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BLDG (00017252)77697 Los Arboles Dr 00017252 PERMIT APPLICATION County of Department of Building Riverside and Safety 4080 Lemon SI. 2nd Floor 135 N. Alessandro Rd. Rm. 203 880 N. State Street 227 North -D- Street 46209 Oasis SI. Run. 310 160 N. Broadway Riverside. CA 92501 Banning. CA 92220 Hemel. CA 92343 Perris. CA 92370 Indio. CA 92201 Blythe. CA 92225 Ph: 787.6146 Ph: 849.7312 Ph. 658.4464 Ph: 6573898 Ph: 3428271 Ph: 922.2670 This permit becomes void it work not commenced within 180 days from dale of issuance. OR. if work has beer suspended or abandoned for a period of 180 days. ❑ CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be com- LICENSED CONTRACTORS DECLARATION: I hereby allirm that I am licensed under provisions of 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 ing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full force and effect. permit is issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensa- MOD 011 tion Laws of California. ❑ Dale _ Applicant f • OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's license Law for the NOTICE TO APPLICANT: IL alter making this Certificate of Exemption, you should become subject to the Workers'' Compensation provisions al the Labor Code. you must forthwith comply with such provisions or this permit shall be lollowin reason Sec. 7031.5, Business and Professions Code: An cit or count which requires a ermil to con- 9 ( Y, Y Y q deemed revoked strati. alter, improve, demolish, or repair any structure, prior to its Issuance. also requires the applicant for such i CITYICOM MUN ITYISTATEIZIP 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- 01 hereby certify that no excavation five (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 lot a per- mit subjects the applicant to a civil penalty al not more Than live hunderd dollars ($500).): be made in connection with work authorized by this permit. and that no building structure, scaffolding, falsework.' ❑ I, as owner of the or demolition or dismantling thereof, will be more than thirty-six (36) feel high. (Chap. 3.2. Grp 2. An 2. Sec 341, Title 8. C.A.C.). 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 ❑ As owner -builder, I will not employ anyone to do work from Division Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or which would require a permit the of In - dustrial Salely. 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. If, however, the building improvement ❑Division of Industrial Safely Permit No. or is sold within One year Of completion, the owner -builder will have the burden of prov- P. ing that he did not build or improve for the purpose Of sale.) ZONE ORD If Ell. as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. Ir CONSTRUCTION LENDING AGENCY: I hereby allirm that there is a construction lending agency foP the perfor- 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who mance of the work for which this permit is issued (Sec. 3097. Civ. C.). .a builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Con- tractor's omtractor's License Law.) _`• ❑I am exempt under Sec. . B.8 P.C. (Attach Certificate). I' WORKERS' COMPENSATION DECLARATION: I hereby affirm [hal 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 (L, F, MI) ANDEN CORPORATION 77697 LOS ARDOLES DLADtl!'4i.iN AZIP CA 922530000 r YgOTESSISPACE LOS ARBOLES LAO{Y V.T, NT TA21P CA 92...2530000 BOK 7'73 PAG 220 PRC Q i 1 C 9 TWNPING Q Q 0 SE 0 0 S TRACT LOT 014496 0212 MOD 011 SB TRACT NAME k, 1 1 Ai D t"tORP©RATION PHONEM CONTRACTOR -FIRM NAME LICNC M ADDRESS CITYICOM MUN ITYISTATEIZIP PHONE N - DG T R FI L A ARCIENG FIRM NAME LICNC M ADDRESS CITYICOMMUNITYISTATEIZI P PLAN M PLANS EXAMINER APPROVE DATE USE OF PERMIT 200 AMP -TENNIS CT/POOL EQ/LIGHTS/I LQ l! R N FSB t)SdBQ &0 01 13 u v COUNTER L.U.T. YC 'D OSUDb ZONE ORD If LOT SZ END Q I _ — _ 60 Lender's Name Lender's Address I CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state that thein rmation given is correct. I agree to comply with all stale laws and county ordinances relating to building n Iruction, and aulhoriz a r p esenjalive of the County of Riverside. Department of Building and Safety to enter I!'po the prom/lyfofor If h I have pjifid for this permit for the purpose of making in@pectio s. X 'rV Signature of Applicant or Agent Date Print Applicant/Agent Name APPLIPRMT N PS DATE 000172 52 P10 Q4/27/82 , CONSTRUCTION FEE 4/J/ {rU• .LWjl 26907 6 n O 7 $0.0o PLUMBING FEE $13.50 ELECTRICAL FEE $29.00 AVID POOL EQUIP. FEE $9.00 SMI FEE 90.00 TOTAL j — FEE CA CI`' NC I UNTER 11 / COUNTER L.U.T. 7 S T R U L T U R A L t BUILDING ) TOTAL PERMXT COST IS $51.50 M CONSTRUCTION ESTIMATE (NOTEi Not to be used as property valuation) Description FCC Group Type Sq Ft Rate Valuation PRIMARY MISC M M 0 $10.00 $0 Construction Fee based on Total. Actual Valuation of $0 is: '0.00 ELECTRICAL FEE COMPUTATIONS * Permit Fee (if applicable) FEET No of Units: 90 Service Volts s 0 FEE: Service Amp* -11 200 Service Amps -2: 0 Service Amps -3► 0 FEE; PLUMBING FEE COMPUTATIONS * Permit Fee (if applicable) FEEL Installation of Water Piping and/or Water Treatment Equipo1 FEET Lawn Sprinkler System, Including Backflow Devine: 2 FEE; SMI FEE ADD POOL EQUIP. FEE FORM 284.208 (11.81) 11WECTOR $3.00 9:19. 00 $7.00 T#4. 0 Q $2.50 $7.00 90,00 $9.00 NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Ser 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 11 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 IDA Fireplace T. 0. E] No ADDITIONAL INFORMATION SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath 12 Internal Lath 12A Drywall 13 Finish Grade INSULATION Thick Value 7A Walls (Batts) 12B Ceiling (Botts) 12C Ceiling (Blown) 14 Final PLUMBING APPROVALS 15 Ground Plumb 16 Water Piping 17 Rough,411umb• 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 P/L P/ ELECTRICAL APPROVALS 26 Power Pole 27 Conduit 28 Service Entrance or AIW 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final STREET NAME APPLICANT NAME (L, F, MI) ANDEN c CORPORATION ADDRESS 77697 LOS ARBOLES CITYICOMM+UNIITqTYApI S TyA TEIZIP 922530000 + y ,t p LA QUIN 1 A CA 71F'.25 30000 1I3 Jo,ESSISPACE LOS ARBI)LES L,0QITTZIPvCul NCA 9225;30a0a BOK 77:312201011 PAG PRC CTWN 9 x000 RNG SE aU S TRACT LOTMOD a 94496 0?'1 2 M e i SB TRACT NAME 040br-9p F'EGRIP01EA i ION PHONE# ,CONTRACTOR -FIRM NAME LICNC # ADDRESS CITYICOMMUNITYISTATEIZIP ' PHONE# - BLDG. INSPECTOR FINAL DATE ARCIENG FIRM NAME LICNC # ADDRESS CITYICOMMUNITYISTATEIZI P PLAN # PLANS EXAMINER APPROVE DATE USE OF PERMIT 00 AMP_TENNIS .C: /POOL EQ/LICHTS/I BL 00 RL:N FSB 0®!i 016% 0110 lilts ZONE ORD p I LOT SZ END a „Seh APPLIPR 00017252 PS A DATE 04I2I /S 2 6 8 9 7 ' J TOTAL . FEE CA CK NC COUNTER B.I. COUNTER L.U.T. APPLICATION FnR STRUCTURAL PERMIT 1 2 6 8 9T TMIS IS - AN AP.FLICAT10N 0 N L Y FO,RM280-208(11.81) INSPECTOR I 1 ' J 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 & 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. NO ADDITIONAL INFORMATION SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath 12 Internal Loth 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Walls (Batts) 12B Ceiling (Botts) 12C Ceiling (Blown) 14 Final PLUMBING APPROVALS 15 Ground Plumb 16 Water Piping 17 Rough-Ptumb., J- 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 P/L P/ ELECTRICAL APPROVALS 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29AGrounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final STREET NAME