SATT (00019070)77568 Avenida Madrugada
00019070
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ANlDEN CORPORATION
ADDRESS BOX98
CITY/CDM MUN ITYISTATEIZIP
LA WUINTA CRS 92e2 30000
JOB SITE ADDRESS/SPACE AVE
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I ! x 68 1VE MADRUGADA
CITY/COMMUNMISTAATE/ZIP
LA QUINiA CA 922530000 22530aa0 '
BOK
631
PAG
380
PRCC
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TRACT LOTMOD
014496 00!5101
TOTAL .
FEE
SB
CA
TRACT NAME "
OWNER NAME L F,MI
L.A QU '(t + / gMpA , JOINT E:NT!!rR
HONE #
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ADDRESS
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CITYICOMMUNITYISTATEIZIP - -
L.A QUINTA * CA 922530000
PH?OyNEA# w p q
714
G. INSPECTOR
BLDG -'
FINAL DATE
ARC/ENG FIRM NAME
LICNC #
ADDRESS
CITY/COMM UNITY/STATEIZIP
PLAN #
PLANS EXAMINER
APPROVE DATE
USE OF PERMIT
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APPLIPRMT #PS DATE 27100
000 19070 X8 a1;
TOTAL .
FEE
CA
CK
NC
COUNTER B.I.
COUNTER L.U.T.
APPLICATION FOR. •STRUCTURAL. PLAN REVIEW
T "H I S 1 9 A N. A P P L I C A T 1 0 N O N L Y
You most see the following Departments (if listed) for concurrence BEFORE
a Permit can be lssuedi
Description XieI to See -----
HOLD HEALTH HEALTH
HOLD -ROAD ROAD
s
r
FORM 284.208 (11.81) I NSPEC70R
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
10A
Fireplace T.O.
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)
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 S.eryiee
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
FiNU N-VC:PRPQRATION
fD�TDjR,�SS, Box 7@0
, �n y� { ypyn r
ErAco [`Yr�ZIP CA 3e'2..62.�330000
9,, ,E�QD�4�RTESSS//SfPACE AVE MADRUCIAy D�^j
l Y7Y2253V0OQ
C..O�11i7j�lVTl /ZIP CA
gyp
ETA
951
1960
'{7 Gam.. 8
9
TWN
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60
S
UT4496
SB
TRACT NAME
WXR6F6ATAlJOINT VENy R
OIN1
PHONE #
)RA ION
ph'00FFl
Un
2g6ti�6�e
49,0 A EIsENHOWEwR DR
Cp � (� n n
coots e ZIP CA 9223.30 V V Q
1N41-5 f_WA — 1 3 1 5
,{ '•1
BLDG. INSPECTOR
FINAL DATE
ARC/ ENG FIRM NAME
LICNC #
ADDRESS
CITY /COM M U N I TV/STATEIZI P
PLAN #
EXAMINER
APPROVE DATE
pp
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�;p
�IStMb' l-DN L1,; & A 6 T �P''f�1�gi$ry$L@d��n
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END
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APPLICATION FOR STRUCTURAL PERMIT
T I3 IS AN AP.P L.I GAT x 0 0NL.Y
r
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 & 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.
FI
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 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
County of Riverside
Department of Building and 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
Riverside. CA 92501 Banning. CA 92220 Hemel, CA 92343
Perris. CA 92370 Indio. CA 92201 Blythe. CA 91225
Ph: 787-6146 Ph: 8497312 Ph: 658.4464
Ph: 657.3898 Ph: 3428271 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 period of 180 days.
0
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be com-
LICENSED CONTRACTORS DECLARATION: I hereby affirm (hat I am licensed under provisions of Chapter 9 (comment.
pleted if The permit is for one hundred ($100) or less. I certify [hal in the perlormance 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-
tion Laws of California.
❑
Date Applicant
r
NOTICE TO APPLICANT: IL alter makinglhis Certificate of Exemption. you should become subject to the Workers'
OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law for the
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
Tig9L FIFUybR
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 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 for a per-
wi
be made in connection with work authorized by This permit. and that no building structure. Scaffolding, falsework,
mit subjects the applicant to a civil penalty of not more than five hunderd dollars ($500).):
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 property, 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 Conlraclor'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 Safely, 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,
❑ Division Industrial Safety Permit No.
the building or improvement is sold within one year of completion, the owner -builder will have The burden of prov-
of
mg 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 properly who
builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Con-
tractor's License Law.)
Of am exempt under Sec. B.8 P.C. (Attach Certificate).
Date Owner
WORKERS' COMPENSATION DECLARATION: 1 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 tiled with the County Building Inspection Department or County Department.
947lCi'I M'iLi�,ilwi��"ORATJ�ON
FORDS BOX f 1 1)
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AVE MAD UGA A
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300
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TRACT NAME
LWPfRWU K JOINT+PHONEN
COU N ERff¢¢'I.
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Tig9L FIFUybR
pgEISENHOWER DR
Si 1ACOWi1'E< VpP CA 92 2
OPI*-*64-13175
BLDG.INSPECTOR
FINAL DATE
ARCIENG FIRM NAME
LICNC d
ADDRESS
CITYICOMMUNITYISTATEIZIP �J .'� r•- '
PLAN p
P EXA ER
AP OVE ATE
/
'W
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RZO ))
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ID 0 11)V`C7
ZONEORDN
LOTSZ
END
ODE UITU_
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a Conslruclion 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 cerlily I have read this application and stale
that the information given is correct. I agree to comply with all slate laws and county ordinances relating to
building constjuclion, and authorize epresenlalive of the County of Riverside. Department of Building and Safety
to enter uypgR I se properlyy 1, 1 W i 1 have applied for this permit for the purpose of making inspections.
X! C.% ^k.w......�. ...� " r.:% E'er � ✓"""
Signature of Applicant or Agent Date
Print Applicant/Agent Name
'11111FITIt 0 7 0 JCPk 05l2 VO2 Q 0
ESTIMATED PLAN REV EE
-r►
L
r
TOTAL
FEE
t 97 c (30
CA
C
NC
COU N ERff¢¢'I.
/—AL
COUNTER L.U.T.
PERMIT FOR STRUCTURAL PLAN! REVIEW
TOTAL PERMIT COST IS $197.60
CONSTRUCTION�sc tlan tN tT".L;t t aati be'T�sed ate prop
Sq tty VRate Valuation
PRIMARY DWLG 101 R^3 W09D 1893 $27460 $52246
; EfflRY PR1GAR 436 M-1 WOOD 48 $9.111 $4413
E6t P an Rey Fee basad an Total Estimated Val ` to of $56659 r9 iso $197.60
FORM 284208(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 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.
NON
ADDITIONAL INFORMATION
j
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
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