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04337 (SFD)Qum& S3 P.O. BOX 1504 Building 4 78-105 CALLE ESTADO Arlrirocc �4-06i Carranta LA QUINTA, CALIFORNIA 92253 Coachella Vallev Land Mailing Address 247 E. Tah uitz Way f2 City Zip 73222-1020 Palmi3prinq, 92262 Contractor Starr Constrattion State Lic. 38934 City & Classif. Lic. # 895 Arch., Engr., Designer Address CityI Zip I State # 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 Processions 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, 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 penatty of not more than five 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 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.) ❑ 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 Ue,!f O 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 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 -of this city to enter the above- mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip BUILDING: TYPE CONST. OCC. GRP. A.P. Number 7741»045-016 Legal Description Project Description ' • 13. Plan Chk. Bal. 39.14 Const. Sq. Ft. 1410 Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ 1701 of 61 wood fence 4281 Garage S.M.I. 5.36 Grading 20.00 Driveway Enc. 20.00 Infrastructure Estimated Valuation $75,305 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 39.14 Const. 364.00 Mech. 33.A0 Electrical 74.17 Plumbing 105.00 S.M.I. 5.36 Grading 20.00 Driveway Enc. 20.00 Infrastructure TOTAL REMARKS t. r 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 7/22/08 Permit Validated by: Validation: WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE CONSTRUCTION ESTIMATL NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SO Fl p S UNITS SLAB GRADE ROUGH PLUMB BONDING YARD SPKLR SYSTEM 2ND FL SO FT. � FORMS SEWER OR SEPTIC TANK ROUGH WIRING _ MOBILEHOME SVC. BAR SINK POR SO FT. a GAS (ROUGH) METER LOOP GAR SO. FT. Cl POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. SO FT. 6 GROUT WATER HEATER WALL SO FT. rd FINAL INSP. DRINKING FOUNTAIN SO FT (3 WATER SYSTEM URINAL ESTIMATED CONSTRUCTION VALUATION $ ' _ $ WATER PIPING NOTE: Not to be used as Property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTONDISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM 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 Q 1 Y. c SEWAGE DISPOSAL SO.FT.GAR @ 3Ac HOUSE SEWER FINISH GRADING 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 SETBACK .GROUND PLUMBINV . 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.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. nn // GAMING /� /G! `� ��q��,,,,,, L FINAL INSP. ROOFING // _ �— G�d VENTILATION / '/ _ %�L�LL,LI%O CVVJ s /, /v � /l ��/ REMARKS: FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING/ MESH �SULATIONISOUND G `�`�i (� FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS , GARDEN WALL FINAL t-5" OI f If,E Of AGRICUL'I URAL C0.14MISSIONER AN D MAGI ITS b.. MEASURES 49-613 Ilwy 86, Suite 11-12 Couchel.ia�, CA 92236 619-342-8291 E. LEON SPAUGY co a.ns;ur..En )AME.S 0 WALLACE ASSISIAM i 0)MMMIoNER CLEMENT f1E`VENISIE SEALER DNFE CASE m. DEVELOPER'S MIE: S N`1^ & /JS4t-LA_ c4 66LJ ADDRESS a 7fA L W A !s '� Z 110" S o TELFN (ONES c (P('J) .3;Z2 - Lh a t_� 53040' BOE C 8r-r-A01A PlAidV lk Dear Developer: After reviewialg your lautdscapi.ng plans, 111 plant mterial listed is -not in violation of quarantine laws governing the Coachella Valley. • If substitutions do occur and they differ fruit plant material listed, this office must be notified immediately. Thank you for protecti:tg and preserving the Coachella Valley's pest -free environment. Agr ultural Cotimissioner's office ccs Indio and Riverside office I 04 z O_ l— U w U) i U) Y Q w fr Ad) Z• ? •C U w U) 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..$37`is.required when the application is submitted. Check must be made payable to the County of Riverside. Hyl Building Department Application Log # Name (Owner, Agent, Contractor, Etc.) G.6 Mailing Address R' 7 L_ Ts3 HQa f T -z !•VA y '� .J/P R 2 Al sr A9 a arl^d City State Zip Code Telephone pAL/f 5 -POQ 1AJ& S L'A 9'2 a 6 z. 3.2 ?_ Job Property Address -�.c��-•- dam.. 'City or Community, Legal Description of Property. (Lot, PM, TR) /,o Qct,/+�J-r� GDT �� 2a/ A)f? 2 'Assessor's Parcel No. Water Aged op Well. C 4 -^S� r,/lA / �/'..J�t, Use of Permit � 64,'4'lJ' f J (F.� Planning Case X ' Lot Size f a;�Is re fr�j SFD, MH Site Preparation Etc. Signature of Applicant Date 'The above information must be verified from Building Application STAFF USE — DO NOT WRITE BELOW THIS LINE Initial Date /e C Certification of Existing S.D. System required. El Yes ❑.Nf ✓v _n WQCB Clearance required. ❑ Yes ®'No ! 1f Soils feasibility report required. ❑ Yes ❑,No// Detailed boring report required. ❑ Yes ❑+NN !' Detailed contour plot plans required. ❑ Yes No - ,❑, Staff Specialist approval required. ❑ Yes I�1 No Lot Inspection Date Soils/boring report by ` Project # Date Soils Map Pag � / f Soil Type (� dC Approved by ��1'5 Date-_ _-2� it Type of System: (/ No. of Bedrooms (1) Septic Tank Soil Rate ❑ Existing 'New El Additional ❑ Replacement 10717) Gals. ,Reequired q, ",f e (2) L`egc line sq. ft. Sidewall allowance Install Line(s) Ft. Long, Leacbed Sq. (Bottom fr"encharea) ft. rock/ Sq. Ft. `N/A Ft. wl a i&-Lmiiwn_ inches Ft. of bottom '°�• per running ft. 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/ Overburden factor Max. allowable depth v This application is,app� r dZdenied 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. Septic tank and sewer lines must be 50' from any wells�� 2) Leach lines must be 100' min. from any wells including expansion area yt Seepage pits must be 150' min. from any wells` including expansion area �p 7- .2 D - c� r��-fie, x=�--, . 15 Signature of Health Official j1 Date 1' RECEIPT NO. Issued by �t �-- v - Date t' District: ❑ Riverside 2 Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe Distribution: WHITE—Office file YELLOW—Applicant PINK—Bldg. Dept. GOLDENROD—Pending File DOH -SAN -122 (Rev. 6/86) n