05579 (SFD)w
P.O. BOX 1504 No. 05579
Building"%I"r� � � 7&105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Coachella Vallieu Land
Address 247 E. Tahquitz Way #2
City Zip Tel.
Palm springsl 92262 1 639/322--1020
Contractor
Starr Construction
Address. .
same
City lZip
State Lic.
& Classif. 367934.
' Arch., Engr.,
Designer
uc'. #895
Tel.
CityI Zip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 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 - 7 DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031-5,Bhshess and Professions Code: Any city or county which requires a
pemrit to construct, ater, krprove, demolish, or repair any structure, prior to its issuance also
requires the applicant for such perm to lie a sigrred statement that he is licensed pursuant to
the provisions of the Contractors 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 av7peraffy of not more than five hundred dollars (E500).
❑ 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 Coraradoes License Law does not apply to an owner of property who
builds or improves do "m and who does such work hinself or through his own employees,
provided that such improvements are not intended or offered for sale. Il, however, the building
or improvements sold within one year of completion, the owner -builder will have the burden
of proving that he did not did 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 Contractor's License Law
does not apply to an owner of property who lids or improves thereon, and who contracts for
such projects with a cont actors) icersed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sem B. i, P -C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION /
I hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereor4Sec. 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 (5100) valuation
or less.) .
I certify that in the performance of the work for which this permit is issued, I shall not
=any person in any manner so as to become subject to the Workers' Compensation
Laws of California
Date Owner
N077CE TO APPLICANT: q after making this Certificate of Exemption you should become
subject to the workers' Conpersatioin provisions of the Labor Code, you must forthwith
comply with such provsioms 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
Lenders Address
This is abuilding permit when property filled out; signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I car tity 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
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number 774-163-001
Legal Description Lot 24 Bilk 237 Unit 22
Project Description
Sq. Ft.
Size 14163
No. No. Dw.
Stories 1 Units
NeWyEl Add ❑
Alter ❑ Repair ❑ c Demolitior ❑
475 square feat Garage
170 -feet 6 -foot good Pence
Estimated Valuation
$?9,7a6,40
PERMIT
AMOUNT
Plan Chk. Dep.
250.00
Plan Chk. Bal.
+� •
Const.
4 9 •
Mech.
Electrical
Plumbing
5 .t
S.M.I.
. Q
Grading
20.00.
0
Driveway Enc
zu.ou
Infrastructure
a 'J
A
TOTAL,
REMARKS
:t'`6rzi.�&'), ,40
A11 L.1714.11 w XVII -44. .. a:,Ju:"i V_
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
3/31/89
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
I
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT. @
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
F
BAR SINK
POR. SO. FT. ®
-
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. SO. FT. ®
FINAL INSP.
BOND BEAM
WATER SYSTEM
DRINKING FOUNTAIN,
WALL SO. FT.
LUMBER GR.
FINAL INSP.
URINAL
SQ. FT. @
ROOFING>C
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
VENTILATION
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FIREPLACE
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,TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1 Vi c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ic
HOUSE SEWER
CERT. OCC.
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
0 (/&TBACK " �
�`6/1&/LAFB
��,ROUND PLUMBIN(i'p
UNDERGROUND
A.C. UNIT
COLL. AREA
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 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.
FRAMING
FINAL INSP.
ROOFING>C
75
V /
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
1
�7�r��+,wr--�: �i�h r;�t>'i;^�'4,�'�'ys�d�i�'�'�;��r'ri,t : � « r_" •�'��,.�.e,I �:�:k�;fi�.tj'+(iqt:�,�,'�f^`Ntyy`�a1'�:;:"'�vr"r�:;*�r+
a
'
COUNTY OF RIVERSIDE DEPARTMENT OF HEALTHAttttessors Parcel No.
�` 1'3 — e''
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 check list
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 & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG' #
Z
O
Agent, Contractor, Contact Person
Phone
Address & Phone
a u a
.32� is zo
ULI
co
Owner
Phone
Mailing Address
.0.09:pti ITL
City
P' 5P2/,JGs
�
State
C.9
Zip
2Z6
9'L
Job Property Address�q
5376 0 [%/1-147. 0
Legal Description Prop. (PM, Tract, Lot)
40-?- zje 44eZ37 Au'r �
Lot Size 1 n
e "Agent II
Use of P1ermk P/P, CU, etc. ir kc•»-*
Other (Gtt.T
s •,.-�G • c�
, el. ling MH Site Pfep, etc.
3/2 -3 /*
Signature of Applicant
! Date
a
CATEGORY: REV CODE FE
,
CATEGORY: REV CODE FEE
(SUBSURFACE DISPOSAL 1236 $45.00
❑ SITE EVALUATION UPON REQUEST 7349 $42.00
❑ MULTIPLE PARCELS WffHIN SAME ..
