00016732 (SFD)B gRESSISPACE:
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E'{ .ARCIENG FIRM NAME
ADDRESS
!F 'CIT.YICOMMUNITYISTATEIZIP
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P'LJANp•w
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. - ZONEORDV
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NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs 8 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. C]
43
Final
IDA
Fireplace T. 0. 0
OP N I
NO.
ADDITIONAL INFORMATION
.t
1
i
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Botts)
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
PSL
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
LICENSED CONTRACTORS DECLARATION: I hereby affirm Thal I am licensed under provisions of Chapter 9 (commenc
ing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect
OWNER -BUILDER DECLARATION: 1 hereby affirm that I am exempt Irom 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-
struct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such
permit to life 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 five hunderd dollars ($500).):
❑ 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, Business and Prolessions 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 that such improvements are not intended or offered for sale. II. however,
the building or improvement is sold within one year of completion, the owner -builder will have the burden of prov-
ing that he did not build or improve for the purpose of sale.)
Of, as owner of the property, am exclusively contracting with licensed contractors to construct 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 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 [hat 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)
HURN, DAN
PERMIT APPLICATION
CITYICOMMUN ITYISTATEIZIP
)'ALM DESERT CA 922600000
'
LAc t:UINT EIZIP CA 922530000
County of Riverside
Department of Building and Safety
PAG
w91
2i080 Lemon St. 2nd Floor
135 N. Alessandro Rd. Rm. 203
880 N. Slate Street 227 North "0" Street
46.209 Oasis St. Rm. 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: 9222670
This Dermic becomes void if work not commenced
within 180 days from dale of issuance.
n
OR, it work has beer suspen� or abantloned1ar a period 41 180 days.
PHONE M
LICENSED CONTRACTORS DECLARATION: I hereby affirm Thal I am licensed under provisions of Chapter 9 (commenc
ing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect
OWNER -BUILDER DECLARATION: 1 hereby affirm that I am exempt Irom 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-
struct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such
permit to life 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 five hunderd dollars ($500).):
❑ 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, Business and Prolessions 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 that such improvements are not intended or offered for sale. II. however,
the building or improvement is sold within one year of completion, the owner -builder will have the burden of prov-
ing that he did not build or improve for the purpose of sale.)
Of, as owner of the property, am exclusively contracting with licensed contractors to construct 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 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 [hat 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)
HURN, DAN
ADDRESS
TUA 1638
CITYICOMMUN ITYISTATEIZIP
)'ALM DESERT CA 922600000
JOB SITE ADDRESSISPACE
54105 AVE RAMIREZ
LAc t:UINT EIZIP CA 922530000
BOK
774
PAG
w91
PRC
0x7
C
4
TWN
0000
PING
SE
00
S
TRACT LOT
000000 Oq-0i
MOD
021
SB
TRACT NAME
rCV LAQ 0261
6j BILK-20
5OWNER
HORN,;, E (LDMI)AN
PHONE M
N
DATtAVUi'�HCII iJi�4�6
LC r
ADDRESS
BOX 1630
CITYICOM MUN ITYISTATEIZIP
PALM DESERT CA 922600000
PHONE#
714-568-10 40
BLDG. INSPECTOR
FINALDATE
ARCIENG FIRM NAME
LICNC #
ADDRESS
CITYICOM MUNITYISTATEIZIP
PLAN If
P E ER r
AP OVE DATE
C *#
.i
NC
COUNTER#B.I. �+
USE OF PERMIT
1?UU3 31 ATT GARAGE
BL
00
ZON
R1
FSB
020
SSB
006
SSB
012
RSB
X25'
OFC
IND
ZONE ORD #
LOT SZ
END
0050 IOU
SIDE
1,i)0
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be com-
pleted if the permit is for one hundred ($100) or less. I certify that in the performance of the work lot which this
permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensa-
tion Laws of California.
Dale _ Applicant
NOTICE TO APPLICANT: If, after makingthis 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:
01 hereby certify that no excavation five (5) or more leet 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, lalsework,
or demolition or dismantling thereof, will be more than thirty-six (36) feel 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 Safely Permit No.
CONSTRUCTION LENDING AGENCY: thereby 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 state laws and county ordinances relating totem
building construction, and authorize a representative of The County of Riverside. Department of Building and Safety
to enter uQon the property lot which I have applied for this permit for the purpose of making inspections.
X �.
p/ 1� e of Applicp gent
,.l1'�nl Aplpllic�ca
�anF*I' enf Name
APPUPFiMT #
t26716
Ei TXNA.1 �yK)
PS DATE
� 6 7 A
PLAN nEV FCC
TOTAL
FEE
Sl1 3 1 x 7
CA
C *#
.i
NC
COUNTER#B.I. �+
COUNTER L.U.T.
