The URL can be used to link to this page

06238 (SFD)Building Address78-x74 Tuga Owner it . Mailing Address P. Q. Bbx 365 City Zip •La QuI nta 92233 Contractor Sam , + Address.. City- Izip State Lica & Classif. 487854 -Arch., Engr., Designer. '44 P.O. BOX 1504 ` . N o . 06238. ` 78-105 CALLE ESTADO- LA QUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST. = OCC: GRP. • ' A.P. Number 769-062-013 .- Tel. $64-4$32 Legal Description ' (- Project Description S.F.D. City Ljc. # r _ ,626 City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that 1 am licensed under provisions of. Chapter 9 (commencing with Section �7f Division 3 of the Business and Professions Code, and my license is in full force and - effect. - SIGNATURE DATE '\)7 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 cityior county which requires a, permit to construct, atter, improve,' demolish, or repair any structure, pdor to -its issuance also . requires the applicant for such permit to rile a signed statement that he is licensed pursuant To Ne provisions of the Contractor's License law, Chapter 9 (commencing with Section 7000) of - 'Division 3 of the Business arid.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 rive hundred doum.(E500): ❑ 1 as owner of the property or my employees with wages as their sole compensation will Sq. Ft. 2444 - NO.• No. Dw. Size Stories Units New ❑ Add ❑ ' Alter ❑. Repair ❑ "Demolition ❑ t Estimated Valuation $133,594 � f. PERMIT +1AMOUNT., Plan Chk.'Dep. $250.00 Plan Chk. Bal.' , 3$b.2� • ' do the work, and the structure is not intended or offered for• sale. (Sec. 7044, Buisness and Const. %�� 50- .Professions Code: The Contractor's License Law does not appy to an owner o/ property who . buikis or improves thereon and who does such work himself or through his own employees, Mech. 53.50 provided that such improvements are not intended or offered for safe. H, however, the building or improvement is sold within one year of completion, the owner -builder wig have the. burden.. Electrical N �.Z(b�t o/ proving that he did not build.or improve for the purpose o/ sale.) p ..j. , ❑' I, as owner of_the property, am exclusively contracting with licensed contractors to con- Plumbing Jjji7• ' struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of propetrffy-who builds or improves thereon, and who contracts for • S.M.I. h -t�g-x,38 • such projects with a contractor(s) ticensbd pursuant to the Contractor's License Law.) � Grading .^ 20.00 - - ❑ I am exempt under Sec B. 8 P.C. for this reason Driveway Enc. f .20400. Date Owner —•--�" Infrastructure 1,948 33 -' .. WORKERS' COMPEN TION DECLARATION .. .. it , • I hereby affirm that I have a certificat of consent to self -insure, or Wrtificate of Workers Compensation Insurance, or a certif copy thereof. (Sece3Bo r Code.) - h Policy No Company ' ❑ Copy is filed with the city. ❑ Certified copy:is hereby furnished. ' TOTAL $4,743.09 r •r -% CERTIFICATE OF EXEMPTION. FROM F ` • WORKERS' COMPENSATION INSURANCE. - REMARKS. (' 's°ti1 ifs`..$.").'A�a. (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 forwhich this permit is issued, I shall not _ d� employ any person in any manner so as'to become subject to. the Workers' Compensation Laws of California ty Date—L--Owner NOTICE TO APPLICANT If, alter. making this Certificate o/ Exemption you should become ' ZONE: - - ( . • • BY: subject to the Workers' Compensation provisions o/ the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. - - ,, Minimum Setback Distances:- • ' Front Setback from Center Line " Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line 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.) Side $etbaCk from -Property Line Lenders Name - Lenders Address A FINAL DATE 2� . INSPECTOR ' 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. ' " Issued by:,Date Permit,:' - 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-.- j mentioned property for inspection purposes. Validated by: Signature of applicant Date , 1[ Mailing Address Validation* City,. State, Zip y y n CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS LAB GRADE ..-� ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL SO. FT. FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SO. FT. ® GAS (ROUGH) Zj 6 ETER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR. SO. FT. ® TEMP. POLE GROUT DRAINAGE PIPING CAR P. SQ. FT. ® FINAL INSP. BOND BEAM WATER SYSTEM DRINKING FOUNTAIN. WALL SO. FT. -$ LUMBER GR. FINAL INSP. O FRAMI q —� URINAL SOFT® O/,-- ( n / / / /—� K//// C••/ /`/ -! �V . ESTIMATED CONSTRUCTION VALUATION $ REMARKS: 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 GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED SPARK ARRESTOR LAUNDRY TRAY AIR HANDLING UNIT CFM GAR. FIREWALL 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. SQ. FT. ® c BATH TUB FINISH GRADING SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® IVT c SEWAGE DISPOSAL SO.FT.GAR ® 3/ic HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE JELECT.FEE I SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR ETBACK_cc��. / ,ROUND PLUMBI / UNDERGROUND A.C. UNIT COLL, AREA LAB GRADE ..-� ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) Zj 6 ETER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL oor GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ -$ LUMBER GR. FINAL INSP. O FRAMI q —� FINAL INSP. OOFINGIC)—1 q —,fq O/,-- ( n / / / /—� K//// C••/ /`/ -! �V . REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL G/ THING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL I Desert Sands Unified School District �y&,�y p g 7 '. p �yCE�R�TIFIgC�ATI�ON OF PAYMENT NOTICE: T bI�, ry,()C �il��^rEN i CAS I O'FF TY FEES. TO: City of La Quinta DATE: Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 This is to certify t at developer of which is located at within this District, has paid schocCY facd4ity fees imposed pursuant to the authority generate Governm nt Code S ction 53 80 in he amount of $ covering a total of squar feet of ( ) reside 1 or ( ) industrial/commercial development and that building permits for this footage in this development may now be issued by your jurisdiction. for DESERT SANDS -AIMED SC L DISTRICT White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer (10)-37 Ordec ' Y Escrow. ` 153577 A & M 2 1 Number.--- Number. RECORDING REQUESTED BY, _................:...............................•---•--........�...................._ ' WHEN RECORDED. PLEASE MAIL TO JPW 'Desert Na 16n'al Bank P.O. BOX 1777 y . ............ ........... ----..,........_..........------...............------------ .... _Pala?:._Desert.,.-.CA......92261 ....... Attention: --Robert _M. CTOSS, .SVP _..-:-- SPACE ABOVE THIS LINE FOR RECORDER'S USE < C 0 N S T R U C T• 10 N deed,"®f Trust a With Assignment of Rents THIS DEED OF TRUST, made this .............. 16th ----.....-_____•-day of -.._----._.__._June___-- __.. _: 19_$_4__; 9 . .. .. . ............ -between ............ ..&-M Construction. aCalod.eeras_ __}______________________________ :. - = ,as TRUSTOR; whose address is P 0. Bo c 366, La Quinta, CA 92253 ' ••---- ------------------------------------------------------------------------- (Number and Street) (City) (State) E1 Paseo Financial, Inc. sn California corporation, as TRUSTEE, and. Palm -Desert National Bank, a National Association, as BENEFICIARY, WITNESSETH.: That Trustor. irrevocably GRANTS,'TRANSFERS and 'ASSIGNS to TRUSTEE IN TRUST, ` WITH POWER OF. SALE, the property in ............ Rive_r'side. ......................... .... ..........:.County, California, described as: Lot 25 of Desert Club Tract, Unit 5, as shown by Map on file in -Book 21, Pages .61 and 62, of Maps,,Records of Riverside County, California. . _ y including all appurtenances, all easements used in connection therewith, all water and water rights (whether riparian, appropriative, or other- wise, and whether or not appurtenant) used in connection therewith, all shares of stock evidencing the same, pumping stations, engines, machinery, and pipes, TOGETHER WITH'the rents, issues and profits thereof, SUBJECT, HOWEVER, to the assignment, as hereinafter set out, to Beneficiary of the rents, issues and profits; and also including as part.of said property all fixtures and equipment now or hereafter thereto attached or, thereon situated and intended'or designed for use. in connection therewith. FOR THE PURPOSE OF SECURING•(1) Payment of the sum of $----- 119,400.00-........ with interest thereon according to the terms of a promissory note or notes of even date herewith, ' made by Trustor, payable to order of Beneficiary, and extensions or renewals thereof;. (2) Performance of each agreement of Trustor herein contained;,(3) Payment of any and all obligations now or hereafter owing from any Trustor hereunder to Beneficiary and secured by RE -1 mortgage or deed of trust'of real property, or stated to be secured by this Degd, -whether: such obligation be (a)' joint or several-,' (b) direct, indirect or contingent; (c) due or not; (d) payable to or otherwise acquired by Beneficiary; (e) evidenced by promissory note or otherwise. In the event that any payment,or portion thereof is not paid within "late fifteen (15) days from the date the same'is due, Trustor agrees to pay a charge", of four cents' (4¢) for each dollar so overdue, if charged by Beneficiary. - To protect the security of this Deed of Trust, Trustor agrees: `fees (1) a. To protect and preserve said property and to maintain it in good condition and repair; L To pay all costs, and expenses of this trust; ti .�',; b. Not to remove, demolish or materially alter any building 1. To a to Beneficiary, " pay ry, upon request, in addition to -pay- ` ments specifically required hereunder and under the note secured or any improvement thereon, nor to change or alter either the terms and conditions of any existing lease of the premises, or the hereby, in instalrrients,'at the times and in the amounts requested by ' present character or use of said property; ,, y' Beneficiary•, sums which when cumulated will be sufficient to pay c., To complete or restore promptly and in and work- one month prior to the time the same become delinquent; all taxes, good manlike manner any.building or improvement which may be'con- structed, damaged or destroyed thereon and when due assessments and insurance premiums. If such sums exceed the amount so required, the excess may be released or held by Bene- pay all costs incurred therefor; and to comply with all of the terms of any build- ing loan agreement between Trustor and Beneficiary; ficiary to apply on subsequent pavments of the same nature, but if such sums are insufficient, Trustor agrees to pay.any deficiency on _ d. Not to commit or permit waste of the property; . `•; demand. If Trustor shall default under this Deed, Beneficiary may - apply all or any part of said funds then held e. To comply with all laws,`covenants, conditions or restric- on any obligations secured hereby. tions affecting the property; 1 f. To v - (2) Should'Trustor fail cultivate, irrigate, fertilize' fumigate, prune and do all ,. other acts which from the character or, use of said•property may. .to make any payment or to do arty act as herein provided, then Beneficiary or Trustee, but without obiiga- , be reasonably necessary, the specific enumerations herein not ex- tion so to do and without notice to or.demar-d upon Trustor and cluding'the•general; without releasing Trustor from, any obligation. hereof, may: Make g. Tprovide ide and maintain fire , and other insurance as s e6fic.to saor do the•me in such manner and to such -extent as either may deem necessary -to protect the security hereof. Beneficiary or Trustee Beneficiary and rodeliverall p I cies to Beneficiarv, 'whlich delivers being authorized to -enter upon file propert for such purposes ; shall constitute an assignment to Beneficiary of all return premiums; commence, appear in and defend am• action or proceeding purport- h. To appear in and defend any action or proceeding purport- • ing to affect the security hereof. or the'ri ius or powerstof Bene - ficiarv, or Trustee; ing tb affect the security hereof or the rights or powers'of Bene- ficiary or Trustee; and should'Beneficiary or Trustee elect to also pay, purchase, contest or .compromise any " encumbrance, charge or lien which in the judgment of either appears ` appear in•or defend anysuch action or proceeding, to nay all costs ?o be prior or superior hereto; and in exercising any such powers, and expenses, including cost of evidence of title and attorney's fees incur any liability, expend whatever amounts in its absolute•dis- in a reasonable sum incurred by Beneficiary or,Trustee; i. To pay at.least fifteen days before deiinquency all taxes,. cretion it may deem necessary thereior. including cost of evidence of title;, employ counsel and pay, itis reasonabie iecs: assessments, and charges afiecting the property including, but not ` limited to any :eater