(NO PLOT PLAN)
M
z
rte,
LAND DIVISION
❑ SEWER/SEPTIC VERIFICATION 7348 $11.00
0
a. 1 st 4 Parcels (Each) 1238 $45.00
(Less than 1 year)
' U
b. Each Parcel after 4 7344 $16.00
❑ PRELIMINARY ELECTIVE 7352 $45.00
LU
❑ Rereview (2nd review same parcel) 7344 $16.00
EVALUATION (Attach DOH SAN 53)
W
❑ . Site Evaluation in Conjunction with
❑ HOLDING TANK 7351 $45.00
Crttl al Area 7346 $86.00
❑ ALTERNATIVE/EXPERIMENTAL 7345 $13200
❑ Site Evaluation Lot Less than
SYSTEM
10,000 Sq. Ft. 7347 $86.00
INITIAL DATE
Holding Tank Agreements Completed Yes �(r f
❑ C7'No
Certification of ExisUng S.D. System Required ❑ Yes 00,
1 11
WOCB Clearance required. (Attach Form ❑ Yeb 13 o p
DOH SAN 007, Santa Ana Region Only) .,
1
Solis Percolation Report Required. ❑ Yes /NOS
.Special Feasibfifiy Boring Report Required. ❑ Yes 0"
Detailed Contour Plot Plans Required (1 to 5 ft interval) ❑ Yes
Other ❑ Yes 2NO '
Staff Specialist Lot Inspection Required ❑ Yes No
Lot Inspection Date
Solis boring report by Date
�^ A %Project
2
Sills Map Page / Gr Soil Type Approved by iv/- Data
U
No. of Systema
Type".61 Sy-stern(s)
No. Dwelling Unb 1%
(1) Septic Tank
Soil Rate
,,4Gresse/Sand
R
❑ Holding Tank ❑ Existing
Bedrooms, Fixture 11rUta
Grease Intcp
O
(
New ❑ Replacement
AD� M • /��
e ?
Gal
_ `�
Gal
(2) Leach Line Sq. Ft
\���trench
' Sidewall allowance
Install Lines) R long n wide with
Leach Bed aq. it
�ot^bdtom
area
R rock/ ' ft
min. vies below drefil'nes or
area
Per running ft �
�
C9"'PIAA
Leachlines/bed special design for slope:
(3) Pit Diameter
No. Pits
Pit Below
Seepage Pi Total Depth
Ot *
Applicable
Inlet (BI)
/
All le Depth
N/A I**' Overburden factor
�(�
.Mex.
Ve
/
No. 2 System N/A
•
REMARKS: %/L�.�,>�G..•a•.., i'L-�1'a7+� ��V �7Cf14�tilX-tP- �.c.�G,.--
%%P�
This application is PROVED. , tED'for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated
0
on the accompanied- pan, using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the
Oabove
-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 �' �i in�a c,.,.,.,,/�
G�
W
Leach lines must be 100' minimum from any wells, including" expansio area i
3 Seepage pits must 150' minimum from any wells,' in�cludin�jg a (pans on ar
/be
`
3'� 7-�p
.(
Si nature of Health Official •' �'-F',�.+�( lit/ ..�.� / .. • pate 7� !/•/Li�.. .�
ov
RECEIPT NO. '570 c;Z 0
Issued By � � Date
DISTRICT: ❑ Riverside, 9 -~Indio ❑ Hemet Q Perris ❑ Rancho Calif. ❑ Blythe
DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD - Plans/Records
7
i N f Of f ICE Of E. LEON SPAUGY "
AGRICULTURAL MNIMISSIONLR
1 • . JAMES 0 WALLACE
O d AND ASSISIANF rgWwSSMER
I�S EMEASURES VErISfE
WLIGICLEMENT BEN
SEALER
49-613 Ilw -
y 86 � Suite i e 8 12
M
'Coachella, CA 92236
q r 9, b
619-342-8191
DATE �%J` `f `Q cASE ,NO. 9�- �� t ,f_� Cy�aq C� _
DEVELOPER'S NAME r S % R." Cm .y S r2Uc
ADDRESS E 7
�is'L.� ,S �.ai,✓ G 0,4 r' z 2- e. Z
TELEPHONE: ( 619 3 Z z-
'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 frun plant material listed, 'this office must be notifi.:ed
imnediately.
Thank you for protecting and preserving the Coachella Valley's pest -free envin)nment.
• i r '
Agr tural Cannissioner's Office
ccs Indio and Riverside Office ,
3 '9 ¢ o 1X4 c. L ✓ a