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COUNTY OF RIVERSIDE, 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 Department Application Log #
Name (Owner- Agent. Contractor, Etc)
% i
Mailing Address
_
�-
City
Slate
Zip Code
Telephone
'Job *y r5 r-,�,! , ,•,::r
;`'Cdy�or. Community
'Legal Description of Properly (Lot, PM TR)
-Assessor s Parcel No - -
A n
� � `��(•;- �1�;��r
Use of Permit Planning Case N
Lot Size
i ` `}
- f- -
• -
__�� "'�
SFD MH Site Preparation Etc
Signature of Applicant Dale
- 'The above information must be verified from Building Application
STAFF USE — DO NOT WRITE BELOW THIS LINE
Initial Date
Certification of Existing S.D. System required. ❑ Yes ❑ No
WOCB Clearance required. ❑ Yes ❑ No
Soils feasibility report required. ❑ Yes ❑ No _
Special feasibility boring report required. ❑ Yes ❑ No
Detailed contour plot plans required. ❑ Yes ❑ No
Staff Specialist approval required- ❑ Yes ❑ No Lot Inspection Date—
Soils/boring reportby Project # Date
Soils Map Page Soil Type I L Approved by �. t-��( �— Date
Type of System:
No, of Bedrooms
(1) Septic Tank
Soil Rate Required
❑ Existing ❑ New ❑ Additional ❑ Replacement
Gals.
(2) I~each line sq. ft.
Sidewall allowance
Install - Line(s) Ft. Long,
Leach bed Sq
(Bottom trench area)
ft. rock/—Sq. Ft
_
Ft. Wide. -with min- inches
Ft of bottom
�
per running 11 ❑,N-[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-=g
f
Max allowable depth
N/A Overburden factor
'{
This application Sapp owed/monied-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.
(1) Septic tank and sewer lines must be 50' from any wells
(2) Leach lines must be 100' min. from any wells including expansion area
(3) Seepage pits must be 150' min, from any wells including expansion area ��• f _J•�. rs`r��w
Signature of Health Official
RECEIPT NO. ="�&?
Issued by Date —
District: ❑ Riverside 0' Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe
Distribution: WHITE —Office file YELLOW —Applicant PINK —Bldg. Dept- GOLDENROD —Pending File
DOH SAN 122 (Rev 8/87)
AT
�I -T- L_ I En P4 Em FF.-Z fL...3 N" ED iPk L. ED kJ L. 01 Ir X C3 hJ 61 FT Q 04 1 11�1
JOHN H. HACKER, CIVIL ENGINEER, PALM SPRINGS 327-4565, OCEANSIDE 721-3721
LATITUDE 33.0 WINTER TEMP. 31 DEG SUMMER TEMP. 110 DEG
NAME ------- GOLDEN WEST HOMES
ADDRESS ---- VELLEJO AVE
| CITY ------- LA QUINTA / CAL
REF.CAL.ENERGY CONSERVATION DESIGN MANUAL, ARM 2, HEATING LOSSES
| MANUAL J FOR COOLING LOSSES
AREA BLDG 1480 SQ. FT. -
PERIMETER 164.4444 SQ. FT.
INSULATION R VALUES .FLOOR 0 ..CEILING 30 ..WALL 19
,
AREA NORTH WINDOWS 102 SQ.FT. PERCENT OF AREA 6.891892
AREA EAST WINDOWS 30 SQ.FT. PERCENT OF AREA 2.027027 '
AREA SOUTH WINDOWS 53 SQ.FT. PERCENT OF AREA 3.581081
AREA WEST WINDOWS 68 SQ.FT. PERCENT OF AREA 4.594595
AREA SKYLIGHTS 0 SQ.FT. PERCENT OF AREA 0
| TOTAL WINDOW AREA 253 SQ.FT. PERCENT OF AREA 17.0946
THE U VALUE OF THE WINDOWS IS .65 DUAL PANE
THIS BLDG USES DRAPES & FLAT SHADING DEVICES* ON WINDOWS
(*mini -blinds, rollar shades, venetian blinds or vertical blinds)
| THE TOTAL S.C. OF THE WINDOWS IS 0.30
SOUTH OVERHANG LENGTH 2
| INTERIOR THERMAL MASS AREA = 296 SQ. FT.
|
ATTIC AREA = 1480 SO FT
INFILTRATION (STD 0.018, MED 0.014, TIGHT 0.012) = .014 '
HEATING LOSSES � '
� FOOTING LOSSES... 7182.934 BTU
�
CEILING LOSSES... 1832.381 BTU
WINDOW LOSSES.. 6413.55 BTU
� WALL LOSSES.... 2021.447 BTU
INFILTRATION LOSSES... 6464.641 BTU
� TOTAL HEAT LOSSES BTU/HR.. 23914.95
GAS FURNANCE SIZE 45889.44 BTU OR 45,000 BTU
COOLING LOSSES
INFILTRATION LOSSES... 6630.401 BTU
FOOTING LOSSES... 7367.112 BTU '
CEILING LOSSES... 1879.365 BTU
WINDOW LOSSES... 13190.61 BTU
WALL LOSSES.... 2069.377 BTU
INFILTRATION LOSSES... 6630.401 BTU
NO. OF PEOPLE... 5 COOLING LOSSES..~ 2000
KITCHEN... 1500 BTU '
DUCT LOSSES INCLUDED IN TOTAL
� TOTAL COOLING LOSSES 34636.86 BTU