05805 (SFD)L ?k
lz
Buildin
Addressg 53_090 Vii pjo
' '
Mailing
Address 79-860 BOQUMON WAY
__
City Zip
?� DMMS 92201
Contractorowwz1Bunm
!Address
SAE
Tity/ 4 4 Q"
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
el.
3454236
Zip Tel.
State Lic. I City
& Classif. B-31739' Lic. #
Arch., Engr.,
Designer
Address*Tel-
City (Zip I
State
Lic. If
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. I r /
_SIGNATURE - 'y f V" ,r !'+-" DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Busfness 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 We 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 rive hundred dollars ($500).
❑ 1, 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 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
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.)
O 1, 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.)
0 1 am exempt under Sec B. & 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. Company 0/
❑Copy is filed with the city. O 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 (x100) valuation
or less.)
1 certify that in the performance of thg work for which this permit is issued, 1 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: B, 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 if 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
I
No. 05805
11LDING: TYPE CONST. OCC: GRP.
P. Number 774-053-M4
gal Description LOT 21
oject Description
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 5/22/89 Permit
Validated by:
Validation:
Sq. Ft. 155
Size
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑
Repair ❑ Demolition ❑
Estimated Valuation
$851980.00
PERMIT
AMOUNT
Plan Chk. Dep.
750.00
Plan Chk. Bal.
237.18
Const.
576*50
Mech.
61,00
Electrical
211.15
Plumbing
154.50
S.M.I.
12.60
Grading
2€ .00
Driveway Enc.
20.00
Infrastructure
1,.8915.30
F� CISE
atS.i)ti
TOTAL
0- t*ASK f 11Y.1 At ,$r. L, �5vv&,::.5
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 5/22/89 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
LAB GRADE Z—
ROUGH PLUMBONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT. ®
ER ORROUGH
76 C/
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. SO. FT. ®
FINAL INSP.
WALL SO. FT.
WATER SYSTEM
DRINKING FOUNTAIN.
GRADING
cu. yd.
$ —Plus—X$—=$
URINAL
SO. FT. @
ING*?
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
/
Iii ` C/_�%�
(� a
4
WATER PIPING
NOTE: Not to be used as property tax valuation
REMARKS:
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOXDISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
SPARK ARRESTOR
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
INSULATIONISOUN ,
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
SO.FT.GAR ® V4c
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
ETBACK —22 7
ROUND PLU#_2UNDERGROUND
A.C. UNIT
COLL. AREA
LAB GRADE Z—
ROUGH PLUMBONDING
HEATING (RO
STORAGE TANKFORMS
ER ORROUGH
76 C/
DUCT WORK
ROCK STORAGE
l FOUND. REINF.
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.
ING*?
FINAL INSP.
ROOFING
/
Iii ` C/_�%�
(� a
4
.
/
i
v
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
WLTHING �� ��/ [
MESH
INSULATIONISOUN ,
FINISH GRADING
NAL INSPECTI09%-//
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/PIITIALS
GARDEN WALL FINAL
I
i-k•tvir ��''S "R`xC.'+.�+W`. •-. V Y �'Y, ti';i'•+�!y:
c 4r
' . Assessors Parcel No.
COUNTY. OF RIVERSIDE DEPARTMENT OF HEALTH
xiY - ENVIRONMENTAL HEALTH SERVICES —
�! ,PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM
t"Appll ant:. 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
• r�r 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 r
app period not to exceed one year from date of approval.
VERIFY ITEMS IN SECTION A FROM BUILDING 8 SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG'*
r;j•,e' Q Agent, Contractor, C�o,ntaacttPersoj iPhone /9 J� Address 8CPtwne (T q
),236
a• W Owner ,a► ;' Phone Meiling Address
77—w
% /•1 , State i Zip Job Property
Address Legal Desori tioin Prop. (PM, Tract, Loot)
k /.f�?�S. �1
Lot Size � tir AgenCy� ell Use of Permit P//P, CU, etc. k��. Glc<�GLtc Other ' ! 7 / ! ��{ �i� f y
pw'elling,,MH Site Prep, etc.
I !' Signature of Applicant / / Data
CATEGORY: REV CODE FEE.,,.;. CATEGORY: REV CODE FEE
S ^y
O5UBSURFACE DISPOSAL ' 1238 t $45.00./ ❑ SITE EVALUATION UPON REQUEST 7349 $42.00
❑ MULTIPLE PARCELS WITHIN SAME (NO PLOT PLAN)
m LAND DIVISION Z SEWER/SEPTIC VERIFICATION 7348 $11.00
Z
y p a. 1 at 4 Parcels (Each) 1238 $45.00 (Less than 1 year)
F- b. Each Parcel after 4 7344 $16.00 ❑ PRELIMINARY ELECTIVE 7352 $45.00
U ❑ 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 $13200
� ❑ Site Evaluation Lot Less than SYSTEM
10,000 Sq. Ft. 7347 $86.00
INITI DATE r
Holding Tank Agreements Completed ❑ Yes Q No'{
CeRHIcation of Existing S.D. System Required ❑ Yes No- / t
WOCB Clearance required. (Attach Form ❑ Yes O.No
" DOH SAN 007, Santa Ana Region Only) ,fes
[ Sills Percolation Report Required. ❑ Yes
l Special Feasibility Boring Report Required. ❑ Yes 2 Nb
' Detailed Contour Plot Plans Required '(1 to 5 ft interval) ❑ Yes
Other ❑ Yes El No I
( Staff Specialist Lot Inspection Required ❑Yes C] No
Lot Inspection Date
i Soils boring report by dr �) / Project Date
Soils Map Page 111"R 14 Soil Type L. !•t Approved by / � h Dale
No. of Systems Type of System(.) • No. Dwelling Units 1 (1) Septic Tank Soil Rate Grease/Sand
Z ,t t7 Holding Tank ❑ Existing Bedrooms, RbdurewUr>ita / �°**Gresse Intcp
D Replacement � �.� /l iY► . /j+j�}r /�� Gal ?"�•�"' / "� �a ��` �
V
W t(2) Leach Line Sq. Ft Sidewall allowance Install Line(s) ft long ft wide with Leach Bed sq. ft
' `Bottom trench
area
". R rock/sq. R min. Inches rodtebelow drainlines or a bottom•area '
per running tL
•• ,} .I. Y N Off" IVA _ e
Leachlines/bed special design for slope: (3) Pit Diameter No. Pits Pit Below Seepage Pit Total,:Depth .Other
Inlet (BI) - •✓ /'
•1
Applicable
,
OAFS. LI 6 / Max. Allowable Depth
r N/A • • ' �r Overburden factor
t
No. 2 System/�.
f
Y . »!REMARKS" An 16A
FV V,#-, "« AJT_-e .�v � _. 141_ alt. f'J 140 11 &1 wa 1.711 A /'L! _.WW -7
This application iVAPPR /DENIED for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated
0 on the;accompan plot'plan, using the *requirements set forth in SECTION C above. A building permit is necessary for the installation of then
Oabove -designed. system. ,No construction is permitted in the required reserved 100% expansion area.
(1)r Septic tank and sewer lines must be 50' minimum from any wells. /0
U , (2) Leach lines must be 100' minimum from any wells, including expansion
U.1
(3! Seepage pits must be 150' minimum from any wells, including expansion area r!
/12I
+- Si nature W HeaRh Official �-A4"d" Date
RECEIPT NO. Issued By 41 V/1 Date
DISTRICT: ❑ "Riverside, O�ndio ❑ Hemet q Perris ❑ Rancho Calif. ❑ Blythe ,
1DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Pians/Records
,r j
Y
.. . 111 I N.E U►
r nVlll(:ULI�u.icnL CU�Ih11551UPIL'�l.
AND
o ! M �Vial;l11S L•• hICASUM.S
49-617 Ilwy 116. oulte II—Il
,.� Cvucl�e I 1 n CA 92t76
E. EEM+ SPAl;I;Y
. �p•.��nSiw',tn
)ARIES U v:AUACF.
�ws���r � �r�.�•.nssnr.tn
CIE�IEYI (IF,`vEtrIS1E .
SLAM
A�� r o.�-�'sq� 61Y-Jrr•t-0'l91 • . .
IMw;
bEHCLAI'Cli' 5 I W1�t �J�j �/ v/�
2 2D/
5 3 .
Dear wveluperl
viewill 1c�11t15Ct11111KI 11lum), fill 1110"t IiV3teriul. listed
is edsullstitutliol�s
After to y your,
violotivu of: yv relltl.ne 1(tstnit�lullt,n lelcl 1 listed, (hisen[[i.ce must tie IlotiEied
dv occur mid they dl[[er .
�1u11ediately,
Lor tectLly a711J l�tesetvilly the Cvechella Valley's Pest-[ree elrv.irdlrlellt.
'1'11autk you ! . ltv
ng�cul.tuxal Caiii s viler s VL [ ice
ccs lI►dly flll(1 liiversitle V[[lce
T I T L :Z"-4 IE-=hJ1E RC3'V Cid L CLI L T I C3 IV r4 RSA 1 tS
'JOHN H. HACKER_, CIVIL ENGINEER, PALM SPRINGS 327-4565
NAME ------- JERRY LUGO
ADDRESS ----
DATE --------
•MANUAL J FOR HEATING AND COOLING LOSSES
AREA BLDG 1500• SCI. FT.