stock and water; (3) To pay immediately and without demand all sums expended' -by j. To pay .when due all encumbrances• charges and liens on hereunder Beneficiary or Trustee, with interest from date of expenditure at the rate of ten the property which at any time appear to be prior or superior hereto ; ' percent per annum, and the repay-'• ment thereof shall be secured hereby, , It is mutually agreed that: - (4) Should the property or any part thereof be taken or damaged by reason of any public improvement or condemnation proceeding, ing any casement or 'creating any restriction thereon; (c) join in any subordination or other agreement or damaged by fire, or earthquake, or in'any other manner, Bene- ficiary shall be entitled .to all compensation, awards, and other pav- affecting this Deed or the lien or charge thereof; (d) reconvey, without warranty, all or any part of the property. The grantee in any reconveyance; may be s ments or relief therefor, and shall' be entitled at its option to . commence, appear in and prosecute in its own name, any action or described as the "person or persons legally entitled thereto," and the recitals therein of any matters 'or facts be • proceedings, or to make any compromise or settlement, in connection- shall conclusive proof of the truthfulness thereof. with, such taking or damage. All such compensation, awards, darn- w ages, rights of action and proceeds, including the'proceeds of any (8) Trustor hereby absolutely assigns to Beneficiary during the policies of fire and .other insurance affectingt said property, are hereby assigned to Beneficiary, who may after deducting therefrom continuance of these trusts,, all. rents, issues, royalties and profits of the .property affecte&by, this Deed and of any all its expenses, including attorney's fees,, release any moneys so personal property, located thereon. Until Trustor shall default in the payment of any received by it or apply the same on any indebtedness secured hereby. Trustor agrees to execute such further assignments of any com- indebtedness secured hereby,or ,in the performance of any agree-' ment hereunder, Trustor shall have the right to collect all such pensation, award, damages and rights of action and proceeds as Beneficiary or Trustee may require. rents, issues, royalties- and profits earned prior to default as they become due and (5) By accepting payment of any:sum secured hereby after its:. payable, save and excepting rents, issues, royalties and profits arising or accruing'by reason of any oil, gas or.mfneral lease of said If Trustor due date, Beneficiary does not waive'its right either to require property. shall default as aforesaid,. Trus - tor's right to collect any of such rr,oneys shall cease and -Beneficiary prompt payment when due of all other sums'.so secured or to declare default for failure so to pay. shall have the right, without, taking possession of the propertv.af- fected hereby, to collect all rents, issues (6) Without affecting the liability of any person, including Trustor, for the payment of any indebtedness hereby royalties, and profits'Failure or discontinuance of Beneficiary at any time, or from time to time to collect any, -such moneys•shall•not in any manner -affect the subse- secured or - the lien of this Deed upon the property for the full amount of'the indebtedness remaining unpaid (excepting only any person or quent enforcement by Beneficiary of the right, power and'authority to collect the same. Nothing contained herein, -nor the exercise of the prop- erty expressly released otherwise by Beneficiary) Beneficiary may from time to time and without notice (a) release any right by Beneficiary to collect, shall be, or be construed to be, an affirmation by Beneficiary of any tenancy, lease or.option, nor•an person liable for payment of any of -the indebtedness; (b) .extend the time of, payment or otherwise alter the terms assumption of liability under, nor a subordination of • the lien or charge of,this Deed to, any such tenancy, lease or option.. of any of the indebtedness; (c) accept additional security therefor of any kind, including trust deeds or mortgages; (d) alter, substitute or release any I • ' (9) Upon- any default by Trustor hereunder Beneficiary may at any time property securing the indebtedness. ' without notice, either in person, by agent,.or by a receiver to be appointed by a court,"and without regard'to (7) At any time and from time to time upon written request of • Beneficiary, payment of its fees and the adequacy any security for the indebtedness hereby secured; enter upon and take possession of saidropert or an presentation,of this Deed and the note for endorsement (in case of full, reconveyance, for can- cellation and retention), without affecting the liability name sue,for or otherwisecollect'•said rent ;th su sartf and rprofits including those past due and unpaid, and apply the same, less of any person for the payment of the indebtedness, Trustee may join consent to the making of any map or plat of the costs and expenses -of operation and collection, including reasonable it - torney's fees, upon any indebtedness secured hereby, grant- and in such order as Beneficiary may determine, -or release any of the same. (10) The entering upon and taking possession of said property, the collection of such rents, issues and profits, or the proceeds of fire and other insurance policies, or compensation or awards for any taking or damage of the property, and the application or release thereof as aforesaid, shall not cure or waive any default or notice of default hereunder or invalidate any act done pursuant to such notice. (11) Should the Trustor or his successors in interest without the consent in writing of the Beneficiary sell, transfer, or convey, or permit to be sold, transferred or conveyed, his interest in the property (or any part thereof) then Beneficiary may declare all sums secured hereby immediately due and payable. This provision shall apply to each and every sale, transfer, or conveyance, regard- less whether or not Beneficiary has consented to, or waived, its right hereunder, whether by action or non -action, in connection with any previous sale, transfer, or conveyance, whether one or more. (12) Should Trustor default hereunder, or should the buildings on the property remain unoccupied for six successive months, not- withstanding any other provisions hereof, and without notice to Trustor, Beneficiary may declare all sums secured hereby imme- diately due and payable by delivery to Trustee of written declara- tion of default and demand for sale, and of written notice of default and of election to cause the property to be sold, which notice Trustee shall cause to be duly filed for record. (13) After the lapse of such time as may then be required by law following the recordation of said notice of default and notice of sale having been given as then required by law, Trustee, without demand on Trustor, shall sell said property at the time and place fixed by it in said notice of sale, either as a whole or in separate parcels, and in such order as it may determine (but subject to. any statutory right of Trustor to direct the order in which such prop- erty, if consisting of several known lots or parcels, shall be sold), at public auction to the highest bidder for cash in lawful money of the United States, payable at time of sale. Trustee may postpone sale of all or any portion of the property by public announcement at the time and place of sale, and from time to time thereafter may postpone the sale by public announcement at the time fixed by the preceding postponement. Any person indudinG the Trustor, Trustee, or Beneficiary, may purchase at the sale. Trustee shall deliver to the purchaser its deed conveying the property so sold, but without any covenant or warranty, express or implied. The recitals in the deed of any matters or facts shall be conclusive proof of the truth- fulness thereof. (14) Beneficiary may from time to time substitute a successor or successors to any Trustee named herein or acting hereunder to execute this Trust. Upon such appointment, and without convey-' ante to the successor trustee, the latter shall be vested with all title, powers and duties conferred upon any Trustee herein named or acting hereunder. Each such appointment and substitution shall be made by written instrument executed by Beneficiary, containing reference to this Deed and its place of record, which, when recorded in the office of the County Recorder of the county or counties in which the property is situated, shall be conclusive proof of proper appointment of the successor trustee. (15) The