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00026688 (PAT)a'TICENSEO CONTRACTORS DECLARATION: I hereby alfirm that I am licensed under provisions of Chapter 9 (commenc- ing with Section 7000( of Division 3 of the Business and Professions Code, and my license is in full force and effect. h a 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 con- ' strucl, 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 X (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cade) or that he is ex- empt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a per- mit subjects the applicant to a civil penally of not more than five hunderd dollars ($500).): ❑ I, as owner of the properly, or my employees with wages as (heir sole compensation, will do the work, and the structure 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 properly who builds or improves (hereon, and who does such work himself or . through his own employees, provided that such improvements are not intended or offered for sale. II, however. the building or improvement is sold within one year of completion, the owner -builder will have the burden of prov- ing that he did not build or improve lot the purpose of sale.) ❑I, as owner of the properly. am exclusively contracting with licensed contractors 10 construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply t0 an owner of property 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 Certdicale). 1 WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell -insure. ora certificate of Workers' Compensation Insurance. or a certified copy thereof (Sec. 3800. Lab. C.). ❑Certified copy is hereby furnished. []Certified copy is tiled with the County Building Inspection Department or County Department. APPLICANT NAME (L, F. MI) LANDMARK LANA CCD OR, 1000 County of Riverside JQt� ol�jRESBISPACE AVE CLUB LA QUIN gITYJCO1A0TA TF�IZIP CA 9225513 0 0 0 0 MI Department of Building and Safety PdC1ti 4080 Lemon St. 2nd Floor 135 N Alessandro Rd. Rm 203 880 N. State Street 227 North "D ' Street 46.209 Oasis Si. Rm. 310 1601 Br Idw y Riverside. CA 9j501 Banning. CA 92220 Hemel CA 92343 Perris, CA 92370 Indio. CA 92201 Blylhe. CA t> 25 Ph: 787.6146 Ph* 849.7312 Ph. 658.4464 Ph6573898 Ph 3428271 Ph 9222670 This permd becomes void d work not commenced within 180 days Iron date of issuance. OR. d work has been suspended or abandoned for a period of 180 days CONTRACTOR -FIRM NAME \ ADDRESS CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be com- a'TICENSEO CONTRACTORS DECLARATION: I hereby alfirm that I am licensed under provisions of Chapter 9 (commenc- ing with Section 7000( of Division 3 of the Business and Professions Code, and my license is in full force and effect. h a 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 con- ' strucl, 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 X (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cade) or that he is ex- empt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a per- mit subjects the applicant to a civil penally of not more than five hunderd dollars ($500).): ❑ I, as owner of the properly, or my employees with wages as (heir sole compensation, will do the work, and the structure 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 properly who builds or improves (hereon, and who does such work himself or . through his own employees, provided that such improvements are not intended or offered for sale. II, however. the building or improvement is sold within one year of completion, the owner -builder will have the burden of prov- ing that he did not build or improve lot the purpose of sale.) ❑I, as owner of the properly. am exclusively contracting with licensed contractors 10 construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply t0 an owner of property 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 Certdicale). 1 WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell -insure. ora certificate of Workers' Compensation Insurance. or a certified copy thereof (Sec. 3800. Lab. C.). ❑Certified copy is hereby furnished. []Certified copy is tiled with the County Building Inspection Department or County Department. APPLICANT NAME (L, F. MI) LANDMARK LANA CCD OR, 1000 ;MTYICOl{1�{.N�T�IZIP CA 922530000 JQt� ol�jRESBISPACE AVE CLUB LA QUIN gITYJCO1A0TA TF�IZIP CA 9225513 0 0 0 0 MI 12070 PdC1ti PL/CH TWINwbo V0 S 1 6 86 LOT0 T616786 i G I wi 1 SB TRACT NAME QINXPAIA&V , LANAI C{,i PHONE N CONTRACTOR -FIRM NAME LICNC N ADDRESS CITYICOMMUN ITYISTATEIZIP PHONE N B . INSP CTOR FINAL DAT / . ARCIENG FIRM NAME LICNC N ADDRESS CITYICOM MUNITYISTATEIZIP PLAN N PLANS EXAMINER APPROVE DATE DJER2 AWNING B� O �PATIO RAQN FSB Orb n OHO 0`n y.. IINB ZONEORDN LOT SZ END 0 O pleled II the permit Is for one hundred ($100) or less. I cerhly 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' Compensa- tion Laws of California. Dale Applicant NOTICE TO APPLICANT: ll, after makingthis Certificate of Exemption, you should become subject to the Workers' Compensalion 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: `. 01 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, lalsework, . or demolition or dismantling thereof, will be more than Ihirly-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 In- dustrial Safety. as noted above. unless such person has a permit to do such work from the division. ❑Division of Industrial Safely Permit No. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the perfor• mance of the work for which this permit is issued (Sec. 3097. Civ. C.). Lender's Name Lender's Address CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and stale that the information given is correct. I agree to comply with all state laws and county ordinances relating to building construction, and authorize a representative of the County of Riverside, Department of Building and Safety to enter upon the property tor.wIIioh I hav app lewd{ for this permit for the purpose of making inspections. Signature of Applicant or Agent Date ` _ _ _ _ _PrinLApolicanl/A•g,P,nL[NaW _ _ _ _ _ — _ _ _ _ __ _ _ _p APPLIPRMT N PSDATE 00026688 PB CONSTRUCTION FEE$43150 10/2$/82 47202 PL/CH $15.27 SMI FEE $0,09 TOTAL FEE ' $38. CA I CKy I� NC COUNTER B.I.COUNTER 's; . /I,-,–' z L.U.T. Alp 5TRUCTUR AL. ( BUILDING > TOTAL PERMIT COST IS $38.86 P E R M X T 02 CONSTRUCTION ESTIMATE (NOTE► Not to be used as property valuation) Description FCC Group rye Sq rt Rare Valuation PRIMARY PATIO 329 M V_ 2 b X4.90 $1352 Construction Fee based on 'Total Actual Valuation of $1352 Isst $23.50 SMI FEE 40.09 PL/CH $15,27 1 L,F.R-�.l 208(11 81) INSPECTOR 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 Q $� 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'N Z ADDITIONAL INFORMATION g+ r r /A%s P • r co �,uq p Boa ooJ �Mc7�paJbB(fl .6y 3,i/ Goy a A) 91 . --. ' �7 r ,tic � Q 8 O•C, f:OOF /nlCi 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 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 i i STREET NAME