INST (00010274)'r nmrr nrruonrrun
County of Riverside
Department of Building and Safety
4080 Lemon St. 2nd Floor 135 N. Alessandro Rd. Rm. 203 880 N. Slate Slre4
227 North ••D•• Street 46-209 Oasis St. Am. 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: 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, 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 it 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 ($700) or less. I certify that in the performance of the work for which Ihis`permit is issued. I
lr
f, -`i r f`J
shall not emplgy any person in any manner so as to become 5ubject;lo the Workers' Compensation Laws of California.
License Class Lic. Number I
Date / 7 -�:� f 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
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 Contractor's License Law (Chapter 9 (commencing 0 1 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, falsework, or
Me 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,
' penalty of not more than five hundred dollars ($500).):
C.A.C.)
I1r❑ 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
strgcture is not intended or offered for sale (Sec. 7044. Business and Professions Code: The Contractor's License Law
Safety. 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 himsell or Through ❑ Division of Industrial Safety Permit No.
his own employees, provided that such improvements are not intended or offered for sale. IL however, the building or Dale Applicant
"rnprovement 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
-
work for which this permit is issued (Sec. 3097, Civ. C.).
�. I.as owner of the properly, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Lender's Name
Pus
' usiness and Professions Code: The Contractor's License Law does not apply to an owner of properly who builds or
-improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the Contractor's Lender's Address
`License Law.).
n�
I certify that I have read this application and state that the above information is correct. 1 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 lar 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
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 properly for which.! have applied for this permit for the purpose of making inspections.
Certified copy is tiled with -the County Building Inspection"DepartmeenI or County Department. ` // fSignat re of Applicant or Agent !Date T
. i !
Date / •- ! / ADPficant by r r ,
Print Applicant/Agent Name
-APPL ANT„NAM MI)
.
IfPS►,i7,. 0-274
� Z
i Z/ 3fI i 1
O .L O 1 H�
ADDRESS
135400 AVR 50
CITY/COMMUNITY/STATE/ZI P
COACMELLA CA 922 010 9 0 0
_JOB 1 6JDRESS/SPACE AVR MENDOZA
CITY/COMMUNITY/STATE/ZIP
LA QUINTA CA 922330000
yB�OtK� PAG PRC �yC TWN RNG j� SE S
/i.3 "433 001aI 00V 0
TRACTLOT MOD SB
dtQiOO OO#' 0
11
TRACT NAME
SCVAt{LAQUINTA #11 1y
i7FW&FMI)
hN
. AR 4EE SOLAR
MT WATER w/y
CONTRACTOR -FIRM NAME -
LQG IND
ADDRESS
854010 AVE 50
D
36441+9
I' ARC/ENG FIRM NAME
i.
F-
ADDRESS
r CITY/COMMUNITY/STATE/ZIP
PHONE N LICNC N
USE OF PERMIT
SOLAR NOT WATER HEATER
BLZON FSB SSB SSB RSB OFC
00 R-1 OOO 000M0 INDI POLAR HUT WATER MAT
ZONE ORD N I LOT SZ END SIDE /
Q'QOO ( Imo._..
TOTAL
�- -- - -- -- ----� -- - E T RCOPY
P E R M I T FOR SOLAR HIDT WATER HEAT
TECTAL. PERM T COST 19 $13.00
SOLAR NOT WATER HEAT
FORM 284-208 (2/81)
$13.00
$13,00
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs 8 Frms
34
Plenums 8 Ducts
2A
Slob Grade
35
Furnace Comport.
3
Steel
36
Inlets B Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
39
Appl. Clearance
7
Framing
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L.
43
Final ,
10A
Fireplace T. 0.
OP
O.
ADDITIONAL INFORMATION
------15
,
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
_.1.3._ ....Finish Grade
INSULATION Thick R
Value
7A Walls (Batts)
12B Ceiling (Batts) '
12C Ceiling (Blown)
14 Final
-----------------------------
-------- -- PLUMBING-APPROVALS--------------------------------------
15Ground Plumb
16 Water Piping
17 Rough Plumb
18 Vents
19 Sewage Disposal
20 Sewer
21 Water Heater
22 Water Softener
23 Water Service
24 Gas Test
25 Final
Tank Pit L. Line
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
P/L
P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
APPLICANT NAME (L. F, MI)
L -'t 0 -
ADDRESS
9%400 AVO, 60'.
CITY/CO MmUNITY/STATE/ZIP
COAMLLA CA i221-01 0000
SITE ADDRESS/SPACE
02B 16 0 t4RNl)oz..A
.02
.CITY/COMMUNITY/STATE/ZIP
t.A. OUINTA CA 92y21UQ4OQ
BOK
773
PAG
U
PRC
00
C
7
TWN
RNG
0 0
000
OSE
D
S
TRACT
000000
LOT
00111%
SOLAR NOT WATER WAT
MOD
all
SB
j&NAME
ALE LAQ4 INTA #1 t'
CeTRACT R -@M NAME
iC;
ADDRESS
85400 AWK 50
a!COMMUNITY STAT
BACNEL / LA E/ZIP CA 19293-6101000
PHONE#
714-19$-7233
LICNC N
;i644919T
ARC/ENG FIRM NAME
ADDRESS
CITY/COMMUNITY/STATE/ZIP
PHONE #
LICNC 0
USE OF PERMIT
SIOLAR HOT VATtR WEATER
BL I
00
ZON
Ift-1
FS.
146 1
SS.
00
RSB
004)
1 1IND
OFC
I
ZONE 080 #
LOT SZ.
END.
SIDE
-— 1111101111111
-
APPUPRMT PS DATE Tci
00 a 102!"74 AZ, I'llsi a /8,1 0784
'00x10274
SOLAR NOT WATER WAT
TFEEOTAL
lllqarc- I VK a %-Vr I
10107
APPLICATION POR SULAR V101 WWtelt HEAT
0 A P P L I C A T 1 0 H 0 H L Y
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Sut 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
Gaioge Fire Wall
42
Commercial Hood
10
Fireplace
P. L.
43
Final
10A
Fireplace
T. 0.
°o
ADDITIONAL INFORMATION
,
SEWAGE SYSTEM SIZE 8r, LOCATION
11 Exterior Lath
12 Internal Loth
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts)
12B Ceiling (Batts)
12C Ceiling (Blown)
14 Final
----FLUMCI`G APPROVALS-
PPROJALS
15
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