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003539 (SFD)3-73 P.O. BOX 1504 Building,, 78-105 CALLE ESTADO Address 79 �'1345- Westward Eo LA QUINTA, CALIFORNIA 92253 Owner Mailing Address City .. Reran Contractor _ Address ountry Club Drive'_ Zip Tel. No. fl039 BUILDING: TYPE CONST: OCC: GRP. A.P..Number 617-121-001. Legal Description. Project Description S3t.nale Family Dwelling 73-811 Country Club Drive, Zip. Tel.. da Maned 92211 345-6225 State Lic. City & Classif. 476007 Lic. # _ Sq. Ft. 1749 No. No. Dw. Size - - Stories Units. Arch:; Engr., Designer New ❑ Add ❑ Alter ❑. Repair ❑ Demolition ❑ Address Tel. d� arf¢ q7S Gin W. _ 94,.150.00 . ❑ 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.) ❑ .I am exempt under.Sec. B: & P.C. for this reason COnSt. - 12) City _ Zip - State Lic. # ' Grading • 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.. Date owner Laws of California. 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, atter, 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 v 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 (8500). Estimated ValUatlOn. ' PERMIT` ' Plan Chk. Dep.. Plan Chk Bal 94,.150.00 . ❑ 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.) ❑ .I am exempt under.Sec. B: & P.C. for this reason COnSt. - Mech.* ' Electrical Plumbing S. M,1, ' Grading Driveway Enc. Date owner Laws of California. �I �nfrastr�uyc/t�ure_ d 7 zgr WORKERS' COMPENSATION DECLARATION 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 Date Owner TOTAL $2. -REMARKS AMOUNT ♦♦■77.9 V' 6V .40 .85 (This section need not be completed it the permit is- for one hundred dollars (8100) valuation or less.) certify that in the performance of tha work for which this permit is issued, I shall not t�} `4 6} #t 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 ZONE: BY: .become subject to the Workers' Compensation provisions of the 'Labor Code, you must Orthwitn comply with such provisions or this permit shall be deemed revoked. - 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 Lenders Address FINAL DATE INSPECTOR 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. R Q �' I certify that I have .read this application and state that the 'above information is correct. Issued by: L 7 Date Permit - I agree to comply with all city and county ordinances and state laws 'relating to bjilding r construction, and hereby authorize representatives sof this city to enter the above-. mentioned property for inspection purposes. Validated by: Signature of applicant Date Mailing Address Validation: City, State, Zip HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. @ $ 2ND FL. SQ. FT. @ POR. SO. FT. @ GAR. SO. FT. @ CARP. SQ. FT. @ WALL SQ. FT. @ SQ. FT. @ ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used as property tax valuation ROUGH PLUMB. FLOOR DRAIN MECHANICAL FEES HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER DUCT WORK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GAS (ROUGH) LAUNDRY TRAY AIR HANDLING UNIT CFM HEATING (FINAL) 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 BOND BEAM SQ. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID @ 11/4 C SEWAGE DISPOSAL LUMBER GR, SQ.FT.GAR @ 3/ac HOUSE SEWER �LFRAMING 7'__� 0 11.1 FINAL INSP. 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 S/ETBACK ROUND PLUMBIN6'' UNDERGROUND A.C. UNIT COLL. AREA C/LSLAB GRADE - ri �` ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS EWER OR SEPTfTgtJf",f�' UGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. 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. �LFRAMING 7'__� 0 11.1 FINAL INSP. ry ` OOFING � �a Y 0 U� � U REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL THING MESH INSULATION/SOUND FINISHGRADING l//F1NAL INSPECTION//-,Z-� /CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL 1 Of' f �� k / f✓ f OFFICE'OF. E. LEOWSPAUGY` QC,Oyui5.10`ER s AGRICULTURAL COti1N11SSI0NER. "+ JAN',ES O WALLACE - 0 �• Q - :.` AN D, ASS;SrTANT fOM>t15510\EP, i { ) ^' CIEVENT BENVEhiSTE t'+ WEIGHTS:& MEASURES SEALER r 49-613, Hwy 86, 'Sui_ to B-12 ; ,,••' Coachella, CA 92236 ,�q r 9•� eq3 619=342-8291 t DATE % '2 - �.6 - $ 7` CASE NO . DEVEIAPER' S NAME: ADDRESS: .7 TELEPHONE: (6/9) 3 1!S`-G 2 2 j .Dear Developers After reviewing:your- landscaping'plans , all plant material listel is not in'.-• violation of quarantine laws'_ governing the.Coachella Valley. ,If`substitutions, y do occur'and',they, differ from plant material listed, this office must be notified • " 4 �imaiediatelt':- ' Thank you `fo protecting an preserving:l,the'Goachella Valleys s pest=free environment. _ y t :� CCI ' ..� . 1'" , j ' � ( !'_. ,�, ^. • • Agricultural Com'ni ner's Office .cc. Indio and Riverside-Office r r/ s,.',�1''•.;` ,r'�y'y'Y,a �'.i.�.s'I�P'�� c2� .. .$ F i. i. n'=}-a..p�,j+ �! .it� v+•$tW YaS'�C,"'*t+;°••r . C} d �'wT y - 1/,� ^.`vi�+'y.,'�' '+t✓"�" �'�i' Y; • �=.u^�'}n+}� i�vj':.-.�'-r7"'�`i� • � Z O F -- U LU U) U Z O F_ U W rn r � j COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM 1 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 ofs$37 is required when the application is submitted. Check must be made payable to the County of Riverside. DSI 'Building Department Applicaton Log # Name (Owner, Agent, Contractor, Etc.) - ~� J+ Mailing Address (l� % //✓/��/ //��/•f ./ ` .l • �/ _/ [i,/ ✓ �Y � i- - �"- /mac City •/� State /j Zip Code« / Telephone_/ I - Job Property Address ( �• o7TCommunity+ Legal Description of Pmpeny. (Lot, PM, TR) 'Assessor's Parcel No. - Wafer Agenc Well //-- t4 � L i4— Use of Permit j,.�A�/./A21/'�+"J Planning Ca a #" Lot Size 6,1)IoRl — SFD, MH Site Preparation Etc. i - 1/�� / i- a Signature of Applicant Date 1, The above information must be verified from Building Application •` STA F USE = D0 NOT WRITE BELOW THIS LINE .• -Initial Date Certification of Existing'S.D. System required. ❑ Yes n-10 WQCB Clearance required. ❑ Yes Soils feasibility report required. ) ❑ Yes ❑sNo!'� �.— Detailed boring report required. , . ❑Yes Detailed. contour plot plans required.' ❑ Yes _Staff;Specialist approval required: El Yes ❑ No Lot inspection Date Soils/boring report by / ,r � { 'Project # 'may �i Date Solis Map Page�v� Soil Type Gf 1.' Approved by �'�� a` - — Date//. Type of System: V ❑ ©*New ❑Additional ❑Replacement No. of Bedrooms (1) Septic Tank Soil Rate Required Existing 074 �, r�Lfi/Az��Gals. (2) Leach line sq. ft. Sidewall allowance Install_ Line(%) ~A 7�� ^-Ft Long, ! • Leach bed%Sq. (Bottom trench area) ft. rock/ Sq. Ft. Ft. wide with min.— inches Ft. of'bottom QQQ 11f per running ft./N A rock below drainlineor area Leach lines%bed-special design for slope: Applicable, (3) Pit Diameter No. Pits Pit BI Seepace Pit,total depth N/A � Overburden factor; ❑ 5 �^,, ❑ 6 y � ��;.,� Max. aJoowabfe--depth ..i!.�i�s'l ,�"'f.",/.7 �cO,r.,+... ,�+•,. .-� !�"1° �lrr�`�'` cr/ �.%s'/���.or,�- - . �i'c.2' . f �.�% •.+'/' f .. +..♦ ..t I'"ill..2'.G':��� I✓L�,.. .Y �-�l•.'�i�f��'7��i^Cl �+.�_' ��GC. /�.�+�-/�-iI ..•..__ C=tl.��. 1�"�`,���st_-a ..��^r,.yt�l.�,f_'/f%cl/��-•'f-]rr... .�'�rj1-J•/"�1 .�.f'�'>.,+�e'.a....�a' e2,.f��Ie�ef' /,I�c�:4rt"-'GC.r-•r✓-=`:`�v/t' �.� bl,ifl.�C-�.•. / S 'iLI�` /lit.!`"-'%J:7/"ir•�c,-''�•✓++`G, i'�L.'t,�+uY /2.. �. ���!{.:tr.... ...ab.�p ��� .T ,p .LK'_� This app cation is a ero d'dentedFfor 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. ` 'r ao.� (1) Septic tank and sewer lines must be 50' from any wells{ G� it t V�vs (2� Leach lines must be 100' min. from any wells including'expanslon areaq ^�,�" �'rs., Ez- J . . �� (3) Seepage pits must be 150'' min. from anywellsincluding expansion area +, > t,�� f�<f • ;� , L ` �'* r( /`,t.�.t,' %"(/• Signature of Health Official .1 • � fes'-Kiy'•?"'�, '�-1`Z..l .r�c�,y,_ •` RECEIPT NO. �' �`% �} Issued by �+ Date District: ❑.Riverside ❑Orrl d ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe d rr .. Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File DOH -SAN -122 (Rev. 6186) �ilIIIIIIIIIIIII E✓, Fidelity National Title INSURANCE COMPANY COMPARISON SHOPPING MAY SAVE YOU MONEY THIS TITLE INFORMATION HAS BEEN FURNISHED WITHOUT CHARGE BY FIDELITY NATIONAL TITLE INSURANCE COMPANY IN CONFORMANCE WITH THE RULES ESTABLISHED BY THE CALIFORNIA INSURANCE COM- MISSIONER, WHO URGES YOU TO SHOP FOR THE BEST SERVICE AVAIL= ABLE AND COMPARE CHARGES AND FEES FOR TITLE INSURANCE; ESCROW, AND OTHER SERVICES ASSOCIATED WITH THE PUR HASE OR SALE OF A HOME. Property Profile Address: Record Owner: Don Howard and Emma Howard Deed Recording Date: 2/20/87 Documentary Transfer Tax: 29.70 Concurrent Trust Deed, If Any:. None (See Attached) Legal Description: Lot 10 Tract 2190 Map Book 41 Page 55 (See Attacaed Deed Copy and Plat) g g TAX INFORMATION:. Assessors Parcel No. 617-121-001 Assessed Value Land $ 28.992 Assessed Value Improvements $ None Exemption $ None Net Assessed Value $ 28.992 Installments $ $ 250.62 ❑ In lieu of the above, see attached copy of Assessment Roll. 1 -.