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04693 (SFD)Building Address 54-905 Diaz Owner Coachella Val T'ani' P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Mailing Address 247 Z. Tahanitz Wav 42 City Zip Palm Springs . 92262 3�2»1Q2Q Contractor Marr Construction Address Same City lZip ITel. State Lia 387934 & Classif. Arch., Engr., Designer Address WILDING: TYPE CONST. t.P. Number 774-266-021 .egal Description Iroject Description • • • City Lic. #g Sq. Ft. 40 No. Size Stori 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 7000) of Division 3,of the Business and Professions Code, and my license is in full force and effect �.. C%{ .�1. a«c+�'1'CfJ;, 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 ($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 t 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.) O 1 am exempt under Sec. B. & P.C. for this reason ='-' zits Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent ,)oself•insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. -(Sec. 3800, Labor Code.) Policy No. Company ,-- A—if ❑ 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. 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. New ❑ Add ❑ Alter ❑ I 04693 OCC. GRP. No. Dw. Units Repair ❑ Demolition ❑ 4301 Garacte 170* 6' wood fence Estimated Valuation 475 * 505 PERMIT AMOUNT Plan Chk. Dep. V25uouo Plan Chk. Bal. • % Const. f b . tlly Mech. 13 001 Electrical '14. V/ Plumbing 105 • V V S.M.I. `J .3b Grading 20.00 Driveway Enc. .20.00 Infrastructure TOTALat: t nEt • fit% i �c '/ <. (� REMARKS #1051WIV,40 G?3 rFar ti)�ii9-F1#T±'Sg ''f, i� ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street 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 Line Lender's Name Lender's Address p This Is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE NSCT 11 E �Y�R expiration if work thereunder is suspended for 180 days. 10 1 Fd 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, State, Zip WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE CONSTRUCTION ESTTMATL NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SO FT (a $ UNITS LAB GRADE — Z. ROUGH PLUMB BONDING YARD SPKLR SYSTEM 2ND FL SO FT. R FORMS C EWER OR SEPT,/IT v ROUGH WIRING MOBILEHOME SVC. BAR SINK POR SO FT at GAS (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR SO. FT. iR LIEMP. POLE GROUT DRAINAGE PIPING CARP. SO FT. it FINAL INSP. WALL SO FT. rd WATER SYSTEM DRINKING FOUNTAIN GRADING cu. yd. $ plus x$ -$ URINAL SO. FT. (B FRAMING FINAL INSP. ESTIMATED CONSTRUCTION VALUATION S J v WATER PIPING NOTE, Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTONDISH) APPLIANCE DRYER FIREPLACE 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, TEMIPERM 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 @ 1'A c SEWAGE DISPOSAL SO.FT.GAR @ 3/4c HOUSE SEWER CERT. OCC. GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE [PL.K.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB FEE STRUCTURE PLUMBING ELECTRICAL HEATING 8 AIR COND. SOLAR SETBACKOUND PLUMBIN -� UNDERGROUND A.C. UNIT COLL. AREA LAB GRADE — Z. ROUGH PLUMB BONDING HEATING (ROUGH) STORAGE TANK FORMS C EWER OR SEPT,/IT v ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. REINF. STEEL GAS (FINAL) LIEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ -$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. J v REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL G LATHING IU -d -/ 'o U MESH ` C / INSULATIONISOUND - 'FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL ,y�_..,:o.-+-_7'i'.: i�'i%i�]^!il�•, _ o'�..X,:��•.;.r•...v+.s-'.,r +y`.• .: t.—R ^,�i;'�a.'�ys:' �.y,'�t1^ �'.�.�n-w.�;aw:�. .:. n.Qv+. +7yll"'�?;-. ,�..,N1e-i .., �—�;�w--.-.,.'.•^'�'�.�:vi�x�,.,r�venf�Z^C"F%rC?T'f�'�, COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH Assessors Parcel No. 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 checklist. 