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00006597 (SFD)ormli.19 loltllfma--� c-ONS'lRuvriom vpp- offirs I Pl.ti"ING FEE ann-CE Avt vaguz ,•G7.�0000 1n�Irl/C'QM "4 T62 M 1 TWN 11Flollie REV FU S M,900 696 19 1 10TI lsa__ MIR NAI F94 SO LA 6 1`0 D9VELOPMENT C Wmvw MORN Offs 116-98 CA 922600000 ff'441568- 1 448J 1=4U I.- ARC/ENG FIRM NAME ADDRESS CITY/COMMUNITY/ST,ATEIZIP PHONE 0 LICNC • gjoeerRV, ATT GAR iib N I 02lb- 101ft on 181ft I I fft I ZONE ORD # LOTSZ I < 9V -4- PERMIT TOTAL FEE ormli.19 loltllfma--� c-ONS'lRuvriom vpp- U180az, $23,31? 50 Pl.ti"ING FEE 44Z. 04 - ELECTRICAL FEE sma-,e NECHAMICAL FCC AWL PLAN REV FU S"I FEE A -1p STRUCTUiAL < 9V -4- PERMIT TOTAL FEE lN-ZIrtUVKZI 01 ° 0-5.2 8 T R U C I-, U 0. A L < bUtLI)ING P.,ERt I T TOTAL. PEAKIT'COST is *326.61 CONSTRUCTION ESTIMATE (NOT' ty Vgu Jr! N*o,t 0 t o betq%od as pgopg 8 *1.0") D4scrlption F C aroup e Valuation Pitt"ARY Dl4LG 0001 *-3 V%Q ?z� I 1 $27,10 $334P�3 SM"DRY p lBAR 0012 vp 320 ill, 1:4 $202 I$Ecmolty, 4111FIODON - 1211 $2664 C 1 '16, -tal-l-citlaIL"Vial wat too of .50 11c,nStpu I bn basod on t233 MUCHANICAL, FEE COMPUTATIONS * 10 of Permiles I at $3. A0 Each Pet, *3.00 . "T*- & 4 ap'09olorke'D H Olddl-01 gther&Q Hi4csO-0 sa.,tj &pp, %A nota- latioviioo 0p4 verl I 01horle'o, $ -3, plo )34-1 1 0 -30J00 Y30-118100 )5,osa E 2 $4 rb It 0 WE 0 .00 l" -,.s M"mw 46 001- Vilu 10 1 . 00 1001 or liore 0TJJi06 $4.00 IC CO -t. 0-60 Each 1' #3100 F A ION$ it 0 -04 per"Nil I's V- T' 11 tuf 0, Ap/voll $poet 0 A0p, im Ft. Resideoce 6 .404- v 'or, 4 'E. . I A D*Lom Ft. IF $101. 14 320 6 Ft. Caraom 0 .0105 Per, 1%. FEEI $2. 0 Pu A&AS 0 mhsl CO if pvrft*l%i4 :1 4� $4 04 'tach FEEt $4.0.0 .F ar Intl k Us -ntn t IF braill 1 0 IXT -ES, A' r , ip�, n Wate . v 0 Va'sher to h) i I. G4rbaqDitpl I V Laundr Tplaiyi 4 Urifval$ Editr Lowl 2 Ll6V&j0j'$#rj ghtwers 0 0 1, L. i I 01,0e%.� F El $22-50 pqt Mpa 11 Taus P-1 -A - 10 $10.0450 0 of We v or Neo.tiars I I. ®r of alina on, Roof 1 04 F C. _l .$2.50 Inpiallation 9f Water P.J.p,$nrQ and/or ' Water Tr ea�ulgn T equ, to I I FEE 1 $2. i5r. Siti kAN REV FEE "D#L PLAN RIEIV FEE ss . off - FORM 284-208 (2/81) NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back �� �' �� 33 Ventilation System 2 Ftgs & Frms 34 Plenums & Ducts 2A Slab Grade !— S 2 35 Furnace Comport. 3 Steel 36 Inlets 8 OutletsIIAV 4 Grout Blocks 37 Combustion Air 5 Bond Beams 38 Compressor 6 Roof Deck Z 7-i T2, 39 Appl. Clearance 7 Framing y '"'���- [[[[!!!!� 40 Fire Damper 8 Vents • 41 Smoke Detection Device 9 G —ge Fre Wall -42 Commercial Hood , 10 Fireplace P. L. 43 - Final 10A Fireplace T.O. NON ADDITIONAL INFO TIUVJ If CEO 11� 0 !!! -- SEWAGE, SYSTEM SIZE & LOCATION 11 Exterior Lath _ 2 r'L 12 Inteinol Lath 12A Drywall 13 Finish Glade �' INSULATION Thick R Value 7A Walls (Batts) !. 2 —Z3 —&Z O 12B Ceiling (Batts) �Z 12C. Ceiling (Blown) 14 Final - - - PLUMBING A P OVALS - - - 15 Ground Plumb 16 Water Piping 17 Rough Plumb 18 Vents 19 Sewage Disposal 20 Sewer 21 Water Heater 22 Water Softener IVA 23 Water Service 24 Gas Test 25 Final Tank. 247$"0 Pit L. Line REAR OF PROPERTY UNE ELECTRICAL APPROVALS P/L [ - N P/ '1 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 1z,✓� 29A Grounding Wire 298 Bonding 30 Fixtures 31 Service 32 Final STREET NAME 284-208 600,0 10180,5 -APPLICATION FOR STR "SURAL ' P 8141 ' YH Ya X$ AtII APPL T CAT 10,0 1bWLY H }RN ,p�gPq��!