04561 (SFD)` Bullding.YE s@s al3.4o
`-i; Address-..
4,Owner ,!" :1
i,,. dretry Lugo
Mailing„- ;
Address • ; . ,, ;.g6,9 3 ttxt �re�.sa
City. i Zip
' Dt rtnuda Dun w 92201
Contractor
Sww
Address
City
•'4I C
y P.O. BOX 1504
78-105 CALLE ESTADO ,
LA QUINTA, CALIF,ORNIA,92253 _
f_
aw "
BUILDING: TYPE CONST. OCC. GRP.
� 2kV A.P. Number �i7��-173-019
Tel. _
3,44�4236 . Legal Description
Project Description • «� •
Zip I Tel.
State. Lic. City
& Classif. 31'9390 Lic. # 1020 . Sq. Ft. • No. No. Dw.
SizeStories Units
Arch., Engr.,
Designer . New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
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
SIGNATURE -.•1 i' ? - DATE -
` `1)WNER•BUILDER DECLARATION
ereby ,• m -i Estimated Valuation
I hereby.afiirm that I am exempt from the Contractors License Law for the following �Yay r. r•
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 Ne a signed statement that he is licensed pursuant to
PERMIT,
,AMOUNT
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 •
plan De''
*�
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
Chk. p
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
Plan Chk. Bal.
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
Const.
r •�
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,
Mech.
J0 suul
•provided, that such, improvements are not intended or offered for sale. If, however, the building
improvement is sold within one year of completion, the owner -builder will have the burden
Electrical
�qy�
•hb:. Vu
idor
of proving that he dnot build or improve for the purpose of sale.)
0 1, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing
Iuth a 0O
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
r;•
does not apply to an owner of property who builds or improves thereon, and who contracts for
S.M,I•
♦
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
arty tiff
' O 1 am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Infrastructure
I �+
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 certifiedicopy thereof. (Sec. 3800, Labor Code.)
PolicyNo'• Company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
`t 1
44 1,11D 9. • V%
?' .�
TOTAL
a
CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS' COMPENSATION INSURANCE
(This, section need not be completed if the permit is for one hundred dollars ($100) valuation
4,1 i; wr;Of
less.) ..t ; ,
I certify thatan the performance of the work for which this permit is issued, I shall not
.....rt 5" ? U i HLA .1 1 w `i'
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
'
• Date • Owtier.
NOTICE, To APPLICANT: •d, after making this Certificate of Exemption you should become
ZONE:
- BY:
' subject to' the Workers' Compensation provisions of the Labor Code, you must forthwith
Minimum Setback
-
Distances:
comply with such provisions or this permit shall be deemed revoked. ..
}
Front Setback from Center Line
' Rear Setback from Rear Prop., Line
k, CONSTRUCTION LENDING AGENCY
• , • -
Side Street Setback from Center Line
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.)
-
r;
Side Setback from Property Line -
Lender's Name
Lender's Address
FINAL DATE
INSPEC OR
This is a building permit when properly filled out, signed and validated, and is subject to
i
expiration if work thereunder is suspended for 180 days.
Permit
I certify that I have read this application and state that the above information is correct.
Issued by:
Date
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. -
Validated by-
" Signature of applicant Date
Mailing'Address
Validation:
City;,:State„'Zip -
s
WHITE FINANCE PINK APPLICANT GREEN BUILDING, GOLDENROD-, ASSESSORS OFFICE, HARD COPY -FILE
1y•� t a s.
..d !�lRl..•A"�1j• ......h .L. st Y.. 1' _. .J.�at-.4. a.S..L.?... r --�.y��c :'2..a ._L.".:� � r...n. y!'•4.4 .1•i?Sf f. l., /t `. �... Y a. Y.Yt.' .Y��e�.. .P.. .•.'!(�..Ai.� t•�6.- .`.1.. ._.1• .y• �. �']\v •.Y .. �1.•}S�bv -r1 �'1��R.
CONSTRUCTION ESTIMATL
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO FT ip $
UNITS
SLAB GRADE
ROUGH PLUMB
BONDING
YARD SPKLR SYSTEM
2ND FL SO FT. a
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR SO FT. a
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR SO. FT. 0
TEMP. POLE
'
GROUT
DRAINAGE PIPING
CARP. SO FT. e
FINAL INSP.
