00017527 (HOTL)_PERMIT APPLICATION
' CounIV of
Riverside
r Department of 4;Vding
and -Safety
4080 Lemon St. 2nd Floor 135 N. Alessandro Rd. Am. 203 880 N. Stale Street
22 North "0" Street 46209 Oasis SI. Rm. 310 160 N. Broadway
Riverside. CA 92501 Banning, CA 92220 Hemet. CA 92343
- Perri;, CA 92370. Indio. CA 92201 Blythe. CA 92225
Ph: 787.6146 Ph: 849.7312 Ph: 658.4464
Ph: 657.3898 Ph: 342.8271 Ph: 9222670
This permit becomes void if work not commenced within 180 days Irom date of issuance. OR. it work has beer suspended
or abandoned for a period of 180 days.
0
CERTIFICATE -OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be com-
LICENSED CONTRACTORS DECLARATION: 1 hereby allirm that I am licensed under provisions of Chapter (comment-
pleted it the permit is for one hundred ($100) or less. I certify that in the performance of the work for which this •
Ing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.
permit issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensa-
1140
' lion Laws of California.
❑
Date Applicant
OWNER -BUILDER DECLARATION: I hereby allirm that I am exempt from the Contractor's License Law for the
NOTICE TO APPLICANT: It. alter 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
following reason (Sec. 7031.5. Business and Professions Code: Any city or county which requires a permit to con-
deemed revoked.
struct. 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
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
(Chapter 9 (commencing with Section 7000) of Division 3 -of the Business and Professions Code) or that he is ex-
❑I hereby certify that no excavation live (5) or more feet in depth into which a person is required to descend. will
empt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a per-
mit subjects the applicant to a civil penally of not more than five hunderd dollars ($500).):
be made in connection with work authorized by this permit. and that no building structure. scaffolding, falsework,
0
or demolition or dismantling thereof, will be more than thirty - six (36) feel high. (Chap. 3.2, Grp 2. Art 2. Sec 341,
❑ I, as owner of the properly, or my employees with wages as their sole compensation, will do The work, and the
Title 8, C.A.C.).-
structure is not intended or offered for sale (Sec. 7044. Business and Professions Code: The Contractor's License
❑ As owner -builder. I will not employ anyone to do work which would require a permit from the Division of In -
Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or
dustrial Safety. 'as noted above. unless such person has a permit to do such work from the division.
through his own employees. provided that such improvements are not intended or offered for sale. ll, however,
-
the building or improvement is sold within one year of completion, the owner -builder will have the burden of prov-
❑Division of Industrial Safety Permit No.
ing that he did not build or improve for the purpose of sale.)
7 A -•w A F4 2!Amil
Of, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency lot the perfor-
7044 Business and Professions Code: The Contractor's License Law does not a I to an owner of to erl who
mance of the work for which this permit is issued (Sec. 3097. Civ. C.).
builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Con-
tractor's License Law.)
01 am exempt under Sec. B.8 P.C. (Attach Certificate).
Date Owner
WORKERS' COMPENSATION DECLARATION: I hereby allirm That I have a certificate of consent to sell -insure. or a
certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800. Lab. C.).
❑Certified copy is hereby furnished.
❑Certified copy is filed with the County Building Inspection Department or County Department
APPLICANT NAME it, F, MI)
PS
e.
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AMIR]«."14 s�
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CITYICOMMUNITYISTATE/ZIP
911�3pslnnflfl
JOB SITE ADDRESSISPACE
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CITY/COMMUNITY/STATEIZIP '
Vrmlrellt P,% 9,1*P!a.,xannn
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TRACT - LOT
MOD
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TRACT NAM
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OWNER NAME (,F,MI) PHONE
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CONTRACTORFIRM NAME
LICNC 0
ADDRESS
CITY/COMMUN ITYISTATE/ZIP
CARMr «
PHONE 0
BLDG. INSPECTOR
FINAL DATE
7 A -•w A F4 2!Amil
ARC/ENG FIRM NAME
LICNC d
ADDRESS
CITYICOMMUNITYISTATEIZIP
PLAN 0
PI.A E%AMI R APPROVE DATE
USE OF PERMIT
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END
SIDE
PP. -41590 1
1
1
1 1
anno
Lender's Name
Lender's Address
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state
that the information given is correct. I agree to comply with all state laws and county ordinances relating to
building construction, and authorize a representative of the County of Riverside. Department of Building and Safety
to enter upon a properly [or which I 1 ve applied Ior this permit for the purpose of making inspections.
STgnalure-A'0plicaW1*or Agent" -'Date
Print Applicant/Agent Name
APPLIPRMT 0:]:
r t
7
PS
e.
1c I
ll Fryr
DATE
�I q!S
3450 45O LJ��IL
A I 0%
_C11111TIMAYrDs.
TOTAL
FEE
CA
CK
NC
COUNTEiRB.I.
. �,
COUNTER L.U.T.
C( PERMIT FOR STRUCTURAL PLAN REVIEW1 345
TOTAL. PERMIT COST IS $201.50
CONSTRUCTXON ESTIMATE (NOTEi Not to be used as property valuation)
Description FCC Group TY90. Sqq Ft Rate Valuatiop
PRIMARY HOTEL 2.13 R- 1 V4..�. i 665 $31,30 052114
SECNDRY PATIO 329 M V• N 408 $4,90 $1999
SECNDR,Y AIRCON 900 R«-3 C. 162* $2.60 $45?5 /j
Es't Flan Rev Veo based on Total Estimated Val'tn of $ 8338 is: $201 150
I �G
INSPECTOR
t NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Figs 8 Frms
34
Plenums 8 Ducts
2A
Slab Grade
35
Furnace Comport.
3
Steel
36
Inlets 8 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
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L.
43
Final
10A
Fireplace T.O. 0
OP'N
NO.
_
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Loth
12 Internal Loth '
12A Drywall
13 Finish Grade
INSULATION Thick R'
Value
7A Walls (Batts)
12B Ceiling (Batts)
12C Ceiling (Blown)
14 Final
PLUMBING APPROVALS'
_
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
PSL
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
PERMIT APPLICATION
County of Riverside
Department of Building alt. Safety
4080 Lemon St. 2nd Floor 135 N. Alessandro Rd. Rm, 203 880 N. slate street 227 North "0" Street 46.209 Oasis St. Rm. 310 160 N. Broadway f
Riverside, CA 92501- Banning. CA 92220 HemelParis,
. CA 92343 CA 92370 Indio. CA 92201 Blythe. CA 92225
In: 7871arili Ph: 849.7312 "Ph: 658.4464 Ph: 657.3898 Ph: 342-8271 Ph: 922.2670
This permit becomes void If work not commenced within 180 days from date of issuance. OR, it work has beer suspe
LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commenc-
ing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.
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 con-
struct, 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 ex-
empt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a per-
mit subjects the applicant to a civil penalty of not more than five hunderd 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, Business 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 lot sale. II, however:
the building or improvement is sold within one year of completion, the owner -builder will have the burden ofprov-
ing that he did not build or improve for the purpose of sale.)
Of. as owner of the property, am exclusively contracting with licensed contractors to construct 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 Con-
tractor's License Law.)
01 am exempt under Sec. , B.8 P.C. (Attach Certificate).
Date Owner
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure, or a
certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec- 3800, Cab. C.).
❑Certified copyls hereby furnished.
❑Certified copy is filed with the County Building Inspection Department'or County Department.
APPLICANT NAME (L, F. MI)
CI IC ITY/STA E Z P -
= m-.
JOB SITE ADDRESSISPACE '
CITY/COMM NITY/STATEIZIP -
^
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BOK
PA PRC
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MOD
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TRACT NAME '
OWNER N,F,MI) PHONE
AME
I I AMD CEI
# '
NAM
CONTRACTOR -FIRM E LICNC #
MARK LAND r-O,INC 33446
ADDRESS
10 0 C1 nC X TOWER PL
CITYICOMMUNITY/STATE/ZIP -
PHONE#
_1
BLDG. INSPECTOR
FINAL DATE
ARC/ENG FIRM NAME
LICNC #
ADDRESS
CITY/COMMUNITYISTATEIZIP
PLAN #
PLANS EXAMINER -
APPROVE DATE
USE OF PERMIT --
-J ,
BL
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18
FSSSB
'SSB RSB
OFC
ZONEORD#
....¢•
LOT S2
END.
SIDE
ntied or abandoned for a period of 180 days
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE, This section need not be com-
pleted if the permit is for one hundred ($100( or less. I certify that in the performance of the work for which this
permit is issued. 1 shall not employ any person in any manner so as to become subject to the Workers' Compensa-'
tion Laws of California.
Date _ Applicant
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.
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
01 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will
be made in connection with work authorized by this permit, and that no building structure. scaffolding, lalsework,
or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2. Art 2. Sec 341.
Title 8. C.A.C.). -
❑As owner -builder. I will not employ anyone to do work which would require a permit from the Division of In-
dustrial Safety. as noted above. unless such person has a permit IO d0 such work from the division.,
❑ Division of Industrial Safety Permit No.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the perfor-
mance of the work for which this permit is issued (Sec, 3097. Civ. C.).
Lender's Name -
Lender's Address
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and stale
that the information given is correct. I agree to comply with all state laws and county ordinances relating to
building construction, and authorize a representative of the County of Riverside. Department of Building and Safely
to enter upon the property for which I have applied for this permit for the purpose of making inspections. "
X
Signature of Applicant or Agent Date
Print Applicant/Agent Name
APPL/PRMT If PS DATE
eoeif5ilf XB 04/_38/82
34502
r
t
< r
/
4
TOTAL .
FEE
CA
CK
NC
I COUNTER B.I.
COUNTER L.U.T.
'
APPLICATION FOR STRUCTURAL. PLAN REVIEW
T H I S I s A N. A P P L' I C A T` I' O N O N L Y
You Must see the following Departments (if listed) for concurrence BEFORE
a Permit can ire.issued
Descr ip tion- -_-------_,__-------....__-�.__ Dep t to See--_.�__ -
HOLD -ROAD HEALT LAND USE
tsd'
FORM 284.208111-81j APPL•IC'A-N.T
'
r
FORM 284.208111-81j APPL•IC'A-N.T
PERMIT APPLICATION
County of
Riverside
Department of $uilding
and Safety
4080 Lemon St. 2nd Floor 135 N. Alessandro Rd. Rm. 203 '880 N. State Street
227 North -D- Street 46.209 Oasis St. Rm. 310 160 N.t Broadway '
Riverside, V 92501 , ,.� "Banning. CA 92220- Hemel. CA 92343Pisrfs.
-. CA 92370 Indio. CA 92201 Blythe. CA 92225
746
I J Ph: 18 %•.>. c • -- Ph: 849.7312 Ph: 658.4464
Ph:. 657-3898 Ph: 342.8271 Ph: 922.2670 r
This Derm 01119 5 N Id f work not commenced within 180 daysdrom date of issuance, OR, if work has beer suspended or abandoned for a period of 180 days'
> <
O. 1•.
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be com-
LICENSED CONTRACTORS DECLARATION: I hereby aflirm that I"am licensed under provisions 61 Chapter 9 (comment-
pleted it the permit is for one hundred ($100) or less. I certify that in, the performance of the work for which this
permit issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensa-
ing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in lull force and ellect.
tion Laws of California.
JOB SITE ACORESS/SPACE
Date Applicant
OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law for the
.NOTICE TO APPLICANT: It. alter 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
following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to con-
deemed revoked.
slruct, 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
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:.
(Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is ex-
of hereby certify that no excavation live (5) or more feet in depth into which a person is required to descend. will `
empl therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a per-
mit subjects the applicant to a civil penally of not more than five hunderd dollars ($500).):
be made in connection with work authorized by this permit. and that no building structure. scaffolding, falsework,
RNG SE S
or demolition or dismantling thereof, will be more than Ihirly-six (36) feel high. (Chap. 3.2, Grp 2. Art 2. Sec 341,
❑ I, as owner of the properly, or my employees with wages as their sole compensation, will do the work, and the
Title 8. C.A.C.).
structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's LiceIT e
❑As owner -builder. I will not employ anyone to do work which require a permit Tram the Division of In-
Law does not a I to an owner of propert who builds or im roves thereon, and who does such work himself r v
PpY Y P o,y
dustrial Safety. as noted above. unless such person has a permit to do such work Irom the division..
t to d
through his own employees, provided That such improvements are not intended or offered for sale. ll, however,
- -
the building or improvement is sold within one year of completion, the owner -builder will have the burden.of prov-
C] Division of Industrial Safety Permit No. _
Ing that he did not build or improve for the purpose of sale.)
-
❑1, as owner of the property, am exclusively contracting with licensedcontractors to construct the project (Sec.
CONSTRUCTION LENDING AGENCY: I hereby aflirm that there is a construction lending agency for the perlor-'
7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of properly who
mance of the work for which this permit is issued (Sec. 3097. Civ. C.).
builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Con-
Lender's Name I
tractor's License Law.)
Lender's Address'
❑1 am exempt under Sec. . B.8 P.C. (Attach Certificate)..
-
Date Owner
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state
A bRESB -
that the information given is correct. I agree to comply with all slate laws and county ordinances relating to
WORKERS' COMPENSATION DECLARATION: I hereby affirm that have a certificate of consent to self -insure, ora
building construction, and authorize a representative of the County of Riverside, Department of Building and Safety
to enter upon the property for which I have applied for this permit for the purpose of making inspections..
certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Lab. C.).
CITYICOMMUNITYISTATEIZIP
X
❑Certified copy is hereby furnished.
"
❑Cerlflied copy is tiled with the County Building Inspection Department or County Department.
h -
'Signature of Applicant or Agent Date
PHONE d -
-Print ADDlicant7ADentName
APPLICANT NAME (L, F, MI)
. .
1D a.. ♦ T LAND
SO
-
CI IC ITYISTAEZIP'••
JOB SITE ACORESS/SPACE
-
A10
9.
CITY/COMMUNITY/STATE/ZIP
- -
•
BOK PAG PRC C
TWN
RNG SE S
TRACT_. LO
ninnnan
MOD 913
"
TRACT NAME
Y 11 it D '
-
OWNER NAME (L,F,MI)
-
PHONE If
Q
CONTRACTOR -FIRM NAME
- - LICNC If '
Ad
A bRESB -
-
*
r
CITYICOMMUNITYISTATEIZIP
o
PHONE d -
BLDG. INSPECTOR FINAL DATE,
ARCIENG FIRM NAME -
LICNC N
ADDRESS
CITYICOMMUNITYISTATEIZIP
"
PLAN q
PLANS EXAMINER
APPROVE DATE
USE OF PERMIT,
SL
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ZONEORD"p
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END
SIDE
PP—AM9 11
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APPL/PRMT d PS DATE
34502/
V M.1 Y
..
r
r ,
TOTAL .
FEE
CACK NC COUNTER B.I. _ COUNTER L.U.T. -
ApPL.II wriON FOR STRiJO'tURAL PLAN REVIEW
7rHIS I A'N ADPL 1 CAT1-0N 0•N1.Y
You Mint sea t•he fol.lowinq Departments (if listed) for concurrence BEFORE
a Permit can be issued3
..., .__
Description -------- Deppt t o, -See .._.,... --
HOLD -ROAD? HEALT LANE USE,
Roo
FORM 284.208 (11.81) ASSESSOR
P IT Fr I) LAND CO
01b v AVE ODRUDON
i ,A,C0umywZIP CA 7 2a*3 f 4 010
,l E�AD�QRESSISPACE A, ! E O &CON
1�
+LI
COlyt��'t�'Iafff � L/1 _€IZIP•
CA V225 0 0 V 0
U ,1
3bc
145
A
W`bmst
$1.95
wk
16
ItI
V 0� W 6 LOT
6Og
x
SB
ACT N
171, W
t1/4 �� COLrWF9!FYI1RdiI�'1lRW.. LAND O
Qp NN yy�g1I��,,y���y�I81
PHONE#
CA' 50AAWRAMLANA Cn, INC
`T 446
T, WVs CLOCK Tp P'L.
A`NlITYISTATE/ZIP CA��
G
44'T.•ic/�"'lf#�
BLD � .... j
8f%ll�9RN,�a".'�i t
ARCIENG FIRM NAME ?� LI. N N
ADDRESS
CITYICOMMUNITYISTATEIZIP
PLAN N
PLANS EXAMINER
APPROVE DATE
pE,
ECHE Iy�+ZLg UNIT'S{S�I
'. 5J
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a 1
nN 7yBLDGG�gp�"{
4/ W y V
v' ! ,
.pI�S
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COUNTER L.U.T.
LOT S2
END
s o S�DFa
I
t VIT,../2! Ps 05/ a;�"2
CONSTRUCTION FIS
25700
$30 1 Uv
ELECTRICAL FEE
$23.81
MECHANICAL FEE
$35,041,
REFUND PLAN WEV FEE
$1.95
1 257
8MI FES:
$4.04
JIr
17 TOTAL
FEE
$424,90
CA
CK
NC
COUN B I.
COUNTER L.U.T.
STRUCTU8'AL
TOTAL. FIE M`IT 069T,11$ "
$424,90
`CIONBTRUCTION ESTIMATE 4*OTWi Not to 4►a used as property toaluatiQni
Dosscription FCC Group Ty ,&* 8� Ft Ratan V�t1uslion
`.
---PRIMP Y . H'CTE t -� y V�t4 i 031.30 $52114
ly
j in
Cwnstr action a66
*, hps*d on Total Actual t *Nation of *5451 isi $367.00
ME IC: L FZ CGM�i�'"�1'4` C� �� P' remit � _s iW appl.icablo I Car. I a$ RE
t p
P114ES 000-3 WPt Y3-11110::0 )10-3010,0 >30-1341019 >5QtGp FEEL 1t12.00
Wi AI' Wil i�4' �i ..• S 8T , t 03 A 44� 6 or Melts STW 0Q FEE t $�12. 00
r C, from c4 PUTUMA-SoCr
A �� ' t�..i t F60 , t 3 �1 ��i � 8{�1+ abl N $INCK Qt40 ft8 + W,rmi.t Fo* li.f sppl.i.rrtl le) FEEL $4.00
sink' 1 brinkirt FnTn t Q Flr braint 0
Kitchion Sisk t -g Ladn4r r r't a14g y� ttw CI sat t 3
Wtetmry a l aaarot� t u t i ott t Q Ei't i n % FIEE t $40,00
8 W R B ilding t 1 InOUstrial.' W-49,10, 'pr O'trw►st I, totrrpt t Q FEET $5.50
Gia t 1 wt Dr* m5 an o.at t to ' 1= EE t $2.50
A W!WI 90141r,%*0-- 1 .:t a O"v1a�ts t l Or mnr* Ertl Zs 8 F t $2 �
nsta lat on of ;4r, "ping and/or Wav r� I'r*#tm*nt qu pt 1 F t $
SMI FEE r. $4.04
REFUND PLAN REV FEE - $1.95
FORM. 284.208 (1181)
INSPECTOR
1
F E
9
H
I
1 257
T
`CIONBTRUCTION ESTIMATE 4*OTWi Not to 4►a used as property toaluatiQni
Dosscription FCC Group Ty ,&* 8� Ft Ratan V�t1uslion
`.
---PRIMP Y . H'CTE t -� y V�t4 i 031.30 $52114
ly
j in
Cwnstr action a66
*, hps*d on Total Actual t *Nation of *5451 isi $367.00
ME IC: L FZ CGM�i�'"�1'4` C� �� P' remit � _s iW appl.icablo I Car. I a$ RE
t p
P114ES 000-3 WPt Y3-11110::0 )10-3010,0 >30-1341019 >5QtGp FEEL 1t12.00
Wi AI' Wil i�4' �i ..• S 8T , t 03 A 44� 6 or Melts STW 0Q FEE t $�12. 00
r C, from c4 PUTUMA-SoCr
A �� ' t�..i t F60 , t 3 �1 ��i � 8{�1+ abl N $INCK Qt40 ft8 + W,rmi.t Fo* li.f sppl.i.rrtl le) FEEL $4.00
sink' 1 brinkirt FnTn t Q Flr braint 0
Kitchion Sisk t -g Ladn4r r r't a14g y� ttw CI sat t 3
Wtetmry a l aaarot� t u t i ott t Q Ei't i n % FIEE t $40,00
8 W R B ilding t 1 InOUstrial.' W-49,10, 'pr O'trw►st I, totrrpt t Q FEET $5.50
Gia t 1 wt Dr* m5 an o.at t to ' 1= EE t $2.50
A W!WI 90141r,%*0-- 1 .:t a O"v1a�ts t l Or mnr* Ertl Zs 8 F t $2 �
nsta lat on of ;4r, "ping and/or Wav r� I'r*#tm*nt qu pt 1 F t $
SMI FEE r. $4.04
REFUND PLAN REV FEE - $1.95
FORM. 284.208 (1181)
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATEINSPECTOR
BUILDING APPROVALS
MECHANIC41. APP90VALS
I
Set Back
33
Ventilation System
2
•Ftgs 8 Frmi
34
Plenums 8 Ducts
2A
Slab Grade
/
35
Furnace Comport.
3
Steel
36
Inlets 8 Outlets
4
Grout Blocks
e
37
Combustion Air
5
Bond Beams
8
Compressor
6
Roof Deck
j
39
Appl. Clearance
Framing
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L.
43
Final
10A
Fireplace T.O.
oo
ADDITIONAL IN ORMATION
I
I
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall r
13 Finish Grade
-42
INSULATION ThickA If R
Value
7A Walls (Batts) r
12B Ceiling (Batts)
12C Ceiling (Blown)
14 Final O /
PLUMBING AISPRovALS
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 r
PSL P/
t
ELECTRICAL APPROVALS
26 Power Pole
27 Conduit
28 Service Entrance s•
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
F Ml)
AA R Wd MY L A N V C 0
0 AVE"ODREGUN
ETACD WRITWIP CA 9-22530-0 00
dEdEURESSISPACE
AVE 9R, ;ON
X ErAcOWWW"' .92"nmoo,ov
U'Wb000
LOT
Wl v
sa
:1 .JQAC
SW 1/4
AND CO
LOV'TIiV
HONE #
7
A
1V /t M Alb" C-O.pINC-,
146
S
CL.O'Cl( TOWER OL
tATAWntCY/STATE/ZIP
CA 939230 [91J 47
Al
BLDG. INSPECTOR
..7FINAL DAT
ARC/ENG FIRM NAME
:ADDRESS.
CITYICOMMUNITYISTATEIZIP
IY
•PLAN #
PLANS EX . AMINER
APPROVE DATE .
N
0
T
ENO
2 5 6
APPLICAT.10N. FOR ;STR,UCTURAL PERMIT
d.'0 N (J N L Y
TS .1 c I.S A N A P' P L J C A T
NO.
OPERATION DATE
INSPECTOR
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 8 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
Garage Fire Wall
42
Commercial Hood v t
10
Fireplace P. L, 0
43
Final
IDA
Fireplace T.O. 0
FIN
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts)
128 Ceiling (Batts)
12C Ceiling (Blown)
14 1 Final
PLUMBING APPROVALS
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
PSL P/
ELECTRICAL APPROVALS
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
APPLICANT,NAME'(L„F, MI)�I
.. ,
t
ARM
p
QNSCAPI;
'CITYICOMM NITYISTATEIZIP
_
. .4
_n... f`'
frIft
JOBSITE ADDRESSISPACE
KYi�"I^•�r.W'
Aso: cw
l CITYICOMMUNITYISTATEIZIP
- - -
�OK,PA PRC
C -- +�TWN `.RNG,^.ySE
5
2,1
' TFIKCT
LO • MOD SB
-
TRACT NAME -'
•OWNER AME'(C,F _Mp
PHONE W
CONTRACTOR --FIRM NAME
ti.
- LICNC q
g - 3 ti
.A S
C C MM SAT IZIP
..
Q_..
O_ E• r
BLOG.lNSPECTOR - FINAL DATE
I' 5
1P
.A7RCTENG•FI M NAME
-
LICNCW -
iADDRESS
-
` t07iCOMMUNITYISTATEIZIP"
'
AN'q
PLANS EXAMINER -
APPROVEDATE••'
iit
K:�L
..
77 USE OF:PERMIT
4': t 11
'FSB. SSB.��.'SSB y.RSB .OFC •.
ra
yn :.
[+'Y., ZONE'6AIN
LOT 9Z ""• '.END - .SIDE
in -5—,
APPLICATION F0R.,--,STRUG.TU At- PLAWREOIEW
i r�v tints ( f . "' � d).. ,o, .a.�cu rence B�:t ORE
You mo, �e•e the• f6.11aw •nth Dppa M: ��s. e # r e � n
w Ya.Deg Saxe
_MUL'D�RC1AD.a `MEALTH LAD USE
,r•
FORM 28d 208 (11.81) I NSPECTOR.,�,
. _..,e?.:+.... c.:�.n.�rm ... .:.._�.'. _'�>a..-_.,*�:., _,. .,. ,,��'.nc:,.. ... .�r.,,t•.'YxJ .Et _�G. n..� � •..r �r� :, ,x. tz �<�._,., _..__.,._ _ ...-_..._ -. ..._
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs 8 Frms
34
Plenums & Ducts
2A
Slab Grade
35
Furnace Comport.
3
Steel
36
Inlets 8 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
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L. C]
43
Final
10A
Fireplace T. 0. C]
No
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
PLUMBING APPROVALS
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
PSL
P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME