11514 (RC)P.O. BOX 1504
7&105 CALLE ESTADO
Address 78-550 HWY I I 1 LA QUINTA, CALIFORNIA 92253
ANSHENG,u, LIU
Mailing
Address 73-091 COUNTRY CLUB DR., A-2
Cityr,,92260,
ip Tel.
PALM DSEERT 1 340-4172
Contractor 0.? (1111 1 t-1-� / ( r o i l �� \ C_
It MIC
No. 11514
BUILDING: TYPE CONST. ®R OCC: GRP. 22
A.P. Number
Legal Description TENANT IMPROVEMENTS FOR
Project Description CHINESE RESTAURANT
75-455 Mr nteci o Dr.
BY:
Minimum Setback
' CityEzA
ip
Tel.' 34U—b/.44
Rear Setback from Rear Prop. Line
Indian we1
92201
:9 _
Side Setback from Property Line
State Lic.
& Classif.
City
Lic. #
fj`
Sq. Ft.
No. No. Dw. '
Validation:
900
Arch., Engr., t ,
Size
Stories Units
Designer - �"" `
New ❑ Add ❑
Alter CR Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
700 0) of D/i4ision 3 of the Business;and Professions Code, and my license is in full force and
effect
SIGNATURE DATE
_
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
Estimated Valuation'
$10,000 ..
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
PERMIT
AMOUNT
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 for a permit
Plan Chk. Dep.
34. rj-
�1 r, 55
subjects the applicant to a civil penalty or not more than five hundred dollars (5500)..
Plan Chk. BBI.
207.00
,❑ I, 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, Buisness and
Const.
� 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,
Mech.
provided . that such improvements are not intended or offered for sale. If, however, the building
orimprovement is sold within one year or completion, the owner -builder will have the burden
Electrical
of proving that he did not build or improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- "
Plumbing
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law -
does to builds improves thereon, for
S.M.1.
4.20
not apply an owner of property who or and who contracts
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
❑ I am exempt under Sec. B. t: P.C. for this reason
Driveway Enc.
Date owner 4
Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
@?Copy Is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (5100) valuation
or less.)
I certify that in the performance of lhg 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 -Owner
NOTICE TO APPLICANT: If, 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.' ' -
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, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application 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 city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
TOTAL 4 . 7
REMARKS
-ami;; Y t..i.h, *Id'76 : 1."i>_Wit?__ *'l_ - _• LI..
ZONE:
BY:
Minimum Setback
Distances:
Front Setback, from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE
INSPECTOR
Issued by:
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO, FT, ®
CAR P. SQ. FT.
WALL SO. FT. ®
SO FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP./EQUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ®c
BATH TUB
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
SO.FT.GAR ® 31'ic
HOUSE SEWER
REMARKS:
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
0
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING ,
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES11NITIALS
GARDEN WALL FINAL
COUNTY OF RIVERSIDE HEALTH SERVICES AGENCY
t EP RTMENT F FINIVIRONMENTAL HEALTH
OFFICIAL INSPECTION REPORT
BUSINESS ADDRESS
.'' II
n \
DATE
2 2
OWNER'S NAMEIOBA i
'n
1
2
aPumps
COMPUTER
NUMBER
I � r• '
MAILING ADDRESS
0
5
6 -
TIME N
^
2 .{J
PERMIT/LICENSE
8
PRDGRAMIELEMENT
Gauges 1
SERVICE
OUTt
TIME
I--
jBack
Skimmer a Gutters
11
12
Flow Prevention
3
14
RATE OF FLOW
pH
15
ICL -
W
TEMP
OTHER
18
cc
Pipe & Fittings
19
n
0
Pool Shell
20
1 I.
The marked items represent Health tode violations an must be corrected as
follows:
STR I
OPER
F
W
Filters
1
2
aPumps
i
3
4
0
Chlorinator t
5
6 -
au
Flowmeter f
7
8
p
Gauges 1
9
10
I--
jBack
Skimmer a Gutters
11
12
Flow Prevention
3
14
Q
Waste Water Prevention
15
16
W
Water Supply & Ouality
7
18
cc
Pipe & Fittings
19
0
Pool Shell
20
Z�
Bottom & Sides
21 •
22
U¢
Decking & Coping
23
24
�
Diving Boards
251
26!
Resure Pole
27 ,
28'I
Z
Life Rings
29
30
U.1
Safety Signs
31
32,
33
a.
Lifeguard
w
Lighting Elec.
34
35+
Ladders
36
371,
LL
Depth Markers
38
391 1
y
First Aid Kits
40
411 1
Gas Masks
42
431 1
�m
Showers
44
45
LUO
Toilet &.Dressing
46
47
�¢
ventilation
148
49
Chlorine
50
pH
51
O<
Cyanurstes
52
a
Clarity53
Teat Kits
54
cc
Supervision & Control
55
XGeneral
Sanitation56
O
Miscellaneous
57
POOL STATUS: (MARK ONE)
58 59 so
61
62
EE] Ga FE] PE]
CU
1 I.
The marked items represent Health tode violations an must be corrected as
follows:
3 �r,4b,4" (n
L I
CL F G. r bo
J -)e -
ri i I( � e. a •r Com- c'�.; • -,.,'`
-4m (
, n , {F r,
1 c � c { •� -
-� r r row.
1 .i l . 1. t�1 r r, k i7` • 4 n r -r ('•
Vii
1 eqF.+
MIKE HARRIS
FIRE CHIEF
RIVERSIDE COUNTY
FIRE DEPARTMENT
210 WEST SAN JACINTO AVENUE • PERRIS, CALIFORNIA 92370
(714) 657-3183
TO: BUILDING & SAFETY
DEPARTMENT
DATE : /—NG
Z vL j
The Riverside County Fire Department considers its requirements met and hearby
releases the following project for _ .' oc c 41P117VCy
ADDRESS: 641-&q
-&q
cc: file 41 v
. bkWDIO OFFICE
79.733 Country Club Drive, Suite F, Indio, CA 92201
(619) 3424886 9 FAX (619) 775.2072
RAYMOND H. REGI
Chief'k par- P ner
By
U
PLANNING DIVISION
O RIVERSIDE OFFICE
3760 12th Street, Riverside, CA 92501
(714) 275.4777 9 FAX (714) 369.7451
O TEMECUTA OFFICE
41002 County Center Drive, Suite 225, Temecula, CA 92390
(714) 694.5070 0 FAX (714) 694.5076
printed on recycled paper
C.L
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TEMPORARY
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Iluffbin!j anb �S�fet� �iuis�inn
This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building
Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following:
BUILDING ADDRESS 78-550 Hwy 111
Use classification Restaurant — China Joe's Bldg. Permit No. 11514
Group B2 Type Construction VN Fire Zone Use Zone rPS
Owner of Building Ansheng Liu Address 73-091 Country Club Dr., A-2
Cit lm Desext. C
By; Richard Kirkland
OF
Date; january 23, 1993
Building Official
• POST IN A CONSPICUOUS PLACE