BLDG (00006593)53880 Avenida Madero
00006593
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_FORM 284-208 (2/81)
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APPLICATION FOR STRUCTURAL PERMIT
TOTAL
FEE
COPY
0108.04
APPLIckriot;
ADDRESS
BOX 11630
CITY/COMMUNITY/STATE/Z"
W -ALK DESERT CA 912-606000
JOB 66A PACE
4DRES /S
453 S . AVE MADERO
CITY/COMMVNITY/STATE/ZIP
t;LA QUINTA CA 924%30000
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1,77
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ALMmu5T9!69,wf CA IZ260000b
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jN45691048
LI c #
13B5436
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ARC/ENG FIRM NAME
'ADDRESS
I
CITY/COMMUNITY/STATEIZIP
PHONE #
LICNC #
USE OF PERMIT
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- pi,
_FORM 284-208 (2/81)
ki
AD
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pi 010804
k
APPLICATION FOR STRUCTURAL PERMIT
TOTAL
FEE
COPY
0108.04
APPLIckriot;
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
Gaiage Fire Wall
42
Commercial Hood
10
Fireplace P. L.
43
Final
10A
Fireplace T. 0.
°o
ADDITIONAL INFORMATION
y
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts)
12B Ceiling (Botts)
12C Ceiling (Blown)
14 Final
rLUXIMCtiC APPROVAi 'v -_-----
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
P/L
P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
—'T
rchmll ArrLuAIIu11
0,AtNUNJVWtCA 928610440.0
fJ_ RESS/SPACE Own, Row,p
County
of Riverside
Department of
Building and Safety
4080 Lemon Sl. 2nd Floor 135 N. Alessandro Rd. Rm. 203
880 N. Stale Street
227 North '0" Street
46-209 Oasis Sl. 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: 8497312
Ph: 658.4464
Ph: 651-3898
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 been suspended or abandoned for a period of 180 days
LICENSED CONTRACTORS DECLARATION: I hereby allirm that I am licensed under provisions of Chapter 9 (commencing
with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.
License Class
Date
Contractor
Lic. Number
'OWNER -BUILDER DECLARATION: 1 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 construct. 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 exempt therefrom and the basis for
the alleged exemption. Any violation of Section 7031.5 by any applicant lot a permit subjects the applicant to a civil
penalty of not more than five hundred dollars (S500).):
YrYI, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the
ructure is not intended or offered for sale (Sec. 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 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 proving that he did not
build or improve for the purpose of sale.).
PI, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec7044,
usiness 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 contractors) licensed pursuant to the Contractor's
License Law.).
❑ I am exempt under Sec. , B. 8 P.C. (Attach Certilicate(
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.).
Policy No. Company
ertified copy is hereby furnished.
16 ertified copy is filed with' the County Building Inspection Department or County Department.
Date Applicant
APPLICANT NA E IL. I)
gss
0,AtNUNJVWtCA 928610440.0
fJ_ RESS/SPACE Own, Row,p
LTACO=f"///zip (yy {{ k
OA i''is2520 WS7#10
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1848
ARC/ENG FIRM NAME
ADDRESS
CITY/COMMUNITY/STATE/ZIP
PHONE N
LICNC N
PINNTT FOR STRU-CTU944L PLM
$@ y..p
MXURM& A J ! IM
Val
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CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed if the
permit is for one hundred (S1OO) 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' Compensation Laws of California.
Date Applicant
NOTICE TO APPLICANT: It, 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
deemed revoked.
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five (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 building structure, scaffolding, falsework, 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.)
RaAs owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial
ety, as noted above, unless such person has a permit to do such work from that division.
❑ Division of Industrial Safety Permit No.
Date Applicant
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of
the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name
Lender's Address
I certify that I have read this aVplication and state that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives of
this county to enter upon the above. merit ioned property tot inspection purposes.
Signature of Applicant or Agent Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state that the
information given is correct. I agree to comply with all state laws and county ordinances relating to building con.
struction; and authorize a representative of the County of Riverside. Department of Building and Safety to enter upon
the property for which I ove applied for this permit for the purpose of making inspections.
•.r__,,,_,,,,/S ap u re giant or Agent Date -
P P-AppIRn icantlOge ame' c: • r
pie JT R 70,
99TIMIAT911 PLAN *9V Flt
001918
$145.92
PINNTT FOR STRU-CTU944L PLM
64KVIKW
TOTAL
FEE
INSPECTOR'S COPY
PERMT FOM STRUCTUOAL PLAN RI VIXW
001913
TGTA L PIMMIT COST 18 $145-92
CO'NSTWeTT M 1i. 'M'ATK fN► N to 0* vial ss 04#0 itV
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FORM 284-208 (2/81)
r
V 1votion
at* Va watlo,n
/1611 6tZ_r14
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
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.