�isAVAR Mrs 1$.`�• 9 �59 •� GA 92£' 600000 T V D6RESSPpCE Avg.WRyAEZ CA/C(SlRw/ZIP M�7 J I4 1'42 956.t TM 410 (10 S ;:f�ao b`�19 ani sa DZY9LOPMENT C ;p s. 630 CA '922600000 i�. �'IQ ARC/ENG FIRM NAME j • _ADDRESS i CITU/COMMUNITV/STATE/ZIP PHONE 0 LICNC 0 bT;gdfR% . of t t GAR at I JF(r 1 10" Ia on ffe the - 204E ORD q LOT SZ „ -a .o ,two 284-208 600,0 10180,5 -APPLICATION FOR STR "SURAL ' P 8141 ' YH Ya X$ AtII APPL T CAT 10,0 1bWLY NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL. APPROVALS 1 Set Back 33 Ventilation System 2 Ftgs & Frms 34 ' Plenums & Duds 2A Slob Grade 35 Furnace Comport. 3 Steel 36 Inlets b Outlets 4 Grout Blocks 37 Combustion Air 5 Bond Beams 39 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 PA. 43 Final 10A Fireplace T.O. P'N ADDITIONAL INFORMATION -----------------------•---- ---- SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath 12 Internal Lath 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Wolfs (Batts) 12B Ceiling (Batts) — 12C Ceiling (Blown) _ 14 Final -- -- - - - 'PLL;Mr?Cfr frFP.OJia�---_------------- 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 REAR OF PROPERTY UNE ELECTRICAL APPROVALS P/L P/ 26 Power Pole ' 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 298 Bonding :30 Fixtures 31 Service 32 Final STREET NAME County of Riverside Department of Building and Safety 1080 Lemon St. 2nd Floor 135 N. Alessandro Rd. Rm-203 880 N.,State Street 227 North "0" Strait 1&209 Oasis St. Rm. 310 160 N. Broadway - Riverside, CA 92501 Banning, CA 92220 Hemet; CA 92813 Perris; CA 82370 Indio. CA 92201 Blythe,�CA 92225 ; Ph:, 7874146 Ph: 8447312 Ph:. 658-0164 ;ti!' Z, Ph: 657.3898 Ph: 342.8271 Ph: 972-2870 - This permit becomes void if'work not commenced within IBD -days from date of issuance. OR, if work has been suspeoed or abandoned for a pedod.of 180 days. LICENSED.CONTRACTORS DECLARATION: I hereby affirm that am licensed underprovisions of Chapter 9 (commencing CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE Thissection 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 hundred (5100) or less. I, certify that in the performance of the work for which this permitisissued, I License Class Lic. Number shall not employ any person in any, manner so.as to become subject to the Workers' Compensation Laws of California. DateApplicant Date ( Contractor NOTICE 10 APPLICANT: ILafter 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 following Compensation provisions of the Labor Code, you must forthwith comply with such provisions'or this permit shall be deemed revoked. reason (Sac: 7031.5. Business and Professions Code: Any city orcounty 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 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��ll I here.certity that no excavation five (5) or more feet in depth into which a person is required to descend„will be Wde with Section 7000) o1 Division 3 of the Business and Professions Code) that he is exempt therefrom and the buts for In connection with work authorized by this permit, and that no building structure. scaffolding. talsework, or fhe afteged eaam91d0n. Any vld1 tier of Sedloa 7031.5 by any ap¢kcant'tes ape M% sWalutsltSs il*%cant to a civ0 dsmo4ilion % dt ni%M%v% ttrarsot, w81 be mora than thifly-irx 13% feet hip. {Chap 32, Grp 2, Art 2, See 341, S551a S. ' penalty of not more than live hundred'dollars,(111500).): - C.A.C.) _ y I, as owner of the property. or my employees with wages -as their sola compensation, will do the work, and the In.