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002805 (SFD)Building 51 ra75 ;1VtV1i& Address Owner Mailing Address 53-400 AWTdda Alves City Zip Tel. 44- a* a 4" P.O. BOX 1504 78.105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Aooress 74-9% Veiie Way mit -W City Zip -Tela " Pala► Degex t 92260 346-8864 State Lic. City & Classif. 354141 Lic. # Arch.,-Engr., Designer Address Tel. CityZip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that.l am licensed under provision -s of Chapter 9 (commencing with Section 7000) of Division 3,of the Business and'Professions Code, and my license is in full force and r effect. / fi e 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 live 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- 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 Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self-insurd, 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 thg work for which,lhis 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"- -2/ Owner f 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 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 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 sof this city to enter the above• mentioned property for inspection purposes. Signature of applicant Date Mailing Address No. 002805 BUILDING: TYPE CONST. OCC: GRP. A.P. Number 773--2:32-020 Legal Description %7t 8 Project Description sJnae' fW 1v dMllL-to MG 1.464 M= 200 Sq. Ft. ,- No. No. Dw. Size Stories Units New E Add" Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation . 78t274.10 PERMIT Plan, Chk. Dep. 'KA'. nn[ Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure AMOUNT y X=6 ! s , 370.01 33.01 c *6.0 103.101 5.5! 20.01 20( H Y, i4i3. fi: TOTAL Z,U94.44 I itU44.44 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 12 30-SrOermit Validated by: Validation: City, State, Zip HARD COPY T CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. @ $ UNITS A.C. UNIT COLL. AREA _ YARD SPKLR SYSTEM 2ND FL. S0. FT. UGH PLUMB. �% Q ri-AFORMS BONDING HEATING (ROUGH) MOBILEHOME SVC. BAR SINK POR. SO. FT. ® SEWER OR SE Kf- GAR. SO. FT. @ POWER OUTLET ROOF DRAINS FOUND. REINF. DRAINAGE PIPING . CAR P. S0. FT. @ METER LOOP HEATING (FINAL) WALL SO. FT. @ DRINKING FOUNTAIN SO. FT. @ GAS (FINAL) URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE ' DRYER FINAL INSP. / $ GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LUMBER GR. LAUNDRY TRAY AIR HANDLING UNIT CFM FINAL INSP. 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 @ 11/4 c SEWAGE DISPOSAL SO.FT.GAR @ 3/ac HOUSE SEWER GAR. FIREWALL 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 _ '-c2 SETBACK 2 -lo- ROUND PLUMBING YQ-F UNDERGROUND A.C. UNIT COLL. AREA _ SLAB GRADE _ �_ UGH PLUMB. �% Q ri-AFORMS BONDING HEATING (ROUGH) STORAGE TANK SEWER OR SE Kf- ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EOUIP. REINF. STEEL GAS (FINAL) A14MP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM FINAL INSP. / $ GRADING cu. yd. plus x$ -$ LUMBER GR. n AMING /Q /� C/7 CCCC//// FINAL INSP. ROOFING (y jna� O 1. �nJ z r a�4 �•�� '� ani DEC ' 7 1907 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING IgeN� MESH �j INSULATION/SOUND �� 2 FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS. GARDEN WALL FINAL u�i'Gu ceitif 4 Aue �4Qvrer6.. P.O. BOX 1504 APPLICATION ONLY Building 78-105 CALLE ESTADO AddressTi4Qail_ 53 v..i LA QUINTA, CALIFORNIA 92253 Owner Garrison Ta Mailing I Address 53400 Avenida Alvarada City I Zip ITel. Contractor Cal West Construction Co. Address 74 990 Velie Way Unit D City lZip I Tel.. State Lic. City & Classif. I Lic. # Arch., Engr., Designer Ed A;dderholt— Designer Address Tel. 3!0-9804 City Zip State — _ _._ 1-1^ 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 `— V 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 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 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.) b 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. * n Company .� r _rte _ r._ _ n Kt1 Copy is flieif C ❑ Certlfled copy is%ereby fqumished v 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. 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 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 BUILDING DIVISION BUILDING: TYPE CONST. R 1 OCC. GRP. A.P. Number 771-112-020 Description T,ot 8 R1k 5.3 Nerrii a Project Description Naey.. a;nal A poet,ra S S/ Sq. Ft. Size _JD No. No. Dw. Stories 1 Units 1 NewX❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation % no PERMIT AMOUNT Plan Chk. Dep. .2317 �b Plan Chk. Bal. 7 7 Const. 3 O . ori Mech. . mo Electrical ro -2 Plumbing / 0 3 - V.- S.M.I. S • 6'G�7 Grading oho • Oo Driveway Enc. ,220,0 Infrastructure k/ G<SX o Ly 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: A 6 9 9 3 12 29 275,00 Tl CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS A.C. UNIT COLL. AREA SLAB GRADE YARD SPKLR SYSTEM 2ND FL. SO. FT. BONDING HEATING (ROUGH) MOBILEHOME SVC. BAR SINK POR. SO. FT. ® SEWER OR SEPTIC TANK ROUGH WIRING GAR. SO. FT. ® POWER OUTLET ROOF DRAINS FOUND. REINF. DRAINAGE PIPING CAR P. SD. FT. HEATING (FINAL) WALL SO. FT. ' DRINKING FOUNTAIN SO. FT. ® TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation WATER HEATER FLOOR DRAIN . MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY 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 ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/.c HOUSE SEWER REMARKS: 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 GOND. 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./EOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING LUMBER GR. FINAL INSP. Cu. yd. FRAMING FINAL INSP. $ plus x$ =$ 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 ��EIEp Co o = = C Desert Sands Unified School District y BERMUDA DUNES r RANCHO MIRAGE 82-879 HIGHWAY 111 • INDIO, CALIFORNIA 92201-5678 • (619) 347-8631 INDIAN WELLS ti PALM DESERT a December 31, 1986 .PLA OUINTA 'O INDIO r City of La Quinta Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 Re: 51-675 Herrera, La Quinta, CA - 1 unit Gentlemen: The developer of the above referenced project has mitigated its impacts on our overcrowded schools by payment of the amount of $628 per unit. This amount is to be applied to the .cost of additional district educational facilities made necessary by such new development. Sincerely, John D. Brooks Assistant S rintendent Business ces By: Richard M. Beck Facilities Planner JDB/vmm This certification of payment of developer fees is valid for issuance of building permits only until and including December 31, 1986. JUL 18 1983 TITLE ORDER N0. ESCROW NO. RECORDING REQUESTED BY CC ANO'WHEN RECORDED MAIL THIS DEED AND UNLESS OTHERWISE SHOWN BELOW MAIL TAI STATEMENT TO: fOName rROBERT •�lldt�ese W. STEWART, JR. _ v 93 V A .LAW CORPORATION 73•-350 E1 Paseo, Suite 203 city& State LPalm Desert, CA 92260 J 00 MAIL TAX STATEMENTS TO Name t'7 1 GARRISON B. TARNOW 7 street Address 51-685 Avenida Herrera City a La Q;:i^ta, CA 92253 slate 1 TITLE ORDER N0. ESCROW NO. SPACE ABOVE THIS LINE FOR RECORDER'S USE QUITCLAIM DEED THE UNDERSIGNED GRANTOR(S) DECLARE(S) DOCUMENTARY TRANSFER TAX -is $ -0- Interspousal Transfer ❑ computed on full value of property conveyed, or ❑ computed on full valueless value of liens or encumbrances remaining.at time of sale. ❑ unincorporated area ❑ city of _ , AND FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, STACIE E. TARNOW hereby remise, release and forever QUITCLAIM to GARRISON B. TARNOW, as his sole and separate property the following described real property in the .County of RIVERSIDE , State of California: Lot 8 in Block'53 of Santa Carmelita at Vale La Quinta Unit #5, as per map recorded in Book 18, page 63 of Maps, in the Office of the County Recorder of Riverside County. Daied e.\zAc- r,h, ` ' ` 3 r � STATE OFL.;CALIFORNIA SS. COUNTY OF RIVERSIDE On JI-Inin ? R - I CIR 3 before me, the undersigned, a Notary Public In and for said State, personally appeared STACIE E. TARNOW known to me to be the person whose name 1 S subscribed to the within instrument and acknowledged that she executed the same. WITNESS my hand and official seal. Signaturec:2lc.t (NOTARY PUBLIC IN AND -FOR SAID STATE EdRR37tBR88LS4L:SDSSSSSSOS952SSi394OI09S:4FEl:SSESOSCSS.'.4l;I�T BAPSA,RA L. P.AR .gA.TCjN '...� NOI ^' RY PUBLIC -CALIFORNIA C PRINCIPAL OFFICE IN •R7 m RIVERSIDE COUNTY My Contrnisaion Expires Dec. 7, 1984 SEE"�RSi0i0el:taosu,tu3:aaR¢a�4eeRa44lauRw3�� (This area for official notarial seal) MAIL TAX STATEMENTS AS DIRECTED ABOVE. I CC YC11 O Cn b Q ra _ v 93 V -5 Q: � A yyy hL SPACE ABOVE THIS LINE FOR RECORDER'S USE QUITCLAIM DEED THE UNDERSIGNED GRANTOR(S) DECLARE(S) DOCUMENTARY TRANSFER TAX -is $ -0- Interspousal Transfer ❑ computed on full value of property conveyed, or ❑ computed on full valueless value of liens or encumbrances remaining.at time of sale. ❑ unincorporated area ❑ city of _ , AND FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, STACIE E. TARNOW hereby remise, release and forever QUITCLAIM to GARRISON B. TARNOW, as his sole and separate property the following described real property in the .County of RIVERSIDE , State of California: Lot 8 in Block'53 of Santa Carmelita at Vale La Quinta Unit #5, as per map recorded in Book 18, page 63 of Maps, in the Office of the County Recorder of Riverside County. Daied e.\zAc- r,h, ` ' ` 3 r � STATE OFL.;CALIFORNIA SS. COUNTY OF RIVERSIDE On JI-Inin ? R - I CIR 3 before me, the undersigned, a Notary Public In and for said State, personally appeared STACIE E. TARNOW known to me to be the person whose name 1 S subscribed to the within instrument and acknowledged that she executed the same. WITNESS my hand and official seal. Signaturec:2lc.t (NOTARY PUBLIC IN AND -FOR SAID STATE EdRR37tBR88LS4L:SDSSSSSSOS952SSi394OI09S:4FEl:SSESOSCSS.'.4l;I�T BAPSA,RA L. P.AR .gA.TCjN '...� NOI ^' RY PUBLIC -CALIFORNIA C PRINCIPAL OFFICE IN •R7 m RIVERSIDE COUNTY My Contrnisaion Expires Dec. 7, 1984 SEE"�RSi0i0el:taosu,tu3:aaR¢a�4eeRa44lauRw3�� (This area for official notarial seal) MAIL TAX STATEMENTS AS DIRECTED ABOVE. I — - RECORDING REODUTED av WOES AECOAOEe •IIIL A/O IRMOTNEMIK ONOM RAIL TAX IMERIEIIT C1+1 O uInAI,,, »I P. o . IC6 0 >( 15-04 MAIL TAX STATEMENTS TO r 1 r , C_I-,a e. , 4- ; a c '► sh00 5 If to -7S AL)en, d4 Herr'eP^q L�` Q L,, i +a, C A- ? aaSJ TITLE ORDER M. ESCROW M. W sx V 8 19 o $ W 10 V W Q SPACE ABOVE THIS LINE FOR RECOROER'S USE GRANT DEED THE UNDERSIGNED GRANTOR(S) DECLARE(S) DOCUMENTARY TRANSFER TAX is S -0- ❑ computed on full value of property conveyed, or ❑ computed on full value less value of liens or encumbrances remaining at time of sale. ❑ unincorporated area ❑ city of _-La QI, ; n t a , AND FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Michael Wayne Shook & Jackie B. Shook, husband & wife as joint tenants of the following described real property in the City of La Quinta,_ County of Riverside. State of California. hereby GRANT(s) to Michael Wayne Shook & Jackie B. Shook, husband & wife as joint tenants the following described real property in the County of RIVERSIDE , State of California: Lot 7 & 8 in Block 53, Santa Carmelita at Vale La Quinta, Unit #5 as per Map recorded in Book 18 Page County Recorder of said County. 63 of maps in the ,off ice of the THIS DEED REFLECTSME,&OEa.-N_0. Cj 3 - 9 G 9 AS APPROVED BY THE CITY OF LA QUINTA. natPri .. Z� 1' .. STATE OF CALIFORNIA SS, COUNTY OF RIVERSIDE On this 23RD day of M-1 r--1-1STin the year 1993 before me, the undersigned, a Notary Public In and for said State, personally appeared 0 personally known to me droved to me on the basis of satisfactory evidence to be the person whose name Is subscribed to this instrument, and acknowl- edged to me that he (she. or they) executed it. Signature Nr1T�pV P r: IN INR rMQ AIn CTATV rn lUha�l Watj-J'-4-_- -�;54.4o4c RNIOTARY OFFICIALSEALTERRY M. ROACH PUBLIC - CALIFORNIARIVERSIDE COUNTYytwmm, expires MAY 20, 1994 /TA;•�.n• 1�. n11:�:�1 nnl t...l •n.11 ON Z O H U W C0 Z O 1-- C) W CO U) Y Q 2 W lcr U Z O F_ U W rn COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION -1-7-S 32.- v2C 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 $37 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 �w City State Zip Code Telephone 41 .re - 3 gS -dV6 Y �� F Job Property Address 'City or Community 'Legal Description of Property. (Lot, PM, TR) / G G `o ( S 1 Ovk `' 'Assessor's Parcel No. Water Agency or Well Lot Size Use of Permit Planning Case # �0�� 772 / 12:-('a0 ,>� SFD, MH Site Preparation Etc. Signature'6f Applicant Date - 'The above information must be verified from Building Application STAFF USE — DO NOT WRITE BELOW THIS LINE Initial Date 12-113 G � Certification of Existing,S.D. System required. - ❑ Yes t No'7 -� WQCB Clearance required. ❑ Yes IJ No t Soils feasibility report required. ❑ Yes No Detailed boring report required. El Yes No Detailed contour plot plans required. ❑ Yes No Staff Specialist approval required. El Yes No Lot Inspection Date y ,, Soils/boring report by ow ' e t Project # Date Soils Map Page Soil Type Approved by Date Type of System: No. of Bedrooms (1) Septic Tank Soil Rate Required ❑ Existing NNew ❑ Additional ❑ Replacement i°Q� vV` X Gals. Z (2) Leach line sq. ft.Sidewall allowance Install Lines) Ft. Long, Leach bed Sq!' (Bottom trench area) ft. rock/ zSq. Ft. Ft. wide with min. inches Ft. of bottom per running ft. E3N/,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 Overburdenfactor ❑.5' ❑ms's! h,_ �+ �.,, R 1 �,.„• „ / L� T Max. allowable depth” U t PAa k kv., 0—e-& This application is approyedZenied 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. (13)Septic tank and sewer lines must be 50' from any wells --- FA'm �(Zb, G� �f'�^Q (2) Leach lines must be 100' min. from any well including expansion area (3) Seepage pits•must be 150' min. from any wells including expansion area S w M • (v` f-,2.0 -� ,�cQ, t- 5 v +.0 ;,.I Signature of Health Official - Date RECEIPT NO. District: El Riverside Indio Distribution: WHITE—Office file DOH -SAN -122 (Rev. 6/86) Issued by ❑ Hemet ❑ Perris ❑ Rancho Calif. YELLOW—Applicant PINK—Bldg. Dept. Date ❑ Blythe GOLDENROD—Pending File -T' I TL,E 24- EhLFEE Ftt3*Ir COm�LrCUL_AT. I UM AFREA 1 5 -JOHN -H.