WALL SO. FT. 0
WATER SYSTEM
DRINKING FOUNTAIN
GRADING
cu. yd.
$ plu5 xE
_$
URINAL
SO. FT. 0
FINAL INSP.
FRAMING
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.0OOL HOOD
SIGN
WASH ER(AUTONDISH)
APPLIANCE DRYER
FIRE ZONE ROOFING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIREPLACE
LAUNDRYTRAY
AIR HANDLING UNIT CFM
IKITCHEN SINK
ABSORPTION SYSTEM B.T.U.
ITEMP 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
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID 1V: c
SEWAGE DISPOSAL
SO.FT.GAR g lv:c
HOUSE SEWER
/G NAL INSPECTION C V
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 I HEATING 8 AIR COND. SOLAR
SETBACK
GROUND PLUMBINC
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER A0P.IEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
'
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plu5 xE
_$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING / r
MESH
�NSULATIONISOUND
FINISH GRADING
/G NAL INSPECTION C V
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
1
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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, Co9tractor, Contact F3erson ? rj
�Pho a ,/b'/
Address & hone
Owner
c2
Phone
Mailing Address
City
State
Zip
S22 60
Job Property Address * .
rl ��5�
Legal Description Prop. (PM, T ct, Lot)
c� ,��vc
Lot Size
Water Agency/Well
Use of PermR P/P, CU, etc.
Other /� AIX'A
�•t'
DwelliK9erMH Site Prep, etc.
Signature of Applicant -
�� Date
CATEGORY: REV CODE FEE
CATEGORY: REV CODE FEE
RK 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 I
SYSTEM
10,000 Sq. Ft. 7347 $86.00
D! TIAL DATE
Holding Tank Agreements Completed ❑ Yes No
Certification of Existing S.D. System Required ❑ Yes No
WQCB Clearance required. (Attach Form ❑ Yes No
DOH SAN 007, Santa Ana Region Only)
Soils Percolation Report Required. ❑ Yes No
Special Feasibility Boring Report Required. ❑ Yes No
Detailed Contour Plot Plans Required (1 to 5 ft. interval) ❑ Yes No
Other ❑ Yes No
Staff Specialist Lot Inspection Required ❑ Yes No
Lot Inspection Date
Soils boring report by' a Project # Date
Soils Map Page Soil Type Approved by Date
No. of Systems
Type of System(s)
❑ Holding Tank ❑Existing
welling Units
edroom Fixture Units
(1) Septic Tank
Soil Rate Grea /Sand
GrIntcp
New ❑, Replacement
`'
AA
7§e
i/
Gal
F4 -Gal
(2) Leach Line Sq. Ft.
Bottom trent area
Sidewall allow ce
ft ft
Install Line(s) R long ft wide with
Leach Bed s . ft
rock/- sq.
per runn g ft.
min. inches below drainlines or
Of bottom rea
j ❑ NA
Leachlines/bed special de ign for slope:
Applicable
(3) Pit Diameter
No. Pits
Pit Below
Inlet (BI)
Seepage PitITgal Depth
4
r:
Othekf
Max. Allowablg Depth
/
❑ 5 6
N/A Overburden factor
L11
No. 2 System
REMARKS: v o O
This application ' PROVED ENIED for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated
on the acro panie"- plan, 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.
(1) Septic tank and sewer lines must be 50' minimum from any wells
Leach lines must be 100'-rnink*mum from any wells, including expansion area
(3) Seepage pitsmu�t�be 50' mi imum from any e , including expansion area
Signature of Health ficial Date
7 RECEIPT NO. Issued By Date
DISTRICT: ❑ Riverside, ❑ Indio ❑ Hemet �❑ . Perris ❑ Rancho Calif. Blythe
DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept. GOLDENROD - Plans/Records
�4
r
4� UII • R! ��
off ICE of E. LEON SPAUGY
+' AGRICULTURAL MMMISSIONER
JAMES 0 WALLACE
o I d AND ASS15fANf �0�1?IIcc1U�EP.
V �. 1 ►^
( WEIGH I TS & MEASURES CLENIEv1 BE`VENISIE
t�St suLEn
;t ter" 49-613 Ilwy 86, Suite D-12
Y 9, 9� Cvaclfeila, CA 92236
619-342-8291
PI
DATE S L �c CASE JO
P.
DEVELOPER'S NAME: T 'I~ 11` SA
ADDRESS t 1-S C, 0, u t
'iELEPI [ONE: 314 5 � 3(
Dear Developer:
After reviewing your landscapi_ttg plans, all plant material listed is not in
violation of qua�ranti.ne laws governing the Coachella Valley. if substitutions
do occur and they differ-frun plant material listed, this office must be notified
imnediately.
Thank you for protecting and preserving the Coachella Valley's pest -free envirotunent.
I
Ag cultural Cetnnissioner's office
cc: Indio and Riverside Office
D
LEIGHTON AND ASSOCIATES
Geotechnical and Environmental. Engineering Consultants '
September. 29, 1988
.Project No. 5880586 -03 -
TO: Mr. Jerry Lugo +�
.:'79-860 Boqueron.Way
Bermuda, Dunes, California 92201 t
SUBJECT: ;'•` Report,of. Compaction Test Results, Building Pad, 51'865 Avenida
Velasco, ;La Qui nta, California
At your request, we have performed four ,compaction -tests on the near surface, soils
at the subject site. The test results and approximate test locati.ons are detailed
on the attached sheets."(Figures 1 and.2). The. maximum density and optimum,':mois-
ture were aetermi ned `as per ASTM Test. Method D1557-78: 'The field 'density, tests
were performed .with a -nuclear densometer i n ,accordance with ASTM Test, Method
D2922-78.
The scope of our work was to perform compaction tests only"and not to provide soil
or foundation engineering recommendations. Our services were performed after the
building pad was completed. The scope of our work did not'include observing the
grading operation 'during placement of fills to check for uniformity of'materials
used, construction meth'o'ds, etc. Therefore, we cannot,- make any statement 'about
conditions below or'beyond our test locations.
Should you have any questions regarding this report, please contact us.
Respectfully submitted;,
LEIGHTON AND ASSOCIATES, INC. ;.
Paul Hoersti g Brent J. Ing ram, RCE:40264,
Field u rviso 9 Chief Engineer .r a
PH/BJI/mu
Distribution: (3) Addressee
Enclosures: Firgure-1, Compaction Test Summary .
Figure
i g))uWWrerrkk2,AASttkhetoc7hZ-
74-240 HIGHWAY 111, PALM DESER7�EA ,Agg 92 -et i on and Agreement Forms (619) 568-0993
FAX (619) 341-7490
DAILY FIELD REPORT
No:
Job Name: RR 1. vG 0
Project No.: 69%058e,0 -03
Zq.
Location 5 VCLNGc0
Weather:
Day: 7`4v0.S
Contractor:
Foreman:
Field Technician: ?
Miles :
Hours:
Equipment Working:
Inspection / Testing of
AD
Test
No.
Test
Location
Elevation
or Depth
Soil
Type
Optimum
Moisture
Field
Moisture
Maximum
Density
Field
Density
Rel.
Comp.
I
6 Et 6kESC1a
t' G -�'i
P�
14.(0
14.0.
\\3.¢
10(a,1
4
2
13-P-
\03.4
91
3
1•i
\o2 :'j
9t
94
Summary of
Operations: F•G . = F \NQS �� �Ro•oE
S o\ T ,-I P E F \NE -f 0 MF. 0 G''NF A S NN VJ
S It_ CdROWn1
L o.4aRN1% MN,)( � �R OCNS\Z�
113• P•C.F.
t4. to
Mo\sZ ARE
Supervisor :
Engineer:
—
Geologist:
Todays Yardage:
Yardage
to Date:
LEIGHTON and ASSOCIATES
17975 Sky Park Circle, Suite E, Irvine, California 92714
Tel: (7 14) 556-1421 556.1422
100A (4.77)
WHITE — File Copy YELLOW — Client Copy PINK — Field Copy GOLD — Office Copy
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AMERICAN ENGINEERING LABORATORIES, INC.
