00008465 GradingAPPLICANT NAME (L, F, MI)
DEU
-PALIA DISEfill CA'
.ADDRESS
5;$620 -AVENIDA CORTEZ
cl OM111J1 E[21P
CA 922=0000
J($jTLffWESS/SPACE AVENIDA . .CORTEZ
C .ADM IP 'CA 92253*0000
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.CONTRACTOR -FIRM NAME
ADDRESS
CITY/COMMUNITY/STATE/ZIP
PHONE
LICNC N
ARC/ENG FIRM NAME
ADDRESS
-cvrNitcoMMUNITY/STATE/ZIP
PHONE
LICNC'#
WAR"TCHECK FOR GRADING
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FORM 2114-206,f2/91)
APPLICATION FOR GRADING PgRMIT
-T H 1 8 I$ A N A P P L I CA T 1 0 N 0 0 L Y
101124
NO.
OPERATION
DATE
INSPECTOR
NO,
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation -System
2
Ftgs & -Frms
34
Plenums 8 Ducts
2A
Slab Grade
35
Furnace Comport.
3
Steel
36
Inlets & Outlets
4
Grout Blocks
37
Combustion Air -
5
Bond Beams
3e
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.
OND
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
---- --, --- -PLUMIDITG--AVVIZOVALS---------------------------_--------
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 LINE
ELECTRICAL APPROVALS
Pj
'
P/
26 Power Pole
27 Conduit
28 Service 'Eritrance
29 Wiring
29A; Grounding Wire
298 Bonding
30 .Fixtures
3.1 Service
32 Final
STREET NAME
APPLICANT NAME (L, F, MI)
A D
CL TY/STAT I -
JOB k,I DRESS/S ACE CA 992534980
CI TY,ISTATE/ZIP
C C TWN E S
T ` T MOD SB
Ann oil;
TRACT ITAME
SO AT 6E 6A Q 10 19
CONTRACTOR -FIRM NAME
ADDRESS
CITY/COMMUNITY/STATE/ZIP
PHONE 0
LICNC 0
ARC/ENO FIRM NAME
ADDRESS
C IT V/COMMUN ITYBTATE/ZI P
PHONE p
LICNC M
USE OF PERMIT - -'
BL S - - RSB OFC
4ND
'ZONE O '# LOf`Sr -
0 107
=S APPLICATXON FOR GRAbING PLAN REVIEW
? N i S 1 0 A N A P P L I C A T I O N ON L Y
NO.
OPERATION
DATE
INSPECTOR
NO, OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33 Ventilation System
2
Figs 8 Frms
34 Plenums & Duch
2A
Slab Grade
35 Furnace Comport.
3
Steel
36 Inlets d Outlets
4
Grout Blocks
37 Combustion Air
5
Bond Beams
38 Compressor
6
Root 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. E:]
43 Final
10A
Fireplace T. 0.
No ADDITIONAL INFORMATION
-
.
-=----------------- --
-
`+
SEWAGE SYSTEM .SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick Value
7A Walls (Botts) - —
12B Ceiling (Batts)
12C Ceiling (Blown)
14 Final
- -- - -- - --- - -PLUMBING-,,'VIZ 'JALa--------------------------------°=-----
15 Ground Plumb
16 Water Piping
17 Rough Plumb
18 Vents
1.9 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 LINE
ELECTRICAL APPROVALS
PSL
P/
26 Power Pole
27 Conduit
28Service Entrance
29 Wiring -
29A Grounding Wire
29B Bonding
• 30 Fixtures
31 Service,
32 Final
STREET NAME
County of Riverside
Department of'Buiiding and Safety
4080 Lemon SL 2nd Floor 135 N. Alessandro Rd. Rm. 201 880 N. State Street 227 North "D" Street 46209Aasts St. Rm. 310 16D N. Broadway
Riverside, GA,92501 Banning, CA,92220 Hemet, CA 92913 Parris, GA 92370 Indio, CA M1 ' Blythe, CA 92175
Ph: 767-6146 Po: 5497312 Ph: 656-4464 � Phi 867.3698 Ph:` 342.6271 Ph: 9722670
This permit becomes void if 'work rhot,00mmenced'wlthin 180days,from date of issuance. OR. it work has"been suspended or abandoned lar a period of 1.811 days.
LICENSED CONTRACTORS DECLARATION: I,hereby affirm that I am Ilcensad;under, provisions ofChapter•99commencing
with Section 70001 of Divi61on.3 of the Business aro`Prohssions Code, and my license is in full'force-and effect.
