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00006599 (SFD)wnvqvq 01 .1 4v- CONSIONUCT1,014 VUE 18(JbU CA qZ266098.0, C TE� OR CI7y/Cf�ljA�.1A�Lpwy .fit TW"'"����&253oeoe .MECHANICAL FEE AWL PLAN 090 FEE TWN 9"1 FIRE 01,0000 14-61i7 q, I SB Kit NAJV4 SC V LAQ 19 isvemmur-weRT VVELOPMENT C DMVW MRM CA 922600000 ARC/ENG FIRM NAME ADDRESS CI'rY/COMMUNIT,Y/STATE/ZIP PHONE N 3 PERMIT LICNC N TOTAL FEE -ATT GAR -on 16ft, 0 No (M MD ZONE ORD # LOT SZ 0 00 0-fut wnvqvq 01 .1 4v- CONSIONUCT1,014 VUE 18(JbU PLUKRUC FEE EUCTRICAL FEE .MECHANICAL FEE AWL PLAN 090 FEE 9"1 FIRE STRUCTURAL BUILDING 3 PERMIT TOTAL FEE U, 61 11140rc%, I VK a t_%Jr I -S I R 0 C T U R -A L f BUILOING 7 P 6 R N I TI UJ_0UJU TOTAL PERMittlfty IS $B0.61 CON'Silk UCT XJON' ESTI NATE (NOTEl to be 11 Meati as-piPoperty ivaluallan), Description FCC w6up T 9_?VlF* Rajea Valaallon 11 $3.34?,3 PRIMAR - Y Y)OLO 0001 R �ZCHDRV PR lGA& 0012 14 Wo to $2912 - _EtC"DRY Alk -4 R $21-20 $2664 1 —RC ''Valualic of $369" ist $233.50 Coniostruction Fee based on Totaf tual on '141tCHANICAL FEE COMPUTATIONS,* 0 *,f Peroq1tst I at $3.001 'Each FEE 00 a fl�o top 100 H- di0l th 1,0 Miscluo FE V N, T V 40- it hetloo. 'Fe AVP414-MCZI*wXoat,q,.Il.ati,antOO 143411,31 ryerlwl ap't , UR t1� HP 11f1. - )3-151 4 )l - -0100 )20-5800 )5ViQ8 FIEF. t 4 14EjA,*rl,.WG 8YGTEtVi*t-10Q Q'Ql_ STUtOl 106,091 or More BTU 100 FEE 1 0, 4: WO t "3 k -Le TRI'CAL Fa C006'(AT f'()N PQ K j4i T� I AA vol -t arvc I f A VVqlti Iff F va 10,4 P, , IF AD'V L' F�Z t 12 .9001 hence 0 � I Or �0 4 el fte los FF- s .144 3 P-1 a QAIP�a* 0 . 4 1 P.5 Per `64- F t. FEEL $a F JU FE113C -PU AT *01* 0 P 'misil'i O� 14.00, Each o Mi $4,10 IXTJRF-S- r Anki ior Dr*nktnj.,.rn*nj Ir'Drat"i ld -ter $of Toer ( 0 Waisher,' (Au *'a I .".age Di%pl I Ullchon- ftnkf.l Laonisrj Tray insl 1. W10 closet 1 #2 ,49&;9eyt 2 Sh,l"r+ I oidwt t 0 other i! 0 F k jub i �-V-1 .Gtw&q.q usps 11 -an I LL F. - P $,t r E o*' walOr -Hewtorsi V 4 of Dr4ins on Raofi 00 PH: *2' 1 so In-stall'At'lon of Wateim-Plping and/gr Wator Treatment 9491-pil FEE'll U 1,50 pp LEE 17 - 'PLLADD' L -PL,A EV FEE' A F REV 4 7 ­ FORM 284208 (2/81) NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPEttTOR r, BUILDING APPROVALS MECHANICAL .APPROVALS I Set Back 33 Ventilation System 1' 2 Figs & Frms 34 Plenums & Ducts 2A Slab Grade 35 Furnace Comport. 3 Steel 36 Inlets & Outlets 4 ,,out Blocks 37 Combustion Air 5 Bond Beams 38 Compressor 6 Roof Deck 1 log 39 Appl.. Clearance 7 Framing / 40 Fire Damper 8 Vents 41 Smoke Detection Device 9 G- ,�qp Fre 'Wall 42 Commercial Hood ot 10 - Fireplace P.L. - 43 Final 10A Fireplace T.O. NN ?(FI U L 1'J ADDITIONAL INFORMAtIION ^ C O M �L POR C �. S l / ✓ S - ---- - - -- - - SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath 12Inte—1 Lath 12A Drywall -13 Finish Grade r- INSULATION Thick Value 7A Walls (Gatti) 3 s--Qr, 12B Ceiling (Batts) r 12C Ceiling (Blown) 14 Final -- - - - - PLUMBING - A OVALS ------------ ... 15 Ground Plumb _ 16 Water Piping ' 17 Rough Plumb Aim 18 Vents 19 Sewage Disposal 20 Sewer JA 21 Water Heater 22 Water Softener 23 Water Service 24 Gas Test 25 Final Tank. Pit L. Line } REAR OF PROPERTY LINE c ELECTRICAL APPROVALS P�L " - r AJC P/ tt 26 Power Pole 27 Conduit 2B Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding ZiaA 30 Fixtures AJ 31 Service 32 Final Tit A STREET NAME County of Riverside Department of Building and Safety 4080 Lemon St 2nd Floor 135 N. Alessandro Rd, Rm. 203 88OkN. State Street 227 North "D" Street 16,209 Oasis St. Am. 