� As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial 0arely, as noted above, unless such person has a permit to do such work.from that division. r a ucture is not intended or offered for sate (Sec..7044, Business.and Professions Code: The Contraetor's,License Law 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, provided that such improvements ire not intended oroffered for sale. It, 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.). FI. as.owner of the property. am exclusively contracting with licensed contractors to construct (Sec. 7044. Gender?s Name atness and Professions Code: The Contractods 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 Contractor's Lender's Address. License Law.). I certify that I have read this application and state that the aboveinformation is correct. 'I agree to comp lhy with all E]I am exempt under Sera, , B. 8 P.C. (Attach Certificate), city and county ordinances and state laws relating to building coretruction, and hereby authorize representatives of "property this county to enter upon me above-mentioned 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 Data . certificate of:Workers' Compensation Insurance, or a certified copy thereof (Sec: 3800; Lab. CJ. CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application andstatethat the Poll No. Company cy y Information -,given is correel., I agree to comply with all state,.laws and county ordinances reletlnp to building con- slruction,,and'autl)orize a resentative of the County of Riverside. Department of Building and Salely to enter upon ❑ Certillecl copy is hereby furnished. the, pro rty Ior�wNtb ve�pplfed.tor this permit icer the purpose o1 making inspections. - ..- ❑ Certified copy, is filed with' the County Building Inspection Department or County Department. 2 . -Signature, ofApplicantor Agent v Date Applicant •-f •�„�,« Int Applicant/Apem-Name7— t:'1400 CF a 0/2e -M-1 0 019 2 V .1430 ESTIMATED PLAN REV FEE 0i MW I,ESS/SPACE Adis pay .¢pp y - TWN /V�V�V +V� .f-'F�R1�,G9`1•�'1�R! 7 .�'�.V �V 'S ��{6V V {i t T caw .se CRNA” i�4 MV I.A .0 10 ! g�pppp��7$�iyl7gM�{�yl t� C1k�a ELoPmElrf�t f r YM�1 iM'S✓f8� 1'9Waf N T+rTuXS t ��� ( }► �y x�g �y �j `' �y (� �Aawi7 U��!\l� 1�� 7�y.V fa V Ktl V 1=436 ARC/ENG FIRM NAME I ADDRESS I PHONE e LICNC . 7IYI`i RM& . ATT . GAR. - 'ZONE ORD a LOT SZ 0 I d 6 . In PERMIT INSPE M'RUCTURA L PLAN AN PeRmi t reit "3.NUCTuIRAL PAN REVIEW TOTAL PERMIT 061 IS $ 92 C00TRUt-TIN WIMATV� tin 'tv-: Hot. t,.a be us,Od as prozoor tv ascTiptlin c�. Ge©Up tv 0p Sq Ft PRIMARY DWLG U'ap i R� W"9 #' l �i�"s1 NORY PR10AR 0012. M '0D 320 Evil PIA" Rau Fere base 0�, oial F-Sti"616d VAIltn 0 , . 1 $! 001.928 qa} luatiop� FdAto Valuati4h $27.60 2.9 $26335 iss � $155.92 Na OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Figs & Frms 34 Plenums & Ducts 2A Slab Grade 35 Furnace Comport.. 