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354013, 360367, 0104-103 (SFD)i /,gW1LLP1nv rescross — PERMIT NO. .� DEPARTMENT OF BUILDING t& SAFETY,' FIEID T' L°1135401-3 i ' ; COUNTY OF RIVERSIDE " "' "_`'°�'� '' '�" - y _ ,, V1. I CONS UCTION,E,, -; ,, (J NO. ELECTRICAL FEES NO. PLUMBING FEES s. ' IST FL. SQ. FT. @ `p R . UNITS f 2ND. FL. y:•L., . n r t •. f .-�.;,-.,-,r SQ. FT. @ �-•.,.•.-, . ♦--,....,;+.+, r-::. _t r`....�.. .,. _.._.:, :..-.. YARD SPKLR SYSTEM- G +0 -.�.E . "�t ` s POR. SQ. FT. @ +- ' ♦ -.. f I r`` MOBILEHOME SVC.';..+ ., ...4N. _ r. :, :+r. a :$AR SINK i !�' -" ^} J .fit+ ;. 19- GAR. SQ. FT., @ ? POWER OUTLET ROOF DRAINS < CAR P. SQ. FT. @ x.. DRAINAGE PIPINGDRINKING ,j I WALL SQ. FT @ FOUNTAIN' SQ. FT. @ r "' URINAL ESTIMATED CONSTRUCTION VALUATION $ 'Micro:Film Fee � WATER PIPING r„ NOTE: Not to be used os property t6x valuatiori SWIM POOL, PVT FLOOR DRAIN. Use/Case N - o. •f, • , r MECHANICAL FEES SWIM POOL, COMM ! WATER SOFTENER S Backs ~- ENT SYSTEM FAN EVAP. COOL HOOD ' SIGN r WASHER (AUTO)(DISH) APPLIANCE : �,.r aDRYER � _ �•r,� # '.„� �.. .� (. +d++ r• ;s., ._.w� GARBAGE, DISPOSAL,,*.;w y Dbl E FURNACE UNIT ,t WALL FLOOR SUSPENDED E 4 1 } LAUNDRY TRAY i AIR HANDLING UNITIf CFM ; t : IDLE METER Y 4j KITCHEN SINK Electrical Fee Dbl E �p/{tv4 ABSORPTION SYSTEM f ! + • B.T.U: ; ' • �' TEMP USE PERMIT SVC t WATER CLOSET _ ' 'COMPRESSOR f HP POLE,TEMP/PERM $ LAVATORY T;.• HEATING SYSTEM J FORCED i. GRAVITY ' AMPERES SERV ENT } SHOWER `. eck BOILER d B. T. U.'N SQ. FT. @ t r BATH TUB Sp. Insp. Fee * E SQ. FT. @ _ •< ;. .._a WATER. HEATER Const. Lender C : fs Branch SQ. FT. RESID @1'/.c ' SEWAGE DISPOSAL' - «� a5 r SQ. FT. GAR @ '/. C t HOUSE SEWER • s ? ! GAS PIPING Mileage Fee E PERMIT FEE 1_ T PERMIT FEE PERMIT FEE , DBL:i —TOYL FEES ) IMO..L.M.FEEI = ` MICRO FEE ! MECH. FEE ` PL. ePE K.E,ej CONST. FEE - 'ELECT. fEE ' "� I FEE ' • ' 'FEE PLUMB. FEE ,Tel. + r.+•++'�+✓Hr•�.eh" 1'8?.yµ�sFa .r rF,,.a.p:i:•i.�.:* Zi F' -•.4.,-, 1 _ Totp'I Fees ' 77E Address f +. !�� '� ., rr City ! r �fi"' - •�`^�: ` -� • .!t - nr c j PERMIT NO. fC7 G` ceSpa 44 �354013 V . f Coryuryj (�,D/,)/ / civokiation • �O yA7 D F.c.c. x.. -MH.Permit Fee 'Micro:Film Fee � Cop E r„ Use of Permit, � -- � � �✓ �� � _ �,' / f � a /� �� y��rrrce � � ry � � � ^� / - - Use/Case N - o. •f, • , Ck � `j` Mech. Fee Dbl E ;PI. Ck. Fee y S Backs ~- Lot Size F S S R, Construction Fee Dbl E s, al D Legal ,. ,Q•� �,, - 4 �,'C•3r�// - ,.. - •• Electrical Fee Dbl E �p/{tv4 ZoneiF�sniclFon� f -?v �� Group. Type i• _ ' ISMI Fee E Plumbing Fee Dbl E Bond Amt. E - a �! 4>�• �G.✓4+. PI eck Final Date L/� 1 3, 7 Inspector' .. - Unit.- -• -I. Sp. Insp. Fee * E Demo!. Fee E Const. Lender C : fs Branch Supplimentdl Permit Numbers «� a5 Registr. fee ? ' Mileage Fee E Address ;{' i' , - City - Zip `• , ' ” Witness Fee E ` Reinsp. Fee E wner/A ent Og tt,♦r i'.. ♦.1F'��k'Zi fro ♦•h R•7. • •�`'' x j� p. !..• ,Tel. + r.+•++'�+✓Hr•�.eh" 1'8?.yµ�sFa .r rF,,.a.p:i:•i.�.:* Zi F' -•.4.,-, 1 _ Totp'I Fees ' 77E Address f +. !�� '� ., rr City ! r �fi"' - •�`^�: ` -� • .!t - Zip ti (.✓ M.O. &sb. Chat •? Rpceivegby _ *Iiy/)pr'' "� Contractor:T if Tel :•.gf� ©- License# Trees required ;.e� Sewage System AddreS• i City Zip ' T U. p THIS PERMIT SHALL BECOME VOID IF WORK ISNOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by: PERMIT TO BECOME VOID ' Sewer District FOR 120 DAYS SHALL ALSO CAUSE PME . ` t tM f. I HEREBY'AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH -THE LAWS OF RIVERSIDE'COUNTY,AND THE STATE OF CALIFORNIA. '-I, HEREBY CERTIFY,THAT fTHE'INDIVIDUAVWHO PREPARED fNE PLANS AND SPEFICATION 8 014 Form 284-208 (Rev.8/78) ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE.OF THE STATE OF CALIFORNIA. r z z x r •: 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 & 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 IDA Fireplace T. 0. E] NO -' ADDITIONAL INFORMATION — •_. ... � __ .� ... _ n..._ ._ _. __ _ ..._ ..__. ,_ _ _, __ � _ _ , 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 LAine 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 BUILDING PERMIT PERMIT NO, DEPARTMENT OF, BUILDING a SAFETY; 3 6 3 6 7 COUNTY OF RIVERSIDE- i FIELD -CONST UCTION ESTIMATE '7oli Address :.s ., y. _ ... +:,+. r}r T7t' �; +• r..,...., .....:-.,+..r>:�.5 ace ' - P X10. '' ELECTRICAL, FEES rNO. PLUMBING FEES ; ISPFL. t SQ. FT.' @ $ ry (U Valuation $ ~ 6 UNITS Off. ''2ND. Ft., SQ. FT. @ I MH.Permit Fee E i 1 -. YARD SPKLR SYSTEM Parcel o. 23:7:2Z SQ. FT. @ G UG r ? C Mech. Fee 'Dbl E' •-.. ,.• • MOBILEHOME SVC., ; • 1 oi, BAR SINK Lot Size/ J d •" r POR SQ. FT. @ `+ ? n• r G Electrical Fee Dbl E POWER OUTLET ROOF DRAINS Group ,,. r• GAR. . SQ. FT. @ ' Plumbing Fee Dbl E r+- Bond Amt- .$ +' DRAINAGE PIPING Unit CAR P. , SQ• FT• @ ►' i • • i + .r t r , r.F r: , i`� i r : ►•,S .! x DRINKING FOUNTAIN Registr. Fee §' +- WALL,',rl `. • s� r,. • . SQ. FT. @ Mileage Fee Address ! ' • •":.City...I Zip .;- - � - � t _i Witness Fee $: � URINAL OwnedAgent ' - + w • s' ► ESTIMATED CONSTRUCTION VALUATION '$ O + �' " dr WATER PIPING M.O. •+ Cash •Check. • : NOTE: Not to be used as property tax valuotiori Contractor rr..� ..i' vtiV+s`-:-`r-'r ./1^wY tY^.14.q,i'. •1 1��.,•,-+ Tel. • ; Y �,.:�:��, SWIM POOL, PVT "y FLOOR DRAIN W MECHANICAL•FEES, :,' _•' ?;: SWIM POOL,'COMM �, WATER SOFTENER VENT SYSTEM FAN EVAP.`000L 'HOOD •' ` v SIGN r 'T - WASHER (AUTO)(DISH) APPLIANCE. `' DRYER. T THE LAWS OF RIVERSIDE COE STATE OF CALIFORNIA. f '. GARBAGE DISPOSAL -. FURNACE UNIT WALL' • FLOOR - SUSPENDED " r" • LAUNDRY TRAY AIR HANDLING UNIT i' 'CFM a t IDLE METER F KITCHEN SINK t i ABSORPTION SYSTEM rB.T.U. TEMP USE PERMIT SVC ' WATER CLOSET e 1 COMPRESSOR HP •„ . ' R POLE,TEMP/PERM. LAVATORY r HEATING SYSTEM' F&RCED GRAVITY a r`, AMPERES SERV ENT SHOWER BOILER B.T.-U..,. SQ. FT. @ c i BATH TUB ri .K.«a....a ♦av .t,» M-�v •k? 4R a >},,k; ' w.' �. • Ea;!: ,..j.... ... tf:, tf r �^ " f•awSQ: - FT:r �.,,'c . @ .• e WATER HEATER e ." _ � ~ SQ. FT. RESID @1'/.c r SEWAGE DISPOSAL, S It ,- Q. FT. GAR @ 3i. c HOUSE SEWER GAS PIPING a PERMIT FEED PERMIT FEE PERMIT FEE DBI. TOTAL FEES MOB.HM.FEE MICRO FEE MEGH.`FE • PL. CK. FEE CONST. FEE EL CT. FEE SMI FEE - FEE PL B. e. PERMIT NO. w:•;:r.v+a, '7oli Address :.s ., y. _ ... +:,+. r}r T7t' �; +• r..,...., .....:-.,+..r>:�.5 ace ' - P Zi � Owner - -' P 1360367 + �-4 1A I Community '-- �` ' -� ( - Valuation $ ~ 6 Date E Off. f.C.' , MH.Permit Fee E Micro Film Fee Cop §• Use o Permit - - - �;,� /._ �/•� Parcel o. 23:7:2Z Use/Case o.Z2 Ck. By Mech. Fee 'Dbl E' •-.. ,.• • • Pl. Ck. Fee$, t et Backs- Lot Size/ J Construction Fee Dbl E A Legal Oesaiption. - F S S _ R Electrical Fee Dbl E �^1 ^y � C G)' f' �- �'�wy.���'L, �./ �� Zone Restrictions Group Type fir SMI Fee 5 Plumbing Fee Dbl E r+- Bond Amt- .$ Plan No. ' ' Plan Checker- (All at ' Ins ctor Unit Sp.' Insp. Fee $ ! ~ Demol. Fee $ �+ Const. Lender - r j ' ' i.'FBianch ,. Supplimental Permit Numbers Registr. Fee §' _ - t• ' t Mileage Fee Address ! ' • •":.City...I Zip .;- - � - � t _i Witness Fee $: � Reinsp. Fee+ $ r + OwnedAgent ' - + w • s' Tel_ t Zip ' Toial Fees -' ?E'.' E 1 Addreis 1 Zip r ; M.O. •+ Cash •Check. Received by �� ,,f, Contractor rr..� ..i' vtiV+s`-:-`r-'r ./1^wY tY^.14.q,i'. •1 1��.,•,-+ Tel. • ; Y �,.:�:��, License# (. Trees requiredr^>'w ^,�4,.+a..`'•...,.�s Sewage System Address +v Zi ' /•- �kT U. [D ••P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by: FOR 120 DAYS SHALL ALSO CAUS 'PERMIT TO BECOME VOID. • '+ �•'� 4 • +�NTYAA S wer Distract % M • • I HEREBY AGREE THAT AL4F*"OeWITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVERSIDE COE STATE OF CALIFORNIA. f •.�r `. • P HEREBY CERTIFY THAT THE INDIVIDUAL WP40 PREWED THE PLANS AND SPECIFICATIONS HAS DONE SO IN ## �" 'A CORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. Form 284-208 (Rev.B/78) T -� 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 Slab 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. ❑ OP'N NO. ADDITIONAL INFORMATION ^ SEWAGE SYSTEM SIZE & 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 ', 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 , a w z O 0 o� �o a) -- Z W O U. J_ Q S in m.6 ad t- IL z t" z O z p J O n. Ix 0 Z Z~ za w J � a o >- Z t_ Uj C LL J_ Q S 'n m 06 APPLICATION FOR TREE PLANTING I (we), the undersigned, hereby certify and acknowledge that I (we) have read the application and agree that if trees are required under River- side County Ordinance No. 457, the applicant agrees to install said trees prior to final inspection. It is understood that no final ins ppection will be given until said requirements have been met or exception has been granted by the County. Now, therefore, i.t is agreed that the prop- erty owner shall cause the property lines to be surveyed in the event no survey stakes can be found. Further, it is agreed that the County of Riverside shall assume no responsibility should trees have to be removed due to lot line errors. Owner's Name C ' • G - — P �o 36 7 Mailing Address iv City Job Address 2 o !/ci1 /j?'d ILL Legal Description '05 L/< � 71 S;7 C% 77 Assessor's Map, Book & Page � 3•` �� Type of Soil „FIs water available li Road `Dept. Plot Plan No. Type of existing trees in road right of wa Trees preferred by applicant (1) /�L/� //c- (2) Date (�I Owner's Signature &6 state ermit No. &state _zip 92201 Community l/-''q'� Type Structure Planning Commission Case No. ROAD DEPARTMENT APPROVAL''N Approved species Washingtonia robusta (Mexican%fan halm) Number of trees 1 Spacing of trees Distance' from lot lines.: Front 21. in R/W Side Additional requirements Per plot plan on reverse - Date Building and Safety notified 5/79 Signature REQUEST FOR EXCEPTION, Reason Request for hearing: YES ❑ Owner's Signature (attach additional page if necessary) (Forward application to Planning Dept. if exception requested) NO REQUEST FOR HEARING Planning Dept. Concur M Date Road Dept. Non -concur M Explanation Signature Concur ❑ Non -Concur M Date Signature REQUEST FOR HEARING AND COMMITTEE DECISION Date hearing established Date hearing notice mailed to owner ' Approved E3 Disapproved ❑ 'Date Owner notified of decision Date Building & Safety notified Signature Final Date Job Address Inspector Requirements for tree planting complied with Remark s ,APPROVAL BY BUILDING INSPECTOR Building Permit No. Community (Detach and forward above information to Road Department Riverside) 284-230, REV. 1/7a APR Q 1979. _ w ,yam., ` •.• rtw.. �}���..,.«.. ,ice. ... NOTICE: THIS IS NOT'A BUILDING PERMIT APPLICATION TO CONSTRUCT DEPARTMENT OF - BUILDING AND SAFETY COUNTY OF RIVERSIDE 'f DISTRICT Permit No �jj,1). � �,�, 3 Jt � ��AL. C=v�.�Gtrr� J. viLi.,stcara� Owner Architect Contractor - _ p %; t3. , b � Address Address} Address— City tl.i�if6% City 1('J'6io? Sj� t�J4i3 /�� City_ Phone Phon `<4-7 "9Phone01 W I (we) the undersigned, hereby certify and acknowledge that 1 (we) have read the application and agree that if Curb and Gutter, and Z Paving, and/or Dedication of right ofway is required by the County of Riverside, the Riverside County Department of Building and Safety 3 shall not make a Final Inspection -until said requirements have been met..,I am Also aware that no work is to be done within the County R/W O without an encroachment permit. NOW, therefore, it is agreed that I (we) will, not occupy said property and will not cause said property o a occupied pntil leve) have complied with al laws of the County of Riverside and the State of California governing said property. l , DATE' t ` r SIGNATURE OF OWNER AND/OR AGENT Approval by Signature from the Following Departments Listed Below Must Be Obtained Prior to the Issuing of a Construction Permit. ' ( SPACE NO. USE OF. ST CTURE JOB ADDRESS I _ LEGAL D SCj21PTIONF PROPER Y ✓. N SINGLE FAMILY DUPLEX Z fJ Jt! )?/ !s';j — APARTMENTS AGRIC. El N Q��r 1 COMMERCIAL INDUSTRIAL ❑ C'^ COMMUNITY . l� C mac' ALTERATIONS LJ Z NO. OF SUBMITTEDPLANS ---_ USE OF PERMIT us --- <, CASE NO. - O Z NO. OF;PARKING SPACES REQUIRED NO. OF BUILDINGS NOWT EXISTING Z ZONE tETBAC'KS: it } SIDE ' y REAR *� Js • r e, m GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE y SETBACK OR�PINANCE # _— OF FEET REQUIRED ON J A ` STREET DATE —_ r SIGNATURE OF LAND USE OFFICIAL., — --- DEDICATION REQUIRED:_ YES [3NO ❑ 0. OF FEET- ,. W CURB AND GUTTER REQUIRED: YES � NO, mfr STREET m W CAN CURB AND GUTTER FEASIBLY BE INSTALLED? 'YES ❑ NO ❑ HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT YPERMIT FOR DRI r/E * NfD `$T9EET /4 C �j IMPROVEME T> ESNO ❑ ✓r wj °C DATE-.�-� SIGNATURE. OF' ROAD DEPT. OFFICIA I SWIMMING POOLS PUB IC erg a W rSEwAGE DISPOSAL �r' "I�1t'JC':. L %i t,l. LL �S~/ _ FOOD ESTABLISHMENT --C �►f3 WATER POLLUTION REMARKS �n FLOOD CONTROL — z AIR POLLUTION t W DIV OF HWY w c <^ — ) YOUR PROPERTY MAY BE SUBJECT T01' c FLOOD. RIVERSIDE COUNTY ASSUMES, A' -� NO RESPONSI`BILITY- IN EVENT OF FLOOD 284 199 9/74 - . _ CANARY—FILE, PINK—APPLICANT PERMIT NO. ^ ^ ^ MOWN�RI 36036`7 -.•r.•.•. .n- - •MH.Permit Job Address r • • • ' s' , ` •'Space 6 G���,` Zip ner r Z2s G o .Community •� EJ�•� Date /p t, L/ /O / -t ist, 1,�� Off. F. C�Cj. ��✓ /' Fee S• Micro Film Fee :. Cop E Z Use of Permit - ,' ' ti t 4 Y• //� `. (/w, (,� .��',� . Legal,Rescription :.- • ^•� 4 L G. �, y '•• /' Parcel No. Use/Case No. Ck?By Mech Feel Dbl E PL CkFee r - E . - tL Construction Fee 7 Obl E'' s Set Backs ,'D Lot Size c F 7t S �•` R� EleUrical Fee Dbl. E Yone Restrictions f .2 "' / Group Type( V S:.�. ��s,tt Plumbing Fee L = Dbl $ Vrr d Bond, Amt. -S•:t.�/OO .Plan Nol Plon t ker r� Firt al_Date' .t ♦ . Inspector Unit Sp.. Insp..Fee E. ' iDemol; Fee E i .dorm"Lender i '. Branch % �• ! � i.' �• Address •I CtyLp •Y, Supplimewal Permit Numbers ' � , Reglstr. Fee �' E �.r, ,Mileage fee , S. 'J ,Wilnesr Fea.; Reirisp.'Fee..,, . 5,,;' Ownel/Agent Tel; Zip Total FBes E: Address t r r� � ' City' •1 Zip r�rr M:'O.El CwhEj Check Recet ed,by t Cant actoi R E/. jfjj ` i..-"�. r. x�... ;`1,+,.. .y a,(iw� .J _ i/ '�` _ 0 License# a .aNeI" .t t2 ....,='w s w • Trees. reguired ,\� Sewage System' Address City sZip °:CiQ'2dT LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by: Sewer. District FOR 120.DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. L . i I HEREBY AGREE TWAT AL'L W'6RK IN'CONNECTION "WITH'"'THISRERMI T WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA,. t �'". ° ''�' •`"� I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE,PLANS AND SPECIFICATIONS HAS DONE SO IN ACCORDANCE WITH SECTION 5541' OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. �. Farm X284-208 (Rev.B/78) fes;• j ,r r PA&rTMENT OF BUILDING..AND, .SAFETY CO NTY OF:RIVERSIDE CLAIM OF:.<DATE: i(:.. � {:. DAT�9e , .{ • �zw � �o = ick:- P ���ra ; ADDRESS: CITY AND STATE ON THE'TREASURER OF TH&COUNTY OF RIVERSIDE, STATE OF CALIFORNIA 'n Instructions:`-P.ermittee •will furnish; the following information: (1) Permit Number (2) . Date Issuedil�,. /n' { <r'7q . (3) Total .Fees.Paid $ W Reason'' for. Refund. I'fiCERTIFY -THAT THIS CLAIM IS TRUE AND CORRECT, AND THAT NO PART`HEREOF .HAS BEEN PREVIOUSLY PAID ABY THE. COUNTY O.F..RIV,ERSIDE. Claimant's -Signature (Do not write -below.. this' line):. - Date:. .AliRu C . ! 2979 General' Fund: 1001-2841231 FROM: DEPARTMENT OF. BUILDING. AND SAFETY TO: AUDITOR=CONTROLLER, COUNTY OF RIVERSIDE Please issue to the. above indicated claimant a refund of .� =.0, on the above permit deposited uri`der Treasurer's;` Receipt N&. OSz23 , dated . AUTHORITY: Ordinance No.. 457, Section 7, Subsection E;, Approved eri�`for the. following reason: (strike 'out words not applicable) is ui^vENSED CGNTRACTOR DECLARATION r, ,I here by';afflrm.under penalty of,perjury that I'am licensed under provisions,of Chapter *(commencing with Section -7000) of Division 3 of the Business and `Professionals Code, and my License is in full force and effect License # Lic. Class Exp. Date „ Qo �. B aa��if A OW 112t Date` i `r Signature of ContractoN� OWNER -BUILDER DECLARATION I hereby ;affirm under penalty of perjury that I am exempt from the Contractor's License Law.for the following reason: 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 & Professionals Code). ( ) I, as ;owner of the property, am exclusively contracting with licensed contractors,.to construct the project (Sec. 7044, Business & Professionals Code). () I am exe' mpt under Section B&P.C. for this reason Date k.'Signature of Owner z: WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: () I have,.and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ( ) I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work fo"r which this permit is.'issued: My workers' compensation insurance carrier & policy no. are: Carrier Policy No. (This section need not be completed if the permit valuation is -for $100.00 or less). () I certifythat 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, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I sITa11 fortpwith comply with those provisions,, 61 v _... ,. - Warr ing: Failure to secure Workers' Compensation coverage is unlawful and "shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Build r R d Safety A for a permit subject to the conditions and restrictions set on his application. 1. Each person upon whose behalf this application is made & pC'' whose request and for whose benefit work is performed under pur any permit issued as a result of this applicaton agrees to, & s , in & hold harmless the City of La Quinta, its officers, agents a d em 2. Any permit issued as a result of this application becomes ull an work is not commenced within 180 days from date of issu ance .of sucp Ty permit, or cessation of work for. 180 days will subject permit t cancellation. F11 I certify that l have read this application and state that the above information is correct. I agree to comply with-alj•City, and State laws relating to the building construction, and hereby'authorize representatives of this City to enter upon the above-mentioned propertyfor inspection purposes. w pf t Signature (Owner/Agent)- Date �ft f ..e BUILDING PERMIT PERMT# DATE VALUATIONLOT (�,9�.. TRACT JOB SITE - APN ' ADDRESS .•(. OWNER CONTRACTOR/DESIGNER/ENGINEER JAC- TCMs n"MIE DE.1 rr COW D1151. 1111C, CO�6'api 1100 XD 0N, 8 YETHS Lac PO BUY.15TS, 7P, O..£3C1�rC 6''a8 LA,C?i3'3kn,,,,� CA, 92253 LAQtFtA1"CA rJ.b1. 92253 (760)771 �3 593 ("BUi 5830 3 � ' USE OF P��Evy.R��MIIT�T�j p �p�y �p y q�g 5 y �y! L}iC':i:C5.96:..�d':�F.V IL.rY J,� Vi�7:gf..•!.�],� 0 • � Wrl) 9 PL„p,Odi T WES :i'O`,t' 1NC1..I D?, Rl.Q?O.F.:Wl'►P..i POP. 0d�3P.A. OR. 1AN I WAY APPROACH, RM,PER M,1-1 TAA,CT Cafe'. i UC TION 1,501.00 OF ' RORCH."PATIO 5:1.00 STS' 5 FT. WWD MIC BCs0.00 tom+ Cis,?( R A,C 9 A¢ f.Of3 SW C 49'1 UCION Fa 301.000-418.000 $612.50 P.11.AN C"HFICK FEE 101-000-439-318 $513.45 fdiRCHANICAL M 101-000.421.000 26010 E1.,M''1'kiICAL F88 7.01-ti00-620-000 $01.38 . t1..11M5'IHO FEE 101 -000-419.000 3t 101”. STI#, O ?c; Uf10W FEE - 3T.,t SID )01-000-241-000 49.31 d3 RAC1IN0 YEE 10 1400.4?.n3-000 $20.00 e.3?c,•'YEWPOR 111NP.&CT t �l,�fi'D.Ot► PRECIN' PLAN 101-000-441-345 $la0,A4 101-000-439-318 � iSf1.00 2 0 2001 .I'MAT.. CO.eaBTRUC° ION JVM ra1.. 0:WX $3,46A.31 LM PRE -PAW MIMS 4250.00 F LADUINTA 'fi'4?`T lite'.=ff1'1i' r5D•9'TENOi1 ANCEDEPT RECEIPT DATE f BY DATE FINALED INSPECTOR 0 INSPECTION RECORD - OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs ' Underground Ducts Forms &'Footings Ducts [ Stab Grade Return Air I ,.Steel Combustion Air Roof Deck Exhaust Fans } OX to Wrap F.A.U. [ Framing Compressor ! Insulation Vents `; t Fireplace P.L. Grills [ Fireplace T.O. Fans & Controls j Party Wall Insulation Condensate Lines { Party Wall Firewall } Exterior Lath [ Drywall - Int. Lath f I Final t Final BLOCKWALL APPROVALS POOLS - SPAS Steel [ Set Backs Electric Bond [ Footings Main Drain j Bond Beam Approval to Cover 1 Equipment Location [ Underground Electric [ Underground Pibg. Test I Final I Gas Piping [ PLUMBING APPROVALS Gas Test t Electric Final Waste Lines Heater Final [ Water Piping Plumbing Final [ Plumbing Top Out Equipment Enclosure } Shower Pans O.K. for Finish Plaster [ Sewer Lateral Pool Cover } Sewer Connection Encapsulation [ Gas Piping [ Gas Test Q — L — O 1rjz I Appliances I Final [ Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. .Smoke Detectors Temp. Use of Power - Final d� Utility Notice (Perm) COMMENTS: L2 Tit�t 0 P.O. BOX 1504 Building 78-495 CALLE TAMPICO Address C 3� 7 `U �%�� LA QUINTA, CALIFORNIA 92253 Owner r Mailing / Address Q r (�j City ?