pleading of any statute of limitations as a defense to any and all obligations secured by this Deed is hereby waived, to the full extent permissible by law. (16) Any Trustor hereby expressly agrees that recourse may be had against their separate property, but without hereby creating any present lien or charge thereon, for any deficiency after sale of the property hereunder. (17) This Deed shall inure to and bind the heirs, legatees, devisees, administrators, executors, successors and assigns of the parties hereto. All obligations of Trustor hereunder are joint and several. The term "Beneficiary" shall mean the owner and holder, including pledgees, of the note secured hereby, whether or not named as bene- ficiary herein. (18) Trustee accepts this Trust when this Deed, duly executed and acknowledged, is made a public record as provided by lay. Trustee is not obligated to notify any party hereto of pending sale under any other Deed of Trust or of any action or proceeding in which Trustor, Beneficiary or Trustee shall be a party, unless brought by Trustee. (19) This Deed shall be construed according to the laws of the State of California. (20) For any statement regarding the obligations secured hereby, Beneficiary may charge the maximum amount permitted by law at the time of the request therefor. The Undersigned Trustor requests that a copy of any notice of default and of any notice of sale hereunder be mailed to him at his address hereinbefore set forth. A & M Construction, a California General Partnership ...... . .................................................................................................................. ...............................................................'--:.-......- �...... Maue1 Abarca BY• - State of California County of Riverside SS. •�', DORIS Y. KAINER NOTARY PUBLIC T RIVERSIDE COUNTY A*'' My Commission CALIFORNIA Exoires January 27, 1992 PARTNERSHIP ACKNOWLEDGMENT =ORM 71-0052 On this the 16 day of June Doris Y. Kainer the undersigned Notary Public, personally appeared Rick Morris and Manuel Abarca XX personally known tome 1919—, before me, proved to me on the basis of satisfactory evidence to be the person(s) who executed the within instrument on behalf of the partnership, and acknowledged to me that the partnership executed it. WITNESS my hand and official seal: Notary's Signature t1ATI0NAL NOTARv . _._.. (COIInty Recotdet. Do not copy) i l REQUEST FOR FULL RECONVEYANCE (To be used only when note:has been paid.) To , Trustee The undersigned is the legal owner and holder of the note arid all other indebtedness secured by the within.Deed of -Trust. You are, hereby requested and directed, on payment:.to you of.any sums owing to you' under the terms of said Deed.of Trust, to reconvey, without - warranty, to theparties designated by the terms of said Deed of Trust, all the estate now held by you thereunder. Said note and said Deed of Trust are herewith surrendered to you `for cancellation and'retention , ..._..... Dated: ..._........------ ----=--- - _ ......_..----...- . ._._., 19..-----• Mn i 'Nati �➢1 d Bar* y St . B ........ _....-..__._..... __.........-----------= ------------------ __...._ (Insert title) By , ► r (Insert name of Branch) Received said Reconveyance_..__ ....................._._......._.._.___; 19. _ _ Address ....... _.......... _._._....... _..__._:..... i q'. 9 O W �. j' j a �" :f�:t '� y � yeti+: r'�:'sY+'-`s��' >`'•J�e;��;,xyy��: ' ��.ys`•-'!�`�' V::i ,~'.`�, "�''„�"`��5's�`€`�•+""'x`�%i=��',n,*�.�.d��^'�''�% M 0 RECEIPT;NO. �l O 9 I f Issued BYC —+ :Dat DISTRICT: . ❑ Riverside, io ❑ Hemet Q. Perris ' ❑ Rancho Calif: ❑ Blythe DOH SAN.122 (Rev. 5/88) DISTRIBUTION WHITE 7 Office filed, ' YELLOW - Applicant PINK -Bldg. Dept GOLDENROD Plans/Records ' COUNTY OF RIVERSIDE DEPARTMENT OF HEALTHAssessors Parcel No. 7�— G621— 0(3 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. Q VERIFY ITEMS IN SECTION A FROM BUILDING 8 SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG # Z O Agent, Contracto C6 ct Pe on Phone Add s P — W Owner N .e'� Phone Mailing Addr _ess AV .' city Ste Z�5, Jo' . ddress4V UN/ A IT Legal Qesclk/!/1 p� Pac) Lot Size titer Agency 1- Use of Permit P/P, CU, etc. Other rZ A C7 Dwelling Site Prep, at (J J O Signature of Applicant Date CATEGORY: REV CODE FEE CATEGORY: REV CODE FEE' [90 SUBSURFACE DISPOSAL 1238. 