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00006596 (SFD)tevowas76ts I I'l oer x 001910 JAPPLICATTOWFOA tSTRUCTURAL KAN RtVlk4i TOTAL, FEE was 1639 CA 926,26-00000 -AVE JUAREZ LWCOWTM)9/ZIP 9eg$30000 "4 T43 TWN iltvbolvo S litlfp 0 0 0 1 Will SB UtIVA198 $CV LAQ I? MWEDOYERT DEVELOPMeNT C IYATRAWN Wen N ms 1630 MowulomMily CA 992600000 ARC/ENG FIRM NAME ADDRESS CITY/COM MUNITV /STATE/ZIP . . I PHONE # LICNC ATT CAR 1601 101 gao 005 ols,oyo MD ZONE ORD # LOT SZ olso tevowas76ts I I'l oer x 001910 JAPPLICATTOWFOA tSTRUCTURAL KAN RtVlk4i TOTAL, FEE IS 16 17 18 19 20 21 22 23 24 25 26• 27 28 29 29A 29B 30 31 32 rLUIVIoilrvv ArrKU V #kLZ0 Ground Plumb Water Piping Rough Plumb Vents Sewage Disposal Sewer Water Heater Water Softener Water Service Gas Test Final SEWAGE SYSTEM SIZE & LOCATION ELECTRICAL APPROVALS REAR OF PROPERTY LINE Power Pole Conduit Service Entrance Wiring Grounding Wire P/L P. Bonding Fixtures Service Final STREET NAME 001910 r APi L�ATIDN "FOR: .STRUCTURAL �l„A'�t REVIEW • � `�' S X$1 A-N APPLICA'T10 H O'N1.Y APPLICANT DRN FHb AWBR 16:50 111WAII HNIt fte . CA 922600000 J AVE lUAR 5l922530000 t��iW§VKTESSSS/ISPACE yl� y� h y� CCAOM 4 �A�RYWIP CA Tri 2530000 '17 PAG PR� C. xx0 TWN 6146 0 SEO S TP6(C 0 0 I L06 0 1 MWI SB T £(LVMEj T it SCV R..AQ 19 Opnew WERT DEVELOPMENT C C lli'dP1D'��Y61T�q�Ag1'�WI'�N ` Ajjyjl gll 6 W W CFA(t'1NIWK§LIcT CA 922600000 UW4436 ARC/ENG FIRM NAME ' ADDRESS CITY/COMMUNITY/STATE/ZIP PHONpE # LICNC M U$rE��F�AIT& ATT CAR py+y� CAR, � at I FI� Q fY4 wX IN ZONE ORD M LOT SZ END i! 0 a SI tf ii A00a06596 a 12/owsi 011229 J APPLICATION FOR STRUCTURAL PES KIT TOTAL . FEE INSPECTOR'S CPY NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Ftgs 8 Frms 34 Plenums 3 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. 43 Final 10A 11 12 12A 13 Fireplace T. 0. Exterior Lath Internal Lath Drywall Finish Grade °o ADDITIONAL INFORMATION INSULATIONI Thick I Value 7A Walls (Batts) 12B Ceiling (Batts) 12C Ceiling (Blown) 14 Final 26 27 28 29 29A 29B 30 31 32 Power Pole Conduit Service Entrance Wiring Grounding Wire Bonding Fixtures Service Final ELECTRICAL APPROVALS SEWAGE SYSTEM SIZE & LOCATION REAR OF PROPERTY LINE P/L P/I STREET NAME rrvnrurrw r�rr nvvr�r:a 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 2s 1 Final 26 27 28 29 29A 29B 30 31 32 Power Pole Conduit Service Entrance Wiring Grounding Wire Bonding Fixtures Service Final ELECTRICAL APPROVALS SEWAGE SYSTEM SIZE & LOCATION REAR OF PROPERTY LINE P/L P/I STREET NAME 1.0 112. i i�H'I $ 1 Ai4 Iii 1P P I:CA,T 1 0 N QNL Y • .t s' t FORM 2!b208 (2/81). _ '. _> . _ .. •(.,. 0 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. °o ADDITIONAL INFORMATION 11 Exterior Lath 12 Internal Lath 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Walls (Botts) 12B Ceiling (Botts) 12C Ceiling (Blown) 14 Final Aftj� i&39 DPyAt.MWNIDf4 T CA 922600000 JQp,3T#"ESS/SPACE AVE JUAREZ C1 V(COMT«Y{$j/}TwIP CA 122530000 '17 '14 12 C U TWN 6,60 E �( S,0 S T`4C6 0 0 0 $2.72 A y L069, M V Q� SB �f 7f T` tRIMEt9fa SCV LAQ 19 Gplft"E'DILVERT DEVELOPMENT C CfyX#,*WWAgORN AnIt 16319 C!` LMF'i"tfiftWT CA 922600000 ARC/ENG FIRM NAME ADDRESS CITY/COMMUNITY/STATE/ZIP PHONE LICNC N PERMIT a Y# t + •UIb0rI..�{i 'T,, Ar { am B W o . K S ft $� t of 101 .' y{ Of" ZONE ORD w LOT SZ_Ef�D SIDF AjjWb*5.f& PM CONSTRUCTION FRE Li 12 3 0 #eii Fsfl PLtmyi"G FRIG K LRCTRICAL FAIR s2�.°ffi MECHANICAL. FEE i $My ITI FELE $2.72 E �f 7f Y AAAiii Y STRUCTURAL ( BUILDING TOTAL >. -3- I- ela- FEE PERMIT a lNZIrtLIUK'J WrT 15 16 17 18 19 20 21 22 23 24 25 ELECTRICAL APPROVALS 26 rLV/BILI/I\V I'9f f RV I'9LJ Ground Plumb 4 Water Piping Rough Plumb Service Entrance Vents 29 Sewage Disposal Sewer Grounding Wire Water Heater 3 3 Water Softener Water Service 3 Gas Test 31 Final 32 Final ELECTRICAL APPROVALS 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 298 Bonding 30 Fixtures 31 Service 32 Final �r SEWAGE SYSTEM SIZE & LOCATION Pit ! J�-- L. Line REAR OF PROPERTY LINE g STREET NAME 011230 TOTAL PERKIT COST M $310,26 ital,tSTRUC' ION T ESTIP'OE (NQTFst Not to 0(? viAed as property v 1.ua�fionr De tcript,on I~�C - �Wroup 'hype Sq F' �ote Valoaitio6 PRIMARY DWLG 0001 R-3 VI -14 1211 $27.60 $33423 R Ct�OR IR1� PRfCAR 0012 t1 W) 320. $9.1`0 *29tiwC ORY :AI UN 00`'A R^ R 121 Cartolruttfoiz Fee based-�on T01-61 Actual Valuation of ' X3$9539 fr»: 233,5U HECNANICAL ,FEE COMPUI61XONS Of Permitsi. 1 a -t $3.00 Each FEE I 2. lilt v A C; o o r 0 W A d i tl 1. € l h r the 1�'1. % i ii (l lt3 . p O oSt.a 1.;AQCtartiRt� toparmitt Dr,vor•10 . Athe �i� � .i 13: NO Ci?t44�R1 �s 3t3l� �0 3 MP 4,01 >3r-1`5 t oQ )15-30100 )30,-5 3 s 00 )50 i illi FR I $4.40 ! �14EA�TyINC :Wei+-f��•;p1p"l�Plp� �1ye..�gtl poil��l. BY:1r01 1001401, yor More. �UyTUa00 F'�E•cR $4, t��0+ E ((.,'TRXCAL FEE pW�S"bJ1�•��1.7 S *.0 oT i":Ormiti*i d a *3,00 Each FEEL *3,00 �WT Un vto i Ara %01 t. Sr` VC 1 0 of �A /Volt t 8' FEF i $5,00 Al3•;i� "l I"EE I 1211 q ► t . Residence 8 A0075 `, or Sq, 'Fl, Mi $15.14 1 3wU FGarage V .0125 ar tae{. Ft, FEET $2,4DY lo'ti F� i E1li�'t3�'A'i T4 +>a of P okisa tt 1 a *4 00 Ear h FEE -t '$4.00 ` Water, Sof ttipr t 0 Washe' r(Auto/Dish) t. 1 Garbage Dfi pa 1 Kitchen Sink-. X Laundry Trayt o Urfstal! 0 Wtr closet t OR '' .`�atratar3r t Uhowmr i I ub t T Pidetf o Athor t o FEE $1412.5 €I R,VT «3€waq vspolil Tanki t"LiD pl,tt1 $lots 1h,*t,�1:1sa� ion of Watery Piping aod/or Wa ter Tre�atezent p. FEEqufP i 1 FM $2.60 $mx FSE $2.72' ,,FORM 284208 (2/81) M NO. OPERATION DATE INSF - 1 NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back _ L 33 Ventilation System 2 Ftgs & Frms / '-_ 34 Plenums & Ducts !J 2A Slab Grade 35 Furnace Comport. 3 Steel r-�L 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 g- 41 Smoke Detection Device 9 Gai•,ge Fire Wall , r'" 42 Commercial Hood 10 Fireplace P. L. u 43 Final 10A Fireplace T.O. El °o ADDITIONAL INFORMATION 11 Exterior Lnth — _-- ' / y� G O'�, I R C f e U & �-> S 'tea 12 Internnl Lath -- --_— 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Walls (Batts) 3 12B Ceiling (Batts) -�� 12C Ceiling (Blown) 14 Final _3 W w z O 0 O Ujj Wo O > Z W O LL J_ Q ;4n m ad Ir Apo, LICATION FOR TREE PLANTING I (we), the undersigned, hereby certify and acknowledge that I (wq).have read the application and agree that if trees are required under River- side County Ordinance No. 457, the applicant agrees to install said trees prior to final inspection. It is understood that no final inspection will be given until said requirements have been met or exception has been granted by the County. Now, therefore, it is agreed that the prop- erty owner shall cause the property lines to be surveyed in the event no survey stakes can be found. Further, it is agreed that the County of Riverside shall assume no responsibility should trees have to be removed due to lot line errors. Owner's Name Palm Desert DeV. C.O. Building Permit No. Mailing Address City State Zip Job Address 53-975 Ave Juarez Community Lq Quinta Legal Description SCV. at Vale LaQuinta Lot 11 R1k_ 198 Unit 19 Assessor's Map, Book & Page 774-143-023 Type Structure Dwlg & Att. Gar. Type of Soil Sandy Is water available Yes Road Dept. Plot Plan No. Type of existing trees in road ri �-h-t�—+-�o —way NO eA Trees preferred by applicant (1) /Cl/J��/C� (2) (3) Date Owner's Signature Planning Commission Case No. ROAD DEPARTMENT APPROVAL Approved species Chilopsis linearis(Desert willow) 15gal.size Number of trees--L— Spacing reesLSpacing of trees Distance from lot lines: Front Side Additional requirements Street tree should be 2' inside right of wiy and a minimum of 10' from driveway. Date Building and Safety notified 1/18/82 Signature D.M. Reason Request for hearing: Owner's Signature Planning Dept. Concur ❑ Date YES ❑ REQUEST FOR EXCEPTION (attach additional page if necessary (Forward application to Planning Dept. if exception requested) NO REQUEST FOR HEARING Non -concur ❑ Explanation Signature Road Dept. Concur ❑ Non -Concur ❑ Date Signature REQUEST FOR HEARING AND COMMITTEE DECISION Date hearing established Approved ❑ Disapproved Date Building & Safety notified`. 701 Date hearing notice mailed to owner Date Owner notified of decision Signature -,-Jj iii' ya Ile fin altY 'r 1,13 !;Dz)-.lJ LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (comi; ,ncing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and Niect. License Class Lic. Number Date Contractor OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from 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 construct, alter, 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 Contractors 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 bass for the alleged exemption.' Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a. civil penalty of not more than five hundred dollars (5500).): yI, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the s ructure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law If 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. 11, 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 build or improve for the purpose of sale.). PI, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, PI1, 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 Contractors License Law.). 0 1 am exempt under Sec. B. 8 P.C. (Attach Certificate). Date Owner WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Lab. Q. Policy No. I Company O Certified copy is hereby furnished. ❑ Certified copy is filed with'the County Building Inspection Department or County Date Applicant Department. 0400Mf7oR j4 on T u 7 a l CA 92260 1000 ,q6fQpRESS/SPACE AIVE $Ul LOMM"/ZIP A 9-22530000 G5VVpy County of Riverside uCp'70 Y Department of Building and Safety SlV 408D Lemon St. 2nd Floor 135 N. Alessandro Rd. Rm. 203 880 N. State Streei 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: 761-6146 - Ph: 849.7312 Ph: '658-4464 - Ph: 6573898 Ph: 342-8271 Ph: 922.2610 This permit becomes void if work d not commenced within 180 days from date of issuance. OR, if work has been suspended or abandoned for a period of 180 days. 7 LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (comi; ,ncing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and Niect. License Class Lic. Number Date Contractor OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from 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 construct, alter, 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 Contractors 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 bass for the alleged exemption.' Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a. civil penalty of not more than five hundred dollars (5500).): yI, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the s ructure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law If 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. 11, 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 build or improve for the purpose of sale.). PI, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, PI1, 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 Contractors License Law.). 0 1 am exempt under Sec. B. 8 P.C. (Attach Certificate). Date Owner WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Lab. Q. Policy No. I Company O Certified copy is hereby furnished. ❑ Certified copy is filed with'the County Building Inspection Department or County Date Applicant Department. 0400Mf7oR j4 on T u 7 a l CA 92260 1000 ,q6fQpRESS/SPACE AIVE $Ul LOMM"/ZIP A 9-22530000 G5VVpy Ms 1 uCp'70 Y TWN SlV S'h4 Iflibaaa vb:A A 4.A SB, ,%V LAQ 19 A 'CRT DEVF!,APMEA T C Wks 2 638 TBA ° ""` CA 922600400 $AN q��yIP/T� p 67 [tl� Q7µ �'L ^0 ' rI ..: 7 ARCO/ENG FIRM NAME ADDRESS CITY/COMMUNITY/STATE/ZIP PHONE 4 W LICNC N VKCRM& AT T .GAR TOTAL . FEE ZONE ORD # LOT SZ 0 �{ D� 0 �Ipfi �y N .y CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed it 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: If, 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: E] I hereby certify that no excavation five (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, falsework, 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.) RaAs owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial ety, as noted above, unless such person has a permit to do such work from that division. I 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. C.). Lender's Name Lender's Address i certify that I have read this aVplication and state 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 slate 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 Safely to enter upon the property. for which I have applied tar this permit for the purpose of making inspections. . "• S.gnature of Applicant 6OAgent - , Aad. f 25 Print Applica0116gent,Name 6iyWi *,;06 2; mys 1 ESTIHA'TED PLAN REV: FE 0 019 2 $145.92 W TOTAL . FEE INSPFCTnp,-q rnpi 15 16 17 18 19 20 21 22 23 24 25 ELECTRICAL APPROVALS 26 27 28 29 29A 29B 30 31 32' gFWOGF SYSTFM 517E 8. IACOTIAN STREET NAME REAR OF PROPERTY LINE 0 0 001926 PERMIT POOR UT•AU&I AL PLAN REVIEKW TOTAL PERMIT OOST IS., $1 4F�i tl�2 ,CONSTRUCTION C8 1MA'tE Q�?TEI Not to :be Q-9L*,d `U0 �� P'ropgr`tp valuation) Descr ptian Y fie Group V,,iluat on PRIMARY I WLC 0001 R-3 V-% .211 $27.60 tat plan 9 Fee 4ased on' Total E1m11m4'vpd-Val-�tn of -C34i, 35 iS: tt4�.qf+ 0 0 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 & 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. °o ADDITIONAL INFORMATION 11 Exterior Lath 12 Internal Lath 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Walls (Bons) �{ 128 Ceiling (Batts) 12C Ceiling (Blown) j' 14 Final rcnmrr nrl"LrbNlrun County of Riverside Department of Building and Safety 4080 Lemon St. 2nd Floor 135 N. Alessandro Rd. Rm. 203 880 N. State Street 227 North "D" Street 46-209 Oasis St. Rm. 310 160 N.Broadwayy Riverside, CA 92501r \ Banning, CA 92220 Hemet, CA 92343 Perris. CA 92370 Indio, CA 92201 Blythe, CA 92225 Ph: 787.6146 4 Ph: 849.7312 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. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 71100) of Division 3 of the Business and Professions Code, and my license is in lull force and effect. License Class Lic. Number Date Contractor OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law for the follywing reason (Sec. 7031.5, Business 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 file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter9 (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 penalty of not more than live hundred dollars ($500).): I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the s ructure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the build no or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he If If not build or improve for the purpose of sale.).Vu- 1I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. .7044, siness and Professions Code: The Contractor's License Law does not apply to an owner of property who bui ds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors License Law.). O 1 am exempt under Sec. B. 8 P.C. (Attach Certificate) Date Owner WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell -insure, or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Lab. C.). Policy No. Company Certified copy is hereby furnished. Certified copy is filed wilh'the County Building Inspection Department or County Department. Date Applicant . pa{�iAl�illTV/{t1��yL�"1CIRN i� RS RtRu`firgnt CA 922600000 tB,iSJ,1: RESS/SPACE AVE JUAREZ 1T0cDultJii�l /ZIP CA 22530000 V! T%3 PN�r7 Y' TWN N �- V{1 S. 4040001 1!�Q �11A + 'wi 9 i SB LAG! 19 9(1�6ij q�NiD��HK4pA�N y,C�Q �1c^1 f'fy�y� 1�t�W ERT PAZ" e:► Gni T �/Li VELDT i" gN 1 C CITQ�FI[ib1NQty1f.,, R N gWppp�T�� I�iJAsp�g$ 16:30 0�gNr�7E�.�""`�T�WY CA94 60Q000 VTV 568-1040 M.436 ARC/ENG FIRM NAME ADDRESS 1 CITY/COMMUNITY/STATE/ZIP PHONE N LICNC N 6W LRM ATT GAR Up I I 40T 620 dh Ota 6 0 fAD ZONE ORD N LOT SZ SIDE THIS t"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 15) 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, falsework, 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 Safety, as noted above, unless such person has a permit to do such work from that division. O 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._, C.). Lender's Name Lender's Address 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 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 properly for which.) have applied for this permit for the purpose of making inspections. Signature of Applicant or Agent Date Print Applicant/Agent Name XB 10 / 2'saw"FMCP 1 