°O.
ADDITIONAL INFORMATION
1
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--'------
PPROVALS-'-----"15
15Ground 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
P/L
P/
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 Sl. 2nd Floor 135 N. Alessandro Rd. Rm. 203 880 N. State Strget
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 Blythe, CA 92225
Ph: 787-6146 It Ph: 849.7312 PP.. 658.4464
Ph: 657.3898 Ph: 342-8271 Ph: 922.2670
This permit becomes void if work not commenced within 180 days from date of issuance. OR, if work has
been suspended or abandoned for a period of 180 days.
LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed if the
with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.
permit is for one hundred ($100) or less. I certify that In the performance of the work for which this permit is issued. I
M0001
shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California.
License Class Lic. Number
Date Applicant
Date Contractor
NOTICE TO APPLICANT: If, after making this 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 following
Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be
deemed revoked.
reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct. alter,
MS
improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ,
signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing
❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be
by
with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for
made in connection with work authorized this permit, and that no building structure, scaffolding, falsework, or
the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil
demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap 3.2. Grp 2. Art 2, Sec 341, Title 8,
penally of not more than live hundred dollars (S500).):
C.A.C.)
I, as owner of the properly, or my employees with wages as their sole compensation, will do the work, and the
As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial
structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law
a ety, as noted above, unless such person has a permit to do such work from that division. ,
does not apply to an owner of property who builds or improves thereon, and who does such work himself or through
❑ Division of Industrial Safety Permit No.
his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or
Date Applicant
improvement is sold within one year of completion, the owner -builder will have the burden of proving that he did not
act$
build or improve for the purpose of sale.).
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of
i`ir"n
the work for which this permit is issued (Sec. 3097, Civ. C.).
I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044,
Lender's Name
usiness 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 Contractors
Lender's Address
License Law.).
I certify that 1 have read this application and state that the above information is correct. I agree to comply with all
I am exempt under Sec. . B. 8 P.C. (Attach Certificate),
city and county ordinances and state laws relating to building construction, and hereby authorize representatives of
this county to enter upon the above-mentioned property for inspection purposes.
Date Owner
_
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure, or a
Signature of Applicant or Agent Date
certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800. Lab. C.).
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state that the
information given is correct. I agree to comply with all slate laws and county ordinances relating to building con -
Policy No. Company
struction, and authorize a representative of the County of Riverside, Department of Building and Safety to enter upon
0 Certified copy is hereby furnished.
the property for which l have applied for this permit for the purpose of making inspections.
❑ Certified copy is filed wilh'the County Building Inspection Department or County Department.
Signature of Applicant or Agent Date
Date Applicant
Print Applicant/Agent Name
IYARN (L.HURN
IiCJIX 1638
FAMUTWM. I CA 922.600000
tqj;DRESS/SPACEottillow AVE MADERO
p rX copaCgt.yvFynIE/ZIP CA 922530000
13
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M0001
10171Wil
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FAELNME#O ASR T DEVELOPMENT C
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R/ X1/6:38
MS
6lT1 NITEM"T CA 922600000
VTV-568-10
48
I It"P11436
'
ARC/ENG FIRM NAME
ADDRESS
CITY/COM MUN ITY/STATE/ZI P
PHONE k
LICNC 0
1dWCL,Rm ATT CAR
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K; ORM 284-208 (2/81)
VVWW65" In 110f20"M1 1-001908
JAPPLICATTON FOR STRUCTURAL PLAN REV1EW1
ASSESSOR COPY TOTAL
: I
1001908 1
APPLICATION FOR STRUCTURAL PLAN REVIEW
T M 1 8 1 S A N A P P L X C A T 1 0 N
0NLYY
, 40 , A, /,
PENMIT APPLIGATION
County of Riverside
4 Department of Building
and Safety
4080 Lemon$t,/1ndlFloor 135 N. Alessandro Rd. Rm. 203 690 N. State St14et
227 North "0" Street 46-209 Oasis St. Rm. 310 160 N. Broadway
Riverside, CA 92501 Banning, CA 92220 Hornet. CA 92343
Perris. CA 92370 Indio, CA 92201 Blythe, CA 92225
Ph: 187.8146 Ph: 840,7312 PI[1 658-4464
Ph: 651-3898 Ph: 342.8271 Ph: 922.2670
This permit becomes void it work not commenced within 180 days from date of issuance, OR, if work
has been suspended or abandoned for a period of 180 days.
LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed if the
with Section 7000) of Division 3 of the Business and Professions Code, and my license is in lull force and effect.
permit is for one hundred (5100) 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' Compensation Laws of California.
