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06093 (SATT)Building Address 54-625 Vallejo Owner T4tyl 4 4 a" P.O. BOX 1504 78-105 CALLE ESTADO LA QUI_NTA, CALIFORNIA 92253 YOU= Mailing Address p. -0. Boz 772 ^^ City h4 Zip 92Tel. 2-35 �t k1a1$ Contractor K C L /a- /L JA- Address .f'ILAddress Cityf4,/f - AujA7R IZip State Lic. & Classif. Arch., Engr., Designer No. €6093 BUILDING: TYPE CONST. OCC: GRP. ' A.P. Number 774-28Ia013-#}3 Legal Description Project Description City : : . .. - Lic. # Sq. Ft.. ,. ' 15343 :•_ No. Size Stories 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 000) 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 Contractor's License Law for the following reason: (Sec. 7031.5,8ushess and Professions Code: Any city or county which requires a permit to construct, after, 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 permit .subjects the applicant to a civilpenally of not more than two 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 or Improves thereon and who does such work himself or through his own employees, provided that such Inprovements are not intended or offered for sale. If, however, the budding or improvement is sok/ within one year of completion. the owner-bullder will have the burden of proving that he did not build or improve for the purpose of sale.) ❑ I, 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 contractors) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec B. & 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 Workers Compensation Insurance, or a certified copy thereof. (Sec.3 00, Labor,Code.) Policy No/- %' i k.:. .i Company '5y:.N , /` .....d 4>'S. P15 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 thg 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: ft, after making this Certificate of Exemption you should become subject to the Workers' Corrqpensation 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.) Lenders Name Lenders Address This is a building permit when property filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 1110 days. I certify that I have read this application and state that the above information is correct. 1 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. Dw. Units -t 1 New O Add ❑ Alter ❑ Repair ❑ -Demolition ❑ 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 7/13/89 Issued by: Estimated Valuation 087,010 PERMIT Validation: AMOUNT Plan Chk. Dep. $aj, Plan Chk. Bal. 335.50 Const. 585.5€3 Mech. 6.00 Electrical 11.3.13 Plumbing 171%.50 ` S. M.I. fs. Ili Grading "A0 Driveway Enc. 20.00 Infrastructure 1,919.48 TOTAL $3,488..47 4 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 7/13/89 Issued by: Date Permit Validated by: Validation: Y CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS A.C. UNIT COLL. AREA emcsLAB GRADE -,9 —,F • YARD SPKLR SYSTEM 2ND FL SQ. FT. BONDING HEATING (ROUGH) MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® ROUGH WIRING POWER OUTLET ROOF DRAINS GAR. SO. FT. ® GAS (ROUGH) METER LOOP DRAINAGE PIPING CAR P. SO. FT. ® REINF. STEEL GAS (FINAL) TEMP. POLE DRINKING FOUNTAIN. WALL SQ. FT. GROUT WATER HEATER URINAL SQ. FT. @ FINAL INSP. ESTIMATED CONSTRUCTION VALUATION $ WATER SYSTEM WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES LUMBER GR. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER ROOFING _ 2%{ l V GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED ,y��,, //n ' LAUNDRYTRAY 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 SPARK ARRESTOR SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1 Vi c SEWAGE DISPOSAL LATHING SQ.FT.GAR ® 3/ic HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE NIECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR �ETBACK^�? —d-'47 GROUND PLUMBIN. -/�_ UNDERGROUND A.C. UNIT COLL. AREA emcsLAB GRADE -,9 —,F • -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 APPJEQUIP. 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 Q i FINAL INSP. ROOFING _ 2%{ l V c L�01 ,y��,, //n ' REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURE SIINITUILS GARDEN WALL FINAL AcG 4�1 v646 7 i Desert Sands Unified School District j _ I CERTIFICATION OF PAYMENT, I OF NOTICE. -SCHOOL FACILITY FEES + I.PQ THIS, D TO: City P('LJ(;ATE®DATE: OCUMENT ���®�a - � Department of Communityt`Development 78-105 Calle Estado- La Quinta, CA 92253 i This is to 5ertify t t Q developer of ( which is located at Q within this District, has paid school facility es imposed pursuantA o the a tho •ty g era d by overnme t Co a Sec iot 53080 in !the -amou nt ( i covering a total of square feet of ( ) residen ( ) industrial/commercial development and that building permits for this footage in -this development may now be issued by your jurisdiction. 