Loading...
04140 (SFD)l 4 04140, - P.O. BOX 1504 Building 78-105 CALLE ESTADO Address 46 -235 -Jefferson LA QUINTA, CALIFORNIA 92253 Owner - FalcrAnn T. POPACk Mailing BUILDING: -TYPE CONST. OCC. GRP. Address 46-175 Jeffewson �•'« .., . A.P. Number City Zip Tel. La 92253 - . ` Legal Description Contractor Project Description rSingle FamilyDwelling Aririracc ' Zip ITel. State Lic. City & Classif. I Lic. # Arcn., tngr., Designer AddressTel. 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 effect. SIGNATURE GATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following 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 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 civil penalty of not more than five hundred dollars (E500). ❑ I, as owner of; the pfopgi•(y, 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:, Th9 Contractor's License Law does not apply to an owner of property who builds or+_improvesAhereoh; and who does such work himself or through his own employees, provided that'. suoh;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.) ❑ 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 town 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.) O 1 am exempt under Sec. B. 8 P.C. for this reason Driveway Enc. 20.00 Date owner Infrastructure 1-t2-36.55 rInge--to 1darct' V00 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 ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars (E100) valuation or less.) I 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: If, 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' 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.) Lender's Name Lender's Address 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. 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 REMARKS AtNewli to 0818 06-29-80 13 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 V $22 OF . Issued by: —Date—Permit OFA. ) Validated by: Validation: . I WHITE,- FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE Sq. Ft. Size 1922 No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ 232' of 5' block Wall Estimated Valuation $1041l,438 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. {f ILA5 .t$4 Const. 44b.:5U Mech. 3b I QU Electrical 80.26 Plumbing 105,100 S. M.I. 7.32 Grading 20.00 Driveway Enc. 20.00 Date owner Infrastructure 1-t2-36.55 rInge--to 1darct' V00 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 ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars (E100) valuation or less.) I 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: If, 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' 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.) Lender's Name Lender's Address 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. 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 REMARKS AtNewli to 0818 06-29-80 13 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 V $22 OF . Issued by: —Date—Permit OFA. ) Validated by: Validation: . I WHITE,- FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES tS1 FL SO FT (p $ UNITS UGH PLUM �'�//�� BONDING HEATING (RO'JGH) STORAGE TANK YARD SPKLR SYSTEM 2ND FL SO F1. dt DUCT WORK ROCKSTORAGE FOUND. REINF. MOBILEHOME SVC BAR SINK POR SO FT. a REINF. STEEL GAS (FINAL) TEMP. POLE GAR SO. FT. 0 POWER OUTLET ROOF DRAINS WATER HEATER SERVICE FINAL INSP. DRAINAGE PIPING CAR P. SO FT. 6 WATER SYSTEM GRADING cu. yd. $ plus x$ WALL SO FT. V LUMBER GR. DRINKING FOUNTAIN SO FT ra FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION S 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(AUTOXDISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEM/PERM 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 g 1 V. c SEWAGE DISPOSAL FINAL INSPECTION G� SO.FT.GAR rg 3/.c 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 8 AIR COND. SOLAR SETBACK A 12XIROUND PLUMBIC UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE UGH PLUM �'�//�� BONDING HEATING (RO'JGH) STORAGE TANK FORMS SEWER OR SEPTIC TANKOUGH WIRINGY—//— DUCT WORK ROCKSTORAGE 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$ =S LUMBER GR. FINAL INSP A M I N G //_F -e' FINAL INSP. OOFING 7� o D REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL THING Z. �0 MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION G� CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL 4 P.O. BOX 1504 / 78-105 CALLE ESTADO Addrress L/,/ - Z ?J U L f �E�•Sr'/�J LA QUINTA, CALIFORNIA 92253 Owner /_/iG1`n/,-- -7` moi' 4 1 f.", Mailing Addressr *-'• /% City Zip Tel. '�� Contractor !.J Ntt:_ ty IZip State Lic.I City & Classif. Lic. # Designer ✓) %l� Address I Tel. CityI Zip I State Lic. # LICENSED CONTRACTOR'S DECLARATION - I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 70f00)ectof Division 3 of the Business and Professions Code, and my license is in full force and ' ef. 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,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 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 civilpenalty of not more than five 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 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.) I, as owner of the property, am exclusively contracting with licensed contractors to con- s rust 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.) O 1 am exempt under Sec. B. & P.C. for this reason Date/ h 1P01 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 , ❑ 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.) I certify that in the performance of thq 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: If, alter 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 �*4n/�" - z- ?111f' /f Lender's Address n`r..4 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 purpose/s. Signature of applicant (2) 1 Date 1/- .Mailing Address //%f City, State, Zip r `/ ✓ �` �. , , _ BUILDING DIVISION APPLICATION ONLY BUILDING: TYPE CONST.OCC. GRP. �f A.P. Number /� j ,/ Legal Description Project Description �. Sq. Ft. Size i 'I ? Zr- No. No. Dw. Stories Units New Q Add ❑ Alter ❑ Repair ❑ Demolition ❑ of Estimated Valuation ♦ o PERMIT AMOUNT Plan Chk. Dep. .. Plan Chk. Bal. 1 7-S' , Const. L( if ' R Mech. s Oa Electrical e Plumbing /05--00 S.M.I.• Z -3 'Z Grading �� _ tl Driveway Enc. r . Infrastructure 1 v.: ' f.^. ; ;;,�y1'c:S. �1'iiT(•IN i? ✓Zr� V S� TOTAL 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 Permit Validated by: Validation: CONSTRUCTION ESTIMATE GROUND PLUMBING UNDERGROUND NO. ELECTRICAL FEES NO. PLUMBING FEES (� �y _ �/ �1 $-1 ROUGH PLUMB. BONDING UNITS STORAGE TANK FORMS 1ST FL. ` SQ. FT. a 190 ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) 2ND FL. SQ. FT. HEATING (FINAL) OTHER APP./EQUIP. REINF. STEEL GAS (FINAL) YARD SPKLR SYSTEM POR. SQ. FT. ® GROUT MOBILEHOME SVC. SERVICE BAR SINK GAR. SQ. FT. ® BOND BEAM WATER SYSTEM POWER OUTLET GRADING cu. yd. $ plus x$ ROOF DRAINS CAR P. � SQ. FT. ® 3 FINAL INSP. FRAMING FINAL INSP. DRAINAGE PIPING WALL Z SO. FT. ® �• a REMARKS: DRINKING FOUNTAIN SQ. FT. ® URINAL ESTIMATED CONSTRUCTION VALUATION $ (V ' i —1 ?j� (� WATER PIPING NOTE: Not to be used as property tax valuation GAR. FIREWALL FLOOR DRAIN MECHANICAL FEES LATHING MESH WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED CERT. OCC. LAUNDRYTRAY AIR HANDLING UNIT CFM INSPECTOR'S SIGNATURESIINITIALS KITCHEN SINK ABSORPTION SYSTEM, B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE,TEMIPERM l LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT I SHOWER BOILER B.T.U. SQ. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ec HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE FEE ELECT. FEES SMI FEE PLUMB. FEE TNST. G !N STRUCTURE PLUMBING ELECTRICAL HEATING & AIR CON D. SOLAR SETBACK GROUND PLUMBING 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 APP./EQUIP. 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 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL Desert Sands Unified School District CERTIFICATION OF PAYMENT OF NOTICE: THIS yJCUNIENTQ0e IL ITY FEES BE DUPLICATED. TO: City of La Quinta DATE: 0 0�1 Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 This is to cdertify that.Y�/ o,,- i - developer of which is located•at3 within this District, has paid sc 1 facility fees imposed pursu nt to the authorit generated by Government C de ec ion 53080, in co ering'a total of s are feet of ( )Nsiential or ( ) industrial/comme cial development and that building permits for this footage in this development may no be issued by your jurisdiction. /D/ or ESERT SANDS•UNIF ED SCHOOL DISTRICT White - Building Department • Yellow - Facilities Planning • Pink - Accounting •. Gold - Developer (10)-37 Z O H U W U) Z O FZ U W U) 7rRC W Sn COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM - - Applicant: Submit this form with four copies of a scaled p;ot plan (1-20 scale) drawn to County specifications required on the attached check list. A non-refundable filing fee of $40 is required whsn the application is submitted. Check must be made payable to the County of Riverside. G Building Department Application Log # Name (Owner. Agent. Contractor. Etc.) Mailing Address 71 City State2 p Code Telephone 'Job Property Address t Cdy o comnn nny— 1 'Legal Description of Property. (Lot. PM. TR) 'Assessor's Parcel No Water Agency a.� X11= M ^, J% Use of Permit Ww', r ✓/fit l✓'T Case M Lot Sze nn,ng X 11 _ SF D. MH Site Preparation Elc. Signature of i -M nI Date 'The above info imation must be verified from Building Application IV STAFF USE — DO NOT WRITE BELOW THIS LINE Initial Date Certification Existing S.D. System ❑ Yes ® of required. .o �" A j WOCB Clearance required. ❑ Yes •L oeop Soils feasibility report required. ❑ Yes ��CI,,N�o�"' Special feasibility, boring report required. ❑ Yes L^TJ �No Detailed contour plot plans required. ❑ Yes 9� Staff Specialist approval required. ❑ Yes U No Lot Inspection Date f Soils/boring report /by r Project # Date r^ Soils Map Page �/ -ifl Soil Type b J Approved bw �� /` ,r.�/ - Date t/, - f 'Y1' Type of System: No. of Bedrooms (1) Septic Tank Soil Rate Required ❑ Existing ❑'New ❑ Additional ❑ Replacement Aft Gals.Deo,. (2) Le.ach line sq. ft. Sidewall allowance Install Line(s)-Ft. Long, Leach bed Sq. (Bottom ch area) ft. rock/ Sq. Ft. ., ft. CP -9/'A -Ft. w -e-With min. inches Ft: of bottom per running rock below drain lines area Leach lines/bed-special design for slope: (3) Pit Diameter No. Pits Pit BI Seepage Pit total depth -^-*' Applicable N/A Overburden factor° ![f Max. allowable depth -V. /J �'�i�..(._ x� ;.-�. r ., �'�� , .�' ,�,�'rf�.�-ct:�., �P�f_ �.�//n' �,��`-t'� /J•�/�.°ria%ti --.«�'C�. f I r`Y ✓^ t� ����-��.(�-' (.'-r /SV -4 ZP '.., 1.�1 1'"KrL " ,J•" /�"l�-✓..e. Ac Yf 7 Cl6l. G�l�r..l�f. )i�fwV'r ..A ;•�-% - .r'.ic? f, � /i: if �r^.�, r�<..•'�;,,�" �. d/ �_ r:�e , c.( �/� zr-�'' .s'.�'.OL�s!_ . . 1� .�a...^I'. � .C/". This application s�approved enied4or the deign of a subsuiace disposal system as indicated on the aecoMp-lnied plot plan using'the requirements .set forth in Section a ove. A building permit isOiInecessary for the installation of the above -designed system. (1 Septic tank and sewer lines must be 50', from any wells �: IV rs •. E-` r cJ �,G� •G+�� 1 ,fes' <.�. G (2) Leach lines must be 100' min. from any wells including expansion area area./ (3 Seepage pits must be 150' min. from any w/ellslinclJding ex/pansion /(I .. a64;P7/I i ' {y. ! el• ,/` Signature of Health Official r - 9/xrbateF,,,,•�•��, _ / RECEIPT NO._ Issued by Date 11,9 -' Lo - 60? District: ❑ Riverside 2 lndio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe Distribution: WHITE -Office file YELLOW -Applicant PINK -Bldg. Dept. GOLDENROD -Pending File DOH SAN 122 (Rev 8187) h IV :baa., Z O U W U) Tel Z O U W U) v� W U) y.(Y' 'r7:K lis 'COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION 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 specifications rquired on the attached check list. A non-refundable filing fee of $40 is required when the application is submitted. Check must be made payable to the County of Riverside. Building Department Application Log # Name (Owner. Agent. Contractor. Etc.) Mailing Address _ l�GC�E / . �- e �� • / �� city Stale Zip Code � Telephone 'Job Properly Address I Ciiy o Q.,,n;fv— 'Legal Description of Properly. (Lot. PM. TR) J. 2 if a 'Assessor's Parcel No; 'afer-Agency -_ :, Lot Size - - C y w (fir atly nn�ng Case M Use of Pest`)/ �f%/ ' - Prepton (�. Flo x 0 0 SFD. MH S le Etc�'i/ S-griffiture of rnDate *The above information must be verified from Building Application STAFF USE — DO NOT WRITE BELOW THIS LINE dial Date // Certification of Existing S.D. System required. ❑ Yes061�5� WQCB Clearance required. 