SFD (00019069)77558
00019069
PIfi..fYATf.I TW) s.
66W 78 a
CIT IGOplfrjl{N I /ZIP CA 922530000
AVE MA/D /RUGADA
%' RESSISPACE
° ° Uf 1 T Sjp /ZIP CA 922530000
(
BO Q
rig
P G
A0
R
W
TWN
a+ 6a
N
SE
-ao
S
M476 . 05
0-1
1 60f
SB
TRACT NAME
W,AER bWqF;ICp-qtc,tTAJOINT tlTNyUR llONE N
,
9
OV 6J ti;I QFIS, 1J Y'S,F Q 1'.R 4114
u .7N :7 G7! G
VeMl EISENHOWER PR
QC.TxIGD I. t TYIrS TEIZIP _ CA 922530000
iO
s j
BLDG. INSPECTOR
FINAL DATE
h
ARC/ENG FIRM.NAME
LICNC N
ADDRESS -
CIITyVICOM M UNITY/STATE/ZIP
PLAN N
PLANS EXAMINER
APPROVE DATE
e MET
UN 1.
R5N.
FSB
OY4
U'PU
oVb
.6FA))
ZONEORDN
LOT SZ
END
OD6
6P0-rjRrV 0 h C1 A a 5 i 2gm 25853
TOTAL .
FEE
CA CK NC COUNTER B.I. COUNTER L.U.T.
APPLICATION FOR STRUCTURAL. PERMIT1 258
•14.1S -I..S AN• AF'.P L. 'I CAT 1014 0 N L Y
3 must 'see -the follo'.Winq Dep4artment% (if li%Ted) for concurrence BEFORE
*r ermit can be 71s ii ued i
ti.dies its t i on - , a . w._.. _ __., ._ _, ,-M......» _._. .. .... aa t t s See .._..... .
{ >rpi}t;. D- -CAD Ft'h'AL,TH LAN USE
r
i
t
FORM 284.208(11-81) INSPECTOR
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs 8 Frms
34
Plenums 6 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
Smoke Detection Device
9
Garage Fire Wall
Commercial Hood
10
Fireplace P. L.
rNO.
Final
10A
Fireplace T.O.
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 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
LICENSED CONTRACTORS DECLARATION: 1 hereby affirm that I am licensed under provisions of Chapter (commenc-
VIng 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-
empl therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a per-
;fj, mil subjects the applicant to a civil penally 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 Conlraclor's License
Iw 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 prov-
ing that he did not build or improve for the purpose of sale.)
;G ❑I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
T 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-
' traclor's License Law.)
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 self -insure, or a
certificate of Workers' Compensation Insurance. or a certified copy thereof (Sec. 3800. Lab. C.).
:i ❑Certified copy is hereby furnished.
$.❑Certified copy is filed with the County Building Inspection Department or County Department.
iQ1pN Yp.1-'qE 7'
`AS t}'Gl\
e.f X I PSB ESS
PERMIT APPLICATION
®6;,9rME.IRESSISPACE AVE MADR 1! ADA
J i7YG [•_1 ►1 \7922530000
ET4C`v°iw lllt
%BYATEIZIP
iN Y CA 2Q2530 0 0 0
011
County of Riverside
G7
v
Department of Building and Safety
4080 Lemon SI. 2nd Floor
135 N. Alessandro Rd. Rm. 203
880 N. Slate Street 227 North "D" Street
46.209 Oasis St. Rm. 310 160 N. Broadway
Riverside. CA 92501
Banning. CA 92220
Hemet. CA 92343 Perris. CA 92370
Indio. CA 92201 Blyrhe. CA 92225
Ph: 787.6146
Ph: 849.7312
Ph: 658.4464 Ph: 6573898
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 suspended or abandoned for a penoo of 180 days.
P J4k— L N, , 1;31 5
LICENSED CONTRACTORS DECLARATION: 1 hereby affirm that I am licensed under provisions of Chapter (commenc-
VIng 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-
empl therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a per-
;fj, mil subjects the applicant to a civil penally 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 Conlraclor's License
Iw 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 prov-
ing that he did not build or improve for the purpose of sale.)
;G ❑I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
T 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-
' traclor's License Law.)
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 self -insure, or a
certificate of Workers' Compensation Insurance. or a certified copy thereof (Sec. 3800. Lab. C.).
:i ❑Certified copy is hereby furnished.
$.❑Certified copy is filed with the County Building Inspection Department or County Department.
iQ1pN Yp.1-'qE 7'
`AS t}'Gl\
e.f X I PSB ESS
LrA°OWrld dF`„ ?IP CA 922530000
®6;,9rME.IRESSISPACE AVE MADR 1! ADA
J i7YG [•_1 ►1 \7922530000
ET4C`v°iw lllt
%BYATEIZIP
iN Y CA 2Q2530 0 0 0
011
Ino
G7
v
N V0V0
\IV
S
UT4496 6050
1 1
1
151T a
56
CA
N NAppM 4E EqLL qqMM
DDTRRWANNCT
7 py q r , ` n
UAE- Utfl% 1nA , Jp
N• /F l VENTUR
.PHONE N
/L i'A(
tgYpl Yp
i IRA I .1.V>f'C„ y
p L )
Lein.- 36 2
gg O%B-FIL
-791 V EISENHOWERSNDR
IEWCOW W. ITrAIZIP CA 722530000
P J4k— L N, , 1;31 5
INSPECTOR
FINAL DATE
ARC/ENG FIRM NAME
LICNC N
ADDRESS
Y
CITYICOMMUNITYISTATEIZIP -
PLAN N
P ER
APP PVE ATE
/_80111,
C :if r' LDWLC a, ATT CARAGE
U 0
R MON
FSB
g
0 W {J
N t/ U
B'LLC 7
0 V
12
p pn
IND
ZONE ORD N
LOT SZ
END
n I n
i1T M+M
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, I 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: It. after makingthis 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 live (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 buildingstructure. scaffolding. falsework,
or demolition or dismantling thereof. will be more than thirty-six (36) leel high. (Chap. 3.2. Grp 2. Art 2. Sec 341,
Title 8. C.A.C.).
OAS owner -builder. I will not employ anyone to do work which would require a permit Irom the Division of In-
dustrial Safety. as noted above, unless such person has a permit to do such work from the division.
❑ Division of Industrial Safety Permit No.
CONSTRUCTION LENDING AGENCY: 1 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 slate
that the inggprmation given is correct. I agree to comply with all slate laws and county ordinances relating to
building cod;14-glion, and authorize a•repiesenlalive of the County of Riverside. Department of Building and -Safety
to enter up.bn t -7perly for hieh,l have applied for this permit for the purpose of makiingo specttops:
Signature of Applicant or Agent Date
Print Applicant/Agent Name
N irVRJ iN069 •K• 05,/21420T82 —_—-J,53,
25819
ESTIMATED PLAN REV PEE L 4
i
1 1
/ TOTAL
FEE
$163. 47
CA
Cn
NC
CO NT Rr9
COUNTER L.U.T.
PERMIT FOR STRUCTURAL PLAN REVIEW
TOTAL PERMIT COST IS $163.47
You must vee the follning Departments (if Iiisted) for concurrence BEFORE
a Permit can be issue :
Description Dept to See
HOLD -ROAD, HEALTH LAND USE
CONSTRUCTION ESTIMATE:. (NOTEt Not to be used as property valuation)
Description FCC Croup Type Sri Ft Rate Valuation
69
PRIMARY DWL.G 101 R-3 WD 1390 $27.60 $.30364
SEFNDRY PRIF.AR 43 Vii-- WOOD 40 $9 10 $4004
y Est Ian Rev ate based on ata t tiMate Val `tn a $42US i%t $163. 4?
FORM 284-208 (11.81) INSPECTOR
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
a
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. E]
43 Final
IDA
Fireplace T. 0. 0
OP•N I
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
APPLICANT NAME (L, F, MI)
BOX 780
ADDRESS
LA QUIN'1iA CA 922530000
CITY/COMMON ITYISTATEIZIP
77558 AVE MAX)RUGAiJDA
JOB SITE ADDRESS/SPACE
LA QUINTA CA 922530000
CITYICOMMUNITY/STATE/ZIP '
631 380 028 3 0000 00
BOK
fV4 Q4
-014496
PAG
7® 6L i
PRC
C
a
TVVN
' a 01
RNG
SE
S
TRACT I LOT
MOD
SB
TRACT NAME
LA AUINTA JOINT VENTURE:
ANDENNER NAME `L'CbRPORATION
rHONE# 333672
CONTRACTOR-FIRM JpM EISENHOWER DR
1- 6`. x 4J 1`ENi
LICNC H
ADDRESS
LA QUINTAi ' CA 922530000
CITYICO M M U N ITV ISTATEIZI P
714-564»-1315
PHONE# _,BLDG.
INSPECTOR
FINAL DATE
ARCIENG FIRM NAME
LICNC #
ADDRESS
CITY/COMMUN ITVISTATEIZIP
e, ! D6-DW G A
jF 6.. Qt
( J
ayXAgAW AGE
APPROVE DATE
USE PERMIT
IlV aoa OiBU ano 14D - -
0 R 2
BL
ZON
FSB
I SSB
SSB
RSB
nFC-
V a
ZONE ORD #
LOT SZ
END
SIDE
-Z
APPLICATION POR STRLIC'rURAL PLAN REVir.w
T H I S .1 S A N A P P L I C A T T U N O N t, Y
You roust see ItMe•following- Departmer trs (if listed)- for concurrence BEFORE
a Permit can be issued:
Description Oe a t to See _M
HOLY?wl OAD A HEALTH LAN USE
INSPECTOR
FORM 284208 (11.81) `
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs & 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.
43
Final
IDA
Fireplace T. 0.
OP'N
NO.
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Loth
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 Woted 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