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11563P.O. BOX 1504 N o . 11563 Building 78-105 CALLE ESTADO Address' 78--580 Hwy 111 Ste. A -1 -j -A QUINTA, CALIFORNIA 92253 � v, Owner Mailing BUILDING: TYPE CONST. OCC: GRP. Address 51-255 Calle Ouinta A.P. Number City Zip Tel. ty �?ii ntao CA 92253 6 — 470 Legal Description Contractor I'em' na i - Improvemm en Project. Description � owner/Builder Address . z ci+tsc BY: Minimum Setback City Zip Tel.: Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line State Lic. City Issued by: Date Permit & Classif. Lic. # Sq. Ft. No. No. Dw. ' Arch., Engr., Size Stories Units Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. [ 1 City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION } I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 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 forthe following Estimated Valuation -$11,000.00 _ _ reason: (Sec. 7031.5,Business and, Professions Code: Any city or county which requires a ' . . permit to construct, atter, 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. '• subjects the applicant to a civil penalty Of not more than five hundred dollars ($500). Plan Chk. BBI. U 1q n 1 ❑ I, as owner of the property, or my employees with wages as their sole compensation, will p . y • do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const.126.00 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 through his own employees, Mech. , Provided that such improvements, are.not intended or offered for sale. If, however, the building or Improvement is sold within one year -of 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 not apply to an owner of property•who builds or improves thereon, and who contracts for S•M•1. y �5 A s 1.4 . such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading O I am exempt under Sec. B. 8 P.C. for this reason Driveway Eno. Date ' �✓ ?—,owner - r ' � Infrastructure WORKERS' COMPENSATION DECLARATION I hereby affirm that t' 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 ($100) valuation 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 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 0 9.O G REMARKS ,?,pY1.R 3�'k.}i�tY �a�'�.fi't.••�� SSV r r��i %�1t•X aJ 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. SQ. FT. ® $ 2ND FL. SQ. FT. POR. SQ. FT. ® GAR. SQ. FT. ® CARP. SO. FT. WALL SQ. FT. @ SQ. 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 APPJEOUIP. LAUNDRYTRAY 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. SO. FT. ® c BATH TUB, SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL � SO.FT.GAR ® V4c 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 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 ROCKSTORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. 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 INSULATION/SOUND FINISH GRADING f FINAL INSPECTION- . CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL i. r RIVERSIDE COUNTY FIRE DEPARTMENT IN COOPERATION WITH THE CALIFORNIA DEPARTMENT OF FORESTRY AND FIRE PROTECTION MIKE HARRIS FIRE CHIEF CkLIFORN/A *ENT of 1061 j RE PRO r/ Y C 1 1 ern. V D iI p TO: BUILDING & SAFETY DEPARTMENT DATEt 06-i7-9.3 The Riverside County Fire Department considers its requirements met and hearby releases the following tenant improvement for occupancy: ADDRESS: __ 7S Seo ---A�-�`-' ��---L A Qtir�✓i Cc.✓�nf ---- _Lt.=' ------------------------------------ C-cl file JU14 ile RAYMOND H. REGIS Chief Fire Department Planner By--------------- V ----------- Juts 2 � i-93 CITY OF L 00A q, svw clot: dwa -71 i o-, Z1 'ON BOr I C ^Ccmw 31V4 V-� V V- VI V H \"� rr� � � I W W>J,-�i Qa -,;+-2 -,�i H 2X43\� F �� Y�� ! h� i::)3rens SUBJECT, t Q -rA C,,,f-A � 5V\5 L-A bl-v, j7� Z I Z- 1-j 0� -RlA -rH f< I -r Z —F DATE- 2 JOB NO. -T-idl K r-� 121 rr� �5- 9 5 0 A 11 51 -� z", tA C5il MAX, VIA r F e M A X,A k7 r -IA SAP P LD L- -Z FT LAZI H —'>-70 1A IZ,A --rid A I' -c zl—::: 15 WiCo F;E- 'rH A A I Ff0 -Z-r5; -Z 5- L,,-, A IK -E Lf f 10 K� 12 5 A, '- -Z, I j- i , -7 -7 rT = 2nd i3 < I oz—j No. CO23724 (, -Z, I- 0 r, uu RMP .106 mas NO. OPERATION 11DATE INSPECTOR N0. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Ftgs & Frms 34 Plenums & Ducts 2A Slab Grade 35 Furnace Compart. 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. ❑ NON ADDITIONAL INFORMATION ICJ lya/ r 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 1.5 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 ELECTRIC APPROVALS REAR OF PROPERTY LINE' PSL PAI STREET NAME 26 Power Pole 27 Conduit a 28 Service Entrance .29 Wiring. i 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final