00013291 (PLBG)APPLICANT NAME (L, F. MI)
ADDRESS
CITY/COMMUNITY/STATE/ZIP
CATHEDRAL CITY
CA 922348000
,JOB SITE ADDRESS/SPACE
CITY/COMM UN I TY/STATE/ZIP
IT '.rA
CA 92pnIA(Inlitl
BOK PAG PRC C TWN RNG SE S
TRACT LOT MOD SB
TRACT NAME
OWNER NAME (L. F, MI)
CONTRACTOR-FIRM NAME
ADDRESS
CITY ICO MM UN ITY/STATE/ZI P
CAINEDRAL Cl_:r1Y
PHONE M
714-3',28-1
CA 9512340000
LICNC N
ARC/ENG FIRM NAME
-
ADDRESS
C I TYICOM MUNI TY/STATE/ZI P
PHONE N
LICNC N
USE OF PERMIT
BLZON
FSB SS8
SSB
RSB
on
OFC
IND
ZONE ORD M
LOT SZ END
SIDE
nfln
r1 018810
P L U M P I N G P E R M I T
TOTAL PERMIT COST IS $14,50
PLUMPING FEE COMPUTATIONS * Peroit fee (if applicable)
Private Sewage D3spoSal^Nows l Olds 0
F
FORM 284-208 (2/81)
FEE $4.00
FEE Y $10.50
NO.
n 'w`OPERATION
DATE
hNSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL `APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs 8 Frms
34
Plenums 8 Ducts
2A
Slab Grade
35
Furnace Comport.
3
Steel
36
Inlets & Outlets
4
Grout Blocks
-
37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
39
Appl. Clearance
7
Framing
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
Gaioge Fre Wall
42
Commercial Hood
•10
Fireplace P. L.
43
Final
10A
Fireplace T.O.
°o
------
ADDITIONAL INFORMATION
-. ..
------------------.--,.
'
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts)
12B Ceiling (Batts)
12C Ceiling (Blown)
14 Final A
--------------------PLL;MBINGAPPROVALS------------------
15 Ground Plumb
16 Water Piping
17 Rough Plumb
18 Vents
19 Sewage Disposal s
20 Sewer
21 Water Heater
22 Water Softener
23 Water Service
24 Gas Test
25 Final Z /�3. _
Tank Pit L. Line
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
P/L
P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
q Q
-Zf /?l
5a 177 0(.jF,
RIVERSIDE COUNTY DEPARTMENT OF PUBLIC HEALTH
DIVISION OF ENVIRONMENTAL HEALTH
Food Establishment (/Sewage Disposal •- .
Trailer Park Gal. Septic Tank
Mote!, Apt., HotelSq. Ft. of Leach Line
Dwelling G' � x .� o � Seepage Pit
Commercial Building Connection to Sewer
Swimming Pool
No on-site regenerating water softening devices may be discharged into the individual sewage disposal
system hercv.,ith approved without clearance from the Water Quality Control Board.
Water supply serving this ins'ai!ation must be from an approved source.
All sewage disposal instaiiation must conform with requirements of current Uniform Plumbing Code.
Any cutting, gracing, or filling in excess of fou,"('d) feet will nullify sewage disposal approval.
Approval has been obtained from the {regional Water Quality Control Board for installation of the sew-
age' disposal system.
Phis is to certify that the Riverside County Department of Public Health approves for ovopi—_y, construction
or installation the item(s) checked above.
Date Z — / r 9Z BY—
FTHIS APPROVAL GRANTED BY THE'
1
IDEFARTf4t� SENT OF PUBLIC HE!.LTI,�
IS VALID FOR ONE (1) YEAT;
F ROM DATE OF APPROVAL.
RIVERSIDE COUNTY DEPARTMENT OF HEALTH
APPLICATION FOR PERMIT TO INSTALL A RESIDENTIAL SUBSURFACE DISPOSAL SYSTEM
Applicant: Submit this form with three copies of a scaled plot plan drawn to the specifications required on the attached
check list. A non refundable filing fee of $15 is required when the application is submitted. Check must be made payable to
County of Riverside.
Name
Mailing Address
Q
City
State
Zip Code
Phone
Z
O
0
'Property Address
'City or Community
'Legal Description of Property
W
N
'Assessors Parcel No.
Water Serving Property From
Signature of Applicant Date
'The above information must be verified from Building Application
Staff Use — Do Not Write Below This Line
Initial Date
Soils feasibility report required Yes ❑ No ❑
Detailed boring report required Yes ❑ No ❑
Detailed contour plot required Yes ❑ No ❑
m
Z
Soils or boring report by Date
O
V
Approved by Date
W
N
Soils Map Page Soil Type Tract File No. Other
Number of Bedrooms
Septic Tank Size (gallons)
Rate Required (sq. ft./l00 gal or gal. sq. ft./day)
Leach line sq. ft. of bottom area trench
Leach bed (sq. ft. of bottom area bed)
Seepage Pit Diameter
Seepage Pit Vertical Feet
Number of Seepage Pits
Maximum Depth of Pit
Location of System
Additional Requirements
V
A permit is approved/denied for the installation of a subsurface disposal system as indicated on the accompanied
Z
plot plan using the requirements set forth in Section C above.
O
H
U
W
(n
Signature of Health Official Date
Receipt No.
Issued By
District: Riverside ❑
DISTRIBUTION: WHITE - Office File
DOH SAN 122 (New 10 81)
Indio ❑ Hemet ❑
YELLOW - Applicant
Date
PINK - Building Dept. GOLDENROD - Attached to Plans
APPLICANT NAME (L, F. MI)
Y � i
A %rz
CITY/COMMUNITY/STATE/ZIP
CATHEMAL CITY CA 922340000
JOB SITE ADDRESS/SPACE
CITY%COMM U N ITY/STATE/ZI P
~s ..
BOK PAG
PRC
C
TWN
RNG
SE
S
M%
TRACT.
I LOT
MOD
SB
TRACT NAME
OWNER NAME (L, F, MI)
ittIRNUl" Lim
CONTRACTOR -FIRM NAME
ADDRESS
C I TY!COMM UN I TY/STATE/ZI P
{1
y, CA 922340000
PHONE # LLICNC #
714-399-2 ,9161 cl
ARC/ENG FIRM NAME
ADDRESS
CITY/COMMUNITY/STATE/ZIP
PHONE #
LICNC N
USE OF PERMIT
BL ZON FSB
SSBSSB RSB
OFC
ZONE ORD N
LOT SZ END
SIDE
APPLICATION FOR PLOMOINO PERMIT
T H 1 S q A N A P P t I 0 A i 1 0 N 0 N L Y
,�-i`u must see the f 110"ing oepar°t"ants «f .Master far cunc "prenceHOLD
I
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs & Frms
34
Plenums 8 Ducts
2A
Slob Grade
35
Furnace Comport.
3
Steel
36
Inlets & Outlets
4
Grout Blocks
37
Combustion Air ,
5
Bond Beams
38
Compressor
6
Roof Deck
39 -
Appl. Clearance
7
Froming
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
G-oge Fire Wall
42
Commercial Hood
10
Fireplace P. L.
❑
43
Final
10A
Fireplace T.O.
°o
ADDITIONAL INFORMATION
s
._ _.__ -- _. _._____-.
1
SEWAGE SYSTEM SIZE & LOCATION
• l l Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts) '
12B Ceiling (Botts)
12C Ceiling (Blown)
14 Final
• �_�____._. ... -YZil /rsbllrG AI'�FCO�%a y"'—'--_______.�___..___�___._._______.__.�________..
15 Ground Plumb
16 Water Piping
17 Rough Plumb
18 Vents
19 Sewage Disposal
20 Sewer
21 Water Heater
22 Water Softener
23 Water Service
24 Gas Test
25
Final
Tank Pit L. Line
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
P/L
P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures `
31 Service
32 Final
STREET NAME