00026687 (PAT)_ County of Riverside
s Department
Of Building and Safety
4080 Lemon SI. 2nd Floor . 135 N Alessandro Rd Rm 203 1880 N. stale street
227 North -0 Street 46.209 Oasis St R. 310 160 N. Broadway
Riverside. CA 92501 Banning, CA 92220 Hemel. CA 92343
Perris. CA 92370 Indio. CA 92201 Blythe. CA 922A
Ph: 787.6146 Ph: 849.7312 Ph- 6584464
Ph, 657.3898 Ph. 342.8271 Ph. 9222670
This permd becomes void if work not commenced within 180 days from date of issuance. OR. if work has been suspended
or abandoned IN a period o1 180 days
- 0 - '•
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be Com-
TRACT LOT
0167'136 Oo
pleted it the permit is for one hundred (5100) or less. I certdy that in the performance o1 the work for which this
. Sirtg with Seillgn�7000) of Division 3 of the Business. and Professions Code. and my license is in full force and effect.
permit issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensa-
tion Laws of California.
SB
Dale Applicant
OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law for the
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
i6 following reason (Sec. 7031.5. Business and Professions Code: Any city or county which requires a permit to con-
deemed revoked.
strucl. alter, improve, demolish, or repair any structure, prior to its issuance, also requires The applicant for such
�CITYICOMMUNITYISTATEIZI P
permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
(Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is ex-
of hereby certify that no excavation five (5) or more feet In depth into which a person is required To descend. will
empt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a per-
1 Insubjects the applicant to a civil penalty of not more than live hunderd dollars ($500).):
be made in connection with work authorized by This permit. and that no building structure. scallotding, falsework,
CITYICOM M U N ITYISTATEIZI P
or demolition or dismantling thereof, will be more than Ihirly•six (36) feet high. (Chap. 3.2, Grp 2. Art 2, Sec 341.
❑ I, as Owner Of the property, Or my employees with wages as their sole compensation, will d0 the work• and the
Title 8. C.A.C.).
structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License
❑As owner -builder. I will not employ anyone to do work which would require a permit from the Division of In -
Law does not apply to an owner of property who builds Or improves thereon• and who does such work himself Or
dustrial Safety. as noted above. unless such person has a permit to do such work Irom the division.
through his own employees, provided that such improvements are not intended or offered for sale. II, however.
❑ Division Industrial Safely Permit No.
j the building or improvement is sold within One year of completion. the owner -builder will have the burden of prov-
of
-{ mg that he did not build or Improve for the purpose of sale.)
❑I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of properly who
builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Con-
tractor's License Law.)
01 am exempt under Sec. . B 8 P.C. (Attach Certificate)
CONSTRUCTION LENDING AGENCY: I hereby affirm [hat there is a construction lending agency lot the perfor-
mance of the work lot which this permit is Issued (Sec. 3097. Civ. C.).
Lender's Name _
Lender's Address
Date Owner CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and stale
[hat the information given is correct. I agree to comply with all stale laws and county ordinances relating to
WORKERS' COMPENSATION DECLARATION: I hereby affirm That I have a certificate of consent to self - insure, or a building construction, and authorize a representative of the County of Riverside. Department of Building and Safely
certificate Of Workers' Compensation Insurance. or a certified copy thereof (Sec. 3800. Lab. C.). to enter upon The property for which I have applied for this permit for the purpose Of making inspections.
Y /
❑Certified copy is hereby furnished. " `- /� ' /'` y r %' �•�
Signature of Appl can�ent
❑Certified copy is filed with the County Building Inspection Department or County Department. f I
APPLICANT NAME (L, F, MI)
LANDMARK LANDGO
ADDRESS
BOX 1000
C-INI`COMMUN IQU TY[STfF 11 CA 922530000
J.B'tJ�D�RESSISPACE CLUB LA QUIN
AVET7
CITYICOMMUNITYISTATEIZIP
LA QUINTA CA 922530000
BOKPAG
631
370
PRC
012
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TWN
RNG
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SE
00
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TRACT LOT
0167'136 Oo
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SB
TRACT NAMEOWNER
NAME
q
LANDM RMk LANA) CO
PHONE N
CONTRACTOR -FIRM NAME
LICNC N
ADDRESS
�CITYICOMMUNITYISTATEIZI P
PHONEN I
SLD SPECTOR
FI DA E
ARCIENG FIRM NAME
I
LICNC N
ADDRESS
CITYICOM M U N ITYISTATEIZI P
PLAN M
PLANS EXAMINER
APPROVE DATE
USE OF PERMIT
23X12�yPATIO COVER
BIL 0
FaN
11N
FSB
OS480
VSV 0
dTo
COUNTER L.U.T.
. 1
ZONE ORD
LOT SZ
END
0 dU
Prinl Applicant/Agent Name
APPLIPRMT NPS
00026687 P8 I
CONSTRUCTION FEE
DATE
1,0/26/82L47201
PL/CH
$15.20
SMI FEE
$0.09
TOTAL
FEE
i►.�iE3
CA
CK`.
J�,
NC
COUNTER B.I.
COUNTER L.U.T.
STR UCTUR AL ( BUILDING ) P E R M
Y. TOTAL PERMIT COST IS $38.86
'.CONSTRUCTION ESTIMATE
PRIMARYPATZQiptlan
:Construction Fee baited
S SMI FEET
PL/CH
FORM 284208 (11.81) INSPECTOR
z 71472 01
(NOTEi Not to be used am property valuation.)
FCC Group Ty a Sq Ft Rate Wiluation
329 M V_ 276 $4.90 $1302
on Total. Actual Valuation of $1352 ist $23.50
$0.09
$15.27
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 Furpoce Comport.
3
Steel
36 Inlets 8 Outlets
4
Grout Blocks
37 Combustion Air
5
Bond Beams
38 Compressor
6
Roof Deck 1�- 9- 8�
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
IDA
Fireplace T. 0.
NNS ADDITIONAL INFORMATION
foo�iNq �NS�ec7iO�i dN Pe,e nA,6,� )690
{ `- j
8!// 6;o& -04
2
f f
r
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
-13-- -Finish Grade-
INSULATION Thick Value
7A Walls (Batts)
12B Ceiling (Batts)
12C Ceiling (Blown)
14 Final /�-
PLUMBING APPROVALS.
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
PSL P/
ELECTRICAL APPROVALS
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
_.. • - - - - -- •- -------- -- - - -- - - - -- - ------ -- - - ---- - --
0
.APPLICANT NAME (L, F, MI)
0 .
CITY/COMMUNITY/STATEIZI P
LA MUINTA CA 992530000
JOB SITE ADDRESS/SPACE pp
49380 AVE CLUB LA �J
CITY/COMMUNITY/STATE/ZIP
^31 •
CA30000
BOK
63113701fliPl7l
PAG
PRCC
TWN
11000
RNG SE
`Q
S
TRACT LOTMOD¢
Q
q
Q 8 i
SB
TRACT NAME
1'
OWNER NAME (L,F,MI)
cn
PHONE #
CONTRACTOR -FIRM NAME
LICNC 0
ADDRESS
CITY/COM MUN ITY/STATE/ZIP
PHONEp
I.BLDG. INSPECTOR
FINAL DATE
ARCIENG FIRM NAME
LICNC #
ADDRESS
CITY/COMMUNITY/STATE/ZIP -
PLAN APLANS
EXAMINER
APPROVE DATE
USE OF PERMIT -
BL
AD S DATE 47199
TOTAL
Q
ZON FSB SSB SSB RSB OFC .
91i 000 ,000 000 IND
ZONEFEE
ORD p LOT SZ END SIDE CA' CK NC COUNTER R.I. COUNTER L.U.T.
Q Q:QQ
47199
APPLICATION -FOR STRUCTURAL.' PER"IT
T N I I 9 A N A P P L I C A T I 0 N O N L Y
,FORM 24208,(11Sl) INSPECTOR
'I
,FORM 24208,(11Sl) INSPECTOR
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
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.
P'
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
PLUMBING APPROVALS . ..
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
PSL P/
ELECTRICAL APPROVALS
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME