LAND DMSION ❑ SEWER/SEPTIC VERIFICATION 7348 $ 17.00 Z a. 1 at 4 Parcels (Each) 1238 $ 57.00 (Less than 1 year) 0 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) C/) ❑ Site Evaluation in Conjunction with ❑ HOLDING TANK 7351 $ 47.00 Critical Area 7346 $111.00 ❑ ALTERNATIVE/EXPERIMENTAL 7345 $222.00 ❑ Site Evaluation Lot Less than SYSTEM 10,000 Sq. Ft. 7347 $ 87.00 AIIIALX DATE Holding Tank Agreements Completed ❑ Yes 0'No �'�'Z' Certification of Existing S.D. System Required ❑ Yes ;N5o re WQCB Cleanoe required. (Attach Form ❑ Yes DOH SAN 007, Santa Ana Region Only) Soils Percolation Report Required. ❑ Yes No Special Feasibility Boring Report Required. ❑ Yes Detailed Contour Plot Plans Required (1 to 5 it interval) ❑ Yes 5N Otter ❑ Yes Staff Specialist Lot Inspection Required ❑ Yes �No Lot InspLon Date Soils boring report by Date R 0Soils Map Page Sol Type Approved by P� / — Date C?— ­217 -f/ 3 No. of Systema T ❑ of Syssenr(s) No. Dwelling Units �/ (1) Septic Tank Soil Rate Grease/Sand Z O ng Tank ❑ Existing Bedrooms 5�xrre�9 �reaae Intcp ❑Replacement4an♦.4{/rra"\ oA...dgzj/�5100 G i 3 p Gal W 2�) Leach Line Sq. Ft. Sidewall allowance Install Line(s) n long re wide with Leach Bed sq. n CO ``arae n Todd aq. R min. cock below drafnlines or .may per running n d fVA Leachlines/bed special design for slope: (3) Pit Diameter No. Pita Pit Below (TD) Seepa� I�TooteJ Depth Inlet (BI ,o "��++�� N//AA �e�rden tactor t 5 A0.0.1, � 1 Max. Mkiwable0epth No. 2 System T n /� n n - REMARKS: v 0 This application isM'P/ED/MNIER for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated on 'the acoompanied`plotIan usi hep i nts set forth in SECTION C above. A buildin rmin is necessary for the installation of the Z igned system. construction is permitted in'the regw resery : 7exon area.L •� O Septic tank and sewer lines must be 50' minimum from any wellsa/tIQ Leach lines must be 100' minimum from any wells: -including expans' are W (3) Seepage pits must be 1 minimum fr/omany wells, including ex pan^s�ilo,.ncur(i/� G� XtnA �QP� Q� P1 Signature of Hearth Official— /¢d`�/ �'✓' w' �/ /�� ! pate -CEIPT NO. / Issued. By / Date � �� T r DISTRICT: ❑ Riverside, C911lcnda❑ Hemet O Perris ❑ _ Rancho Calif:: ❑ Blythe DOH -SAN -122 (Rev. 3/90) DISTRIBUTION: WHITE -Office file YELLOW - Applicant PINK . Bldg. Dept GOLDENROD - Plans/Reoords CALVIN C. KAMINSKAS i�!, Assistant Commissioner C (714) 275-3000 FYI OFFICE OF AGRICULTURAL COMMISSIONER JAMES O. WALLACE, Commissioner 83-612 Avenue 45 Suite 7 Indio, CA 92201 (619) 342-8291 DATE S' o� a - DAN RILEY Sealer, Weights & Measures (714) 275.3030 CASE NO.�C C a I DEVELOPER'S NAIL : L S. r5 S`AY b h V-P� C4 1�v S A ADDRESS: �_ C7 , ' z,,1_- i C A TELEPHONE: (� —9 VC Vern �� Cc3v e • L in Q,:., �, x, at c \A , Dear Developer: 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 immediately. Thank you for protecting and preserving the Coachella Valley's pest -free environment. Agricult 1 Commissioner's Office ccs Indio and Riverside l )P�\., �sc V -e 4080 LEMON STREET, ROOM 19, RIVERSIDE, CALIFORNIA 92501 — FAX (714) 275-3012 r,