2j (5 1 0 fo DEk��4'�'Z�rlrVIT; DISTRICT. White - Building Department • Yellow = Facilities Planning • Pink - Accounting; • Gold - Developer 0 0)-37 t; Vis; 7 VV Q Z 0 W co M Z U W co :Wj Z O U W to Z 0r Assessors Parcel No. COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH „�7 _ U / ^ O ENVIRONMENTAL HEALTH SERVICES PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM Y� 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 bt3 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. w VERIFY ITEMS IN SECTION A FROM BUILDING 8 SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG,* Agent. Contractor, Contact Person' !1/111e -s Hit A) �" Phone Phone J�`7 -53�° Address 8 Phone ((� ++ •!-091 1 f+ f q)UJ- Lfv?4+v.` ... Owner Phone Mailing Address•] 1., 771 ' -C City / i Sip i ' Zip d Job Property Address , Legal Description Prop. (PISA, Tract, Lot) Lot Size ^ter A lye11 Use of P/P, CU, etc. �;� ` 3� ti Other I i1} j(1 0•,t) c. V wo 71 .v 31 a- r Dwelling, MH Site Prep, etc. Signature of Applicant 17' pate ' CATEGORY: REV CODE FEE ' ,. CATEGORY: REV CODE FEE ©SUBSURFACE DISPOSAL 1238 ' $45.00. ❑ SITE EVALUATION UPON REQUEST 7349 $42.00 ❑ MULTIPLE PARCELS WITHIN SAME (NO PLOT PLAN) . LAND DIVISIONi riri ❑ SEWER/SEPTIC VERIFICATION 7348 $11.00 a. 1 st 4 Parcels (Each) A`�- 1238 $45.00 ,1. �' . (Less than 1 year) t s b. Each Parcel after 4; 7344 �' $16.00 ❑ PRELIMINARY ELECTIVE f 7352 $45.00 ❑ Rereview (2nd review same parcel)'. 7344 $16.00'' EVALUATION (Attach DOH SAN 53)' ❑ Site Evaluation in Conjunction with 1 _ ❑ HOLDING TANK- , 7351 $45.00 Critical Area a 7348 "$86.00 ❑ ALTERNATIVE/EXPERIMENTAL 7345 $13200 ❑ Site Evaluation Lot Less than ,i ',v SYSTEM F 10,000 Sq. Ft. 7347. $86.00 } • INITIAL DATE Holding Tank Agreements Completed CI Yes W No :. �.O CertfflcaUon of Existing, S.D. System Required ❑Yes i.I �0 WQCB Clearance required. (Attach Form - ' ❑ Yes • Qo'N' o ' [ DOH SAN 007, Santa Ana Region Only) Soils Percolation Report Required. r ❑ Yes. ❑ow Special Feasibility Boring Report Required. ❑ Yes j Detailed Contour Plot Plans Required (1,to 5 R interval) ❑ Yes 121,No/;, ," - r�• r µ Outer �* ❑ Yes l Staff Specialist Lot Inspection Required ❑ Yes E' No t Lot Inspection Date Soils boring report by 4 Pngect # Data , Soils Map Page i ° 1 SON Type �" . Approved by N ' No. of Systems Type t# System(s) No. Dwelling Units j) (1) Septic Tank Soil Rate `r- _ Grease/Sand ❑ Holding Tank ❑ Existing flew ❑ Replaoentemt Bedroortra„Eizkrra U� `-Grease Ir`p Ai .4 M .. MAk.Gal V 17, cal- dn/ Gal (2)LeachLine Sq. Ft Sidewall allowance Insta1l*,. Lines) R long' R wide with teach Bed eqft. Bottom trench area ft rook/ sq. R min. - i ruck below drainlines or ch -o tom -roe"• per running ft "'�+n�,�_ + � r.. Leacltlines/bed special design for slope:`.A (3) Pit Diameter . , No: Pita Pit -Blow, Seepage Pit Total Depth Other: Applicable N/A Overburden factor r LTJ 6 Inlet (BI) (� - Max.Allo�wable Depth 15 ! t , No. 2 System A REMARKS: `J'�� Y't•- Q.•�-r✓i[=•t� •fJ71;�� ���-m stn.. �,.,�„r�_ '{• �• �/'Z-,O'er viii [ fi � n 2..c.. /L,LL .. ��� .C% -.J �.c'"[ T \`[�`-..7 �l�r.� 1.c-.•. / - l.Z=:s"t s�c'F�:.•�to.,( -.n This application i AFPRO,V�E,..D�Y�DENIED for the category checked in SECTION B `above, regarding the design of a subsurface disposal •system as indicated on the accompan lo't'°bj n using the requirements set forth in SECTION,:.G-above A building permit is necessary for the installation of the above -designed system. .No construction: is permitted in the required re.served1'100% expansion area. (1) Septic tank and sewer lines .niust be 50' minimum from any wells I L �,ad! S� y""' t.'. • ; - L ` 2) Leach lines must be' 1l)0' minimum from any wells, includin expansion are��j� ( r4 g s s. _s�taiu�fc[ (3 Seepage must be .150' minimum from including pits any wells expans�on area , a ' I e 5o c•<- . X.�s s. a� %� :. r-11 Signature of Health Official • A / Date RECEIPT NO. � !,i Issued By -� K f Date ,5/r5'3 A'• DISTRICT: ❑ Riverside, O Indio O AHemet ' q Perris 1 Rancho Calif. 'N,-❑ Blythe DOH SAN 122 (Rev, 5%88) DISTRIBUTION: WHITE - Office file .;!-YELLOW - Applicant PINK - Bldg. Dept GOLDENROD Plans/Records 01/31/90 16:20 a 619 724 8639 1st FIDELITY 04 i �,• i' .�'(r i.%1.r. ';'fG " ..;;;:??`iC'�Oj'rE'bcTrY:i�A�fEAQISTFit�iT . t �' ! : i`. ', >�: • Od '� �': Recelved From! Q � 1 A h u \ �i (C'{ (I ate 1 1 1 8 Address:. YACcounl No. (9 6`, ` �� 1 y' V Lots) J s "r ' 25 - Tract i: '2 $q • V rJ G.A. Code v '•I U V 7 Meter(a) _ j ;r u • l `i `C� S U o o �. O Back(low(s) LJ house Lateral(s) 4 u Detector Check(&) u M6t$rSuronarge. Sanitattoncapacity charpe ❑ W.S.B.F.C. O Temporary Construction Motor, L:I Turn on,Chargo• _ ❑ Uncollected Account -Nemo ❑ InspectlonFee-Tract- Fes O Plan Check Flies Water 18owor - ° Tract - C1 Gond Payment - AD. -Bona Assmt .. 0 Customer Deposit U other TOTAL Remarks:° ❑Copy to: Cash _ Check Money Order 1-tel-qo .000 Yr�n C 0 4O • �. • - Water SeMce .. CYWD-136 ($1N) � r y