PERIMETER 166.6667. SO FT.
INSULATION -R VALUES .FLOOR 0 :.CEILING 38 ..WALL
11
AREA NORTH WINDOWS 48 SQ.FT.. PERCENT OF AREA
3.2
AREA EAST WINDOWS 28 SO.FT. PERCENT OF AREA
1.866667.
AREA SOUTH WINDOWS 331SQ. FT. PERCENT OF AREA
2.2
AREA WEST WINDOWS 55 SO.FT. PERCENT,OF AREA
3.666667
AREA SKYLIGHTS 0 SO.FT. PERCENT OF AREA 0
'TOTAL WINDOW AREA 164 SO.FT.•PERCENT OF AREA
10.53333
THE U VALUE OF THE WINDOWS IS .65 'DUAL PANE
'THIS BLDG USES DRAPES °< FLAT SHADING DEVICES*
ON WINDOWS
(*mini -blinds, rollar'shades, venetian blinds
or vertical blinds)
THE TOTAL S.C. OF THE WINDOWS IS 0.30
SOUTH OVERHANG LENGTH 2
IN-RIOR THERMAL MASS AREA = 384 SO FT.
I TRATION '(STD 0.0)18, MED 0.014, TIGHT 0.012)
= .018
HEATING LOSSES
FOOTING LOSSES...'5786.667. BTU
CEILING LOSSES .., . 1 177. ' 15 BTU.
WINDOW LOSSES.. 3304.6 BTU
WALL I OSSES.... 2855.547 BTU
INFILTRATION LOSSES... 6656 ETU.
TOTAL HEAT LOSSES BTU/HR.. 15864.43
GAS FURNANCE SIZE 40823.76 BTU OR 45,000 BTU
COOLING LOSSES
FOOTING LOSSES... 2488.885 BTU
CEILING LOSSES... 1.518.587 BTU
WINDOW LOSSES... 7715 BTU
WALL LOSSES.... 3741.867 BTU
INFILTRATION LOSSES... 2880 BTU
NO. OF PEOPLE... 5 COOLING LOSSES.'_ 2000
KITCHEN... 1500 BTU
DUCT LOSSES INCLUDED IN TOTAL
TOTAL COOLING LOSSES 27604.74 BTU
0
rt
.'POT. SYSTEM SUMMARY: CL IMATE ZONE
'15 P-'
R
PR ECT TITLE=JERRY LUGO +'
DATE=.'
JOB SITE--
ITE=BUILDING
BUILDINGDATA
CONDITIONED FLOOR AREA= 1500
NUMBER OF.,S_TORIES=
1
SLAB/RAISED FLOOR SLAB
TOTAL GLASS AREA 164 SQ.FT
%GLASS 10.93333
CHECK: ALL APPLICABLE UNIT,TYPE CONDITIONS)
(X) SINGLE FAMILY DETACHED (SFD)
( ) ADDITION ALONE
( SINGLE FAMILY ATTACHED (SFA)
( ) EXISTING•BUILDING
( ) MULTI -FAMILY (MF)
( ) EXISTING -PLUS -ADDITION
SCORE CARD
MEASURES
POINT SCORES
1.CEILING INSU. 38
0 ,
2.WALL INSU.- 11
-8
3.RAISED FLOOR INSU 0-
0
4.SLAB EDGE INSU 0
0
5.INFILTRATION STANDARD
0 w
6.GLASS HEAT LOSS DOUBLE PANE
U=.'65 6
SUM 1-6=
(-2 )
7.,ADING (SHADE OPEN)
GLASS AREA
-
SC= .6776
A. NORTH
0
48
B. EAST °
0
28
D. SOUTH
0
33
E. WEST
1
55
H. SKYLIGHT
0
0
8. SHADING (SHADE CLOSED),
X GLASS
SC= .2552
A. NORTH
o'
3.2,
B. EAST
3
1.866667
C. SOUTH
4.2
D. WEST
3
3.666667
E. SKYLIGHT SC= 0.77
0
0
9. INTERIOR THERMAL MASS '2.56
1
110. EXTERIOR WALL MASS 0
0
SUM 7-10 =( 12 ,)
11.HEATING SYSTEM 72 1 S.E.
0
12:COOLING SYSTEM 9:5 SEER
0
13 WATER HEATING S.G.
0
TOTAL POINTS 10
k