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003772 (SFD)4 P.O. BOX 1504 No, 003772 Building 78-105 CALLE ESTADO Address 54"065 Diaz LA QUINTA, CALIFORNIA 92253 Owner Mailing - E'oaC�1ei.1a Vallev mid Co. BUILDING: -TYPE CONST. OCC. GRP. - - - Address 247 E. `Pahquit2 tray #2 _ A.P..Number '7'74-194--.025 CityZip Tel. . lm S�r� S - - 922612 322--1020 Legal Description Contractor Project Description * .�'' ..D. Address Casr�r.. City Zip Tela State Lic. City & Classif: 387934 Lic. # 895. , . , Sq. Ft. 1410 No. No. Dw. Size Stories - Units Arch., Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State 4281 , sarailue, Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section T 7000) of Division 3//of the Business and Professions Code, and myslidbrise is in full force and effect. L . J: , - � s } % - _ -5�-y SIGNATURE 7AV DATE y OWNER -BUILDER DECLARATION I here4v/affirm that I am exempt from the Contractors License Law for the following Estimated Valuation reason;'(Sec. 7031.5,8usiness and Professions Code: Any city or 'county which requires a All -A r _513 5 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 thatheis licensed pursuant to PERMIT "AMOUNT the provisions of the Contractor's License Law, Chapter9 (commencing with Section 7000) of ' Division 3 of the Business and Piofessions Code, or that. he is exempt therefrom, and thebasis p Nh . - - for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit Plan Chk. DB S° 0 subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ' ❑ I, as owner of the property, or mPlan Chk. Bal. y employees with wages as their sole compensation, will S 39 a 1� do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and COr1St.� V© Professions Code: The Contractor's License Law does not apply to an owner of property who • builds or improves thereon and who does such work himself or through his own employees, , provided that such improvements are not intended or'offered for sale. If, however, the building MBCh..33.00 or improvement is sold within one year or completion, the owner -builder will have the burden Electrical l y1� of proving that he did not build or improve for the purpose of sale.). . ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 1055 .00 struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for S.M.I. „6 such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ I am exempt under Sec. B. & P.C..for this reason Grading 20.00 Driveway Enc. 20.00 Date Owner Infrastructure 1.69$•$6 WORKERS' COMPENSATION DECLARATION Ihereby 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. . ' c Company ' O Copy is filed with the city. ❑ Certified copy is hereby furnished. _ TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS .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 tha 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 ZONE: BY: subject to the Workers' Compensation provisions of the Labor Code, you must forthwith -Minimum Setback Distances: comply with such provisions or this permit shall be deemed revoked. ' Front Setback from Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY.SIdB StrBet Setback from Center Line 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.) - Side Setback from Property.Llne ' Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and'is subject to FINAL DATE INSPECTOR expiration it work thereunder is suspended for 180 days. 4/4/88 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-. mentioned property for inspection purposes. Validated by: Signature of applicant Date Mailing Address Validation: City, Stale, Zip HARD COPYI T CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ® $ UNITS n ROUGH PLLUUMB. — �� BONDING HEATING (ROUGH) STORAGE TANK YARD SPKLR SYSTEM 2ND FL. SQ. FT. p DUCT WORK ROCK STORAGE FOUND. REINF. MOBILEKOME SVC. BAR SINK POR. SO. FT. ® REINF. STEEL GAS (FINAL) TEMP. POLE GAR. SO. FT. ® POWER OUTLET ROOF DRAINS WATER HEATER SERVICE FINAL INSP. DRAINAGE PIPING CAR P. SQ. FT. WATER SYSTEM GRADING cu. yd. $ plus x$ WALL SO. FT. ® LUMBER GR. DRINKING FOUNTAIN SQ. FT. ® FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation VENTILATION FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM I IKITCHEN 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 ® 11/4 c SEWAGE DISPOSAL rr�� �Lj&NAL INSPECTION �.../G SQ.FT.GAR ® 3/ac 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 V SETBACK V—/ GROUND PL MBI UNDERGROUND A.C. UNIT COLL. AREA 2 IS LAB GRADE L ,Z n ROUGH PLLUUMB. — �� BONDING HEATING (ROUGH) STORAGE TANK FORMS SEW0ac!R PT /;"OUGH WIRINGS3�go DUCT WORK ROCK STORAGE FOUND. REINF. GAS (RO GH) 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. V/LFRAMING S ��j- FOP-- FINAL INSP. ROOFING 17 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING,,ko/w MESH INSULATION/SOUND, FINISH GRADING rr�� �Lj&NAL INSPECTION �.../G CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS. GARDEN WALL FINAL Z O 1— U LU U) m Z O H U w rn U) Y Q W (r X COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM — — 0 Applicant: Submit this form with four copies of a scaled plot plan (1.20 scale) drawn to County specifications required 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 1. "I if�f% lJ/TZ Lira5� 57Wlrc.:T/r,A) 0 City ,. , State Zip Code Telephone I.;,'?z _ is 7— 'Job Property Address 'Job 'City or. Community 'Legal Description of Property. (Lot. PM. TR) ,5_111 r G .S" - ) / A Z ti /4 4:: U /tid7-A_1 Gr,T ,3 (L� , S"G &iL) ,7 .241 'Assessor's Parcel No Well Water Agency or Well Lot Size U4 ACAA,(1.4 ' y Use of Permit Planning Case # ?,(/—©/"� �,ew���r — /G13 MH Site Preparation Etc (� l Sionature of Appy - Date *The above information must be verified from Building Application STAFF USE — DO NOT WRITE BELPW THIS LINE Initial Date Certification of Existing S.D. System required. ❑ Yes ❑ No WOCB Clearance required. ❑ Yes © No Soils feasibility report required. ❑ Yes LTJ No Special feasibility boring report required. ❑ Yes L9 No Detailed contour plot plans required. ❑ Yes No ,®,� Staff Specialist approval required. El Yes LJ No Lot Inspection Date Soils/boring report by Project # Date t - Soils Map Page Soil Type Approved by Date Type of System: No. of Bedrooms (1) Septic Tank Soil Rate Required ❑ Existing 2"'New ❑ Additional ❑ Replacement Gals. .� (2) Leach line sq. ft. Sicewall allowance Install Lines) Ft. Long, Leach bed Sq. (Bottom trench area) ft. rock/ Sq. Ft. Ft. wide with min. inches Ft. of bottom rr per running ft. ,❑ N/A 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 ❑ 5' 2'6' Max. allowable depth This application is'approved/denied for the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements set forth in Section B above. A building permit is necessary for the installation of the above -designed system. (ty Septic tank and sewer lines must be 50' from any wells (2) Leach lines must be 100' min. from any wells including expansion area (3) Seepage pits must be 150' min. from any wells including expansion area Signature of Health Official Date RECEIPT NO. District: ❑ Riverside E Indio Distribution: WHITE—Office file DOH SAN 122 (Rev 8187) Issued by Date r' ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File ff: OF R O►FICE OF E. LEON SPAUGY AMIM15310`ER AGRICULTURAL UftA� Otit(�115510NER TAMES O WALLACE o) ASS;S;A.%f CON?115SIONEP. ' ^'S CLEMENT BENVENISTE 1VEIGf115 £� NiE�15U(ZES SEALER ke - 49-613 Hwy 86, Suite B-12 ��,,,,_•''� Coachella, CA 92236 q Y o, s9 619-342-8291 DATE 3 CASE NO. I� �fl S 03 2 9 A DEVELOPER'S NAME:104— ADDRESS: 2 •y 7 . L! • i ,,, 2-- TELFEPF LONE : Dear Developer: 322--/02 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 notified ilnnediately. Thank you for protecting and preserving the Coachella Valley's pest -free environment. Agricultural Culmis per's Office cc: Indio and Riverside Office