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: 8147312 Ph: 6684464 Ph;, 657.3898 Ph: 342 -WI Ph: 922.2670 This permit Vaccines void if work not commenced within 180 days from date of issuance, OR, it work h&- n sus ;� ded or abandoned for a -period. of '180 days. 'LICENSED CONTRACTORS DECLARATION Ihereby affirm that 1 am licensed under provisions of Chapter 9 (commencing CERTIFICATE 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 effect. permit is for one hundred (SIOD) or less. I certily that in the performance o1 the work for which this permit issued, l shall not employ any person in any manner so as to become subject to.the Workers' Compensation Laws of California. License Class Lia Number Date Applicant Dale Cordractor 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 Contraclor's License Law for the.following Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. re'ason (Sec. 7031.5. Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demoUsh, or repair any structure, prior to its issuance. also requires the, applicant,lor such permit to file a DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: . signed statement that he islicensed pursuant to the provisions o1 the Contractors License Law (Chapter 9 (commencing ❑ I hereby earthy that noexcavation five (5) of 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 therefromand the basis for made in connection with work authorized by this permit. and that no buildi7 structure, swNoWinp 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 &2. Grp Z Art 2, Sec 341, Title S. .penally of not.more,than five hundred dollars ($501)1.): 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 at Industrial Re sbucture is riot.imended.or offered for sale (Sac: 7044. Business and Professions Code: The Contractor's License Law 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 through ❑ Division of Industrial Safety Permit No. his:own employees, provideddhat such improvements are not intended or offered lot sale. It, however, the buildingat Date Applicant_ improvem'ent.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 aconstruction lending agency for the performance of the work for which this permit is issued (Sec. 3097. C14. C.). PI, as owner of the property, am,exclusively contracting with licensed contractors to construct the project (Sec, 7044. Lenders Name siness'and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contractsforsuch projects with a;contractor(s) licensed pursuant to the Contractor's Lender's Address. License Law:): s I certify That I.have road,this-application and slats that. the above information is correct. I agree to compo with all ❑ I am exempt under Sea . S. 8 P.C.(Attach Certificate). city and county ordinances and state laws relating to building construction, and hereby authorize repress I abves of this coolly to enter upon the above-mentioned property for inspection purposes. Date — Owner WORKERS' COMPENSATION DECLARATION: I hereby affirm that I 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 [hereof (Sec. 3800, Lab., C.). CERTIFICATEOFCOMPLIANCE-ANO AUTHORIZATION OF ENTRY: I certify I have read thisapplicationand stale that the Poli No. _ Company. Information given is.correcl., I agree to comply with all,stale laws and county ordinances relating to building con- struction, end�authorize,a representative of the County of Riverside. Department of Building and Safety to enter upon ❑ Certified copy is hereby furnished. 'ti . the Groper rlo4which I h$w$.ap r this permit for the purpose o1 making Inspections. ❑ Certllied copy Is filed wlth'.the County Building Inspection Department or County Department. ��,/- ..�-Signatbre of Applicant or Agent Data . _ `i�' Date Applicant .._ WW"..6 �rm'e g.�* h. • � ('-� 1` r '�',`',�°'�T19.► s R%,.... 0 01931 4i� 8 EST NAlt4 PLAN .FEV''FEE:: $145.V-2 CA 922660000' � RESS/SPACE AVE CO R TEE gp.��°�y}j. }�{�,¢ra�2tPs y��r�t0f O�Qj 7 I°'1� IY.C. 1iAYN VUV to S r V0000 10151 1 iii 1 S8 r 101CRIAMI tlG V LAW i 9 M"MEUMT DEVELOPMENT C VaffijafflN&hRN 1 -163 13 PrAmulvemIlt CA 922600000 P1y-s68-i O4e I M436 ARC/ENG FIRM NAME. PHONE,a LICNC e M�4 ATT CAR rips' ops 10,bi 6, 0 TRO ZONE;ORD N LOT SZ V n M 0 itvo PERMIT FOR STRUCTURAL PLAN REVIEW yf,' .✓ TOTAL FEE�A1I:f e -� — -001931 i PERMIT FAR STRUC'T' kAL PLAN REVIEW TOTAL PERM11---i ©8T IS COSTRUC'TJQN ESTIMATE (NC Et. Not to be sed As pr. ertyl valuation) esF�C Croup 'i'y. s ffi � t 0atite Y&Ivaation ,PRIMARY OWLG 000i R-3 1. ��!.6.q D33 ia:C{X}RY PRIGAR 4012 M - 'WD �� $9 to 02 CAT PlAn R-t�o F.eo basal oft 'Total Estimated V 1'tn # b iii. , D u;g'? i FORM 264.209 (2/61) NO: OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Ftgs 8 Frms 34 Plenums & 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.O. 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 (Batts) 12C 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 no Tank Pit L. Line REAR, OF PROPERTY UNE ELECTRICAL APPROVALS P/L P/ 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding - 30 Fixtures 31 Service 32 Final j.., y J STREET NAME 4088-lamon.St. 2nd Floor Riverside,, CA 92501 Ph: 787$148 46209 Oasis St. Rm. 310 160 N, Broadway Ind10,:CA.9220t Blythe, CA 02225 Ph: 342 -SM Ph; '1122.2870 This' permit becomes'vold It worknot commenced within Hill days from date at rseuanee,:OR, it work l -A been syppernled orabundoned fora period of 190 days: LICENSED CONTRACTORS DECLARATION: I,here0y affirm that.l am licensed ands provieione oCChepter•9;(eammpncinp V' CERTIF►CATEOF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE This section need not be completed if the with Section 7000) of Division 3 o1 the Business and Professions C6de, and my license .R 7n full force and effect, permit Is for one litindred (5100) or 1gae, I certify that in the performance of the work` or which this permit is issued. l' License Class Lie. Number, shall not einployany person in any manner so alto become sub►ed to the Workers' Compenistipn Lawi:ol,CalitwniIL Date Appricant Data, Contractor OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law for me:followin l reason (Sec. 7031:5.'6usiness and Professions Code: Aiy'dttr or county which requires a Permit to construct, alter, improve, demolish, or repair any allucture,.prior to its issuance; stow requires the applicant' ler such permit to file a sippnnad statemen'that he 13 licensed pursuant to the provisions of the Comracloes LlconseLaw (Chapter 8 (commencing wil$,Seetion 7010)of Division 3 of the Business and Professions Code) or that he is exempt thereirom,and the basis for the alleged exemption, Any violation of Section 7037.5 by any applicant for permit subfects'the applicant to a civil penalty' of not more. than live hundred dollars P=).); yL� I, as owner ofthe property, or my employees with wages as their sole rrompensatlon, will do the work, and the l ucture is notrihtendedor offered for sale.(Sea 7W. allsiness and Protessions,Code; The Contractor's, 1cense Law ,does not, apply to�an owner of property whm.build$,or improves thersom and who does'such work himseltor through his own employees, provided that such+imlaovements aro not Intended or offered for sale If. however, th&building,or improvementirsold.wlthimone year of"completion. the owner -builder will have the burden of proving that he d4 not build or improve for the,purpose'ef safe). PPI, as,owner of the Property, am exclusively contracting with licensed contradicts to construct the protect (Sec, 7014, usand Professions Code: The Colitractor s License Law does. riot apply to an owner of propertywho buitds;or improvee-thereon, and who contracts for such pto►ects with a-contriclor(s) licensed putsuant'to the Contractor's Lietore 'Law.). ❑ I am exempt under Sec. B. A P.C. (Attach Certificate) Date Owner WORKERS' COMPENSATION DECLARATION: I hereby, affirm that I have a certificate Of consent to sell-ingure! or a certificaWof Workers' Compensation Inturance; or a certified copy thereof (Sec., 3800. Lab. C.). Policy No. Company ❑ Certified copy is,hereby furnished. ❑ Cediffed.copy is filed' will; the,Counly Building Inspection Department or County :Department. Date Applicant relRrrirlcCt�uDATrots 9' o f"pftsw'T CA 929800000 County of, Riverside Depirtrnerlto 8utlding and Safety va" SPP /ZIF CA 9UM0040 "4 135 N. Alessandro Rd. Rm. 203 00 N. State Street 227 North 'D" Street 68nnn , CA 92220 IItseqeI, CA' 92943 Perris, CA gliM Ph:. $49.7812 Ph �$6$ AN Ph: 6573868 46209 Oasis St. Rm. 310 160 N, Broadway Ind10,:CA.9220t Blythe, CA 02225 Ph: 342 -SM Ph; '1122.2870 This' permit becomes'vold It worknot commenced within Hill days from date at rseuanee,:OR, it work l -A been syppernled orabundoned fora period of 190 days: LICENSED CONTRACTORS DECLARATION: I,here0y affirm that.l am licensed ands provieione oCChepter•9;(eammpncinp V' CERTIF►CATEOF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE This section need not be completed if the with Section 7000) of Division 3 o1 the Business and Professions C6de, and my license .R 7n full force and effect, permit Is for one litindred (5100) or 1gae, I certify that in the performance of the work` or which this permit is issued. l' License Class Lie. Number, shall not einployany person in any manner so alto become sub►ed to the Workers' Compenistipn Lawi:ol,CalitwniIL Date Appricant Data, Contractor OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law for me:followin l reason (Sec. 7031:5.'6usiness and Professions Code: Aiy'dttr or county which requires a Permit to construct, alter, improve, demolish, or repair any allucture,.prior to its issuance; stow requires the applicant' ler such permit to file a sippnnad statemen'that he 13 licensed pursuant to the provisions of the Comracloes LlconseLaw (Chapter 8 (commencing wil$,Seetion 7010)of Division 3 of the Business and Professions Code) or that he is exempt thereirom,and the basis for the alleged exemption, Any violation of Section 7037.5 by any applicant for permit subfects'the applicant to a civil penalty' of not more. than live hundred dollars P=).); yL� I, as owner ofthe property, or my employees with wages as their sole rrompensatlon, will do the work, and the l ucture is notrihtendedor offered for sale.(Sea 7W. allsiness and Protessions,Code; The Contractor's, 1cense Law ,does not, apply to�an owner of property whm.build$,or improves thersom and who does'such work himseltor through his own employees, provided that such+imlaovements aro not Intended or offered for sale If. however, th&building,or improvementirsold.wlthimone year of"completion. the owner -builder will have the burden of proving that he d4 not build or improve for the,purpose'ef safe). PPI, as,owner of the Property, am exclusively contracting with licensed contradicts to construct the protect (Sec, 7014, usand Professions Code: The Colitractor s License Law does. riot apply to an owner of propertywho buitds;or improvee-thereon, and who contracts for such pto►ects