00027735 (GRP)PERMIT APPLICATION
t.
County of Riverside
t❑ 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 it the permit is for one hundred ($100) or less. I certify that in the performance of the work for which this
ing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full force and effect. Permit issued. I shall not employ any person in any manner so as to became subject to the Workers' Compensa-
tion Laws of California.
.a
OWNER -BUILDER DECLARATION: I 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 lot 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 Seclion 7031.5 by any applicant for a per -
mil subjects the applicant to a civil penalty of not more than live hunderd dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the
{t structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License
f< 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. If, 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.)
El, 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.)
'❑I am exempt under Sec. B.d P.C. (Attach Certllicale).
Date Owner
. WORKERS' COMPENSATION DECLARATION: 1 hereby affirm that I have a certificate of consent to sell -insure, or a
certilicate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800. Lab. C.).
S3�❑Certified copy is hereby furnished. •.
r'i❑Certilied copy is filed with the County Building Inspection Department or County Department.
APPLICANT NAME (L, F, MI)
RIC:C:IARDI
AD W21600
600. BOB HOPE DR
Department of
Building and Safety
7yS�ITpS,�PAFrC�EZ7�� r�r�! a{� ,y
CITyICQMM �TYdr iVS1 9'1 CA 9225 7�0 9250000 0
4080 Lemon SL 2nd Floor
MI
135 N. Alessandro Rd. Rm. 203
880 N. State Street
227 North "D" Street
46.209 Oasis St. Rm. 310 160 N. Broadway
Riverside. CA 92501
Banning. CA 92220
Hemel. CA 92343
Perris. CA 92370
Indio. CA 92201 Blythe. CA 92225
Ph: 787.6146
Ph: 8497312
Ph: 658.4464
Ph: 657.3898
Ph: 342.8271 Ph: 922.2670
This permit becomes void if work nor commenced
within 180 days from date of issuance.
OR, it work has been suspended
or abandoned for a period of 180 days.
PHONE# BLDG.
t❑ 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 it the permit is for one hundred ($100) or less. I certify that in the performance of the work for which this
ing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full force and effect. Permit issued. I shall not employ any person in any manner so as to became subject to the Workers' Compensa-
tion Laws of California.
.a
OWNER -BUILDER DECLARATION: I 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 lot 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 Seclion 7031.5 by any applicant for a per -
mil subjects the applicant to a civil penalty of not more than live hunderd dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the
{t structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License
f< 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. If, 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.)
El, 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.)
'❑I am exempt under Sec. B.d P.C. (Attach Certllicale).
Date Owner
. WORKERS' COMPENSATION DECLARATION: 1 hereby affirm that I have a certificate of consent to sell -insure, or a
certilicate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800. Lab. C.).
S3�❑Certified copy is hereby furnished. •.
r'i❑Certilied copy is filed with the County Building Inspection Department or County Department.
APPLICANT NAME (L, F, MI)
RIC:C:IARDI
AD W21600
600. BOB HOPE DR
CITx(CglXlalWdTAW'R AGE Cha 92,2700000
JO dD
SAW ,t,IpM•�OTEOy
7yS�ITpS,�PAFrC�EZ7�� r�r�! a{� ,y
CITyICQMM �TYdr iVS1 9'1 CA 9225 7�0 9250000 0
BOK PAG PRC (� C
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PHONE #
CONTRACTOR -FIRM NAME
LICNC N
ADDRESS
CITYICOMMUN ITY/STATE/ZIP
PHONE# BLDG.
INSPECTOR
FINAL DATE
ARC/ENG FIRM NAME
LICNC #
ADDRESS
CITY/COM MUNITY/STATE/ZI P
PLAN If
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uate Applicant
NOTICE TO APPLICAN r: II, 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:
01 hereby certify that no excavation live (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 buildingstructure. scalfofding.'lalsework.
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. ).
❑As owner -builder. I will not employ anyone to do work which would require a permit from the Division of In-
dustrial Safety. 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 stale
that theinformation 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 properly for which I have applied -for this permit lot the purpose of making inspections.
Signature of Applicant or Agent Date
PrjnL9pPlicant/.AoenUame_....-..-.-_._.
APPLIPRMT p I
O 0027735,
GRADIM30,1 PLAN
PS 4 DATE 5 5121
G 11/1
9/9 6/92
REVIEW FEE $10.00
TOTAL
FEE
1 r
CA
CK
NC
CO E
.I.
COUNTER L.U.T.-
55121
PERMIT FOR QRADINI� PLAID! REVIEW
TOTAL. PERMIT
0 of Lots s 0 CLI YIDS—Cut t
Grading Plan Review. Fel~ (based
INSPECTOR
FORM 2i4-208 (11.81)
COST is _.. . - $i0.00 - -
25 Fill! 900 Total Mauedt 125
an cubic; yds Cut and Filled) xst $10 r OQ
A
N
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE '
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs & Frms
34
Plenums 8 Ducts
0
J
2A
Slab Grade
35
Furnace Comport.
r
3
Steel
36
Inlets & Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
39
Appl. Clearance
7
Framing
-
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L. C]
43
Final
IDA
Fireplace T.O.
FI
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Loth
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts)
12B Ceiling (Botts)
12C Ceiling (Blown)
14 Final
_ _PLUMBING APPROVALS_
15 .Ground Plumb
16 Water Piping
17 Rough Plumb
18 Vents
19 Sewage Disposal
20 Sewer
21 Water Heater
22 Water Softener
23 Water Service
24 Gas Test
25
Final
Tank Pit I-Aine
REAR OF PROPERTY LINE
PSL
P/
ELECTRICAL APPROVALS
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
APPLICANT NAME (L; F, MI)
,v
_..
y 'A -D5
?4: �U'0 i CJS HOPE: DR
s i TA
TAYRAGE CA 922700000
+
SISPACE SAN �TIMO1ED
CIT)IC�MM�(J�TY�S� / P CA 922530000
80
PA(J.
PRC
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16TO0000
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MOj�Y
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°.,� WAW- .'L, MIN, IN N t PHONEp
CONTRACTOR• FIRM NAME
.
LICNC q
i
ADDRESS.
1 CITYICOMMUNITYISTATEIZIP
CK
PHONE # ° w BLDG.
INSPECTOR
FINAL DATE
-
ARCIENG FIRM NAME ,'
LICNC #
'i
�'ADD)7ESS
CIT7MMUNITYISTATEIZIP -
PLAN 0 PLANS
EXAMINER
APPROVE DATE
usfyVnlNG--CU'TF��25 �'$D��fFIL L A 00 CU.
BL'-"
s j
iiQN: Y
V
$CSU
17 A
{1 iJ�t
.61
OF A
"�ZpyNrF g�7p�p
LOT SZ
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Osf6 ^4 '
APPUPRMT NPS DATE
55118-- 5118_—
r'
I
f
TOTAL .
.. FEE '
CA
CK
NC
COUNTER B.I.. -
COUNTER L.U.T.
-
8
APDL IC,A"t ION FOR GRADING PLAN REVIF-W
' 'T M I' 8 1 'S A N A P P L. S C A Y I G N Q N L. Y
r.E '
INSPECTOR'
FORM 284-208(71-81) -
.. i -
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs & Frms
34
Plenums 8 Ducts i
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. E]
NO
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Loth
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
r
STREET NAME