3 Steel 36 Inlets 8 Outlets 4 Grout Blocks 37 Combustion Air 5 Bond Beams 38 Compressor ' 6 Roo! Deck 39 Appl.. Clearance 7 Framing 40 Fire Damper 8 Vents 41 Smoke Detection Device 9 Garage Fire Wall 42 Commercial Hood 10 Fireplace P.L. F-] 43 Final 10A Fireplace T.O. No ADDITIONAL INFORMATION " SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lathe 12 Internal Lath 1,2A Drywall 13 Finish Grade INSULATION Thick Value 7A Walls (Batts) 12B Ceiling (Botts) 12C Ceiling (Blown) 14 Final - - - - - — - - - PLUMBING- APPROVALS - - -------------------- --------- 15 GroundPlumb 15 16 Water Piping , 17 Rough Plumb 18 Vents 19 Sewage Disposal 20 Sewer 21 Water Heater 22 Water Softener 23 Water Service 24 Gas Test 25 Final Tank - Pit L. Line P/l REAR OF PROPERTY LINE ELECTRICAL, APPROVALS P/ 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 298 Bonding 30 Fixtures 31 Service. 32 Final STREET NAME . En'airt� Krr,Ll�Nnule � , County of Riverside Department of Building and Safety 408DLemon-$L.2nd floor r* T35 N. Alessandro Rd, Rm. 203 8111) N. State Street 227 North 'D" Street 46.209 OasisSt. Rm. 310 Riverside. CA 92501 Banning, CA'9=- Hemet, CA 5234,9 Perris: CA'22370 Indio22Uf , CA'9 Ph: 787414d Ph,' 149.7312. Ph: 658-4464 Ph; 6574BS Ph: 312-8271 This permit, becomeY, void it•work not commenced within 1110 days>Irom Cate of Issuance; OR, 41, work has: been Suspended or abandoned fot a period of 180 days. LICENSED CONTRACTORS DECLARATION: 1 hereby affirm thal;l am heenaed'under provisions of Chapter 9 (commencing with Section 7080] of Diiiision,3 of Ina BusineWand P.rofesslons Code, ani'my license .is iq full force•and effect. License Class Lic. Number. Date Contractor OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors License Law tot the following feasoq,(Seo: 7031.5, Business and Professions Code: Any citylor county which' requires d• permit to construct, alter. jmprove. demolish, or repair any structure, prior to its issuance, also requires -the applicant for.sugh permit to foe a signed atesmarit that he.iis licensed pdrauant to theprovisions of tfie Contractor's Llcense,Law (Chapter9 tammendrq wF0 Section 7DDO) of Division 3;of4he Buahlens and Prolessions,Cods) or that he is exempt therMOrem•and the baste -for the alleged exemption. Any violation of -Section 7031:6 by arty applicant for a'permit subjects the applicarm to a civil penalty -01 not,more than five -hundred dollars (SiOO).): ❑ I, az• owner of the property, or my employees with wages as their Bola cortlperis-atiori, will do the"work. and the struU it. re nct Intended or offered for sale (Sec. 704/ 1"kess and Professions Code: The Contracto'r's License Ldw does not apply to an ov3rterob property; wh' builds or improves thereon, and who does such wprk himself or through his. own employees, provided that such improvements arena intended or offered forsafe. If,.hgwever, thebutldingnor 'improvement•is sold within one year of-egmitletion. the owner -builder will havethe burden of proving that he did' not build or improve for the purpose of sale:. . 1. as owneroUths property„ am exclusively contracting With licensed:comractors to construct the project (Sec. 7044, uainess and Professions Code: The Comrsaor's Ucbnse.Law does not appiY to an owner of property who -builds or tmproJas thereon, and wtw contracts for such prejeels with a coniractgr(s) licensed pursuant to the Nnireclars '{iderrse Law.t. E] I am exempt under See. .B. & P.'C. (Attach ,Cortificale) Dale Owen 'WORKERS` COMPENSATION DECLARATION: I hereby affirm that 1 -have acertificate of consent to self -insure, oras certificate.,of Workers"Compensation Insurance; or a certified copythereof. (Sec.. 3800, Lab. C;). Policy No. Company 'Certified copy is hereby furnished: Caitiffed:copy, is pled with' the County Building Inspection Department�or County Department, Oat& Applicant >Rfi�L NiYR N . ADDRESS BOX 3838 nvw,iuvm ' . CA 922600000 gDRESS/SPACE AVE CORTEZ vvl . CO `P GA 929530/00 BOK 974 PAG- 11,09 PRC 0 01, � '7WN NG �f 0 p SE p 0 8 Tai"0000 Tat 7a Wi I 38 �ijCrM194 60V LA Q 19 ( WE6 "WRT DEVELOPMENT C "Na N€ URN NIS 1.638 K/Unit l w� CA 922600060 9TW -568- 1048 436' AFIC/ENG FIRM NAME ADDRESS CITY/COMMUNITYATATE/ZIP PHONE a LICNC. a MORMKI -ATT GAR Volf20 615 oft 00 TAD ZONE ORD a LOT SZ 0 S 0 160 N. Broadwayy Blythe, CA 92225 Ph: 922.2670 CERTIFICATE'GF•EXEMPTION FROM WORKM' COMPENSATION INSURANCE: This section need not be completed it thi permit is for ode hundred (6108) or less, I eerlify that In the perfoliaanpe;of the work for which "tfifs permit b issued, i shall not employ any pejAh,hi any manner. sous-to,bedbme subject to'the Workers' Compensation. Law aaf•Callfomia: Date Applicant NOTICE TO APPLICANT: If, Defter making this Certificate of Exemption, you should become Subject to the'Warkers' Compensation provisions of the Labor Oode.,you'musrforthwith comply with inch provisions or this permit shall be deemed revoked. i DIVISION -OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: l� I hereby certify that on excavation five (5) or more feet in de h Into which a person is required to descend, will be rt ode in connection with wofk authorized by this permit an"d.thet no buildlnp struclurii• scaffolding, Ialsswork, of demolition or dismantling thereof, will be more than thirty-six (30) feet high. (Chap 32; Grp 2, Art Z Sec 341, Tif s,& C.A.C.) ASownsr-bullder, I will. not.employ anyone to do work,which would requires permit from the'Division'dVInd'ustri-al Safety, as noted above, unless such pefon has a paPmit,td do such workfrom that division. 0 Division of Industrial Sotgty Permit )10. Date Applicant CONSTRUCTION LENOIN&AGENCY: Ifiereby affirm that there is a consnuctlon lending agency for the performance of the work for which this perm t' is issued (Sed. 3087. Civ. C.). Lender's, Name Lender's Address I.cerlify 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-stat9''lews relating to building cbmitruction; and hetaby-authorize'repiWsWatives of this couny to enter upon the abovi�-mentiomxl property for Inspeaton purposes. Signature of Applicant or Agent Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OFENTRY: I certify I',fiave read this application and state4hat it" Information giverT w correct. I agtee to uomp y 'with, alt state taws and eaenty ordlnanpes retatinpp to building con dGuction', and authorize 5 represemative of the County W Riverside. Oepartrnent of Building and Safety to enter upor the property for which, I have applied for Viii de'rmit for tits purpose Of4haking inspections: Signature of.,APDlicant,or Agent Date . Prim Applicant/Agent Name AI 10MOMS I 1001 9],J IMPLICATION FOR STRUCTURAL PLAN REVIEW! I ASSESSOR COPY TOTAL APPLICATION FOR STRUCTUML PLAN REVIEW T H 1 8 I 0 A N A P P Lr T C A T I 0 N O N L Y 001911 i ( . 3 &tf, -Uat-,� " � rEfRlrtT�trraexT County of Riverside Department of Building and Safety 1080 Lemon St. 2nd Floor�`135•N: Allsandro Rd. Rm.203 680 N. Stale'Sgqpp -T, 277 North it Street *209Oasis 'SL Rm. 310 Riverside,, CA 92501 g�n CA 92220 Hemel CA li231S Perris. CA 92379' Indio,.CA 9=1 Ph: 7874146 PNS 73f2 Rljf W40 Ph: 697-9898 Ph: 3178471 This permit becomes vold if .work not commenced within 180 dais from date of issupnce, OR', it Work has, been iuspended or abandoned for a parted of 180 days. LICENSED CONTRACTORS DECLARATION I herebyaffirm that ,f am licensed'umW provisions of Chapter9'(commencing with Section 7000) o1 Division 3 of Ike,Busln'ei`s and Professions Code, ani my license is in full forceand' eNed. License Class Lic..Number Due, Contractor OWNER-BUILDEOtDECLARATIONr I hereby,affirm that 14m exempt :fromthe Contractor's License, Law for the following reason (Sac 7031.5. Business• and Professions Code: Any city or county which requlna a .permit to constrod.41ter, improve, demolish, or repair any+Strupltre: prior to"ifs iseuanoe, also requires the .applicant fart such permttto_file•a signed statedient thaf;he is licerfsed pyrsuantto the proJielons of the.Cent[actoYs License Law (Chapter 9tgommenclirp wild Section 7000) of Division 9 o19eStrainess and;Professions Code) or that he le exempt therefrom:and the basis for the alleged exemption. Any violadon af,6ection,7031.5 bY' any applirantfor a permn subjects the appllCanrto a civil penury of no mere thantive hundred -dollen Is500)J: ij��iI 1, as owner of the property, or,my employees-wlth'wages as their soleoompensation. will do,th'e work. and the slrueture'is bol intended or offered for sale (Set: 71M4,,,Businese and Professions Code: The. Contractor's License Law does n6vioply to an ownerof property who builds or improvae thereon, and who does such work himself or through his•own employees, provided that such Improvements are not intended or Off red for sale. It, however, the building or Improvement is sold within one year of completion. the owner-Euilder wU,.have the burden of proving that he did not build or Improve for the purpose of sale.). ❑j j L as ownevot the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044. &shifts and Professions Code: The ContractoN: Limnos Law does not apply. to an owner of properly who, builds or Improves thereon: and who contracts• for such profecas-with a, contractor(i) licensed pursuant to, the Contractor's License Law.). ' ❑ I am exempt under Sec. 0. 8 P,C.,(Attach Certificate). Date Owner WORKERS' COMPENSATIONDECLARATION: 1 hereby affirm that I have a certificate of consent to -self -insure, or a certificate of Workers' Compensation Insurance..ara certified copy thereof (Sec 3000, LAb. C.). Policy No. Compsrry. 0 Certified Way, it hereby fumishid, Certified copy is filed, with' the, County Building Inspection Department or -County ,Department. Date Applicant MORN ��F►0"INWOL' MIX t639 .rrUIDR R'T 1101>A 922600000 @lh�RESS/SPACE AV9 CORTE Z VV w17W0��,•ee ZIP CA 922530000 ��'si�' A 712 V%4 ? TVVN folio 'go S V{ coo 1019 1 V1 1 IS, Orth'WAM1194 DCV LA Q 19 {�/� y WEAEGE �T D&VELOP"O"T C VKHMN! "M'fi.RN BOW 1639 Paw" T CA 990690480 `7T1*_ 1B_1 0401 1 44436 ARC/EN6. FIRM NAME ADDRESS CITY/COMMUNITY/STATE/ZI P PHONE N LICNC e K WM& ATT 40 R°t' 990 "s 411 IIT0' "4 ZONE ORD N LOT SZ A /itlBr,ak dill]) A 160 N. Broadwayy Blythe, CA,92225 Ph: 842.2670 CERTIFICATE Of- EXEMPTION FROM WORKERS' COMPENSATION