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00017249 (ELEC)PERMIT APPLICATION County *of Riverside Department of Building and Safety .• 4080 Lemon St. 2nd Floor r 135 N. Alessandro Rd. Rm. 203 880 N. Slate Street 227 North "D" Street 46209 Oasis S1. Rm. 310 160 N. Broadway , Riverside. CA 92501 Banning, CA 92220 Hemet, CA 92343 Perris. CA 92370 Indio, CA 92201 Blythe. CA 92225 't 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 Irom date of issuance. OR, it work has beer suspended or abandoned for a period of 180 days. �0 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 (commenc-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 0l 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 California. Q Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers' OWNER -BUILDER DECLARATION: 1 hereby affirm that I am exempt from the Contractor's License Law for the 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. struct. after, 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 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 Professions Code) or that he is ex- Of hereby certify that no excavation live (5) or more feet in depth into which a person is required t0 descend, will empt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a per- be made in connection with work authorized by this permit, and that no building structure. scaffolding, falsework. • mit subjects the applicant to a civil penalty of not more than live hunderd dollars ($500).): or demolition or dismantling thereof. will be more than thirty-six (36) feet high. (Chap. 3.2. Grp 2. Art 2. Sec 341, ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the Title 8. C.A.C.). structure is not intended or offered for safe (Sec. 7044, Business and Professions Code: The Contractor's License ❑ As owner -builder. I will not employ anyone to do work which would require a permit Irom the Division of In - Law does not apply to an owner of properly who builds or improves thereon, and who does such work himself or dustrial Safety, as noted above. unless such person has a permit to do such work Irom the division. .,through his own employees. provided that such improvements are not intended or offered for sale. 11. however. ❑ Division Industrial Safety Permit No. 1;�-the building or improvement is sold within one year of completion, the owner -builder will have the burden of prov- of {.Ing that he did not build or improve for the purpose of sale.) 111. 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. BA P.C. (Attach Certificate). Date Owner +'WORKERS' COMPENSATION DECLARATION: I hereby affirm that 1 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. h❑Certified copy is filed with the County Building Inspection Department Or County Department. WE Apt)RATION ADDRESS 50033 CAi.•LE OAXACA CITYICOM M U N ITYISTATEIZI P L,A '@UINTA CA 922530000 ! .�OBgSIu ISR SSISPACE L. cAL©AXA6•i'f CITYIC0140 ZIP CA, 922530000' BOKPAG PRC C TWIN PING SE S 773 0 011 7 C 000 loo TRACT LOT MOD SB 1014496 0212 011 TRAM NAMF -__ 0409Al' F- WR R ORA 1 .I ON PHONE B CONTRACTOR -FIRM NAME LICNC If I ADDRESS I I CITYICOMMUNITYISTATEIZIP I I PHONE IF I BLDG. INSPECTOR I FINAL DATE I I ARCIENG FIRM NAME I LICNC If ADDRESS CITYICO M M U N ITYISTATEIZI P 1 PLAN p I PLANS EXAMINER I APPROVE DATE 'f rl0_..AMP !SERV -L IGHT NG';ryhSSE, qq{g}/► rF�`y� 001 RBL , � FSB 04, 009 9 6 VBl! P.F" o 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 Lende�is Address CERTI CATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state that th! i rmation given is correct. I agree to comply with all state laws and county ordinances relating to building o siruction and authorize a rept nlalive of the County of Riverside. Department of Building and Safety to ente p n the p operly,fforL ich,l havetpplied lot this permit for the purpose of making inspections. 1 Sionature of ADolicant or Aaent Date Print Applicant/Agent Name AV Pl7IT`/.�45� 'f».Pl�� 04/.2.�r��3_- -. 0-1-- - ELECTRICAL FE -E $14,00 ire 5X TOTAL $14-00 FEE ZONE ORD p LOT SZ END 00% CA CIX• INCC N �. COUNTER L.U.T. 014 _ `l �j . tV EL EA., F 7I6A1» r t K M A I `TOTAL PERMIT C0$T Iii $14.00 ` ELE".CT ICAL. FEE COMPUTATIONS *tFermit Fee (if applicable) No of Unitut a Service VAITS1 0 Service IAmp%-1 t 100 Servs cell.. Amps.,.2 i 0 Service Amps ---3j k _ 1 1 r FORM 284-208(1181) INSPECTOR r FEE $3.00 1) FEES 55.00 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 10A Fireplace T. 0. E:] OP'N ADDITIONAL INFORMATION NO. _ ` ' 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 Plums a 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 V Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final i STREET NAME i NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR ' BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back " 33 'Ventifation System 2 Ftgs & Frms 34 Plenums & Ducts 2A Slob 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. 0 43 Final IDA Fireplace T.O. 0 OFIN 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) 12B Ceiling (Botts) 12C Ceiling (Blown) 14 Final PLUMBING APPROVALS 15 Ground Plumb 16 Water Piping - 17 Rougk fPluinb 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 TM PORATION '4466 E (Leo ADDRESS 50033 CLLE OAp ^CA CITY/COMMUNITYISTA,TE/ZIP J.A QUINTACA 922530000 225300n0 JO''�ryB,tSIlbITEESS/SPACE CALLS OAXAC A M' ''C�TY��/0 mm QUFAITAZIP CA 922530000 .'BOK /Jw7 PAG g �y V1G2 PRC q 0x1 rCC i' TWN ♦ \ +RINGG oNo SSyEn V0 S TRACT A q �y y LOT 0144 67 021 y 2 M„DO a SS i b SB ” TRACT NNAME ry1r� t' I�p p�q 8 }��,{ (Y F wultOO AT A. 4lY`t PHONE # ' CONTRACTOR -FIRM NAME LICNC # ADDRESS CITY/COMMUNITY/STATE/ZIP F PHONE# i BLDG. INSPECTOR FINAL DATE ARC/ENG FIRM NAME LICNC # ADDRESS r 'CITY/COM MUNITY/STATEIZIP PLAN # PLANS EXAMINER APPROVE DATE USE OF PERMIT y� �.}per! � y ! g p +rye q�,t� 1 0 0 AMP. 4e ERV-LIGM 6 .6,nG�y BL SQ 82 FSB. QV •WtiQ ry }� 0To yy ANO ZONE ORD # LOT SZ ENDh Slb 26895 TOTAL. FEE CA CK NC I COUNTER B.I. COUNTER L.U.T. APPLICATION FOR ELECTRICAL PERMIT T H I S I. S A N A P P L T C A T I 0 N 0 N L Y FORM 284.208 (1181) 1 NSPECTOR