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00024487 (PAT)F.m LICENSED CONTRACTORS DECLARATION: I hereby affirm 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. Fes. OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law for the IWlowing reason (Sec. 7031.5. Business and Professions Code: Any city or county which requires a permit to con- struct, 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 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 penalty of not more than five 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 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 does such work himself or through his Own employees, provided that such improvements are not intended or offered for sale. If, t 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'M owner of the properly. am exclusively contracting with licensed contractors t0 construct the project (Sec. 77444; Business and Professions Code: The Contractor's License Law does not apply to an owner of property who .1;or improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the Con- , (i[s License Law.) f4iia exempt under Sec. . 8.8 P.C. (Attach Certificate). d: Dale Owner WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self - insure, or a .'cegjlfi ate of Workers' Compensation Insurance. or a certified copy thereof (Sec. 3800, Lab. C.). copy is hereby furnished. copy is filed with the County Building Inspeglion Department or County Department. APPLICANT NAME (I., F, MI) f R88 ` CS County of Riverside T CD WIP CA I 30000 E Department of Building and Safety Al 4080 Lemon St, 2nd Floor 135 N Alessandro Rd. Rm. 203 880 N. State Street 227 North "D Sheet 46209 basis SI Rm. 310 160 N. BroWway RNerside. CA 92501 Banning. CA 92220 Hemet. CA 92343 Perris. CA 92370 Indio, CA 92201 Blythe. CA 92225 ' Ph: 787.6146 Ph. 849.7312 g Ph. 658.4464 Ph 657.3898 Ph 3428271 Ph- 922.2670 This permit biomes void II work not cOfrllMnoed within 180 days Irom date of issuance. OR. it work has beer suspended or abandoned la a period of 180 days e ription f Group F.m LICENSED CONTRACTORS DECLARATION: I hereby affirm 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. Fes. OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law for the IWlowing reason (Sec. 7031.5. Business and Professions Code: Any city or county which requires a permit to con- struct, 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 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 penalty of not more than five 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 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 does such work himself or through his Own employees, provided that such improvements are not intended or offered for sale. If, t 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'M owner of the properly. am exclusively contracting with licensed contractors t0 construct the project (Sec. 77444; Business and Professions Code: The Contractor's License Law does not apply to an owner of property who .1;or improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the Con- , (i[s License Law.) f4iia exempt under Sec. . 8.8 P.C. (Attach Certificate). d: Dale Owner WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self - insure, or a .'cegjlfi ate of Workers' Compensation Insurance. or a certified copy thereof (Sec. 3800, Lab. C.). copy is hereby furnished. copy is filed with the County Building Inspeglion Department or County Department. APPLICANT NAME (I., F, MI) f R88 ` CS 6 IAS 1000 T CD WIP CA I 30000 U RESSISPACE AVE CLUB LA QUIN LTTWOWNYWIP CA 122530000 Al Ji3tfia r612 1i I JTWN fj a Ito. Is TJ' b7S,6 0 t e ription f Group �� t SB on 33 TRACT NAME D""O 'LAND CO PHONEN CONTRACTOR -FIRM NAME LICNC N ADDRESS CITYICOM MUN ITYISTATEIZIP PHONE N BLD SPE OR FINAL DATE OCR 49–C7ENG FIRM NAMELICNC N ADDRESS CITYJCOMMUNITYISTATEIZIP - PLAN N PLANS EXAMINER APPROVE DATE yfalff COVER (TYPE S) to Z'2Fj R I COUNTER B.I. 14U 0 CV&D Cu—;94715LOT S2 END CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE This section need not be Com- pleted if the permit is for one hundred ($100) or less. I certify 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. Date _ _Applicant NOTICE TO APPLICANT. ll, after makmglhis Certificate of Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code. you must lorthwilh comply with such provisions or this permit shall be deemed revoked. DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: Of hereby certify that no excavation live (5) or more feel in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no buildingstructure. 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.). 0 A 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 Safety 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 01 the County of Riverside. Department of Building and Safety to enter upon the property for which I have applied for this permit lot the purpose of making inspections. X =% Signature of Applicant or AQenl �"�— ' Data Print AODlicant/Anent Name I PLIP f4J OW JP*_ 69/9V CONSTRUCTION FEt 40414 - C _ ------ CTr;U1, R88RDEr ERMITCANI1S81 _____ BEn____, SolA C9 • No ----- PL/CH & ADx $1?. 77 SMI FEE tOiOa valuation) e ription f Group Tyg* Sq Ft V—N i50 Rate Valuat l�.90 D on 33 PRIMARYAO 3 M Construction Fee based on Total Actual Valuation of $733 iso $14.50 r $MI 'FEE PL/CN # ADJ $0.03 $?.37 ,sl TOTAL FEE CA I CKX NC I COUNTER B.I. COUNTER L.U.T. + STRUCTURALI 4U4 4 BUILDING > P E R M I T I TOTAL PERMIT COST FORM 19 023.g2 - C _ ------ CTr;U1, R88RDEr ERMITCANI1S81 _____ BEn____, SolA C9 • No ----- CONSTRUCTION ESTIMATE (NOTEt Not to be used as property valuation) e ription f Group Tyg* Sq Ft V—N i50 Rate Valuat l�.90 D on 33 PRIMARYAO 3 M Construction Fee based on Total Actual Valuation of $733 iso $14.50 r $MI 'FEE PL/CN # ADJ $0.03 $?.37 284-201B (1181) I'vVE 1 OR NO. OPERATION DATE NSPECTOR NO. OPERATION DATE INSPECTOR n BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Bock 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 f3earits 3B Compressor 6 Roof Deck �� 9— 8 Z 39 Appl. Clearance 7 Framing /�_ 40 Fire Damper 8 Vents 41 Smoke Detection Device 9 Garage Fire Wall 42 Commercial Hood 10 Fireplace 1, P.L. ❑ 43 Final 10A Fireplace L T.O. OP'N ADDITIONAL INFORMATION NO. , Fi r o'f n19 1A S�GCioAJ oAJ Y 'V 2XZ G40rC SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Loth 12 Internal Lath 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Wolls (Batts) 12B Ceiling (Batts) 12C Ceiling (Blown) 14 Final //� / ` 2 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 PSL P/ 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final STREET NAME APPLICANT NAME (L, F, MI) , L.ANDMARX s LANDCO i�OX 1000 �IGDt aNYT€IZIP CA 92253060.0 S;�j�t��RESj�SISPA�CE AVE CLUB LA QUIN GKDWNYT€IZIP CA 922530000 G ag o wcl � `j�� N ro ¢, go S yl JdAfT6786 `��T0 Yp ypTW 41 8 SB . TRACT NAME `,y� 16W ECRJV ►7f�14} +� LAND CO PHONE# CONTRACTOR -FIRM NAME LICNC # ADDRESS CITY/COMMUNITYISTATEIZI P PHONE# BLDG. INSPECTOR FINALDATE ARCIENG FIRM NAME LICNC # ADDRESS CITYICOMMUNITYISTATEIZIP PLAN # PLANS EXAMINER, APPROVE DATE PEAMT COVER (TYPE B) BH 0 RZOt� FSB 0 � ,y V BV n 0980 Q Ny� D C UG:N LOTSZ END oVb APPL/PRMT # , (1fi024487 PS DATE --j 404 AT flri103lE � -07 TOTAL . FEE 4' CA CK I NC I COUNTER B.I. COUNTER L.U.T. ' Y APPLICATION FOR STRUi:TURAL. PERMIT / }(. ' '( H i S ISS AN APPLICATION ONLY Nature of Situs Comment. ..»..a..,». Action Taken Casae Use No _ _... TRACT MUST RECORD BEFORE PERMITCANLSE lSSU6:.xD CU -2375 FORM 284-208 (11.81) INSPECTOR _.Y..•,.._.�...._��.n...:e�._.—tee .,...e� 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 1 Final IDA Fireplace T. 0. 0 FI ADDITIONAL INFORMATION SEWAGE SYSTEM SIZE & LOCATION I1 Exterior Lath 12 Internal Loth 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 P/L P/ ELECTRICAL APPROVALS 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A- Grounding Wire 298 Bonding 30 Fixtures 31 Service 32 Final STREET NAME