BLDG (00017825)50172 Calle Maria
00017825
_ PERMIT APPLICATION
Countyy+of Riverside
Department oliBuilding
and Safety
4080 Lemon St. 2nd Floor 135 N. Alessandro Rd. Rm. 203 880 N. Stale Street'-'` 7€,•,
..a'
227 North •'D" Street 46209 Oasis SI. Rm. 310 160 N. Broadway
Riverside, CA 92501 Banning. CA 92220 Hemel. CA 92343 I
Perris. CA 92370 Indio. CA 92201 Blythe. CA 92225
Ph: 787-6146 Ph: 849.7312 Ph: 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. it work has beer suspended
or abandoned for a period of 180 days.
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CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be com-
•' LICENSED CONTRACTORS DECLARATION: I hereby allirm that I am licensed under provisions of Chapter 9 (commeric-,
pleled if the permit is for one hundred ($100) or less. I certify that in the performance of the work for which this
ing with Section 7000) of Division 3 0l the Business and Professions Code, and my license is in full force
permit issued. I shall not employ any person in any manner so as to became subject to the Workers' Compensa-
and effect.
tion laws of California.
r
Dale Applicant _
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OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law for the
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NOTICE TO APPLICANT: If. alter 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
following reason (Sec. 7031.5. Business and Professions Code: Any city or county,which requires a permit to con-
deemed revoked.
slrucl, after, improve. demolish, or repair any structure, prior to its issuance. also requires the applicant for such
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-
❑I hereby certify that no excavation live (5) or more lee[ 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-
mit subjects the applicant to a civif,penafly of not more than live hunderd dollars ($500).):
be made in connection with work authorized by this permit, and that no buildingstructure. scaffolding, lalsework. ,
ADDRESS
or demolition or dismantling thereof, will be more than thirty-six (36) feel high. (Chap. 3.2. Grp 2. Art 2. Sec 341,
k . ❑ 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.).
i- 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 from the Division In
Law does not apply to an owner of property who builds or improves (hereon, and who does such work himself or
a permit of -
dustrial Safety. 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 Safety Permit No.
or sold within one year of completion, the owner -builder will have the burden of prov-
CITYICOM MUNITYISTATEIZIP
Ing that he did not build or improve for the purpose of sale.)
contracting with licensed contractors to the project (Sec.
❑1, as owner of the properly, am exclusivelyContractor's
CONSTRUCTION LENDING AGENCY: I hereby affirm that There is a construction lending agency for the perfor-
an own
7044, Business and Professions Cade: 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 conlraclor(s) licensed pursuant To the Con-
Lender's Name
tractor's License Law.)
C
Lender's Address
❑I am exempt under Sec. . B.b P.C. (Attach Certificate).
Date Owner
I
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state
that the f ormation given is correct I a ree to com I with all state laws and count rd' 11' t
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.).
y
❑Certified copy is hereby furnished.
❑Certified copy is filed with the County Building Inspection Department or County Department.
APdlDENCANT A -CORP
ADDUgRESS y
BOX 680
4
CITYICOMMUNITYIST TE/ZIP
LA WIt N 'IA
CA 922530000
•' B( 2p?RESSISPACE CALLE
MARIA
` .ADD til TYI S AZIP .
ry
CA 922530000
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TRACT NAME
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CONTRACTOR -FIRM NAME
LICNC #
ADDRESS
CITYICOMMUNITYISTATEIZIP
PHONE p BL I P
F IL 1
ARCIENG FIRM NAME
LICNC d
ADDRESS
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CITYICOM MUNITYISTATEIZIP
PLAN N I PLANS EXAMINER ) APPROVE DATE
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building cobs uc[ion. and authorizV repress nlatiCe' of the County of Riverside. Department of Building and Safety
to enter upb a property for whit I h6e app ieil for this permit for the purpose of making inspections.
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Signature of Applicam or Agent Date
pymv Hyem rvame
APPPnLI{P RIAT p «ra w - yPS - rL
00017025TEt 0
CONSTRUCTION ION FEE
PLUMBING FEE
ELECTRICAL FEE
DA TrE '25720
1 r /1 O
$13.00
ASMI FEE $0,00 1
fi CUi•Az:?'_N U" 00
SZ END 0 S DE ICA ICI X INC (COUNT(
ISTR UCTUR AL. ( BUILDING )
TOTAL
FEE ,
COUNTER L.U.T.
1 257
P E R M I T
TOTAL PERMIT COST :tri t$27.00
CONSTRUCTION ESTIMATE (NOTEt Not to be used as property valuation)
Description FCC Group Type. Sq Ft Rate Valuation
PRIMARY MISC 329 M M 0 $10.00 $0
I. Construction Faye based on Total Actual Valuation of $0 ist $0.00
ELECTRICAL FEE COMPUTATIONS * Pernit Fee (if applicable) F"EEt $3.00
• SWIMMING PODL.-Priyatet Y Commerci:alt N Service Chanaae R/C: FEE,. $10.00
PLUMBING FEE COMPUTATIONS rn Permit Fee (:if applicable) FEE-. $4.00
FIXTURES -Bar Bink t 0 Drinkinq- F"n•tn t 0 Fir Drain t 1
of Water Heaters., 1 4 of Drains on Roof; 00 FEEL $2.50
GAS PIPING.SYSTEM- 1 to 5 Outlels:1 6 or More Outletst 0 i -EEE $2150
:installation of Water Piping and/or Water Treatment E.quipti F'EEt x:2.50
SMI FEE $0.00
J
FORM 284.208 (11.61) .INSPECTOR-~
FORM 284.208 (11.61) .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
IDA
Fireplace T.O.
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
Gas
25
Fin
. i
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 ,
i
29B Bonding r
30 Fixtures ;
31 Service
32 Final 01
I
STREET NAME
La Quinta, Lot #6 50-172 Calle Maria•
. Owertrl rntin
. FirelYwa• E
' - Cath,,d ai Ceiling ,
Dining Room Living Roorn
Papo
r
siecw,wo,
J-, 3a - t+
_ , W:dk-In
t+'et —_ — Closet
-F Kitchen " =_
rc,
— Raised Ceiling
0°O 11,"m Master Bedroom ,
Suite
• u.w.
1'QAIo - 0
Morning —
Room --- --
.
L
' Service 'r—_J O
.
r77-1
-e, j
L__J
`1 Spa
Bedroom U2 -
0
! f
• g W/11
ti Guest Bedroom
Suite
tr
2 -Car Garage
Dressing 0
Room
G3 .
All dimensions approximate. '
Artist's rendering.
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APPLICANT NAME (L, F, MI).'
APPLIPRMT p
-
PS
DATE
10619p
34620
ADDRAR
ESS
. BOX 680''
CITY/COMMUNITYISTATE/ZIP
LA .QUIN'TA .
�. A 92253000.0
r JOB SITE ADDRESSISPACE -
.50172 GALL.
MARIA
CITYICOMMUNITY/STATEIZIP
-LA 'GbL INTA
CA 92,E 530000
BOK-
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390
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TRACT NAME'
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CONTRACTOR. FIRM. NAME
LICNCp
ADDRESS
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CITY/COMMUNITYISTATE/ZIP
PHONE p
BLDG; INSPECTOR
FINAL DATE
-
,
'ARC/ENG FIRM NAME
LICNC p
ADDRESS
CITY/COMMUNITY/STATEIZIP
_
..PLANA
PLANS EXAMINER
APPROVE DATE
-
:. USE OF PERMIT.
SPA 6 DIA STPV
B'L
ZON
FSB
SSB
SSB
RSB
OFC
TOTAL .
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END
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COUNTER B.I.
COUNTER
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APPLI Ai ION. FOR 'S'TRUC ILIRAL PERMIT
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S. A''.' A p P
L.1 C A
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L7 P� i. Y
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FORM 284.208(11.81) INSPECTOR.
� � /'\ 0_.
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. 0
43 j
Final
10A
Fireplace T. 0. 0
FI
- - -
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 FJeater
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 1
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME