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04110 (SFD). QUM& 4 04110 City( Zip I 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. ,f.{ l.+rt.-'� t-. t,.w•. �„-.....a•.M:-«-.'.!. _.'.....-f"`Y� 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 civil penalty of not more than five hundred dollars (5500). ❑ 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- 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.) ❑ 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. In Company O 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 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. j 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. k b • 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 I 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 5timated Valuation BY: Minimum Setback Distances: P.O. BOX 1504 Front Setback from Center Line Building78-105 Address CALLE ESTADO 54-840 Avenida .Dila; .. LA QUINTA, CALIFORNIA 92253.. . $250 * 00 Owner Plan Chk. Bal. Side Setback from Property Line w Const. :367 . VU Mech. Issued by: jib . UU Electrical 112.7-1 BUILDING: TYPE CONST. OCC. GRP: Mailing 105 . Ute S.M.I. 5.44 - Address Box 1499 20 * UU A.P. Number 774-291-005 City Zip Tel. i `IUti • 53 Pain. Borings; 1 92263 Legal Description Contractor Mason Enterprises Project Description+F+�+ , . _ . Address TOTALi�S�EY•:►% » REMARKS Same qMw City Zip Tel. State Lic. City & Classif. 498210 Lic. # 932 Sq.,Ft. 1356 No. No. Dw. Size Stories ` Units Arch., Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City( Zip I 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. ,f.{ l.+rt.-'� t-. t,.w•. �„-.....a•.M:-«-.'.!. _.'.....-f"`Y� 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 civil penalty of not more than five hundred dollars (5500). ❑ 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- 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.) ❑ 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. In Company O 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 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. j 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. k b • 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 I 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 5timated Valuation BY: Minimum Setback Distances: PERMIT Front Setback from Center Line AMOUNT Plan Chk. Dep. $250 * 00 Side Street Setback from Center Line Plan Chk. Bal. Side Setback from Property Line 6 `J . to 4 Const. :367 . VU Mech. Issued by: jib . UU Electrical 112.7-1 Plumbing r 105 . Ute S.M.I. 5.44 - Grading 20 * UU Driveway Enc. 20.100 Infrastructure i `IUti • 53 it TOTALi�S�EY•:►% REMARKS >`;,�'...�t;4±:J'ff•' a'YF�.�ir1C� x'- �wi�•Ih.:►� �„+ ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATEINSPECCT�OR Issued by: Date Permit Validated by: Validation: e � r ' WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING_ , GOLDENROD -,ASSESSOR'S OFFICE, HARD COPY - FILE x'- . 's'v..-_ ...• ...,-.! ��.-. M:i,r^_� -r `"� ` _ .e•e`_. .cw----.,.e2 i._..:.._ > ._-::%tt. r....._:...-*. .-.t+.....,..�..� .. . �z,, ... _:_ __ .. _. ..... -- CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING,, FEES IST FL SO FT (1 S UNITS SLAB GRADE ROUGH PLUMB BONDING YARD SPKLR SYSTEM 2ND FL SO FT, q FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR SO FT. at GAS (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR SO. FT. a POLE �j L VVV y GROUT DRAINAGE PIPING CAR P. SO FT. (d FINAL INSP. BOND BEAM WATER SYSTEM DRINKING FOUNTAIN WALL SO. FT. rd -$ LUMBER GR. FINAL INSP. / F AMING _ /_ URINAL SO. FT. td ESTIMATED CONSTRUCTION VALUATION S REMARKS: 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(AUTOYDISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED SPARK ARRESTOR - LAUNDRYTRAY AIR HANDLING UNIT CFM GAR. FIREWALL 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 FINISH GRADING SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID 1'A c SEWAGE DISPOSAL SO.FT.GAR @ 3/,c HOUSE SEWER FENCE FINAL GAS PIPING PERMIT FEE INSPECTOR'S SIGNATURESIINITIALS PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB FEE STRUCTURE PLUMBING . i ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PL ING 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.IEOUIP. REINF. STEEL GAS (FINAL)1rEMP. POLE �j L VVV y GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ -$ LUMBER GR. FINAL INSP. / F AMING _ /_ FINAL INSP. ROOFINGv 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 an Z O F_ U W W. Z O F_ U W U) U) Y Cr Q W Cr Z:'4 tr"0 W rn SCOUNTY OF RIVERSIDE, DEPARTMENT OF HEALTH 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 required on the attached check list. A non-refundable filing fee of S40 is required when the application is submitted. Check must be made payable to the County of Riverside. Building Dep jment A li, tion Lo.