1:1Yes X Soils feasibility report required. El YesrN9,0# Special feasibility boring report required. ❑ Yes No Detailed contour plot plans required. ❑ Yes Staff Specialist approval required. ❑ Yes No Lot Inspection Date f Soils/boring repo y Project # Date Soils Map Page Soil Type�ILCtApproved by 4.4 Z& Date__...,/'2 Type of System: No. of Bedrooms (1) Septic TankSoil Rate Required E3 Existing l `New ElAdditional ❑ Replacement 3'eK4- I' —Gals. J D Q (2) L ch line sq. ft. (Bottom ch area) Sidewall allowance ft. rock/ Sq. Ft. Install Line(s)—Ft. Long, Ft. wi a min. inches Leach bed Sq. Ft. of bottom per running ft. /A rock below drain lines area f Leach lines/bed-special design for slope: (3) Pit Diameter / No. Pits Pit BI Seepage Pit total depthApp N A licable Overburden factor L—►J'fif I Max. allowable depth (� (1 - • � � /1 N it ", d(K. ��-c, �. / c /ta mle This applicati0 prove r the ign of a subsurface dis at system as indicated on the corn nied plot p n usinehe re uire ents set forth in S fon a ove. A building permit is nem ssary for the ingtallation of the above designed system. (1 Septic tank and sewer lines must be 50',from any wells � /0 (2) Leach lines must be 100' min. from any wells including expan ion a� 9 Seepage pits must be 150' min. from anywels ' eluding expansion area,// �e Signature of Health Official / .a RECEIPT NO._ (0 Issued by s�� V �/ Date —. ,d" ti District: ❑ Riverside ndio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File DOH SAN 122 (Rev 8187) 1 Order No' Escrow No. TRMS OAL TMA Co. q, Loan Not WHEN RECORDED MAIL TO: ® Eugene T. Feack Carol A. Feack MAIL TAX STATEMENTS TO: DOCUMENTARY TRANSFER TAX $...44.00 same ' as above X Computed on the consideration or value of property conveyed; OR ...... Computed on the consideration or value less liens or encumbrances remaining at time of sale. T�a�-MaAL. Co. Signature of Declarant or Agent determining tax —Firm Name GRANT DEED FOR A'VALUABLE CONSIDERATION, receipt of which is hereby acknowledged C.W. CURL, a married man and LOLA M. CURL, his wife hereby GRANT(S) to EUGENE T. FEACK and CAROL A. FEACK, Husband and Wife As Joint Tenants. the real property in the City of County of Riverside State of California, described as N OLot 24 of Tract 2190 as per map recorded in Book 41, pages 55-57 of Maps, N in the office of the county recorder of said county. Dated April 18, 1988 STATE OFXXN0W9M OREGON )ss. COUNTY OF_jON I On ARK; 1 2 , 19�R before me, the undersigned, a Notary Public in and for said State, per- sonallyappeared C.W, CUrl and3 Tnla M Oirl personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same. WITNESS y ha d an I. CU c::: TC �.CU�RL� Signature 2 , (This area for official notarial seal) Ccnanission Expires: 7/2 1002 (6/62) MAIL TAX STATEMENTS AS DIRECTED ABOVE ® me 1C CO Cr f3 4 Cn Z y C, ` cz a a W In A 1L oar a+�� fl61 o w � E ABOVE THIS LINE FnR aFrnanFa1c ileo' DOCUMENTARY TRANSFER TAX $...44.00 same ' as above X Computed on the consideration or value of property conveyed; OR ...... Computed on the consideration or value less liens or encumbrances remaining at time of sale. T�a�-MaAL. Co. Signature of Declarant or Agent determining tax —Firm Name GRANT DEED FOR A'VALUABLE CONSIDERATION, receipt of which is hereby acknowledged C.W. CURL, a married man and LOLA M. CURL, his wife hereby GRANT(S) to EUGENE T. FEACK and CAROL A. FEACK, Husband and Wife As Joint Tenants. the real property in the City of County of Riverside State of California, described as N OLot 24 of Tract 2190 as per map recorded in Book 41, pages 55-57 of Maps, N in the office of the county recorder of said county. Dated April 18, 1988 STATE OFXXN0W9M OREGON )ss. COUNTY OF_jON I On ARK; 1 2 , 19�R before me, the undersigned, a Notary Public in and for said State, per- sonallyappeared C.W, CUrl and3 Tnla M Oirl personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same. WITNESS y ha d an I. CU c::: TC �.CU�RL� Signature 2 , (This area for official notarial seal) Ccnanission Expires: 7/2 1002 (6/62) MAIL TAX STATEMENTS AS DIRECTED ABOVE