SFD (00019079)77632 Avenida Madrugada
00019079
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ADDRESS
P .O BOX 'Feil
bT 'f W.l9 d. 19 .{TNZIP CA 922 5;30000
JO_B RE ODRESS /SPACE AVE MADRUGADA
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CITY COMUTYJST TE^/'ZIP CA
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ADDRESS
IR?l ElSaNHOWER DR
CITY/COMMUNITYISTATE/ZIP
LA QUINTA GA 922:530000 .
PVIiO E q G,
BLDG. INSPECTOR
FINAL DATE
ARC/ENG FIRM NAME
LICNC N
ADDRESS
CITYICOMMUN ITY/STATE/ZI P
PLAN p
PLANS EXAMINER
APPROVE DATE
USE OF PERMIT -
CONDO-1DWL G & ATT GARAGE = w
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013610
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TOTAL .
FEE '
CA CK . NC COUNTER B.I. COUNTER L.U.T.
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APPILI CATION FOR STRUCTURAL PLAN REVIEW
T H 1 a I S AA P P L I. C A T I O N O N 1. Y
You must see the following Departments (if listed) for concurrence BEFORE
a Permit can be isdued
Aesc*r-ip t i on Dv;),t to See ..w,... .
HOLD- EALTH 0AL. 'N
HOLD ROAD R AID
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FORM 284-208 (11.81(
A, p
1 NSPECTOR
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 't
9
Garage Fire Wall
42 Commercial Hood
10
Fireplace P. L.
43 Final
IDA
Fireplace T.O. ❑
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 f
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
90)VEW"CURP
BOX 780
' f l cow. rV i PY/ZIP Y7 922530000
-yVgE32RESS/SPACE AVE MADRUGADA
TACOWIT'RAA/ZIP CA 922530000' 0000
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TRACT NAME
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KNIV:iF�MN3RATUIN
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,CIw/COOWAIZIP CA 922530000BLDG.
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INSPECTOR
FINAL DATE
ARCIENG FIRM NAME
LICNC p
ADDRESS
CITY/COM M U N ITYISTATE/ZI P
EXAMINER
APPROVE DATE
1�POANN i# nPLAANSS
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W}I.7OfYhRW-DWL,1Y 4'Y 1 1 /AGE
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APPLICA'iION FOO ;QTR
r
, FORM 284.208 (1.1.81) 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 & 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. 0. 0
P'
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
P/L 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 46209 Oasis St. Rm. 310 160 N. Broadway
Riverside, CA 92501 Banning, CA 92220 Hemet. CA 92343 -
Perris. CA 92370 Indio, CA 92201 Blythe, CA 92225
Ph: 7876146 Ph: 849.7312 Ph: 658.4464
Ph: 6573898 Ph: 3428271 Ph: 9222670
This permil becomes void if work not commenced within 180 days from date of issuance. OR, it work has beer suspended
or abandoned for a period at 180 days.
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be com-
LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (comment-
pleled 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 full force and ellecl.
tion Laws of California.
uielTU U 0 0 LD1055
Date _ Applicant
OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law for the
NOTICE TO APPLICANT: If, alter makingthis Certibcale Of Exemplion, you should become subject to the Workers'
Compensation provisions of the Labor Code. you must lorthwilh comply with such provisions or this permit shall be
' following reason (Sec. 7031.5. Business and Professions Cade: Any city or county which requires a permit to con-
deemed revoked.
struct, after, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such
lffR ".. )A'. ",+
permit to life 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 excavation five (5) or more feet inand 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-
mil subjects the applicant to a civil penally of not more than five hunderd dollars ($500).):
wi
be made in connection with work authorized by this permit. and that no building structure, scallolding, falsework,
BLDG. INSPECTOR
or demolition or dismantling thereof, will be more than thirly-six (36) feet 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 Contractor's License
❑ As owner -builder. I will not employ anyone To do work which would require a from the Division of In-.
Law does not apply to an owner of property who builds or improves thereon, and who does such work himsell or
permit
duslrial 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 is
❑ Division of industrial Safely Permit No.
or 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.)
R-
' ❑I, as owner of the property, am exclusive) contractingCONSTRUCTION
nnrot
LENDING AGENCY: I hereby affirm that there is a construction lending agency for the perfor-
'r1 7044, Business and Professions Code: The Contractor's License Law does apply To anownerof p pro I' 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
Lender's Name
License Law.)
Lender's Address
❑f am exempt under Sec. . B.8 P.C. (Attach Certificate).
r Date Owner
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state
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that the iglormation given is correct. I agree to comply with all stale laws and county ordinances relating to
' WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell insure, or
I� certificate of Workers' Compensation Insurance, or a certified copy Thereof (Sec. 3800. Lab. C.).
building construction, and authorize a representative of the County of Riverside, Department of Building and Safety
to enter up o the #rope ly %? whit have applied for this permit for the purpose of making inspections.
zp 1�
� � '�� _ ,
,# ❑Certified copy is hereby furnished.
'
r. ❑Certified copy is filed with the County Building Inspection Department or County Department.
Sighalure of Applicant or Agent Date
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TRACT NAME
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BLDG. INSPECTOR
FINAL DATE
.ARCIENG FIRM NAME
LICNC #
ADDRESS
CITYICOM MUNITY/STATE/ZI P
#
P EX ER
APP VE TE r_
MPCLAN
til Ff T W 6i
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END
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Print Applicant/Agent Name
'v Putti ITIS' 075+
a 3 Mfg 1
CP8 05/2700><2 J,n n 4
F1P! Kt.V
TOTAL 7
FEE
CA
CPA
NC
COUNT R BtC
COUNTER L.U.T.
PERMIT FOR STRUCTURAL. PLAN REVIEW
TOTAL, PERMIT COST IS $163.47
CONSTRUCTION ESTIMATE (NOTEt Not to be usod as property valuation)
Description FC :roup Typ� Sq Ft Rate Valuation
PRIMARY DWLG 101 R-3 WO D 1390 $27.60 $38364
SECNiDRY NRIGAR 436 M-1 WOOD 440 $9.10 $4004
Est Plan Rey Fee based on Total Estimated Val -to of $42368 ist $163.47
I
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FORM 284.208 (1181) INSPECTOR
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE I:ISPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
I
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.
Noo
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
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