SFD (00019088)77662 Avenida Madrugada
00019088
x PERMIT APPLICATION
County of
Riverside
Department of Building
and Safety
4080 Lemon SI. 2nd Floor 135 N. Alessandro Rd. Am. 203 880 N. Slate Street
227 North "0" Street 46.209 Oasis St. Am. 310 150 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: 657.3898 Phi 342.8271 Ph: 922.2670
This permit becomes void it work not commenced within 180 days from date of issuance. OR, it work las beer suspended
or abandoned for a period of Ia0 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 (commenc-
pleted if the permit is for one hundred (8100) 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
permit is issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensa-
effect.
tion Laws of California.
1 ❑
Date Applicant
r
.j OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law for the
NOTICE TO APPLICANT: If, after makinglhis Cerlificate 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
5 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
BLDG. INSPECTOR
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 leet in depth into which a person is required to descend, will
empt therelrom 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, falsework,
APP VE D TE
or demolition or dismantling Ihereol. will be more than thirty-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.).
1, 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 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 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. It, however,
improvement
[)Division of Industrial Safety Permit No.
the building or is sold within one year of completion, the owner -builder will have the burden of prow
Ing that he did not build or improve for the purpose of sale.)
ZONE ORD M
'
111, as owner of the property, 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 property 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 conlractor(s) licensed pursuant to the Con-
tractor's License Law.)
❑I am exempt under Sec. . B.8 P.C. (Attach Certificate).
Date Owner
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell -insure, or a
Acertificale of Workers' Compensation Insurance. or a certified copy thereof (Sec. 3800. Lab. C.).
❑Certified copy is hereby furnished.
❑Certilied copy is filed with the County Building Inspection Department Or County Department.
F1fI4"A R.iM61 _
P' ° US BOX 700
L{°°'f> f''1t4 Ti'n.IZIP CA 922530000
17131 Et eRESSISPACE AVE MADR UGADA
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CA 911530000
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L' 13672
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BLDG. INSPECTOR
FINAL DATE
ARC/ENG FIRM NAME
LICNC p
ADDRESS
CITYICOMMUNITYISTATEIZIP
PLAN p P EXA ER
APP VE D TE
& ATT ARn
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Lender's Name _
Lender's Address
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state
(hal the information given is correct. I agree to comply with all slate laws and county ordinances relating to
building nstruclion, afd•author ze a representative of the County of Riverside. Department of Building and Safety
10 enle u on the properly for iih have applied for this permit for the pose of m3 ing.inspectivo j
Signature of Applicant or Agent Date
Print Applicant/Agent Name
fftYlrv'r l0Be C;3 05/2
ES'TIMA'TED PLAN REV
PT02
FEE
25827
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TOTAL .
FEE
$197.60
CA
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I NC
COUI.
COUNTER L.U.T.
1 258
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PERMIT FOR STRUCTURAL PLAN REVIEW
TOTAL PERMIT COST IS $197460
CONSTRUCTION ESTIMATE (NOTE: Nat to be used ars property valuation)
A Description FCC; Group T rppe Sq FtRate Valuation
PRIMARY DWLG 101 R-3 WCiCiD 1093 $27.60 $52246
SEC:NDRY PRIGAR 436 M-1 WOOD 485 $9.10 $4413
.y ERt Plant Rev Fee bawd on Total Es Timated Val t to of $56659 is; $197.60
• i
'FORM 284208111.81) INSPECTOR
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs & Frms
34
Plenums & Ducts
2A
Slab Grade
35
Furnace Comport.
3
Steel
36
Inlets & Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beams
38 1
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
10A
Fireplace T. 0.
P'
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 (Botts)
12C Ceiling (Blown)
14 1 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
APPLICANT NAME (L, F, O MI)
ANDEN RP
ADDRESS
P O RQX 780
CITYICOM MUN ITYISTATEIZIP
LA QUINTA CA 922530000
Y,!
JiftP) ESSISPACE .AVE MADR�UGADA
CITYICOMMUNITYISTATEIZIP '
LA QUINTA OA 911530000
BOK
631
PAG
380
PRC
028
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TRACT NAME
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ADDRESS
49991 EISENHOWER DR
CITYICOM MUN ITYISTATEIZIP
LA QUINTA. CA 922530000.
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BLDG. INSPECTOR
FINAL DATE
ARRCIIENNG FIRM NAME
LICNC p ,
ADDRESS
CITYICOMMUNITYISTATEIZIP .,
PLAN p
PLANS EXAMINER
APPROVE DATE
USE OF PERMIT
E��:i7WVO-DWL G � ATT GARAGE P.
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APPLIPRMT p�`6 12 DATE ^ �I A ol9^
00019088 XPS, 05,E/e2
TOTAL
FEE
CA
CK
NC
I COUNTER B.I.
COUNTER L.U.T.
APPLICATION. FOR STRUCTURAL: PLAN REVIEW 1 271
T H-1 S I S 6A N A P P 1. 1 G A T I O N O N L. Y
You must see Th'e'f'ollowihq Departmehts (if listed) fors concurrence BEFORE
aPer rrip �t+/,can be issued i p See DOGil.�r9 ip l i o��-w+Y�w�wwer ww r,W.arar wws r�w.,w.w+u rw er w. .w.ww w.w Mc. wr wr,ww.w r.n..o uw DWT t to (. ee
HOL.DPHE HEALTH HEALTH
HOLD R.O AD ROAD
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. 0.
OP'N
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 F-Teoter
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
,$jA Iw G.70Y }"
P"$ IDOX780
CWCOWjffjAjjlZIP
CA 922530000 2253N0VA
FySRESSISPACE `E MADR Utz ¢a D E
AVE1 G
eiwcG l rglzIP
CA 911530000(
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se
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TRACT NAME
ppAERNtf:tlMllW't yU
JyItiT VFNR
PHONEp
gKjK{V FI�i pt�{tTPORA` ION
tE�,LI1T.�iaENHOWER
T-3 3672
�1 DR
I L.AGGmTF+p. IZIP CA 922330000
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7 IN41
8 tJ
BLDG. INSPECTOR
FINAL DATE
ARCIENG FIRM NAME
LICNC It
ADDRESS
. CITY/COMMUNITYISTATE/ZI P "
"PLAN #
PLANS EXAMINER
APPROVE DATE
MR601-DW1.0 &. ATT GARAGE
t1 "G4
FSB
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Aub
VIA D,
.
ZONE ORD #
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END„'y
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QPb`taR 0C3 8 JAN 051207824'' J (J
TOTAL .
FEE
CA
CK
NC
COUNTER B.I.
COUNTERL.U.T.
APPLICATION. FOR -S` RUCTURAL. PERMIT
T... H I s .1 s A 14`- A P P A.. I C A T 1 0 M 0 M U Y
c
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 & 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)
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
Gas
25
Fin
Tank Pit L.Line
PSL
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
. P/
.. a.
'
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME