00008774 (OFC)I
APPLICANT NAME (L, F. MI)
ADpD�RESS -
7 35 V AVE FERNA"O
CITY/COMMUNITY/STATE/ZIP
LA QUINTA CA ?"'.2530000
JOB SITE ADDRESS/SPACE
f.•15-Tw 1M 1l i0l.S
,V7315()
CITY/COMM UN I TY/STATE/ZI P
LA UINTf/A CA 929510000
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TRACT NAME
OWNER NAME (L, F, MI)
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CONTRACTOR -FIRM NAME
ADDRESS
C I TY/COMM UN I TY/STATE/ZI P
PHONE #
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ARC/ENG FIRM NAME
ADDRESS
CITY /COMMUNITY/ST ATE/ZIP
PHONE N
LICNC #
USE OF PERMIT -
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MOSTLE HOME 9l're PREIP P 6 N.
TOTAL PERMIT COST is
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iFORM 284-208 (2/81)
A
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 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
loA
Fireplace
T. 0.
°o
_...--
ADDITIONAL INFORMATION
'
'.._�_._...__..-..^r...._.a..._. �_.__..._..__.._ ......_._.._.__�_ ....
-
,
..
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 PgPROVAL-.----------------------------------------------------_-.-
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 P
Tank Pit L. Line
REAR OF PROPERTY LINE
I
/C
P/L 1 P/
V
ELECTRICAL APPROVALS
E
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
298 Bonding
30 Fixtures
31 Service
32 Final p IL
STREET NAME ku �'✓"y�>•
?' County of Riverside
Department of Building and Safety
1 ..
. = 4080 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
�4 Riverside. CA 92501 Banning, CA 92220 Hemet, CA 92343 Perris, CA 92370 Indio. CA 92201 Blythe. CA 92225,
Ph: 787-6146 [ Ph: 849.1312 Ph: 658.4464 Ph 657-3898 Ph: 342-8271 Ph: 922-2670
` This permit becomes void if work not commenced within 180 days from date of issuance, OR, if work has been suspended or abandoned for a period of 180 days.
XQENSED CONTRACTORS DECLARATION:' I hereby affirm that I am licensed under provisions of Chapter 9 (commencing
vFilh Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.
'r
License Class Lic. Number
Contractor
(OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law for the following
Treason (Sec. 7031.5. Business and Professions Code: Any city or county which requires a permit to construct. 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 (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
'(t5y of not more than five hundred dollars ($500).):
�bas 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 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
-.phis 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 proving that he did not
Uugd-or improve for the purpose of sale.).
r � I, 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 contractors) licensed pursuant to the Contractors
}License
r -',M am exempt under Sec.
B. 8 P.C. (Attach Certificate).
"Date - Owner
i(WORKERS' COMPENSATION DECLARATION: I hereby affirm that 1 have a certificate of consent to self -insure. or a
hcertificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800. Lab. C.).
;,Policy No. Company
Certified copy is hereby furnished.
0 Certified copy is filed with'the County Building Inspection Department or County Department.
Date Applicant
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed if the
permit is for one hundred ($100) 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 Applicant
NOTICE TO APPLICANT: IL 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.
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation live (5) or more feet 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, talsework, 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 Industrial
Wely, as noted above, unless such person has a permit 10 do such work from that division.
❑ Division of Industrial Safety Permit No.
Date Applicant
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, Civ. Q. i
Lender's Name -
Lender's Address
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 county to enter upon the above-mentioned property for inspection purposes. ,
Signature of Applicant or Agent Date
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 to building con-
struction, and authorize a representative of the County of Riverside. Department of Building and Safety to enter upon
the property for which I have applied for this permit for the purpose of making inspections.
Signature of Applicant or Agent
Print Applicant/Agent Name
APPLICANT NAME (L, F. MI)
Abibi-74, CORROPATION
ADDRESS
77350 AVE 'EVANANDO
CITY/COMMUNITY/STATE/ZIP
LA QUINTA CA 929530060
JOB SITE ADDRESS/SPACE
73!5 0 E1,1914ANDU
CITY/COMMUNITY/STATE/ZIP
-LA"'GIVINTA CA -9,22530000
BOK
631
PAG PRC C
361 on
TWN
FING SE S
000 a
TRACT
0 1 427A
LOT
1 001011
1
MOD
11
SB
TRACT NAME
OWNER NAME (L, F, MI)
ANDE" Cibit p lift Alt 1014
CONTRACTOR -FIRM NAME
ADDRESS
CITN'!COMMUNITY/STATE/ZIP
PHONE #
LICNC
ARC/ENG FIRM NAME
ADDRESS
CITY/COMMUNITY/STATE/ZIP
PHONE #
LICNC 9
USE OF PERMIT.
'AA
BIL ZON FSB SSB sse RSB OFC
.0 al I R 2 L 0 1 tit (0) A 0 1 11
ZONE ORD #
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END
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10111
APPLICATION FOR' mooll.E HOME sile"PRep
9 Asp APPLI C A T I D 0 i 4Y.
.FIORM,184-208 (2/81)
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
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
,Fireplace
Gauge Fre Wall
42
Commercial Hood
10
P. L.
43
Final
10A
Fireplace T.0.
n
°o
ADDITIONAL INFORMATION
-
+
k t
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Loth
12 Internal Lath — —
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts) ;+
12B Ceiling (Batts)
QC Ceiling (Blown)
14 Final
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
T .
}
REAR OF PROPERTY AINE
. '< .
ELECTRICAL' APPROVALS
PSL
P/
26 Power Pole-'
27 Conduit
28 Service Entrance
29 'Wiring
29A Grounding Wire
29B Bonding
Fixtures '
-3 1 Service
32 Final
STREET NAME
eto
�
RIVERSIDE COUNTY
FIRE DEPARTMENT
cbuNrr
IN COOPERATION WITH THE
RIVBRsl6::...:,.
CALIFORNIA DEPARTMENT OF FORESTRY
AND FIRE PROTECTION
GLEN J. NEWMAN
FIRE CHIEF
TO: BUILDING & SAFETY DEPARTMENT
DATE: ----_-
The Riverside County Fire Department considers its requirements
met and hearby releases the following project and/or.building(s)
for occupancy:
ADDRESS:-,--------------
S/,¢_/r
_ /�f/n/S19f} _ �ER t/ifr✓00 L/f QGtSN/A . '
RAYMOND H. REGIS
Chief Fire Department Planner
By /d_ /K .
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