License Class Lic. Number
Date Applicant
Date Contractor
NOTICE TO APPLICANT: IL after making this Certificate of Exemption, you should become subject to the Workers' '
OWNER -BUILDER DECLARATION: I hereby affirm that 1 am exempt from the Contractor's License Law for the following
Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be
reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter,
deemed revoked.
improve, demolish. or repair any structure, prior to its issuance, also requires the applicant for such permit to file a
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
signed statement that he is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing
0 I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be
with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for
made in connection with work authorized by this permit, and that no building structure, scaffolding, lalsework, or
the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil
demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap 3.2. Grp 2, Art 2, Sec 341, Title 8.
penally of not more than five hundred dollars ($500).):
C.A.C.)
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the
As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial
structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law
a ety, as noted above, unless such person has a permit to do such work from that division.
does not apply to an owner of property who builds or improves thereon, and who does such work himself or Through
Division of Industrial Safety Permit No.
his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or
Date Applicant
improvement is sold within one year of completion, the owner -builder will have the burden of proving that he did not
build or improve for the purpose of sale.).
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of
the work for which this permit is issued (Sec. 3097, Civ. C.).
I,as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec7044,
Lender's Name
usiness 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 Contractors
Lender's Address
License Law.).
I certify that I have read this application and state that the above information is correct. I agree to comply with all
am exempt under Sec. . B. & P.C. (Attach Certificate).
city and county ordinances and state laws relating to building construction, and hereby authorize representatives of
this county to enter upon the above-mentioned property for inspection purposes.
Date Owner
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure, or a
Signature of Applicant or Agent Date
certificate of Workers' Compensation Insurance. or a certified copy thereof (Sec. 3900, Lab. C.).
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state that the
Policy No. Company
information given is correct. I agree to comply with all slate laws and county ordinances relating to building con-
❑ Certified copy is hereby furnished.
struction, and authorize a representative of the County of Riverside. Department of Building and Safety to enter upon
the property for which.) have applied for this permit for the purpose of making inspections. 111iii
0 Certified copy is filed with'the County Building Inspection Department or County T -Department.
Signature of Applicant or Agent Date
Date Applicant
Print Applicant/Agent Name
XrANAA#A1N(L-HORN
0s 1 638
PT,AVWu` EVM'T CA 722600000
15WWU_ lIDRESS/SPACE Jl71 L;RO
AVEFfVfr f 7'FACQA F7922530000
CIT/IVCO!}KITIYB'[YJ1E/ZIP
4r 22530000
fW"f7 # 1t T+43 f YVbG
6
TWN W0 0
N V
S
n00001
1,80171
"t
I Sa
ei(NA1198 SCV LA Q 19
i-T7li MME]W RT DEVELOPMENT C
VM%q"f W "RN
BONS 1639
PTA0 UTXMIT CA 922600000
711* -569-1048
3=436
ARC/ENG FIRM NAME
ADDRESS
CITY/COMMUNITY/STATE/ZIP
PHO,NNE N
APPLICATION FOR STRUCTURAL PLAN REVIEW
LICNC N
T L
U.S. CENSUS COPY TOTAL
PHiM
A7:r 0RM67 ATT T MATT
00
R -r
(raQ
IOUs
OV5
INTO I
TRD
ZONE ORD N
I
LOT SZ
no
10
o tgo
#""3" fnee I 10 / 2twex 001908
APPLICATION FOR STRUCTURAL PLAN REVIEW
T L
U.S. CENSUS COPY TOTAL
APPLICATION FOR STRUCTUROAi. PLAN REVIEW
T H I S 1 9 A tN A P P L I C fA T 1 0 N
0 N L Y
001908 1
• ,,AP LlCA'i`l0N FOR STRUCTURAL PLA" ROM
001908
N
UNS .638
'PlAWL"Vemy CA 022400000
(Q {1j DRESS/SPACE AVE i ADERO
yytAC CCii11 ►1 MM. i''1
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C'"JMMMEU'ii , Rif.DEVELOPMENT OPMENT C
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RtQFg i@pTI Y$tOVW6l I
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TA 'i CA 922600000
9 -568.9, 0481=436
1
ARC/ENG FIRM NAME
ADDRESS
CITY/COMMUNITY/STATE/ZIP
PHONE #
LICNC #
VKCRM& ATT GAR
00
g -f
00
'033
Ors
IT O
ND
ZONE ORD #
LOT SZ
• ,,AP LlCA'i`l0N FOR STRUCTURAL PLA" ROM
001908
N
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
I
Set Bock
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
Band 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.
°o
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 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
P/L
P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
298 Bonding
'30 Fixtures
31- Service
32 Final
STREET NAME