---HACKER C I V'I•i_-ENG I NEER? PALM SPR I LATITUDE 33.8 WINTER TEMP. 31 DEG. SUMMER TEMP. 110 DEG OWNER__-__'�'�L _Li i�9-7 �OAl5------------------- -- J 08 SITE LOCATION ------------------------------------ REF . CAL : ENER(3Y CONSE-RVATION DESIGN MANUAL , FORM 2 ,- HEAT I NO , LOSSES MANUAL J FOR COOLING LOSSES AREA BLDG 1364 SO. -FT. PERIMETER 160 SO. FT. - I NSULATI ON -R -VALUES :-.-SLAB --0--.:CEILING -38' :.-WALL 1-1 AREA NORTH WINDOWS -36 SQ.FT. -PERCENT OF AREA 2.6393 -AREA-EAST WINDOWS-30-SQ.FT. PERCENT -OF -AREA -2:1-9941 AREA SOUTH WINDOWS 32. 80iiFT. -'• PERCENT- OF .-AREA 2.34604 AREA WEST WINDOWS 73 SQ.FT. PERCENT OF AREA 5.35191 ---AREA-SKYL.IGHTS-----O--SQ: FT-.-,PERCENT-OF--AREA-0 --`- TOTAL WINDOW AREA 171 SQ.FT. PERCENT OF AREA 12.5367 THE -U-VALUE-OF-THE-WINDOWS-IS�i3 (-b5= DUAL PANE, -i:t, 'S-INGLE-PAN THIS BLDG USES DRAPES & FLAT SHADING DEVICES* ON WINDOWS(S.C.=:41) (* mini-blinds;-rollar shades, venetian blinds or vertical blinds) -----T'H16--TOTAL-S-C-OF THE WINDOWS-IS-0:29-- SOI,ITHOVERHANG LENGTH 2 -I NTER I -OR THERMAL MASS -AREA --341-SQ- FT ATTIC -AREA = 1364 SO -FT INFILTRATION (STD 0.018, --MED 0.014, TIGHT 0.012) - .01:4 3 HEATING LOSSES F=OOTING LOSSES... 6988.8 BTU --' GE-It:•INO--COSSES... i 346.. 73 -BTU WINDOW LOSSES.. -4334.85 BTU WALL LOSSES.... 3460:08 BTU - ' INFILTRATION -LOSSES -5957.95 --BTU ----- TOTAL•HEAT LOSSES BTU/HR... 22088.4 - GAS FURNANCE SIZE 35729.7 BTU OR 45,000 BTU COOL I•N[3 LOSSES FOOTING LOSSES... 7168 BTU -CEI L ---I NG -LOSSES :.: 1-381.- 27- BTU- WINDOW TU-WINDOW LOSSES... 7330BT'U WALL LOSSES.... 3548.8 BTU --INF'-IL-TRATI-ON-L08SES..—.61-10-.;-72-BTU NO. OF PEOPLE... 5 COOLING LOSSES... 2000 KITCHEN... 1500 BTU ---DUCT -LOSSES-INCLUDED--IN--TOTAL--------------- TOTAL COOLING LOSSES 29038.8 BTU .3Xz A -C, COMPLIANCE CHECK LIST•PER DESIGN DATA ELAN ON GROUND, -4 POINTS WALL INSULATI.ON,_ -6-POINTS CEILING INSULATION, O POINTS ATTIC, 4 POINTS NORTH WINDOWS GLAZING 0 POINTS EAST WINDOWS GLAZING 2 POINTS _ SQU_T_H-WINDOWS-GLAZ.ING O -POINTS WEST WINDOWS -GLAZING -6 POINTS SKYLIGHT GLAZING O POINTS EAST SHADING COEFFICIENT SOUTH SHADING COEFFICIENT ---WEST --- SHAD I NG - COEFF I C I ENT NORTH SHADING COEFFICIENT SKYLIGHT -SHADING COEFFICIENT INFILTRATION __THERMAL_MASS__341-.SQ._F-T SOUTH OVERHANG -1 POINTS O POINTS -3- PO I NTIS 0 POINTS 0 POINTS --1 POINTS ---- g._POINTS O POINTS _GAS FURNANCS. 74_.8E_AND _ REFR I GERA•T ION .-COOL. I THE EER OF THE -COOLING SYSTEM I -S 8.7 - _ -COOL ING 6--PO-I N TS THE ALLOWABLE POINTS -PER A8 163 -16 -4 -.FOR THIS AREA 1.5 --_THE._TOTAL- _PO INTS..ARE-1-------------------- --- ---- THE FOLLOWING MANDITORY FEATURES/DEVICES ARE REQUIRED PERCAC TITLE 24 ;NSU-LAT_l-ON-AS-SPEC-I F I ED;-PER=MANUFACTURES-L-ABLE - INFILTRATION CONTROL. DOORS, WINDOWS FULLY WEATHERSTRIPPED OPENINGS -CAULKED AND SEALED AROUND JOINTS--IN--WINDOW-AND.-WALL SOLE -PLATES-AND _-ELECTRI.C__OUTLET. GASKETS --.ON ALL -EXTERIOR WALLS------ MANUFACTURED-DOORS-SHALL t4EET ALLS------MANUFACTURED DOORS SHALL•MEET APPLICABLE -STANDARDS BACK DRAFT DAMPERS ON EXHAUST FAN .-E.1 REFLACES_MUSTHAVE T-I-GHT-.F_I-T-T I NG-,-CLOSEABL-E-DOORS-COVER I NG --FIREBOX PROVIDE COMBUSTION AIR-INTAKE DUCTS (6 SQ. IN.) WITH TI•GHT•F'ITTING DAMPER DUCTS;--BUILTPER CHAPTER 10 U.M.C. _...GAS_.FURNANCE___SIZED .,TO._1..3-DESIGN LOGS -+-10 BTUH PER000-BTU--------- SETBACK THERMOSTATS SHALL_ HAVE AUTOMATIC SETBACK CAPABILITY /2 PERIODS PER 24 HR WATER HEATER TO HAVE R-12 INSULATION WRAPPING, AND R-3 ON FIRST -3' OF PIPE -NAY -GAS S_T_OVES-SHALLL_NOT-HAVE:-CONT..=BURN I NG -P -I LOTS LIGHT- I N KITCHEN AND- TO • BE FLOURECENT , EXCEPT BATH MIRROR KIT- SINK ; TABLE . - - -CERTIFIED