BLDG (00017823)50241 Calle Maria
00017823
APPLICANT NAME (L, F. MI)
17 ngp
' ADDRESS
XISOX 680
PITY/COMMUNITY/STATE/ZIP '
i A Cl1J lTA • CA 922530000
JOB SITE ADDRESS/SPACE
r' -5,0241 L. . - CAS, LE MARIA
CITYICOMMUNITYISTATE/ZIP '
LA QUINTA CA 922530000 .
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PHONE #
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a CONTRACTOR -FIRM NAME
LICNC #
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'-CITY/COMMUNITYISTATEIZIP
'PHONE #
BLDG. INSPECTOR
FINAL DATE
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+` ARCIENG FIRM NAME
LICNC #
ADDRESS
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PLANS EXAMINER
APPROVE DATE
OF PERMIT - -
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APPLIPRMT # PS DATE Q
00017823 AR 5/06/62 3 4 6f 1
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COUNTER B.I.
COUNTER L.U.T. '
Y, 10"., FQR •13MG' APf!Z AT`iAL PERMIT,
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FORM 284.208 (11.81) I NSPECTOR-
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.
NO
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Botts)
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
PERMIT APPLICATION
County of Riverside
Department of Building and Safety
4080 Lemon SI. 2nd Floor 135 N. Alessandro Rd, Rm. 203 880 N. Slate Street 227 North "D" Street 46.209 Oasis Sl. Rm. 310 160 N. 8roadway
Riverside, CA 92501 Banning, CA 92220 Hemet. CA 92343 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 it work not commenced within 180 days from date of issuance. OR. if work has beer suspended or abandoned ler a perloo of 180 days.
❑ CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be corn
LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter9 (comment-
pleled if the permit is for one hundred ($100) 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 became 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 effect.
tion Laws of California.
e ❑
Date _._ _Applicant _.
Z OWNER -BUILDER DECLARATION: I hereby allirm that I am exempt from the Contractor's License Law lot the
NOTICE TO APPLICANT: If. alter 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
.. 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
aha
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 feel 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 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. scalfoltling, falsework.
' ❑ I, as owner of the properly, or my employees with wages as their sole compensation, will do the work, and the
or demolition or dismantling thereof. will be more than thirty-six (36) feet high. (Chap. 3.2. Grp 2. Ar[ 2. Sec 341.
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 himself or
'through
6through his own employees, provided that such improvements are not intended or offered lot sale. IL however,
permit
duslrial Safety, as noted above. unless such person has a permit to do such Work from the division.
or improvement is sold within one year of completion, the owner -builder will have the burden of prov-
❑Division of Industrial Safety Permit No.
'ung that he did not build or improve for the purpose of sale.)
PHONE# 'BLDG. INSPE TOR
❑1, 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 lot the perfOr-
- 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of properly who
mance of the work for which this permit is issued (Sec. 3097. Civ. C.).
buds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Con-
1 :+
Lender's Name
tractor's License Law.)
Lender's Address
" 01 am exempt under Sec. B.8 P.C. (Attach Certificate).
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7' WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell -insure, or a
f certificate of Workers' Compensation Insurance. or a certified copy thereof (Sec. 3800. Lab. C.).
V'❑Cerlified copy is hereby furnished.
❑Cerlffied copy is filed with the County Building Inspection Department or County Department.
M
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
build
ing cons ruction, antl authorize a representative of the County of Riverside. Department of Building and Safety
to enter upon the property for whJCh I have 15plied for [his permit for the purpose of making inspections.
j Signature of Applicant or Agent Date
Print Applicant/Agent Name
TVi P�I{IF 1 7'/423 ps I o.5 oSAVE8(2
CONSTRUCTION FEE
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CONTRACTOR -FIRM NAME
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CITYICOMMUN ITYISTATEIZI P
PHONE# 'BLDG. INSPE TOR
FINJ DATE
ARCIENG FIRM NAME
LICNC N
ADDRESS
CITYICOM MUN ITY/STATE/ZIP
PLAN N
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PLANS EXAMINER
APPROVE DATE
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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
build
ing cons ruction, antl authorize a representative of the County of Riverside. Department of Building and Safety
to enter upon the property for whJCh I have 15plied for [his permit for the purpose of making inspections.
j Signature of Applicant or Agent Date
Print Applicant/Agent Name
TVi P�I{IF 1 7'/423 ps I o.5 oSAVE8(2
CONSTRUCTION FEE
2 5 1 22
00 1 uta
PLUMBING FEE
$14.00
ELECTRICAL FEE
$13,00
SMI FEE.
$0.00
TOTALr�7
/r FEE
CA
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NC
COUNTER B.I.
COUNTER L.U.T.
STRUCTURAL( BUILDING )
TOTAL PERMIT COST IS $27.00
r�.y�xa
CONSTRUCTIRN ESTIMATE (N , 9: Not to baa usod gas prop ,rtu v luation)
ascription C� roup Typo 64 �t ate Valuation
PRIMARY MISC 329 M M 0 $10.00 $0
Construction Fee baked on Total Actual Valuation of $0 itat TK0.00
ELECTRICAL FEE COMPUTATIONS * Permit Fane (if applicable) FEE: $3.00
SWIMMING PO L-Privataw: Y Commerciali N Service Change R/Ct FEEt $10.00
PLUMBING FEE COMP'UTA'TIONS * Permit Fee (if applicabl*3 FEE: $4.0U
FrIK'PURES-Dar Sink: 0 Drinking Fntn: 1 F'lr Drain: 0
0 of Water, Heaters: 1 * of brains on Roof: 00 F'E'E: $0.50
GAS PIPING SYSTEM- 1 to 5 Outletsil 6 or More Outletsi 0 FEE: $2.50
Installation of Water Piping and/or Water Treatment Equip:1 F'EEc ' 2.50
SMI FEE $0.00
FORM 284.208 (11.81) INSPECTOR
q
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
Slob 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.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
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 9 _�
30 Fixtures
31 Service
32 Final
STREET NAME
Ofincr
Nook
I
3)
.4 -------
Kitchen
-r-Je
T.C.
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I
—
Master Bedroom
Suite
Patio
C.(h.firA Ceiling
Living Room
-h Ch-n-.ry Wi,M.,
Dining Room
FineV
N
Master Bedroom 2 -Car Garage
Suite
6.2
All dimensions approximate.
Artist's rendering.
rV
. . . . . . . . . .
.V
.4 -------
Service
F-1
Whel
F.A.U.
Li
Dining Room
FineV
N
Master Bedroom 2 -Car Garage
Suite
6.2
All dimensions approximate.
Artist's rendering.
rV
. . . . . . . . . .
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