License Class Llc. Number
Date Contractor
OWNER -BUILDER DECLARATION: I hereby affirm. that I am exempt+from ;the Contractor's License Low for the following
reason (sec. 7031.5, ,business and Professions. Codec Any city.or,county,which,requires a permit to construct., alter,
Improve,. demolish, or repair any structure, prior to its: issumm also requires the:applicant for such permit to Ilia a
signed statement that he is licensedRursuent to.the provisions of the. Contracters'Lleense Law (Chapter 9 (commitricinp.
whh Section 7000) of Division 3 otthe Business acid Professions Code) -or that het;exempt tlhetefrom`add,thebisfs,for
the alleged ekeroption. Any violation of Section 7031.5 by'.any applicantfor a permit'sdblects tke applicant,ta a civil
penalty of al.more the ''vs.hundred dollars (1156011,
f-1 I,. ae owher of the property, W, my emptpyees with,wages as their sole compensation. will do, the work, and the
s acture is nbtantended 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 doe6'sucWwdrk himself or through
his own emplpyees, provided that suchlmprovements are not intended at offered for sale. It, however, the building or
Imp rovemenl4"saoldrwllhia one'year of completion, the owner buiider'wilthave the burden of proving;thathe did not
build or imYrove foi tha`pprpose of satej.
1, as ownerohthe property, am exclusively contracting with licensed contractors to,construct the project (Sec. 7044.
Iness and Professions Code; The Contraetor's.Ueense Law does not apply to an owner of property woo builds -or
improve" thereon, and who contracts, for such projects with a -contractors) licensed! pursuant to the Contractors
License Law.).
17 1 amexempt under Satz . B. & P.C. (Attach Certificate)
Data Owner
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a eedificate of consent to self -insure, or a
'certificate of Workers' Compensation Insurance: of a certified ropy thereof (Sec. r 38 Lab. C.).
Policy No, Company
Certified copy is hereby furnished.
E) Certified copy is filed wlth'the Coumy Building Inspection Department or County Department.
bate _ Applicant _
APPLICANT NAME (L, F, MI)
A DftM DOSERT 0
IDEV CO
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Y/STATE/ZIP
B C TWN S
T T
0047
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041
DEV
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ADDRESS
CITY/COMMUNITY/STATE/ZIP
PHONE%
LICNC=.e
ARC/ENO FIRM NAME
ADDRESS
CITY/COMMUN ITY./STATE/ZI P
PHONE a
LICNC'N
USE'OF. PERMIT
Ja
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ND
FORM 491.206 (4/81)
CERTIFICATE OF'EXEMPTION FROM WORKERB' CCOMPENSATION INSURANCE: This septlon need not be oempteted II; the
permit is for one hundred' (5100) or leis. I terh7y that In the performance of the work for whlch this permit Is issued, l
shall no(emptb'yany person In any manner so as to become subject 16 the Workers' Compensatlan Caws of Catffotnia.
Date A01)HOnt
NOTICE TO APPLICANT: IF after making this Certificate of Exemption, you should become such d to the Workers'
Compensation provisions of the labor Code, you. must forthwith cemply,with such provisions, or this Permit %hall be
deerned revoked.
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:.
thereby certify that r1moxcavation five'(6) or more feet in dapth.into.which ,a'person is required to descend, will be
made In connection wit, work authorized by this WrmiL and pail no building structure, scaffoldinngp falsewdrk, or
demolition or dismadtong thereof, will be,more than tarty-sht (36) leetlhigN (Chep 3.2 Grp,2. Art 2,:Sec 341, Title B,
CA.0'.)
VAs owner -builder. I will not employ anyone to do work, which would require a permit from the Division of Industrial
aajety, as noted above, unlessisuch person has a permit to do such work from lost division.
0 Division; of Industrial Safety Permit No.
Data Applicant -
CONSTRUCTiON I.ENOINB AGENCY: I hereby affirm that there is a,constructfon,lending agency for the performance of
the work for whllch This permit, is issued(Sec. 3097. Civ, C.),
Lender's Name
Lenders Address
I certify that I have read this a�ppplication and slate that the 'above information is correct. I agree to comply with all
city and caumy ordinances aad stat&lawirrelatingto building construction, and hereby authorize representatives of
this county, to enter upon the abov6mentimed property for ihspediod purposes.
Signature of'Applicanter Agent Date
CERTIFICATEXIF:COMPLIANCE ANDAUTHORIZATION OF ENTRY: I certiy I have read this application and state that the
Idformatim di4en,is correlt._ 1 agree to comply with all state laws. and county ordinances relating to buildino,con-
structl'on, and aothorize.4 representative of'the,Connty of Riverside, Department of Buddingsand-Safety to enter upon
the property for wh0kI have applleG tar this 0"Wt for the purpose'of making imilig Uorhs.,
Signature of'Applicanl or Agent Date
Print kplifcimt/Agent Name
APPL/PRMT,e PS DATE O�1 O 1 3
L
FEE •
APPLICATION FOR GRADING PLAN REVIEW
T -H X B 1$ AH APP).1CAT 1 QN 0NLY
10110731