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04328 (SFD)Building Address Owner P.O. BOX 1504 �� C"ax'rinnzi� 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Coachella valley Limed CompAny _ mailing Address 247 E. Ta,hqu i,ts Shay, 02 City Zip Tel. Palm springs92202 1 322-1728 _ . Contractor Address Zip 8Classif. 307934 16:o,# 895 Arch., Engr., Designer Address I Tel. CityI Zip I State I Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that t am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business an�d. +Professions Code, and my license is in full force and effect. 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, after, 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 rive hundred dollars ($500). O 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 or 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 or completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) O l, as ovine%of the property, am exclusively contracting with licensed contractors to con- strucl'the'project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does ndt'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. Company It—, ,#. 4. ❑ 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 the 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 03219 BUILDING: TYPE CONST.' OCC. GRP. A.P. Number. - 773-•321-010 Legal Description Project Description •' • Sq. Ft. 1410 No. Size Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ 438' Gavage 170 6' fence Estimated Valuation yy PERMIT AMOUNT Plan Chk. Dep. Ubu lJo Plan Chk. Bal. �� • Const. . inti Mech. Electrical 74 r 1 Plumbing 10b 14#U S.M.I. ')..$10 Grading +dU r QV Driveway Enc. wU • U Infrastructure t + TOTAL 44.- tiffl* 0:)4 REMARKS 04YA02 W W63 07 di- W9 f s tO fASH f ftftgL 1 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 INS�PEC�TjO�R Issued by: Date Permit Validated by: Validation: 1 WHITE - FINANCE, PINK - APPLICANT, GREEN -BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. P;.UMBING FEES IST FL SO F1 h S UNITS COLL. AREA SLAB GRADE OUGH PLUMB YARD SPKLR SYSTEM 2ND FL SO FT, ra HEATING (ROUGH) STORAGE TANK POR SO Fl. qf MOBILEHOME SVC. BAR SINK GAR SO. FT. (a POWER OUTLET ROOF DRAINS GAS (ROUGH) METER LOOP DRAINAGE PIPING CAR P. SO FT. rg OTHER APP.IEOUIP. I WALL SO. FT, a Aaew. POLE DRINKING FOUNTAIN SO FT Ia URINAL ESTIMATED CONSTRUCTION VALUATION $ SERVICE WATER PIPING NOTE' Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTONDISH) APPLIANCE DRYER ^^ ERAMING / GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED /�r V ! �✓ /it—/��� LAUNDRYTRAY AIR HANDLING UNIT CFM REMARKS:CROOFING 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 C 11A c SEWAGE DISPOSAL SO.FT.GAR @ 3/.c HOUSE SEWER 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 8 AIR COND. SOLAR SETBACK ` v GROUND PLUMBIN _� UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE OUGH PLUMB BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK (,`ROUGH WIRINVO 12--9; DUCT WORK ROCKSTORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. REINF. STEEL GAS (FINAL) Aaew. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. ^^ ERAMING / FINAL INSP. �� t/ /�r V ! �✓ /it—/��� �'- .c�°� REMARKS:CROOFING VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR - GAR. FIREWALL LATHING G- / / " y MESH SULATIONISOUND 6 /Z� FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL T Z O H U W 0 r� Y cr Q W Cr COUNTY OF RIVERSIDE, ENVIRONMENTAL HEALTH SERVICES DIVISION 7 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 Uis required when the application is submitted. Check must be made payable to the County of Riverside. Building Department Application Log # Name (Owner. �AygenNt, contractor. Etc.) ^ ? `) V / W /G. 'G V 4 � 5 %r A 1�I c - . / .1 � 4) Mailing Address ( � � / 4r City State Zip Code l�Z2�Z� Telephone �Z2—ioZo 'Job Property Address�41 1 F'Cit or. 'Legal Description of Property. (Lot. PM. TR)'s... RC-" Jr� • F— S" /¢ 61 0- a Z A X,4 Qc.L i J 'r oo o T /O dz)e /no uAj ry-. 14 'Assessor's Parcel No �Wa e�r,Ao'enc ;v �T ---� / / �./ / Use of Permq J/1:1.��'i�_Gt�.c�-f� �e'Pia^^^ng Case M Lot Size / 7�3 — O V C a '–��� ��37.���.�r SFD. MH Site Preparation Etc §gnatur of-ApplicanT Date / The above information must be verified from Building Application % 1 STAFF USE — DO NOT WRITE BELOW THIS LINE Initial Date "7• Certification of Existing S.D. System required. ❑ Yes 2/N o �'/��� + �! . WOCB Clearance required. ❑ Yes © No/ r I Soils feasibility report required. ❑ Yes CD N►o/ bAR Special feasibility boring report required. E) Yes Detailed contour plot plans required. E) Yes 12 No Staff Specialist approval required. ❑ Yes IJ No Lot Inspection Date ' Soils/boring report by Project # Date_„ Soils Map Page/10/ / I Soil Type/6' Approved by ,/rZ�-" Date Type of System: of Bedrooms (1) Septic Tank Rate Required VewNo. ❑ Existing ❑ Additional ❑ Replacement /'x�C • A�Gals. (�Soil (2Leach line sq. ft. Sidewall allowance Install_ Line(s) Ft. Long, Ft. i 1_064 bed Sq. Ft. ami (Bofto rench area) ft. rock/ / Sq. Ft. w�min__,,;,_inches of bolt "'`�� per running ft. CJ'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 factor ( /[� Max. allowable depth �o N/A Overburden / A /�f v This application irove ! nied,for the design of a subsurface disposal system as indicated on the accompanied plot plan using the requirements set forth in Section a ove. 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, 4,01�q' +. f 4..P k Leach lines must be 100' min. from any wells including expansion area ,(�2) (30 Seepage pits must be 150' min. from any wells including expansion are a`.r411 7f ' f 14 n a t rto Signature of Health Official /pjw;J��� ` RECEIPT NO._ _V01 -34?4 % Issued by �iC 'G Date-- District: ate District: ❑ Riverside Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File DOH SAN 122 (Rev 8/87) o R� { OFFICE OF E. LEON SPAUGY CO�f�nS:In�Eq AGRICULTURAL CO;NIMISSIONER J VI ? )AMES 0 WALLACE O , d A V D ASSISTANI CIDINIISSIWAR " WEIGHTS & MEASURES CLEMENTEpvENIStE. -'� 49-613 Ilwy 86, Suite 8-12 ''►.,"� ,,,,e••'• 'Coachella, CA 92236 MgY9, i q3 619-342-8.291 DATE CASE N0k G - 0-712 C DEVELOPER'S NAMES :5+ Pt (-r- C-0 "N J rL, C-1,-6 ") ADDRESS:2 y 7 Ta �. LJ Ate-, -$- Z TELEPHONEe (611) 3aV_/Oad Sa4SS CAO-AJ7 ; tiP, Q-...:,y4A CG�Pta, Dear Developer: After reviewing your landscaphig plains,'all plant material listed is not in violation of quarantine laws governing the Coachella Valley. If substitutions do occur and they differ fran plant material listed, this office must be notified immediately. Thank you for protecting and preserving the Coachella Valley's pest -free enviratment. Agric4jtural Cannissioner's Office cct Indio and Riverside Office