�° Nam (Owner. AgContractor. Etc) 0 n Maihn Address p. 0 �n4 City 1 i s Slate /� (l nom, Zip Code 2, Telephone 'Job ropeay Add ss L .foearummM� 'Legal Description of Property (Lot. PM, TR) 8 O /'1 1/�' N; �L� z, >�'�°-- c t Al*,— D It Z 0 -;,-7 7 ' Assessor s Parcel No .' afar Agenc �Nin ,r.�'t'�% - ' Use of Perm n� U r"^''�5RPiang Case a_ - • . .'�''-s' ` ,; Lol Sze fY +� {' 7 /00S-_/ F ..�GFiL6%^• �•.. �nrgk �.r.•rz•j SFD. MH Site Preparation Etc — � �i _��T•�'��'i �G /:%(J/ i, Signature of APph nt _--_--------_- Dates-- ' The above information must be verified from Building Application l., STAFF USE — DO NOT WHITE BELOW THIS LINE r InitialDate Certification of Existing S.D. System required. ❑ Yes WOCB Clearance required. ❑ Yes E21 1p+ Soils feasibility report required. ❑ Yes 12 ve-'e, Special feasibility boring report required. ❑ Yes /// Detailed contour plot plans required. ❑ Yes Staff Specialist approval required. ❑ Yes No Lot Ir; pection Date— Soils/boring report by _Project q Date r � -s— Soils Map Page % �? Soil Type—=--� ---Approved by—------------ Date�'�� Type of System: C/ No. of Bedrooms I (1) Septic Tank Soil Rate Reequired EJ Existing © New ❑ Additional. EJ Replacement , Y P t �j! /Gals.� / (2) Leach line sq. ft. Sidewall allowance Sq. Ft. Installs., Line(s)--Ft. Long. U evide inches Leach ed Sq. F (Bottom . ench area) ___—ft, rock/_—_... _ —.._—Ft with min. fofkb`o�ttom� -. per running ft. V N?A rock below drain lines area=`"�,,• Leach lines/bed-special design for slope: ApplicableO (3) Pit Diameter ,✓ No. Pits Pit BI / Seepage Pit total depth_ � _._ N/A___ �(� ✓ ® jf f Max. allowable depth---- D--____ Oyv�-erburden factor_____ ����*`t/..i'% t,.r, �i� .f /Y,+4�fi l�r d %�Y�t��.t...s r.. Gam•-�.�. i r This application is a proved eniednfor the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements forth for installation set in Section Bmove. A building permit isn Vessary the of the above -designed system. ti0 Septic tank and sewer lines must be 50' from any wells `' /0&.��" * ��� l I C J%"✓�. ,�� rw � .� (2) Leach lines must be 100' min. from any wells includingexpani fon+area "A" (3) Seepage pits must be 150' min. from any wells including expansion area^�,ff7 ♦. /{ T 'y� • i" V`�a "� ^.'-• '+�.+-7 • /' l t I / -I __•.C.r-.. , SG_ V"�r- j'ir>" . / r Signature of Heauh official X y 1 � f' �Da)e .,�,--r•L�i%i.�rr.c ,la•!'S—t•. RECEIPT NO. 36116 Issued by_.— SJ69�._ District: ❑ Riverside 'Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File • DOH -SAN -122 (Rev. 4/88) i OF q� J• til � Q\ AI O I t7 V DATE C'�/ % k orFIC.E OF AGRICULTURAL COMMISSIONER AN D WEIGHTS & MEASURES 49-613 Ilwy 86, Suite B-12 'Coachella, CA 92236 619-342-8291 DEVELOPER'S NAME: IMg� ADDRESS: �ILl 9 E. LEON SPAUGY CO%Im '10`ER MMES 0 WALLACE ASS;S,A%t rON>uSSiO`ER CLEMENT BENVENISTE SEALER CASE NO.4N93��C)6z1 TELEPHONE: qe) Dear Developer: After reviewing your landscaping platis,'all plant material listed is not in violation of quarantine laws governing the Coachella Valley. If substitutions do occur and they differ frau plaint material listed, this office must be notified immediately. Thank you for protecting and preserving the Coachella Valley's pest -free environment. ,n Agricultural Cq:t sioner's Office cc: Indio and Riverside Office Tit�J of 14a Quiuta �,�Ui��ili� �1Ti� ��l�P��1 .1yIbY£4i11Tt This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building! Code certifying that at the time of issuance this structure was in compliance with the various. ordinances of the City regulating building construction or use. For the following: BUILDING ADDRESS 54-840 Diaz Use Classification Single Family Dwelling Bldg. Permit No. 04110 Group R3 Type Construction VN Fre Zone Use Zone SR. Owner of Building Joe Corrall Address P. 0. Box 1499 City Palm S rings By. Richard Kirkland Dote; March 3. 1989 Building Official P08T IN A CON61PICU0U9 PLACE i