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BLCK (00017312)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 St. Rm. 310 160 N. Broadway giverside. CA 92501 Banning, CA 92220 Hemet. CA 92343 r Perris. CA 92370 Indio. CA 92201 Blythe. CA 92225 Ph: 787.6146 Ph: 8497312 Ph: 6584464 Ph: 657.3898 Ph: 342.8271 Ph: 9222670 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. N, LICENSED CONTRACTORS DECLARATION: 1 hereby affirm that I am licensed under provisions of Chapter 9 (comment; Ing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect so 1 7 OWNER -BUILDER DECLARATION: I 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 con- slruct, 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 ex- 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 live hunderd dollars ($500).): ❑ 1, as owner of the property, or my employees with wages as Their sole compensation, will do the work, and the structure 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 lthrough 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 01 completion, the owner -builder will have the burden of prov- ing that he did not build or improve lot the purpose of sale.) Of. as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 9044, Business 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 Con- tractor's License Law.) 01 am exempt under Sec. B.& P.C. (Attach Certificate). 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.). ❑Certified copy is hereby furnished. ❑Certified copy is filed with the County Building Inspection Department or County Department. APPLICANT NAME (L, F, MI) A17CHISON . fw ADDRESS 52426 AVE MENDOZA CITY/COM MUNITYISTATEIZI P LA QUINTA CA 911-:12530000 JOB SITE ADDRESSISPACE 5"142-6 AVE MEr�ElD,eye OZA CITY/COMMUNITY/STATE/ZIP �±� I� �g �9 Q �y LA Q��Af`0'�A CA 22530000 BOK 773 PAG 273 PRC 007 C v TWN 1000100 RNG SE S TRACTN �y LOT�q 000.000 QA q A l MOD + 01 SB TRACT NAME SLV 'LAO #11, EILK ••-101 LOTS 15&16 A ��R NA E( ,M1 } PHONEp CONTRACTOR -FIRM NAME LICNC N ADDRESS CITY/COM M U N ITY/STATEIZI P PHONE# BLDG. INSPECTOR FINAL DATE r ARC/ENG FIRM NAME LICNC N ADDRESS CITY/COMMUNITYISTATEIZIP , PLAN # PLANS EXAMINER APPROVE DATE USE «pO {F�PERMIT A n/� q� p 135XIS & 4X20 CA�2DEN WALL BL 00 ON A FSB SSB 000 SSB �� PSB ii00 OFC IND ZONE ORD If LOT SZ . a END SIDE av00 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be com- pleted i1 the permit is for One hundred ($100) or less. I certify [hat 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' Compensa- lion Laws of California. Date _ Applicant NOTICE TO APPLICANT: IL 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 deemed revoked. DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑I hereby certify that no excavation five (5) or more feel 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.). OAS owner -builder. I will not employ anyone to do work which would require a permit from the Division of In- dustrial Safely. as noted above. unless such person has a permit to do such work from the division. ❑ Division of Industrial Safety Permit No. CONSTRUCTION LENDING AGENCY: I hereby affirm that There is a construction lending agency for The perfor- mance of the work for which this permit is issued (Sec. 3097. Civ. C.). Lender's Name Lender's Address 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 construction, and authorize a representative of The County of Riverside. Department of Building and Safety to enter upon the .property lot which)1"have applied for this permit for the purpose of making inspections. Signature of ApkUcc nt of Agent If Date r I Print Applicant/Agent Name APPLIPRMTp . DATE ,�6�7}�y001n1rw1� "z A 135xi) & 4X20 GARDEN $29.50 TOTAL FEE . a CA CK X NC I COUNTER B.I. .-Ir . COUNTER L.U.T. P E R M I T FOR 135X6 4 4x20 GARDEN TOTAL PERMIT COST IS 135X6 & 4x20 GARDEN FORM 284.208 (11.81) INSPECTOR • $24.,0 $29.50 NO. OPERATION DATE INSPECTOR NO. OPERATION - DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Figs 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.O. ❑ No ADDITIONAL INFORMATION Ae, /��/l�sf ,*%�L Q LUA-� l SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Loth 12 Internal Lath 12A Drywall 13 Finish Grade INSULATION Thick Values�v 7A Walls (Batts) 128 Ceiling (Batts) 12C Ceiling (Blown) 14 Final PLUMBING APPROVALS 15 Ground Plumb 16 Water Piping 17 Rough Plumb 18 Vents y 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 KP— ELECTRICAL APPROVALS.; PSL 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) AITCHISON, F: .ADDRESS 52426 AVE F4ENDOZA CITYICOMMUNITYISTATEIZIP LA QUINTA CA 922530000 JOB SITE ADDRESSISPACE 52426 AVE MENDOZA CITYICOMMUNITYISTATEIZIP LA GIL!'INTA CA 922530000 BOKPAG ~rig 27 PRC 007 C a TWN RNG aaa SE 00 S TRACT LOT 0041000 afll�i. MOD qi1 SB TRACT NAME SCV L.AQ 011, BLK--a 0' LOTS I S& I & OWNER NAME A ITCH PHONE M CONTRACTOR -FIRM NAME LICNC It ADDRESS CITYICOMMUNITYISTATEIZIP 4 PHONE pBLDG. 1. INSPECTOR FINAL DATE ARC/ENG FIRM NAME LICNC N ADDRESS _CIT'Y/COMMUNITYiSTATEIZIP PLAN # PLANS EXAMINER APPROVE DATE USE OF PERMIT 713SX6 & 4X20 GARDEN 14Ay�.L BN R 1aW00V FSB I` aW 008, q y� A XP ZONE ORD N LOT SZ END SIDE v0a0 APPLIPRMT 0PS DATE -26916 00017312 Ai. 04lR'�..8/82 4X20 GARDEN t trtz x S APS A P P L S CAT 100 CNL Y TOTAL . FEE $ 0 00 CA CK NC I COUNTER B.I. COUNTER L.U.T. ' i; AFPP LCAT I ON FOR 135X6 4X20 GARDEN t trtz x S APS A P P L S CAT 100 CNL Y r t Cp�+y�ye �� FORM 284-208(11.811 �I�C 70R NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Figs 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.O. 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 (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 ELECTRICAL APPROVALS PSL P) 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 298 Bonding 30 Fixtures 31 Service 32 Final STREET NAME