INSURANCE This section deed not;be completed if 0 Airmil"ii for hundred (9101) or leas_ T certify that in the performance of'the work for which lhjs,permit iaiaiued stialf n5teipploy arty peraonm,any manner so as:to becomea't aubjeo'the whirs"Compensation Laws of Cslildret Due Applicant NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Worker Compensation privtsiore of the Libor Code, you must forthwith comply whhspch provlsiods or this permit shall I deemed'vevoked:. DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify Maine exra rationif" 15) ormoreieefln depth into which a parson le required todescend. will t Sdi in "connection with, work authorized Dy this permit, and that no building structure, s alioldinp, falsework. I demolition or dismantling thereof, will be more thin.thirty-ilk (30 feet high. (Chap 32, Grp Z Art 2, Sec 341, Title i C.A.C.) PaA3 owner<bulldir, I will not employ anyone to do work, which would requke A permit from the DNlslon,otandustri ety, as noted above, unless such person has a permitto do such work from that divislam E] Division of Industrial Safety Permit No. Date Applicant CONSTRUCTION LENDING,ABENCY: I herebyy affirm that Otero is a construction. lending agency for the, performance i Me work for'which this permit is issued N. 3097. Civ. C.). Lender's Name, Lender's Addrese, I tartly that;I have read this yapplication.and state that the above information Incorrect. 'I agree to comply with r city and county ardinairiees an' state laws relating to building constriction, and h"by-a0c;dz!representatives this county to enter upon the aboveomentloned property for inspection purposes. .Signature of Applicant a Agent Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY tcefify I have read this application and state that 8 intor,'mition given is correct. f agree to'compty with all state laws and county ordinances retatinp to building, co structidn; arm! authorize A iepraeentu iva of the Courcy of flWarildi, Department of Building,aitd Safety, to enter up`i .the property for^whlch l have applied torl�fhis per ift for the purpose of making inspections': Signatute,of Applicant or Agent Date. Print Applicant%Agent Name APPLICATION iR STRUCTURAL.LAN 'Italvilli r T H 19 1 8 A N A P P L I C A t 1 4 N Q N L Y 001911 -a141 00191.1 APPLICATION OR STRUCTURAL PLAN REVIEW i a I .IM AN A..PPL I C A T 100 ONLY FORM 28/-20B .12811 .. AyliR 1639 04 922600000 vwRESS/SPACE AVg CORTEZ `TOOGyWA/ZIP CA92330000 MP4 Ybi 1`66 TW" wbo t0 5 ftboo0 w-bvp I I XPi 1 I sa KICA194 SCV LA 4 19 .WEKBRRT DEVELOPMENT C JYMMWN NWRN NW 1$30 MR` usmw CA 992606400 79CV-5613-1949 tli436 ARC/ENO FIRM NAME' ADDRESS' - CITY/COMMUNITY/STATE/ZIP PHONE a. LICNC, a G"M& ATT GAR DOI IRA1' 4n0 I digit I on I a0 1, ZONE ORD a LOT SZ one "o -two 00191.1 APPLICATION OR STRUCTURAL PLAN REVIEW i a I .IM AN A..PPL I C A T 100 ONLY FORM 28/-20B .12811 .. 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 d 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 Wdlls (Batts) 128 Ceiling (Batts) 12C Ceiling (Blown) 14 Final ------------ --PLUMBING-APPROVALS--------------- 1'5 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 P/L R EAR OF PROPERTY UNE ELECTRICAL APPROVALS P/ 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring '29A Grounding Wire 298 Bonding 30 Fixtures 31 Service 32 Final STREET NAME