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00024492 (PAT)County of Riverside Department of Building and Safety 4080 lemon Si 2nd Floor 135 N Alessandro Rd Rm 203 880 N Stale Street 227 North *'0 ' Street 46.209 Oasis St Rin 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 849.7312 Ph, 6584464 Ph 657.3898 Ph 342.8271 Ph 922.2670 This permit becomes void d work n01 tormented within 180 days from date of issuance. OR, it work has beer suspended or abandoned for a period of 180 days ❑ CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE This section need not be com- LICENSED CONTRACTORS DECLARATION: I hereby affirm That I am licensed under provisions of Chapter 9 (comment- pleted if the permit is for one hundred ($100) or less. I certify that in the performance of the work for which this ing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. Permit is w issued. 1 shall not employ any person m any manner so as to become subject to the Workers' Compensa- tion Laws of California. OWNER -BUILDER DECLARATION: I hereby allum 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- slrucl. 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 Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is ex- empt Iherelrom 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 live hunderd dollars ($500).): ❑ 1, as owner of the property, or my employees with wages as Their sole compensation, will do the work, and the structure is not intended or offered lot sale (Sec. 7044, Business and Prolessions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees. provided that such improvements are not intended or offered for sale. If. 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 for the purpose of sale.) + ❑I, as owner of the properly, am exCtusively 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 property who . _ builds or improves thereon, and who Contracts lot such projects with a contractOr(s) licensed pursuant To the Con- tractor's License Law.) ❑1 am exempt under Sec. B & P.C. (Attach Certificate). Date —Owner WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell -insure, or a ?certificate of Workers' Compensation Insurance. or a certified copy thereof (Sec. 3800. Lab. C.). ❑Certified copy is hereby lurnished. ❑Certified copy is tiled with the County Building Inspection Department or County --Department. APPLICANT NAME If, F, MI) L.ANbMARK . L*ND, CC VUR, 1000 �1T1jIC07QEAJ,1[!u1(�^�yT€121F CA922530000 AYMNRESSISPACE AVE CLUB LA QUIN T°°t 1tJ1 YTf4 CA 92530000 6�1 9/ o WC12 / TWN brd 0 Vo S T�AJT6786 'db 19 'vol 1 sB TRACT NAME „ MWFi�`fiJi AOR I LANA/ CO PHONE# CONTRACTOR -FIRM NAME LICNC N ADDRESS CITYICOMMUNITYISTATEIZI P PHONEN BLD SP TOR FINAL TE ARC/ENG FIRM NAME LICNC N ADDRESS CIT V ICOM M U N ITY/STATEIZI P PLAN N PLANS EXAMINER APPROVE DATE CAVY'dT COVER (A) p7 V 0 RZ—i FSB O u V Y V t �D CU—Z°N44'N LOT SZ END o OSI b uaie -- --- -- – – AppncaOt - -- ------- NOTICE TO APPLICANT: II, 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 deemed revoked. DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION 01 hereby certify That no excavation live (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. scalfoldmg. lalsework. or demolition or dismantling thereof, will be more Than thirty-six (36) feet high. (Chap. 3.2. Grp 2. Art 2. Sec 341. Title 8. C.A.C.). OAS Owner -builder. I will not employ anyone 10 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. F] Division of industrial Safety Permit No. CONSTRUCTION LENDING AGENCY. I hereby alfirm 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 1 have read this application and stale that the inlormalion 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 for which I have applied for this permit for the purpose of making inspections. X Signature of Applicant or Agent Date Print Applicant/Agent Name APPLIPRMT N PS DATE 6Ui241+1�42 FB O+p/83l92 CONSTRUCTION FEE 4 0 419 s0 . PL/CH & ADJ $16.15 SMI FEE $0.10 TOTAL . FEE $41.25 CA CII NC I COUNTER B.I. COUNTER L.U.T. STRUCTURAL ( BUILDING ) P E R M I T 1 04 TOTAL PERMIT COST I5 $41,25 Nature of Situs Comment ---------- Action Taken ---------- Case see No ----- TRACT MUST RECORD BEFORE PERMIT CAN BE ISSUED CU -2475 CONSTRUCTION ESTIMATE (NOTEi Not to be used as property valuation) Description FCC Group Typpe Sq Ft Rate Valuation PRIMARY PATIO 329 M V—N 2136 $4.90 $1401 Construction Fee based on Total Actual Valuation of !1401 ist $25.00 SMI FEE PL/CH h ADJ FORM 284208 (11.81) INSPECTOR $0.10 $16.15 NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System iG 2 Ftgs & Frms 34 Plenums 8 Ducts 2A Slab Grade 35 Furnace Comport. 3 Steel 36 Inlets 8 Outlets 4 Grout Blocks 37 Combustion Air 5 Bond jB@Oms 38 Compressor 6 Roof Deck 39 Appl. Clearance 7 Framing 1 _ 40 Fire Damper 8 Vents 41 Smoke Detection Device 9 Garage Fire Wall 42 Commercial Hood 10 Fireplace P. L. ❑ 43 Final IDA Fireplace T. 0. OFINNO ADDITIONAL INFORMATION �OO�j�� //�y�Q�S�-- " O� l ��/O�q' G'p✓17�/ � _ SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath 12 Internal Lath 12A Drywall�oS 13 Finish Grade INSULATION ••R" Thick Value 7A Walls (Botts) 12B Ceiling (Botts) 12C Ceiling (Blown) 14 Final / PLUMBING APPROVALS 15 Ground Plumb 16 Water Piping 17 Rough Plumb 18 Vents 19 Sewage Disposal 20 Sewer 21 Water Heater 22 Water Softener 23 Water Service 24 Gas Test 25 Final Tank Pit L.Line REAR OF PROPERTY LINE P/L P/ ELECTRICAL APPROVALS 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final STREET NAME APP �.,AL��►/Ti��F)MI� LAND, CO ug, 1a0a LWOMINT,8T�I2IP CA 9225300 00 JFAB,$IJEJNRESSITS�PACE AVEr ' C levy LA ryvy W6,SC7 &A1 !12(2543. i0 ``ACOOM I �IZIP gp��y� N C V V a i"iTWN 9� I 1 Q W91 2 � ONO V to S (f YT6 6D 6. ,^ vb d 10,11 SB TRACTNAME .fir AND CO. W �♦ � ��) A LAND- CO PHONE p CONTRACTOR -FIRM NAME LICNC p ADDRESS CITYICOM MUN ITYISTATEIZIP PHONE # BLDG. INSPECTOR FINAL DATE ARCIENG FIRM NAME - LICNC N ADDRESS CITYICOMMUNITYISTATEIZI P PLAN # PLANS EXAMINER APPROVE DATE {I YEAYYOT COVER ( A ) 1!10 1 00-1 FSB qVb Qijb ulabI IrAD cu. -Nn LOT SZ END n OW6 c VY01,1T449 � r. AP 09/VF, 8P 40413 TOTAL . FEE CA CK . - NC I COUNTER 8.1. COUNTER L.U.T. APPLICATION FOR STRUCTURAL PERMIT / T H I S X 8 A N A P P L. T C A T 1 0 M 0 N L Y Nature 44 ;situs Comment 'Action Taken Case Use No ., TRACT MUST RECORD BEFORE PERMIT CAN BE ISSUED Cu -2475 FORM 284208 �1L8p I�dS?ECT�R NO. OPERATION DATE I14SPECTOR 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 8 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 IDA Fireplace T. 0. E] 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 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 PSL 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