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10467 (PLBG)10 P.O. BOX 1504 4 A �: N Q . "t V Building �� - 78-105 CALLE ESTADO ' j` Address 77-290 Calle Chihual"Ua LA QUINTA, CALIFORNIA 92253 Owner J Mr. and Mrs. Robert Carranza (tenant) BUILDING: TYPE CONST. OCC. GRP. Mailing Address same A.P. Number 773'311-014 City Zip Tel. ,g Qti.3ltr"2 92253 Legal Description Contractor Project Description Sever Flook rip Ecom Sewer Service Address 68415 Perez Roam CityZip Tel.: Cat. Cite 92234 346-2793 State Lic. City & Classif. 480961 Lic. # 342 Sq. Ft. No. No. Dw. Size Stories Units Arch., Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. ` City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 off he Business and•Professions Code, and license is in full force and fectSIGNAL^^^^"" ��''-�-"""" A' :�' DATE OWNER -BUILDER DECLARATION Estimated Valuation -�-� I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Buslness 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 PERMIT AMOUNT 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 Plan Chk. Dep. subjects the applicant to a civil penalty of not more than five hundred dollars (5500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 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, Mech. . provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year or completion, the owner -builder will have the burden Electrical of proving that he did not build or improve for the purpose of sale.) ❑ I, as' owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 30.00 struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of propertywhobuilds or Improves thereon, and who contracts for S.M.I. such -projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading ❑ 1 am exempt under Sec. B. & P.C. for this reason Driveway Enc. Date owner Infrastructure WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Seca 3800, Labor Code.) Policy No. Company 0 Copy Is filed with the city. O Certified copy is hereby furnished. TOTAL 3U • UU 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 anymanner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT., If, after making this Certificate or 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 Ihereby 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 it work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and slate laws relating to building construction, and hereby authorize representatives -of this city to enter the above-. mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip REMARKS �rr.aFs� Fn -)r,n47n_c;t t� ... 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: Validation: CONSTRUCTION ESTIMATE. NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ UNITS SLAB GRADE 2ND FL. SO. FT. BONDING YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS FOUND. REINF. GAS (ROUGH) DRAINAGE PIPING CAR P. SO. FT. OTHER APPJEOUIP. REINF. STEEL WALL SO. Fi. TEMP. POLE DRINKING FOUNTAIN. SO FT ® GROUT URINAL ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation WATER SYSTEM FLOOR DRAIN MECHANICAL FEES =$ WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER. B.T.U. SO. FT. ® c BATH TUB SPARK ARRESTOR SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL LATHING SO.FT.GAR ® V4c HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWE K GGGGGGCCC OUGH WIRING. DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL NOTICE: THIS IS NOT A BUILDING PERMIT DISTRICT ■ APPLICATION TO CONSTRUCT Permit No DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE s tai A0-- Col t Owner12,40 e Fam Dr Addres�prjrgbp Addr _ T Ctty { s 1-- City--- __ _ — City_ Phone - _- Phone —- P"Jfec J mu I (we) the undersigned, hereby certify and acknowledge that I (we) have read the application and agree that if Curb and Gutter, and m Z Paving, and/or Dedication of right of way 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 r g ( ) py said property and will not cause said praper�yr to be occupied VF1fi[ I (we) have complied with all laws of the County of Riverside and the State Of CalT(nrnia goVerntng said property, i1 idt-l�r�J� ` DATE —i' ___1979 SIGNATURE OF OWNER AND OR AGENT % ROBERTSM Approval by Signature from the Following Departments Listed1r below Must Be Obtained Prior to the Issuing of a Construction Permit. I SPACE NO. I: USE OF JTRUCTURE A JOB ADDRESS SINGLE FAMILY [] DUPLEX ❑ z W LEGALjD�,$CRI,P.TIA►I.OF,P,ROPE�� --y__ APARTMENTS [] AGRIC. L� uss 1t ts,—:�m, OLL .4 N Q I-YR �- COMMERCIAL �] INDUSTRIAL L� 6a-a�� •' GG COMMUNITY 4 ALTERATIONS C� Z NO. OF SUBMITTED PLANS ___ _--_ USE OF PERMIT N Q CASE NO. — p Z NO. OF PARKING SPACES REQUIRED — __ NO. OF BUILDINGS NOW EXISTING Q ZONE-- - SETBACKS: FRONT SIDE REAR J m GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE SETBACK ORDINANCE # OF FEET REQUIRED ON STREET DATE ___ SIGNATURE OF LAND USE OFFICIAL DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET W CURB.' AND GUTTER REQUIRED: YES ❑ NO ❑ - -STREET H CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑ W HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET IMPROVEMENT? YES [ - NO ❑ �% °C DATE —__ SIGNATURE OF ROAD DEPT. OFFICIAL_ x STIPINI'Mr, F`O6Lr=C W SEWAGE DISPOSAL �� ' Q► �— NT ul _ WATER POLLUTION REMARKS FLOOD CONTROL 12 W AIR POLLUTION _ W DIV OF HWY e % — YOUR PROPERTY MAY BE SUBJECT TO 0 c FLOOD. RIVERSIDE COUNTY ASSUMES NO RESPONSIBILITY IN EVENT OF FLOOD. 284 199 9/74 CANARY —FILE, PINK —APPLICANT