SATT (00019065)77528 Avenida Madrugada
00019065
1 270
APPLICATION FOR -STRUCTURAL PLAN REVIEW
L' M I SI S. A N A P P L I C A T 10 N O N L Y
You -must nee the following Departments (if listed) for concurrence I4EFOR
A Permit can be i%sua d s
- ,- Descr• i tion . -._..». .----...» . .----. . --- .._ .. ,... . . . ,. .. .. ..-- De pp t to See .._
, MALI) -•ROAD f H ALTM LANL) USE
ti
FORM,284-208(ii-81) INSKCTOR
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ADDRESS
49991 EISENHOWER DR
CITYICOM MUN ITYISTATEIZIP
LA QUINTA CA 922530000
P- {OfJE N
BLDG. INSPECTOR
FINAL GATE
ARCIENG FIRM NAME
LICNC #
ADDRESS
CITY/COMMON ITYISTATEIZIP
PLAN #
PLANS EXAMINER
'.APPROVE DATE
USE OF PERMIT
C13ND13- iWLG & ATT GARAGE 'F'- t
BL ,
.00
ION
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SSB
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SSB
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aha
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LOT SZ
END
.SIDE
0000
1 270
APPLICATION FOR -STRUCTURAL PLAN REVIEW
L' M I SI S. A N A P P L I C A T 10 N O N L Y
You -must nee the following Departments (if listed) for concurrence I4EFOR
A Permit can be i%sua d s
- ,- Descr• i tion . -._..». .----...» . .----. . --- .._ .. ,... . . . ,. .. .. ..-- De pp t to See .._
, MALI) -•ROAD f H ALTM LANL) USE
ti
FORM,284-208(ii-81) INSKCTOR
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
10
Fireplace P. L.
43
Final
IDA
Fireplace T.O.
P'
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Botts)
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 Serviee ^.
24 Gas Test
2s
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
APPLICATION. FUR. STRUCTURAL PERMIT
I s A N A P P L. I C A T Y 0 N 0 N L Y
FORM 284.208(11.81) INSPEKTOR
S7(30
EWCOjA{rj f!!iMIZIP CA 922530000
lyrmuRESSISPACE AVE NADRUGADA
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OW a
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NAME
QTRACT
;PHONE0
I)A D
.AER kVVGT j '
•V
FIS°faIrMA4
RATION
i.
AMI El'S-'E-N-HOWER DR
•r
cIwCOwft llglI IP. CA 922530000
7lN4p .y„+_IRL{ 4- dj 3 1 5
BLDG. INSPECTOR
FINAL DATE
AARCIENG FIRM NAME
LICNC H
- ADDRESS
CITYICOMMUNITY/STATE/ZIP
PLAN #
PLANS EXAMINER
APPROVE DATE
. I Ari "r ( 'GARAGE
@L} lOP&T-DWa_r
V;,`37.:
R {T« N
FSB
Ion
U n
U n
f IND
ZONE ORD #
LOT SZ
END
SIDE
0000
APPLICATION. FUR. STRUCTURAL PERMIT
I s A N A P P L. I C A T Y 0 N 0 N L Y
FORM 284.208(11.81) INSPEKTOR
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 6 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
IDA
Fireplace T.O. ❑
No
ADDITIONAL INFORMATION
_
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Botts)
12B Ceiling (Botts)
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
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
PERMIT APPLICATION
Cou't of
Riverside
_- Department of Building
and Safety
4080 Lemon St. 2nd Floor 135 N. Alessandro Rd. Tim. 203 880 N. Stale Street
227 North "0" Street 46209 Oasis 51. Rm. 310 160 N. Broadway
- Riverside. CA 92501 Banning, CA 92220 Hemet. CA 92343
Perris. CA 92370 Indio. CA 92201 Blythe. CA 92225
Ph: 787.6146 Ph: 849.7312 Ph: 658-4464
Ph: 657-3898 Ph: 342.8271 Ph: 922.2670
This permit becomes void it work not commenced within 180 days from date of issuance. OR, it work has Deer suspended or abandoned lot a period of 180 days.
Q
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be com-
LICENSED CONTRACTORS DECLARATION: I hereby affirm that am licensed under provisions al Chapter (comment-
pleted if 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 lull force and effect.
Permit is issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensa-
r
lion Laws of California.
TRACT NAME
.V
Dale Applicant
`O
OWNER -BUILDER DECLARATION: I hereby alfirm that I am exempt from the Contractor's License Law for the
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
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
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3
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
empt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a per-
mil subjects the applicant to a civil penalty of not more than five hunderd dollars ($500).):
be made in connection with work authorized by this permit. and that no building structure. scaffolding, lalsework.
❑ I,
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 of the properly, 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 which would require a from the Division In
Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or
permit of -
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. Il, however.
0 6V_[d_V__J)T
- 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 lot the purpose of sale.)
01, as owner of the properly, am exclusively contracting with licensed contractors to construct the project (Sec.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the perfor-
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.).
n builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Con-
tractor's License Law.)
1 01 am exempt under Sec. . B.& P.C. (Attach Certificate).
Date Owner
- WORKERS' COMPENSATION DECLARATION: I hereby affirm 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.
`Cy, NTAMi t( *F13r•11)
VMS 7 80
FIrA°OINWITN l lVIP CA 922530000
JO`;J 2ppR1 TE SISSISPTACE AVE MADRUCADA
PITACO VIP CA 30 000
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TRACT NAME
.V
WMR0p11♦T A, JOINT
INyENTUR
HONEN
Flwpip
ORAT1O,
LICNOMQQiTVC1`P4I2
WEISENHOWER DR
,GITxICO[.1 r1,UfltT1(yt6TyAWIP CA 922530000
1P..g.IF1'1NE1p--57y11aC„+„F134
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BLDG.INSPECTOR
FINAL DATE
ARC/ENG FIRM NAME
LICNC p
ADDRESS
CITYICOMMUNITYISTATEIZIP -
PLAN M I P 5 EX INER_
A ROVF. D=TEA
Cx
V_t?KVUT-DWLC ,& ATT 16ARAGE
UO I
R ON
F..
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0 6V_[d_V__J)T
11WD
ZONEORDN
LOT SZ
r
END
TOTAL
/
FEE
Lender's Name
Lender's Address
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state
that the inlormalion given is correct. I agree to comply with all state laws and county ordinances relating to
building consir ction, and authorize a representative of the County of Riverside. Department of Building and Safely
to enter upgn t e roperlyfi`which I ave applied for this permit for the purpose of making inspections.
Signature of Applicant or Agent "' Date
Print Applicant/Agent Name
UIUIUITT 0 6
ESTIMATED
CPQ u5/26°Y
PLAN REV FEE
5 8
r
TOTAL
/
FEE
$165. 32
CA
I Cy,,,,
NC
COUNTER B.///
//
COUNTERL.U.T.
/ '
l f PERMIT FOR STRUCTURAL PLAN REVIEW
TOTAL PERMIT COST x5 $169,32
!c
CONSTRUCTION ESTIMATE: (NOTE: Not to be used as property valuation)
Description FCC Group WE? 5q Ft Rate Valuation
'PRIMARY DWLC 101 R-3WU D 1481 $27.60 $40075
SEFTDRY PRIFAR 436 T -1 WOOD X448 $9.10 $4076
r Eat an Rev oe based on 'Tats Estimated Val'tYt of $449.51 iat $169.32
FORM 284.208 (11-81) 'INSPECTOR
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System t
2
Figs & Frms
34
Plenums 8 Ducts
2A
Slab Grade
35
Furnace Comport. i
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. 0
P'
ADDITIONAL INFORMATION
'
—
i
i
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
71 STREET NAME