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. VERIFY ITEMS IN SECTION A FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG"* Agent, Contractor, Contact Person S A C'D1�s �r.L,? ia,� Phone 3Zz -le ap Address & Phone .2V7671411,0lir-z� ct/e$� �Z Owner Phone Mailing Address City State Zip Job Property d Legal Description Prop. (PM, Tract, Lot) 01;? t S R i c9 G s Z Z S'i'lo s L�ess 1-07'1 46 2 74- IVN/7 r,7 Lot Size r Water Agency w Use of Permit P/P, CU, etc.A u 01V"A Other ellirZiy AAH Sit/ a Prep, etc. Signature of Applicant l5ate CATEGORY: REV CODE FEE DE F2 CATEGORY: REV CODE Of SUBSURFACE DISPOSAL 1238 5.00 $42.00 ❑ SITE EVALUATIONUPON REQUEST � � ❑ MULTIPLE PARCELS WITHIN SAME (NO PLOT PLAN) LAND DIVISION ❑ SEWER/SEPTIC VERIFICATION 7348 $11.00 a. 1 st 4 Parcels (Each) 1238 $45.00 (Less than 1 year) b. Each Parcel after 4 , 7344 $16.00 ❑ PRELIMINARY ELECTIVE 7352 $45.00 ❑ Rereview (2nd review same parcel) 7344 $16.00 EVALUATION (Attach DOH SAN 53) ❑ Site Evaluation in Conjunction with ❑ HOLDING TANK 7351 $45.00 Critical Area 7346 $86.00 ❑ ALTERNATIVE/EXPERIMENTAL 7345 $132.00, ❑ Site Evaluation Lot Less than SYSTEM 10,000 Sq. Ft. 7347 $86.00 INITIAL DATE f �/ Y, Holding Tank Agreements Completed 11 Yes 2'NNo- / Certification of Existing S.D. System Required ❑ Yes WQCB Clearance required. (Attach Form ❑ Yes A No t DOH SAN 007, Santa Ana Region Only) X Soils Percolation Report Required. ❑ Yes�N Special Feasibility Boring Report Required. ❑ Yes No/� Detailed Contour Plot Plans Required (1 to 5 ft. interval) ❑ Yes6 Other ❑ Yes No Staff Specialist Lot Inspection Required ❑ Yes Z No Lot Inspection Date Soils boring report by Project # Date Soils Map Page Soil Type Approved byDateiv— • No. of Systems Typo f System(s) No. Dwelling Unitsd/J (1) Septic TankL;Soilte Grease/Sand ❑ Holding Tank ❑ Existing ❑Replacement3 Bedrooms, Fixturwwt ret i1 'Gre. s� a Intcp❑*New "�Gah p4 y N Gal (2) Leach Line Sq. Ft. Sidewall allowance It Install Line(s) ft. long ft wide with LeachBedsq. It t B0,t ranch area R rock/ sq. ft "^^ min. inches k,_below drainlines or of bottotmarea per running ft. l7 NA Leachlines/bed special design for slope: (3) Pit Diameter No. Pits Pit Below Seepage Pit Tgtal,Depth , Other. Applicable N/A li,� Overburden factor r Inlet (BI) / (�) Max. Allowable Depth No. 2 System REMARKS: ,! % l This application issAPPROVED > ENIED for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated on the accompanied p o pan, using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the above -designed system. No construction is permitted in the required reserved 100% expansion area. 10) Septic tank and sewer lines must be 50' minimum from any wells,.{ U '4--r - '{ A"- (),Leach lines must be 100' minimum from any wells, including expansion area u r z (3 Seepage pits must be 150' minimum from any wells, including expansion area �r Si nature of Health Official Dat i 41 RECEIPT NO. / /C{ / Issued By X�C� Date DISTRICT: ❑ Riverside, 0,.1 dio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept. GOLDENROD - Plans/Records o► offIr.E OF E. LEON SrAUGY AGRICULTURAL URAL COfMMISSIONER CO�rin5:10`.Eq J fl ) JAMES O WALLACE O J O IHV D ASSISTANT f,.)�1?ucclq�EP, "' WEIGHTS & MEASURES CLE?IE,V1 OE\VEIvISfE MAUR '-fib }•'��`' 49-613 Ilwy 86, Bulte 8-12 -- CA 92236 �►jqY"�%°�•'7 Coacltelln, o, 1 t►Q 619-342-8291 t DATE dc� . I I• t S � 77 CASE U) . DEVELOPER'S NAME: S T R R R C', ©A_1 s y- 2u e 7 -,Io L ADDRESS s 117 T;,d 1VQc( I r z W,4 V 2 PALM 59)eiAj& s c/I 9 7-24,2, TELUP110M 32 2 '- io z o Dear Developers .77,V _ .� _ m 7-6 After reviewing your landscaping plans, all plant material listed is riot in violation of quarantine laws govenrLig the Coachella Vailey. if substitutions do occur acid they differ frun plat material listed, this office must be notified immediately. Thank you for protecting and preserviJig the Coachella Valley's pest -free enviror-fiEent. I Agr ultural Carnussiolser's Of f ice ccs Indio acid Riverside Office