with a-contriclor(s) licensed putsuant'to the Contractor's Lietore 'Law.). ❑ I am exempt under Sec. B. A P.C. (Attach Certificate) Date Owner WORKERS' COMPENSATION DECLARATION: I hereby, affirm that I have a certificate Of consent to sell-ingure! or a certificaWof Workers' Compensation Inturance; or a certified copy thereof (Sec., 3800. Lab. C.). Policy No. Company ❑ Certified copy is,hereby furnished. ❑ Cediffed.copy is filed' will; the,Counly Building Inspection Department or County :Department. Date Applicant NOTICE TO APPLiCANTG If, after making this Cerltricale•of Exemption, you should beeome•sub)ect to the Workets' Compensation provisions of lhe:f tbor Code. you must forthwith comply with such pf6isidns or lhf t permit shall'tid deemed revoked, DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cerfi fy that po,excavalion live (5) or mon feet in depth into which apersen Is required to descend, will be made in connection with work qullherliod by this permh, and that no buildin0 structure. scaffolding, 4alseworR, or demolition or dismantling insect, villl'tis more than thlrtyaix (98) feet high. (Chap 3:2; Drp 2 Art 2. Sac 317. Title & CA.C,) E] As owner-tiuiltler, 1 will not employ anyone to do Work which would require a parmn nom Ma Division of Industrial Safety, as noted above: unless such person has a permit to do such work from that division. 0 Otyision of Industrial Safety Permit No, Date'. Applicant CONSTRUCTION LENDING AGENCY: I hereby `affirm, that there Is a.construction leading .agency, (or the performance of the work for which this permit 7s,. issued'(Sec, 9097, Civ. C.). Lender's Name Lenders Address I Certify that I have read this appplication,and stale that the aboveltdormation is correct. I agree to compy:with all city and county ordinances antl'slaw iowa relating: to building copstruclio6,,and tierehy authorize representatives of this county to'enter upon the above-mentioned property for inspection purpose& ignature of Appllcant.,or Agent Data CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY! I ratify I:have read this application and stale that the, information given is cgfrecL I agree to comply with all state laws and county ordinan s totaling to building, con- struitlon and suthordwa representative pf the County of Riverside, Department of Building and Safety to enter upon the property twithich,I have applied lir thW permit for the •pu'r'ooss:of makinp'inspectlohi Signature o(Appllcant or Agent Date Print Applicant/Agent Name 001910 101JR-6 1639 9' o f"pftsw'T CA 929800000 ®RESS/SPACE AVE CORTEZ va" SPP /ZIF CA 9UM0040 "4 71 1"0101 0 TWN ` 4" le s i 01111000 8,015 APPLICATION FOR 6TOUCTURAL PLAN RRVIO: WMAk194 .SC 1) LAO It WE0Z8gR­T DEVELOPMENT C 914NWJGR 47iiPl N 00Ra 16 319 i �'UVi R`T C�A�` 9^.2800000 ?T44-069-10461 ARC/ENO FIRM NAME AOORES9 - CITY/COMMUNITY/ST,ATE21P` PHONE til LICNC M' 990 M## ATT CAR 90 " 00c M. 0 0v0 "D ZONE ORD x LOT SZ Q, l A 0 tv 0 NOTICE TO APPLiCANTG If, after making this Cerltricale•of Exemption, you should beeome•sub)ect to the Workets' Compensation provisions of lhe:f tbor Code. you must forthwith comply with such pf6isidns or lhf t permit shall'tid deemed revoked, DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cerfi fy that po,excavalion live (5) or mon feet in depth into which apersen Is required to descend, will be made in connection with work qullherliod by this permh, and that no buildin0 structure. scaffolding, 4alseworR, or demolition or dismantling insect, villl'tis more than thlrtyaix (98) feet high. (Chap 3:2; Drp 2 Art 2. Sac 317. Title & CA.C,) E] As owner-tiuiltler, 1 will not employ anyone to do Work which would require a parmn nom Ma Division of Industrial Safety, as noted above: unless such person has a permit to do such work from that division. 0 Otyision of Industrial Safety Permit No, Date'. Applicant CONSTRUCTION LENDING AGENCY: I hereby `affirm, that there Is a.construction leading .agency, (or the performance of the work for which this permit 7s,. issued'(Sec, 9097, Civ. C.). Lender's Name Lenders Address I Certify that I have read this appplication,and stale that the aboveltdormation is correct. I agree to compy:with all city and county ordinances antl'slaw iowa relating: to building copstruclio6,,and tierehy authorize representatives of this county to'enter upon the above-mentioned property for inspection purpose& ignature of Appllcant.,or Agent Data CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY! I ratify I:have read this application and stale that the, information given is cgfrecL I agree to comply with all state laws and county ordinan s totaling to building, con- struitlon and suthordwa representative pf the County of Riverside, Department of Building and Safety to enter upon the property twithich,I have applied lir thW permit for the •pu'r'ooss:of makinp'inspectlohi Signature o(Appllcant or Agent Date Print Applicant/Agent Name 001910 APPLICATION FOR 6TOUCTURAL PLAN RRVIO: U.S. CENSUS COPY TOTAL FEE • APPLICATION FOR STRUCTURAL PLAN REVIEW iNl�i x$ AN A P P L ICAT10N. ONLY 001910 r County of Riverside Department o1 Building and Safety 4080 Lemon St. 2nd Floor 135 N. Alassandro,Ad, Am. 209 880 N. Stale Street 227, North "D" Street' 48208'0&919 SL Rm. 310 deo N. Broadway Riverside. CA: 92501 B'annina„ CAIUM Hemet. CA 928/9 Perfis. OA,;92370 Iddio, CA 92201 Btylhe, CA 92225 Ph: 787 6146 IM: B/& 312 Po"d.E56 4464 pR �7.38eB Ph: 342-8271 Ph: 922-2670 This permit becomes void if work mit,commenced within 100 days from date o1 issuance, OR. If work has: been^s�pended orebandoned for a ,period of 180 days. $ LICENSED CONTRACTORS DECLARATION: I hereby affirm that am licensed under provisions.of Chaptor99commencing CERTIFlCATE OF•EXEMPiION FROM'WORKEAS' COMPENSATION INSURANCE: This section need not be comppleted if'the is l with Section 7000) of Oiviskmn3 of,the Business and Professions Code. and my license Is in full force and effect; permit tafor orro hundred (51Dp) or less. 1 certify that m the performan6amtthe work for which Mie permit issued, `�� shall not employ, arty` person In any manner so as,t0 become subject to the,Workki' Compensation Laws of California. .License Class Lie. Number Oafs Applicant Dated Contractor NOTICE TO APPLICANT. If, alter making lhfs,Certifiute of Exemption:. you Should become subject to.tha Workers' OW10MILDER DECLARATION: ;I hereby affirm that !I am, exempt from theLicense Law for the fallowing Compensation provisions of'Labpr Code, you must forthwith comply with such provisions or this permit shall be NeContractor's deemed revbkeQ reason (Sec. 7031.5, Business and Professions Code: Anycity, .a or county which requirespermit to construct, after. . 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 MIT19CATION: signed -statement that he, is licensed pursuant to the provisions of the cantracror s License Law (Chapter 9 (commencing with. Section 7000) of Division:3+of the Business Professions Code) livis therelrom.snd the basis for 10 I hereby certity that nq.excovalien five (5) or more fast In.depthinto which a person required to descend, will e 6y falaework, and or �thal exempt the alleged exemption. Arlt' violation of Section 7001.5 by eery applicant for a permit aubjecte Me appfitant to a Yivll made in connection -with work authorized this; permit, and'that no building strudlure. scaffolding, or demolition or dismantling thereof, Will be more then thirty-six (11% feet high. (chap 32 Grp 2; Art 2, Sec 341, Tlge:ar penalty of not more than live'hundted dollars fii0D1•)% C.A.C:) �' I, as owner of he property, or my employees with wagesras their sole compensation: will do the work, and,the AS owner -builder. I will not,"ploy anyone to do work`whibh would require a p irmil from the Division of Industrial ae -ty, as. noted above, unless such person has.a permit to do such work from that divislom structure, is not Intended or offered' for sale 15ec. 704 Business and Professions Code: The Coatraclor's License1aw does not apply,to an owner of property who builds or improves thereon, and'who does such work.himself or through Division of Industrial Safely Permit No. his own employees, provided lhahsuch improvements are not intended of offered for sale. dl, however,. the building of Dale, Applicant Improvement Is sold within one year of completion, th6 owner -builder will have. the burden of proving'B'at'he did not build or improve for the purpose of sale.). CONSTRUCTION" LENDING AGENCY: I herabv aNtrm that,there is a,constructlon lending agency tor• the performance of Ins -the work for which' this permit k isaua1 (3Seecc. 3097, Civ. C.). ll1�II I,.as Owner of he property. am exclusively gntracting withiloensod contractors to construct the project (Sec: 7044. Lender's Name. Business and Prolesstons Code: The Contractor% license'Law does not apply to an owner of property who builds or ZONE ORD+9 .improves thereon, and Whol contracts for such projects with a contractoris) licensed pursuant to the Contractors Lender's Address License Lew,), I..am Sec. Certificate), i certify that l' have read this, Ipplicolion and state that U4shoverinformation is correct. I agree. to comply with all city and county ordtnanoss end slate laws rNa ting to building cofgtruotion,.and hereby authorize iepiesentatives of exempt under B. A P.C. (Attach this county to enter vpg the above-mentioned property for Inspection purposes. Date Owner WORKERS' COMPENSATION DECLARATION: I hereby affirm ;,that] have a certiffcate of constant to sef -1 ure. or a 'Signature of Applicant or Agent Date cortttieets of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800. Lab. t.). CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certlryd haver this appticellon and state that the Popsy No. Companry, Information given ns correct. _ I, agree to comply with all state lows and cap inances'relailhpp 10 bu;ldlhg"qUn• etrgcdon, and authorize a representative of the County otRiverside; Deparfm of Bgfldi(ID and Safely to enter upon 0 Certified copy is hereby furnished. the propaity for wlilchl have applied for this permit for the purpose it making inspections. Cenifted dopy is filed with' Ohm Courcy Building fnspectlon,bapartment or -County Department - Stgnature,of Applicant or Agent we Date Applicant Print ApplioeptlAgent.Name BJ�iVN"If' "WR fa A15XS X638 OA 922600000 8 I&MVPRESS/SPA'CE AVE C'ORTEZ 1.1%QITX(HWAIZIP CA T�.2330O4.0 12h„A `41q. a $ T" no s60 g M000 `�� f& wit se, TeA1194 Se LAG1 9 �V, y� YEVELOPFMRT 0 iJANVOiv "tRiCkIRN 151W 1639 01KRUM ' CA 9122600,000 s'b0-'10 49 U&36 ARC/ENG FIRM NAME ADDRESS CITY/COMMUNITY/STATE/ZIP , PHONE a LICNC M irml, -ATT GAR be . WT 00 Ins 01b d 0 TWa) ZONE ORD+9 LOT SZ 106%0 %0 0 $1w o APPLICATION1.00 STRUCTURAL PLAN-REVIEWIVAI ASSESSOR COPY TOTAL FEE 1001913 APPLICATION FOR STRUCTURAL PLAN REVTEW T H 18 x S A N A P P L x 0 A T 1 O N 0 N L Y