PERMIT FOR STRUCTURAL PLAN REVIEW
TOTAL PERMIT Gil«'T 15 X151 .77
CONSTRUCTION ESTIMATE (NOTt7i Not to baiI uou-0 npropertp
Unt;criptton FQC group Typpo �q V
PRIMAnY DULL, 101 !:-3 V_l3 1211
SECHDRY IAIRCON 700 R°•-3 R 2;x'»2 2
S1;CN01:Y PIJIGAR 4Z6 0 WD�,-j)
Lot 1'lon Rem Fee) aced on Total E tinated VoIrto o
FORM 284.208(11-81), I NSPECTOR
illaluation)
Wavcf Vc' Iuation
127. 60 i33 41113
1321 .20 $2664
1fl 9 Ili 1291 r
t)9.1;� is., . .77
1
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs 8 Frms
34
Plenums 8 Ducts
2A
Slab Grade
35,
Furnace Comport.
3
Steel
36
Inlets 8 Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
39
Appl. Clearance
7
Framing
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L. C]
43
Final
IDA
Fireplace T. 0.
NO
. ADDITIONAL INFORMATION
_
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts)
128 Ceiling. (Batts) - ,
12C Ceiling (Blown)
14 Final
PLUMBING APPROVALS
15 Ground Plumb
16 Water Piping
17 Rough Plumb
18 Vents
19 Sewage Disposal
20 Sewer
21. Water Heater
22 Water Softener
23 Water Service
24 Gas Test
25
Final
Tank Pit L.Line
REAR OF PROPERTY LINE
PSL P/
1
ELECTRICAL APPROVALS
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30.• Fixtures
31 Service
32 Final
STREET NAME
PERMIT APPLICATION +'
Riverside
� County of Riverside
> De artment'of Buildingand
,a p
Safet Y
0�. „off 2nd Floor 135 N. Alessandro -Rd. Rm. 203 880 N. Slate Street
227 North "0" Street 46.209 Oasis St. Rm. 310 160 N. Broadway
y
C 2501 ," Banning, CA 92220 Hemet. CA 92343
"14
_
Perris. CA 92370 Indio. CA 92201 Blythe. CA 92225
Phr,M( Ph: 849.7812 Ph: 658.4464
Ica - -
Ph: 657-3898 Ph: 342.8271 Ph: 922.2670
' This permit bac mes void it work nor commenced within Bg days from date'of issuance. OR, it work has beer suspended, abandoned Ion4 period of 180 days.
- TWN
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be com-
LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (comment-
pleted if the permit is for one hundred ($l00) or less. I certify that in the performance of the work for which this
ing with Section 7000) 9 ivision 3 of the Business and Professions Code, and my license is in full force and effect.
' - _
permit is issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensa-
tion Laws of Calilornia.
O.. ,_ •
Dale .... •.. Applicant !
OWNER -BUILDER DECLARATION^ I hereby affirm that I am_exempt from the Contractor's License Law for the
NOTICE TO APPLICANT: II. alter making this Certilicale 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
following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to con-
deemed revoked.
{lruct, alter, improve, demolish: or repair any structure, prior to its Issuance, also requires the applicant)or'such
permit to file.a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law ,
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: -
(Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Prolessions Code) or that he is ex-
❑I hereby certify that no excavation live (5) or more feel in depth into which a person is' required to descentl, will
empl therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 any applicant for aper-
mit subjects the applicant to a civil penalty of not more than live huntlerd dollars ($5000)).):
be made in connection with work authorized by this permit, and that no building structure, scaffolding; falsework,
-
or demolitionor dismantling thereof, will be more than thirty-six (36) feel high. (Chap. 3.2, Grp 2. Art 2, Sec 341,'
❑ 1, as owner of the property, or my employees with wages as their sole compensation, viill do the work, and the
Title 8, C.A.C.). _
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 himselCor
❑ As owner -builder. I will not employ'anyone Id do work which would require a permit from the Division. of In -
' through his own employees, provided that such improvements are not intended or offered for sale. If, however,
dustrial Safety, as noted above. unless such person has a permit to do such work from the division.
the building or improvement is sold within one year of completion, the owner -builder will have the burden of prov-
❑Division of Industrial Safety Permit No.
ing that he did not build or improve for the purpose of sale.) -
-
❑I, as owner of the properly, am exclusively contracting with licensed contractors to construct the project (Sec. -
CONSTRUCTION LENDING AGENCY: I hereby allirm that there is a construction lending agency for We perfor-
7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who
mance of the work for which this permit is issued (Sec. 3097, Civ. C.).
builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Con-
Lender's Name
tractor's License Law.)
Lender's Address
❑I am exempeunder Sec. _ . B.8 P.C. (Attach Certificate).
SSB
till
Date - Owner
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state
- -
that the inlormation given is correct. I agree to comply with all state laws and county ordinances relating to
WORKERS' COMPENSATION DECLARATION: I hereby affirm That I have a certificate of consent to WI -insure, or a
building construction, and authorize a representative of the County of Riverside, Department of Building and Safety.
to enter upon the property for which t have applied for This permit for the purpose of making inspections.
certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800. LabrC.).
END
❑Certified copy is hereby furnished.
❑Certified copy is tiled with the County Building Inspection Department or County Department.
Signature of Applicant or Agent Date
-
1
APPLICANT -NAME (L, F, MI) ;
ADDRESS
BOX 1630'
CITYICOM MUNITYISTATEIZI P
PALM DESERT ,.., CA ?22600000
JOB SITE ADDRESSISPACE
54105 AVS RAMIREZ
CITYICOMMUNITY/STATE21P -
LA•QUINTA CA 922530000
BOK
PAG
PRC
C
- TWN
RING
SE -S
774
21'1
,017
4(1000
00
TRACT LOT
1)00000 100051
MOD
11)1
Be
'
TRACT NAMEAp� n ( BLq
SCV LAQ *260 Kx 285
H011 ,. F, AN
PHONE M
CONTRACTOR*FIRM NAME `
1DANAVON HORN
LICNC f1'
3354:36
ADDRESS .• _
BOX. 1638 �
CITYVCOM MUNITYISTATEIZI P
'ALM DESERT 922600000
-CA
PHONE N
714-568-1.048
BLDG. INSPECTOR
FINAL DATE
ARC/ENG FIRM NAME •
LICNC d
ADDRESS -
L4VAPOOVIOUNITYISTATEIZIP
PLAN #
PLANS EXAMINER
APPROVE DATE
USE OF PERMIT
DWLG. &. ATT GARAGE.
BLZON
00-1. 'R1'
FSB
020
SSB
006
SSB
till
RSB
0:'_�.�
OFC
TND
ZONE ORD 0 •
LOT SZ
END
SIDE
rant Applicant/Agent Name
APPLIPRMTk `IPS - ' ' "" DATE -' - '%
00016732 R XE3 04/20182, 1 1 O
<
TOTAL .
_
1—FEE _
- CA - CK NC - COUNTER B.I. COUNTER L.U.T.
j r
APPLICATION FOR , ST UQTURAL PLAIN . REVIEW
-T H I S I S A N' A P P, L .,t C A, T 1 0 M G N L Y
f
FOFM.2U-208(11.81).. ASSESSOR .
"AP,PUCANT NAME
�f(/L,�Fj�-MI).
.' Y1 - ktc` d�A{VN .
r ADDRESS,
' CITYICOMMUNITYISTATEIZIP._
JOB SITEADDRESSISPACE' --
54105". AV ..RAHIREZ.....
CITYICOMMUNITYISTATEIZIP . -
� LA Qt INTA t:A- x fl � fl
BOKPAG
^77�i�
PRC
C
TWN
00'011
RNG ,
"SE't
00.
S
F TRACT LOT
000000 0,a�S
MOD'
MODS.
SB
TRACT,NAME'.
:' `,V 'L AQ 026,
OWNER NAME'(LF,MI);
HORN, ?AN .
PHONEN
.
NAME
i'ANAVCWHJyyaa
L
TT43, 7. :
ADDRESS yq;1
ATTEII�ZIIPppr� - CpA 9 fG 0 ry, 0 `' '
CIT//Y�1COMMMUNIT{Y`�'I-S�TT.S
'. �P9HgONEE # t �y
S
BLDG. INSPECTOR
FINAL DATE
'ARCIENG.FIRM NAME
tICNC N
'ADDRESS ,
'CITYICOMMUNITYISTATEIZIP ^-
:- .PLAN p
PLANS EXAMINER'" `^:""-
}"'APPROVEDATE .
gUSS'E•`OF-PyEyRMITR
� A/.W�W Ytl Ynn4W{LAY
L�N
�qq`Y4�.{
.,1Y,A. '
(Wyy
6i�
SS B
V
RSB,
OF
",• ZONEORD#`LOT
SZET-
END
-SIDE
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 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
IDA
Fireplace T. 0.
NO
. ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Loth
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts)
128 Ceilin6'(Bat1s).`
12C Ceiling (Blown)
14 Final
_ PLUMBING APPROVALS
T
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
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME