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00024489 (PAT)PERMITv APPLICATION ~'lt Build ng6and Departmentnof Safety s 4080 Lemon Sr 2nd Floor 135 N. Alessandro Rd. Rm 203 880 N. Slate Street 227 North "D" Street 46.209 Oasis St Rm, 310 160 N Broadway it Riverside. CA 92501 Banning, CA 92220 Hemet. CA 92343 Perris. CA 92370 Indio. CA 92201 Blythe. CA 92225 Y i Ph: 787.6146 Ph 849.7312 Ph. 658.4464 Ph 657.3898 Ph. 342.8271 Ph 9222670 This permit becomes void it work not commenced within 180 days from dale of issuance. OR, it work has beer suspended or abandoned for a period of 180 days El 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 it the permit is for one hundred ($100) or less. I certify that in The performance of the work for which this ►`* with Shlion 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensa- r tion Laws of California. TRACT NAME Date _Applicant _ +� OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law for The NOTICE TO APPLICANT: II, after makingthis Certificate 01 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 Vollowing reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to con- deemed revoked. struct, alter, improve. demolish. or repair any structure, prior to its issuance, also requires the applicant for such PHONErI 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- Any ❑I hereby certify that excavation five (5) or more leer in depth into which person Is required to descend, will empt therefrom and the basis for the alleged exemption. violation of Section 7031.5 by any applicant for a per- F> mit subjects the applicant t0 a civil penalty of not more than live hunderd dollars ($500).): with i made in connection with work authorized by this permit, and that n building structure. scrp 40 I, as owner of the property. or my employees with wages as their sole compensation, will do the work, and the or rt . Sec 41. or demolition or dismantling thereof. will be more than thirty-six (36) feet high. (Chap. 3.2. Grp 2. Art 2. Sec 34 t, feet 2. Title 8. C.A.C.). structure is not intended or ollered for sale (Sec. 7044. Business and Professions Code: The Contractor's License ElAs owner -builder, I will not employ anyone to do work which would require a permit from the Division of In - i?. Law does not apply to an owner of properly who builds or improves thereon, and who does such work himsell or dusirial 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, Q M the building or improvement is sold within one year of completion, the owner -builder will have the burden of prov- ❑ Division of Industrial Safety Permit No. that he did not build or improve for the purpose of sale.) ND �ing �- ❑l, as owner of the property, am exclu5ively contracting with licensed contractors to construct the project (Sec. CONSTRUCTION LENDING AGENCY. 1 hereby affirm that there a construction lending agency for the perlor• mance of the work for which this is issued (Sec. 3097. Civ. C.). p 7044. Business and Professions Code: The Contractor's License Law does not apply to an owner of property who permit builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Con- Lender's Name tractor's License Law.) Lender's Address of am exempt under Sec. . B.8 P.C. (Attach Certilicate). WORKERS' COMPENSATION DECLARATION: I hereby affirm Thal 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.). ,I ❑Certified copy is hereby furnished. ❑Certified copy is filed with the County Building Inspection Department or County Department. APPLICANT NAME (L, F, MI) LANDMARK. LAND DO 13 10 0 ETKOMMAYTAIZIP CA 922530000 JQQ.$1406RE83/BPACE AVE CLUB LA QUIN LTlj.(COVFILJ(jl(($T(Tf/ZIP CA 922530000 �9 J�, �� E(dc12 6NI � TWN 660 90 S T6AJT6786 ` T01 fl i!°�i 1 BB TRACT NAME ',l Ir TiE«i/AM.N.,, LAND CID PHONE# CONTRACTOR -FIRM NAME LICNC N ADDRESS C ITV/COM M U N ITYISTATE/ZI P PHONErI BLD NSPE TOR FINAL DATE ARCIENG FIRM NAME LICNC It ADDRESS CITYICOM MUNITY/STATEIZI P PLAN N PLANS EXAMINER APPROVE DATE ,( VENNpF,�P�i�T COVER (A) to I RZOr FSB Q M 0%90 Ob ND Cu'" N / .J LOT SZ END „ 0Vb CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state 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 for which I have applied to this permit for the purpose of making inspections. X v Signature of Applicant or Agent Date Print Applicant/Aaeni Name APPL/PRMT X PS DATE 00084449 PB 09/Q3/82 CONSTRUCTION FEE 40417 .UU PL/CH 6 ADS' $16.115 SMI FEE $0.10 TOTAL FEE $41.25 CA I CK)( I INC COUNTER B.I. 7 COUNTER L.U.T. S T R U C T U R A L E BUILDING > P E R M I T I 4U4 TOTAL PERMIT COST IS $41,25 Nature of Situs Commeni - -.------- Action Taken ---------- Case Use No ----- TRACT MUST RECORD BEFORE PERMIT CAN BE ISSUED CU -2475 r CONSTRUCTION ESTIMATE (NOTE: Not to be used as property valuation) Description FCC Group Typa Sq Ft Rate Valuation PRIMARY PATIO 329 M V_N 206 $4.90 $1401 Construction Fire bleed on Total. Actual Valuation of $1401 ist $25-00 SMI FEE PL/CH 6 ADJ INSPECTOR 10.10 $16.15 NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System W2 Ftgs & Frms 34 Plenums 8 Ducts 2A Slob Grade 35 Furnace Comport. 3 Steel 36 Inlets & Outlets 4 Grout Blocks 37 Combustion Air 5 Bond Beams 38 Compressor f6 Roof Deck 39 Appl. Clearance 7 Framing � _ 40 Fire Damper 8 Vents 41 Smoke Detection Device 9 Garage Fire Wall 42 Commercial Hood 10 Fireplace P. L. E] 43 Final IDA Fireplace T. 0. 0 OFI ADDITIONAL INFORMATION O� f�,,,_;,� oai� 99 ��✓�/ edo�a ZKg `)0, C, �h/APg _ SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath 12 Internal Lath 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Walls (Batts) 12B Ceiling (Botts) 12C Ceiling (Blown) 14 Final /�— PLUMBING APPROVALS 15 Ground Plumb 16 Water Piping 17 Rough Plumb 18 Vents 19 Sewage Disposal 20 Sewer 21 Water Heater 22 Water Softener 23 Water Service 24 Gas Test 25 Final Tank Pit L.Line REAR OF PROPERTY LINE PA P) ELECTRICAL APPROVALS 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final STREET NAME 11, APPLICANT NAME It., F, MI) LANDMARK) LAND CO ADD ESS Wbx 9000. MO,Uufhy hlzIP CA 922 530000 4141,40-IjiESSISPACE AVE. CLUB LA QUIN 090��1'($�TEWIP CA 922530000 BOK 631 3gg,?0jj I PA, QN2 � �N �Nh0 U0 S T6Ai67U6 ITO IS 1 I SB TRACT NAME UN A , LAND CO PHONE # CONTRACTOR -FIRM NAME LICNC # ADDRESS CITYICOM M U N ITV ISTATEIZI P PHONEM BLDG. INSPECTOR FINAL DATE ARCIENG FIRM NAME LICNC 0 ADDRESS CITYICOMMUN_ ITYISTATEIZIP ! - r PLAN # PLANS EXAMINER APPROVE DATE AOYW COVER (A) RZOON� FSB hh �ry VS V }� Otho �y �p Q .i D h yy �N€QJP LOT SZ END .`SIpb 0-U,bM+�T- 4SS? AIA09109 404101 TOTAL . FEE /I 4U4 APPLICATION FOR :STRUCTURAL. PERMIT IF T H I S I S A N A P P L. T C. A T X C •N O L. Y •.;-Na.,,.ure of SiTus Comment K. -��» Action Taken w....»�..�w.�.�� Case Use No-.._..� ARACT MUST RECORD BEFORE: PERMIT CAN BE: ISSUED CU -2475 1 4 ' • FORM 2a4.20e h,.B,) INSPECTOR CA CK NC TOTAL . FEE /I 4U4 APPLICATION FOR :STRUCTURAL. PERMIT IF T H I S I S A N A P P L. T C. A T X C •N O L. Y •.;-Na.,,.ure of SiTus Comment K. -��» Action Taken w....»�..�w.�.�� Case Use No-.._..� ARACT MUST RECORD BEFORE: PERMIT CAN BE: ISSUED CU -2475 1 4 ' • FORM 2a4.20e h,.B,) INSPECTOR NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS I Set Bock 33 Ventilation System 2 Ftgs 8 Firms 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. E] 43 Final 10A Fireplace T.O. 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 (Botts) 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