1001910 APPLICATIUN FOR STRUCTURAL. PLAN REVIEW ASSESSOR COPY TOTAL T L 00 910 APPLICATION FOR STRUCTURAL PLAN REVIEW I S A N A P P L, I C A T I U N 0 N L. Y/ <3lgc -i_ " `� Ijh`� I_'M 284-209 (2/61) r rCht8I1 ArrLWAII11R County of Riverside Department of Building and Safety 4080 Lemon St.2nd*ogr 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 Hemet, CA 92343 �' Perris, CA 92370 Indio, CA 92201 Blythe,CA 92225 Ph: 787.6146 Ph: 849.7312 Ph: 65&4464 Ph: 657.998 Ph: 342.8271 Ph: 922.2670 This permit becomes void it work not commenced within 180 days from date of Issuance, OR, if work has been suspended or abandoned for a period of 180 days. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commVqncing y,CERTIRCATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed if the with•Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and ef'bct. ' permit is for one hundred ($100) or less. I certify that in the performance of the work for which this permit is issued. I Class shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. License Llc. Number Date Applicant Date Contractor NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law for the foll3wing Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be reason (Sec. 7031.5. Business and Professions Code: Any city or county which requires a permit to construct, alter, deemed revoked. improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing 0 1 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap 3.2. Grp 2. Art 2, Sec 341, Title 8, penalty of not more than five hundred dollars (5500)J: C.A.C.) ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law a ety, as noted above, unless such person has a permit to do such work from that division. . does not apply to an owner of property who builds or improves thereon, and who does such work himself or though ❑ Division of Industrial Safety Permit No. his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or Date Applicant improvement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.). 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. C.). I,aowner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 704,4, Lender's Name ors usiness and Professions Code: The Contractor's License Law does not apply to an owner of property who builds 01,00 improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's Lender's Address License Law.). I certify that I have read this application and state that the above information is correct. I agree to comply with all 0 1 am exempt under Sec. B. 8 P.C. (Attach Certificate), 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. Date Owner _ WORKERS' COMPENSATION DECLARATION: I hereby affirm that 1 have a certificate of consent to self -insure, or a Signature of Applicant or Agent Date certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800. Lab. C.). CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state that the Policy No. Y D y information given is correct. I agree to comply with all state laws and county ordinances relating to building can. -Company Certified copy is hereby furnished. struclion, and authorize a representative of the County of Riverside, Department of Building and Safety to enter upon the property for which.l have applied for this permit for the purpose of making inspections. 0 Certified copy is filed with'the County Building Inspection Department or County ,Department. Signature of Applicant or Agent Date Date Applicant Print Applicant/Agent Name VAN"ft"L' i4diK N 1 rAto"U'Do 'If CA V22600000 �"e7ZPRESSISPACE AVEUAREZ rr Yr e. F3CA %T"DOQMITWPA 1P 922530000 7741T`43 0fT 3 'F TWN V 0 0 10 S U16,0000 I I Vol 1 "I SB I ftCf A11f 7 V f3G:V LAQ I.? Pft".Ebe"W"RT DEVELOPMENT C ligW V ft Ni -10R# VMS 16a3O PIALO 'UrOeff"T CA 922604000 T��•��0�•� OHO �!4"�b ARC/ENG FIRM NAME ADDRESS CITY/COMMUNITY/STATE/ZIP PHONE a LICNC N VWE9`M& ATT CAR 001 JR1 no 0 is 015 010 no ZONE ORD a LOT SZ 01,00 FORM 284-208 (2/81) as XID 10/2! 00 1910 APPLICATION FOR s'rRUCTURAL PLAN RCVXZW U.S. CENSUS COPY TOTAL FEE w�. APPLICATION FOR STRUCTURAL PLAN REVIEW 00191 T N I S x6 AN APPLICATI'0N 0N4,1,1, LY , ,v1 '/a-ZB -0,