-))L,.nt Zip%A953 TA0 T7/ X93 vntractd U' l r"t�7� 1 ZiP � C� cam• Js� 1�% State Lic.' City & Classif. Arch., Engr., Designer Address Tel.. CityI Zip I State I Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby'affirm that I am. licensed under provisions of Chapter 9 (commencing wlt -Section 7(X10) Toff Division 3.of the Bu/sin`es�ss-brad. rofessiio/hs Code, and my Iicen y/�jry ull orce and effGNAT -k r / DATE � � LD OWNER-BUIER DEC RA ION ha"e'by affirm that 1 am exempt from the Codtactors License Law for the following reason: (Sec.,17031.5, 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 rile 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 exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (S500). I: 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, Buisness 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 through his own employees, provided 'hat 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 of proving that he did not build or improve for the purpose of sale.) I 1 I, as owner of the property, am exclusively contracting with licensed contractors to con. 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 such projects with a contractors) licensed pursuant to the Contractor's License Law.) . I'! I am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that 1 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. Com an a P Y� n Copy is filed with the city. . „fJ Certified copy is hereby furnished. i 1y,N 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 thg 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, atter 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 slate 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 adplicant Ii Date Mailing Address t City, State, Zip r,v�u1: BUILDING: TYPE'CONST. OCC. GRP. A.P. Number �J� C70* r Legal Description Lk3r 2 1 d 1 Vr,) tT I Project Description S b -SA - Sq. Ft. o. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ j Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Z. h'•'. . Plan Chk. Bal. Const. _ " ./ - y. .•r,a . Mech.� Electrical Plumbing S.M.I. Gradino Driveway Enc. f >- r .�. �• oC� APPLICATIO ONLY ,n r,v�u1: BUILDING: TYPE'CONST. OCC. GRP. A.P. Number �J� C70* r Legal Description Lk3r 2 1 d 1 Vr,) tT I Project Description S b -SA - Sq. Ft. o. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ j Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Z. h'•'. . Plan Chk. Bal. Const. _ " ./ - y. .•r,a . Mech.� Electrical Plumbing S.M.I. Gradino Driveway Enc. f >- r .�. �• Infrastructure t - TOTAL REMARKS 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: YJ f Validation: WHITE = FINANCE YELLOW = APPLICANT ~ PINK --_-BUILDING DIVISION 1:", Notice: Document Cannot Be Duplicated Date 4/20/01 No. 21918. Desert Sands °Unif ed School District 47-950 Dune'Palms Road LaQ.uinta, CA 92253. t_ ,l 760 -77f -85t5- CERTIFICATE OF COMPLIANCE Jurisdiction APN:# 773-313-005 Ia; Quinta Owner NameJack McKenzie Desert Cove Dev. LLC No. 52-866 Street Avenida Rubio City La Quinta zip 92253. Tract # BL171 U17 Lot #-_ 21 Square Footage Type of Development Single -Family Residence Comments Permit # 0104-103 -Log # StudyArea 1501; No. of Units 1 At the present time, the Desert , Sands Unified School, District .-does ,riot collect - fees on garages/carports, covered patios/walkways, residential additions under'500 square:feet;'detached,.accessorV structures or replacerfient mobilehomes. It has been determined the above-named owner is exempt from;paymg.school fees at this time due to the following reason: EXEMPTION NOTAPPLICABLE This certifies that school facility. -fees imposed pursuant to ` ,Government ciide:53080 inithe amount of 2.05 X 1;501 or $ 3,077.05 theproperty listed aliove andythat building permits and/or Certificates of Occupancy for this square footage in this proposed project may now -be issued Fees Paid By OCL Bank .& Trust.- Deanne Madsen.'. Telephone" Name the C'6'c = - - By Dr. Doris Wilson ". Superintendent Fee collected /exe pted by �.aAnn6fte-Bdrlo'W Payment Received $3;077.05 J� Check No. 520999744 Signature 40TICE: Pursuant of Assembly Bill 3081 '(CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified above will begin to run from the date on which the building or installation permit for this project is sssued or on whichthey_arepaid to the District(s) or to another public entity authorized to :ollect them on the District(s)(s') behalf, whichever -is earlier..: Collector: Attach a copy of county- or city 'plan check application form to district copy for all waivers. Embossed Original- Building Dept./Appl1. icant Copy - Applicant/Receipt Copy = Accounting +:'.. (760)568-3627 Escrow No. ,17014125 - EBB 1. 2. 3. 4. 5. 6. 7. e. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. O' TITt RING DF Fax (761 ESCROW .INSTRUCTIONS iartment of Insurance 341-8296 Escrow Officer JACKIE, FELDMAN Date February 21, 2001 On or before the TIME UMIT DATE of March 1, 2001. ALAN R. POLLOCK, AS TRUSTEE, Seller: (s),.herein will hand you a Grant Deed conveying the property described herein to vestee named below; JOHN M. MCKENZIE, A MARRIED MAN AS HIS SOLE AND SEPARATE PROPERTY, buyer,(s) herein; hands) you herewith $500.00 will hand you prior to date of close of escrow $53,500.00 TO COMPLETE A TOTAL PURCHASE PRICE OF $54,000:00 I I � j ill O which you are Instructed to use when you can obtain a Owners. Policy, is d by Fidelity Title .Company which Policy of Title Insurance will contain th6�insuring clauses, exceptions; excl ns,' provisions and stipulations customarily contained in`the printed provisions.of:such form with liability not ss than $54,000.00 describing the land in the City of LA QUINTA, County of RIVERSIDE;. State of -California, desc Abed as: 7-M �5 2Y n commonly known as: VACANT LAND,/77005 AND6LA QUINTA; CALIFORNIA 92253 (Escrow holder is not re to verify sam A 0 d?T6SOOK .21 AND 22 BLOCK.171 F SANTA CARMELITA AT VALE LA,QUINTA, UNIT NO. 17, AS PER MAP:RECORDED 19, PAGES 19 AN 0 OF MAPS; IN THE OFFICE -OF THE COUNTY:RECORDER OF SAID COUNTY 26. howing the FEE to said land:vested in: JOHN. M. MCKENZIE; A MARRIED MAN AS HIS SOLE AND 29. S ROPERTY (exact vesting shall be determined priorAo close of escrow, without further approval from 30. Seller) 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48: 49. 51. 52. SUBJECT TO: 1. Real Property General and special taxes for current fiscal year in which this escrow closes, and subsequent years, including reassessments if any and including any special district levies -or personal property taxes, payment for which are included therein and collected therewith and improvement bondassessments, when applicable. 2. The Lien of Supplemental Taxes, if any, assessed:pursuantto the provisions..of Chapter. 3.5 (commencing with Section 75) of the Revenue and TaxationCode of the•State of California. 3. Bonds and/or assessments now alien, if any, tgbe paid current by Seller; payments not.yet due to be assumed by Buyer. 4. Covenants, Conditions, restrictions, reservations, easements, rights and rights, of way of record, if any; and Ahe exception of reservations of water, oil', gas minerals, carbons, Hydrocarbons or.kindred substances on or under said land, now of record, if any. VESTING --The exact manner.of buyer's vesting Is to bei -provided escrow hoider,by.,buyer prior to the close of escrow. Such notification Is to be In writing; and upon receipt of same, escrdw:holderJs authorized to Insert the vesting Into each pertinent document4s requlrad-In this transaction withoi.1tfi.irfhar nnnrnvaI mf colln. 1 RC`DISTRICT - VLANNING`REVIEW FORM This form is to be used by CDD staff for review of single family dwellings;in the RC (Cove Residential) District, in order to determine the applicability_of compatibility issues'or need`�to require the filing'of Master Design Guidelines by the applicant: 4.It shall'be-transmitted to the Building and Safety Department as your correction list. Please attach. additional explanations a's necessary.' APPLICANT Construction Design Systems �ac10ESSn�G SITE ADDRESS 52-860 Avenida -Rubio cS\6NSG APN 773 _ 313 _ 005 ' gINNO:: ' �C" CASENO.: 2001-443 .LEGAL: LOT '?�ZBLOCK 1 1 UNIT ` 1 S.C.@V.L.Q. CHECKED BY: Greg Trousdell*' DATE: Inform the assigned Building plan checker upon your assignment to this case. The CDD Executive Secretary maintains a log book td-track.app licqjkons, and assi'gh case /numbers. REQUIRED .ITEM.. Y 'N ~ COMMENUCORRECTION Compatibility Review Case, logged and number assigned'`'. Verify legal and APN information:. Te Consistent -with MDG on file (as.applicable e MDG filing required (5 filings since 9/3/98) ° pj Consistency with street/surrounding area •Z-- a " o PaILI.vpep1• CAV S t6eiarts dor b l G Other Requirements: 41 ` April.9, 2001 Ms. Nickie J..Gormley' City of La Quinta Building Department, 78-495 Calle Tampico.. P.O. Box' 1504 La Quinta, CA 92253 RE: Construction Design Systems Inc. Dear Nickie: Please be advised that the'.following plans have been. previously ap pfoved for use in the Cove area of La.Qu'inta by-the,..Planning Co'm'm­i's"'si0n. The fift'of.Cbnstructibn� Design Systems, Inc. has myperm,issionto'use-the pI.ans'6nfVattli&foIIowing iocations* 2. Plan Mali,b.0 1: 5284.0'Avenid-a Rubio 3. Plan- Malibu- 1: 534'45 Eisenhower 4. Plan 9A-1: 5294�tisenhower If you-have.any other qa6stions,, pl ease call me, at -760/564-1866. NT,URES, INC. —LEN NTU I A.P. Lench, I P Pr s t resident A PL. I .v PL:vI Apoibygd bjj-�,. Reso # pliihhinGi Comm O'Cit 6 o MU' U6pL Ahiti ' ils Y C V, a s 0. o. Exhibit -.U. h.Qo "ditions n 4,Lf .P. O.,BOX 450 �A QUINTk* CALI OkN'IA,* 02253-0450 L F 760/564-1866 F AX 6-` .760 5 4m2627 �¢-i11"'�Y�`I'iif$^�Kev1F ' t ii.t"'"'"'"W'^' ,5 ,•n;"'•r<la• r t. .w , . .. WSlad'den-Engineering 6782 Stan.'tori Ave:, Suite E, Buena Park, CA.90621 (562) 864-4121 (714) 523-0952 Fax (714) 523-1369 39-725 Garand Ln., Suite G, Palm Desert, CA 92211. (760).772-3893 Fax (760) 772-3895 ` Date Job No: 5 ..FIELD MEMO' Project'Name �ly�rF.. ��_ Client: Site'Address L11 CL aAl Job Phone Work Done?'--'. S` , L-="R='+r�i�'9 �*rS:a" sj U'ti'',• �"icau�.�- ' �6,� C`.• � ' ' Test Summary/ Footings Inspected Test No. Location Elev. Dry Density Moist %/ % RelativeRef. Compaction Max pcf Moist •- ,G`r .� 1 e1' t �. 't. . �.1 `Ca ► nn �' ^ p [ �L7�7, �L!'• • 6 ! • % Cr . r`nmmonte X19 l..^r/ �� �• .--`' Field Tech. Super. or Agent ,w 24 hour notice requested to schedule Field Technician. Thank you for the opportunity to be of service. April 9, 2001 T Ms: Nickie J. Gormley City of La Quinta Building Department 78-495 Calle Tampico P.O: Box 1504 La Quinta, CA 92253 RE: Construction Design Systems Inc. Dear Nickie: Please be advised that the following ,plans. have been previously approved for use in the Cove area of La Quinta by the Planning Commission. The firm of Construction Design Systems, Inc. has my permission to -use the plans only at the following, locations: 1. Plan BA -1: 52860 a ida1-Rubio:— 2. Plan Malibu 1: 52840 Avenida -Rubio 3. Plan Malibu 1: 53445 Eisenhower 4. Plan BA -1: 52940 Eisenhower If you have any other questions, please callmeat 760/564-1866. L - E, N 7 TURES, .INC. A.P. Lench, 1 President APL:vI 'L7 IPtenningCots�si� ��.....� .�-o O City Co it Commu v. iDOOL 0ra8wkb d.®.....e asa.® `.IExhitit E':1rVith coridiions, P. O. BOX 450 *'LA. QOINTA ! CALIFORNIA ` 92253- 760/564-1866 "'FAX -7.60/564=2627 Certificate of Occupancy City of L,a Quin, ta Buildin and Safety Departm.'ent This Certificate issued pursuant to. --the requirements of Section 109 of the Uniform Building- Code, certifying that, at "the- time of issuance, this.structure was -,in compliance with the various -ordinances of the City, regu/ating_bui/ding construction or use: For Me fd# wing:. BUILDING ADDRESS: .52.860_AVENIDA RU:81.0 Use Classification: SFD Bldg. Permit No.: 0104-103 Occupancy Group: R 3 Type. of Construction: VN Land Use Zone: RC - Owner of Building: JACK McKENZIE DESERT COVE DEV. LLC Building Official Address: P.O.- 60X`628 City:. LA.QWNTA, , CA,, 9.2253 . By: STEVE TRAXEL Date: 10-18-01 POST IN A CONSPICUOUS PLACE