❑ 7940 kjons Drive, Suite A El1490 Rincon Street, Unit Z ❑ 515 Galaxy Way 58945 Business Center Dr.. Unit A
San Diego. CA 92126 Corona. CA 91720 Modesto. CA 95356 Yucca Valley, CA 92284
(619)695-3730 (714)272-4230 (209)576-0813 (619)228-1754
CLIENT: '3 F Q Q� L. V G A
PROJECT: S\ •— ,I a 0 K�j E N k N A DATE: 2' - 3 - 8
I.D. NO.:
PROJECT NO.: 10 X11
REPORT OF FIELD COMPACTION TEST
TEST N
LOCATION OF TEST
N'
F O O N G -
F• G- 1
2
FIELD
DRY DENSITY
P.C.F.
MAXIMUM
DRY DENSITY
PERCENT
RELATIVE'
COMPACTION
PERCENT
REL COMP.
REQUIRED
REMARKS: _
- _ _ _ •. -
FIELD
FIELD
MOISTURE
%
OPTIMUM
MOISTURE
%
FIELD
DRY DENSITY
P.C.F.
MAXIMUM
DRY DENSITY
PERCENT
RELATIVE
COMPACTION
PERCENT
REL COMP.
REQUIRED
REMARKS:
v R
Q Nsat n
\2.5
i3.S
08.4
113.5
9(0
90
TEST 0
LOCATION OF TEST
>� S `
F 0 0 \ N G
�G - `•
2
FIELD
DRY DENSITY
P.C.F.
MAXIMUM
DRY DENSITY
PERCENT
RELATIVE'
COMPACTION
PERCENT
REL COMP.
REQUIRED
REMARKS: _
- _ _ _ •. -
FIELD
OPTIMUM
FIELD
MAXIMUM
PERCENT
PERCENT
REMARKS: TIS V R�
MOISTURE
MOISTURE
DRY DENSITY
DRY DENSITY
RELATIVE
REL COMP.
'
%
%
P.C.F.
P.C.F.
COMPACTION
REQUIRED
QNss�p
12• cj
13.5
108 �-
113.5
9(0,
9V
TEST q
LOCATION OF TEST
SOV
% \ N
` ` G ' `• }
3
FIELD
DRY DENSITY
P.C.F.
MAXIMUM
DRY DENSITY
PERCENT
RELATIVE'
COMPACTION
PERCENT
REL COMP.
REQUIRED
REMARKS: _
- _ _ _ •. -
v
FIELD
OPTIMUM
FIELD
MAXIMUM
PERCENT
PERCENT
REMARKS: \ 'tom
MOISTURE
MOISTURE
DAY -DENSITY
DRY DENSITY
RELATIVE
REL COMP.
P.C.F.
COMPACTION
REQUIRED
-
Qt�sSE b
io' S
13.5
112.0
\13.5.
99
g o
TEST 4
LOCATION OF TEST
FIELD
MOISTURE
%
OPTIMUM
MOISTURE
%
FIELD
DRY DENSITY
P.C.F.
MAXIMUM
DRY DENSITY
PERCENT
RELATIVE'
COMPACTION
PERCENT
REL COMP.
REQUIRED
REMARKS: _
- _ _ _ •. -
v
FIELD
MOISTURE-
OPTIMUM
MOISTURE
s
FIELD
DRY DENSITY
P.
MAXIMUM
DRY DENSITY
PERCENT
RELATIVE
COMPACTION
PERCENT
REL COMP.
REQUIRED
REMARKS: `(•(\ 0 R \ .
-
�,• qro
\ 3
QC �
11 � . �
TEST 4 .
LOCATION OF TEST
FIELD
MOISTURE
%
OPTIMUM
MOISTURE
%
FIELD
DRY DENSITY
P.C.F.
MAXIMUM
DRY DENSITY
PERCENT
RELATIVE'
COMPACTION
PERCENT
REL COMP.
REQUIRED
REMARKS: _
- _ _ _ •. -
G