5: po SITE EVALUATION UPON REQUEST 7349 $42.00 m ❑ MULTIPLE PARCELS WITHIN SAME _ (NO PLOT�PLAN) . . Z LAND DIVISION ❑ SEWER/SEPTIC VERIFICATION 7348 $11.00 O a. 1.st 4 Parcels (Each) 1238 $45.00 (Less than 1 year) F- b. Each Parcel after 4 7344 $16.00 ❑ PRELIMINARY ELECTIVE 7352 $45.00 W ❑ Rereview (2nd review same parcel) 7344, $16.00 EVALUATION (Attach DOH SAN 53) U) ❑ 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 F �E I �NITIAL� . D �O Holding Tank Agreements Completed _ ❑Yes o�/� Cl Certification of Existing S.D. Syslem-Required t ❑ Yes �o� WQCB Clearance required. (Attach Form- ` ❑ Yes o DOH SAN 007, Santa Ana Region Only) ti - Soils Percolation Report Required. 11 Yes m"N Special Feasibility Boring Report Required. ❑ Yes Detailed Contour Plot Plans Required (1 to 5 ft. interval) r� ❑ Yes ;NNoo Other ❑ Yes 121 o Staff Specialist Lot Inspection Required ❑ Yes Lot Inspection Date t Soils boring report by Project # Date p A f Soils Map Page �c% Soil Type ` Approved by Date U Z No. of Systems a of Systt'm(s) ❑ Ho ifig Tank ❑ Existing No. Dwelling Unit f Bedrooms,, FixtaDDrektaits•�^ (1) Septic Tank Soil Rate Grease/Sand Q6 ase Intcp ,% / ew ❑Replacement • 1500 Gal t/ �• � //'t/ 2)�Leach Line Sq. Ft. om trench area Sidewall allowance tt rock/sq. ft Insta Line(s) ft long - ft wide with min. inc roc below drainlines or Laqch Bed sq. ft. of bo om e_.._ t per running ft. �/ MI A Leachlines/bed. special design for slope: Applica ble (3) Pit Diameter % No. Pits Pit BOW Seepage Pitt TO# Depth pE Max. Allo wab le Depth N/A Overbn factor urde ' 8 �O 5�L No. 2. System A7114 f - REMARKS: 0. This application i P�Ej/fED for the category checked in SECTION.B above, regarding the design of a subsurface disposal system as indicated C1 Z on the accompan13ing the requirements set forth in SECTION C above. A building permit is necessary for the installation of the O�1� above -designed system. No construction is permitted in the required reserved 100%expansion area. ' ��z ,q Septic f-ij 11ze,,`. tank and sewer lines must be 50' minimum from any wells ('i (2Leach lines must be 100' minimum from any wells, including expansion' ea 3� �/. . ,Seepage pits must be 150' minimum from. any wells, including expansion areaCAL e Si nature of Health Officials G`�% �,/ �J Date` M 0 RECEIPT;NO. �l O 9 I f Issued BYC —+ :Dat DISTRICT: . ❑ Riverside, io ❑ Hemet Q. Perris ' ❑ Rancho Calif: ❑ Blythe DOH SAN.122 (Rev. 5/88) DISTRIBUTION WHITE 7 Office filed, ' YELLOW - Applicant PINK -Bldg. Dept GOLDENROD Plans/Records N Buena Engineers, Inc. 79-811 Country Club Drive, Suite 4 Bermuda Dunes, CA 92201 • (619) 345-1588 /328-9131 Client Name F. Client Address .. .,..-'`�� •� t:r -•..�,' .{ 4:- e• .pay"' ;"°�+ - Client Phone sJ • DATE 9 - _1/ - n/FZ_,6f JOB NO. / RODE D% J% uSllA/ ELEVATION LOCA ION' CONTRACTOR OWNER WEATHER TEMP. o at AM ° at PM PRESEIW AT SITE MAXIMUM DRY DENSITY Ibs./cu. ft. OPTIMUM MOISTURE CONTENT % TEST NUMBER, TEST LOCATION LOT NO. ELEVATION FIELD TESTING REFERENCE CURVE MOISTURE CONTENT % DRY DENSITY IbsiCu. ft. MAXIMUM DRY , .DENSITY % MAXIMUM DRY DENSITY Ibs./cu. ft. OPTIMUM MOISTURE CONTENT % REMARKS: j/ QFC: �c= ��U �`> Sr v 11.4 x 4 CLIENT REPRESENTATIVE SIGNATURE f4 -82E FIELD LD REPORT TECHNICIANS SIGNATURE s, • E. LEt)ro SPA"(1y a . p 1. R`�• t)t t.It.E OF ' • , - • �{ t�teia)rarlt.� � -1 ',•y; �Q•.tvtS:uY.�ln - ' '. AGIIIC:UL I UM1. WNWISs101"E", ' JAMES o v;nunt:F ASStSt�H � i):.�•.uSStu�i.t! r - AN ! •its 1 1 �� o, CIENIEvI I{F.�iVEhIS1E tt M MAGI I I's H ASUn- s so Un 7, Ilwy 'lIG –—, . 2236 Colic l In CA .9'i 619l' - o _ CASE UEVEL)DE' - it' 5 1'IN•1E r 57 { ` ' !U)UKESSr I t F f il<rt cl�llot46 ' C j �, — Y S,3�. s L)ear nevelohert i .. rafter reviewing your '101 id C60.f.tuI Itl�i► Itll iri�tlt 11HtValle llsz[,sulisli utliolis violation o[ ,yu rvltine 'l0WS Jtjuvew1-lly lite Cvacliel•la y_. do occur Etna they diEEer [rtm lllat{t' nlaletial listed, tltlstiv[[ice nnlst.l)e I�otiEied i Milt-diately:_ Mlle 'C chell GvrscvlectLty attd 'it�eservluy a Valley's Lest-Ereet enviroUtetll. lI.tmik you L w J ray }cul ku> al Canttiss onerl s [ice Indio and ItlVerside UEEice r s cc �. f . � - 1 . .. � , � : tw I , - - s T ~N 1 � � .. � it •• - �t .. .I.i� ...,r •• f M - •r ri. ' w'i. . � i .y r • '' • 4. . .• i, rF�. •1. , At • t•r , '� _ I 1