00024486 (PC)PERMIT APPLICATION
County of Riverside
Department of Building and Safety
4080 Lemon St. 2nd Floor 135 N. Alessandro Rd. Rm, 203 880 N. Slate Street 227 North "0" Street 46.209 Oasis St. Rm. 310 160 N. Broadway
Riverside. CA 92501 Banning. CA 92220 Hemet. CA 92343 Perris. CA 92370 Indra, CA 92201 Blythe. CA 92225
Ph: 787.6146 Ph: 849.7312 Ph. 658-4464 Ph: 6573898 Ph; 342.8271 Ph: 922.2670
This permit becomes void it work not commenced within 180 days from date of issuance. OR. it work has beer suspended or abandoned lot a period of 188 days
n 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 (cornmenc- pleted it 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) o1 Division 3 o1 the Business and Professions Code, and my license is in full force and ellecl. 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.
a Q
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-
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 -
em of therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a per -
mil subjects the applicant to a civil penalty of not more than live hunderd dollars ($500).):
x
❑ I, as owner of the properly, or my employees with wages as their sole compensation, will do the work, and the
structure is not intended ar offered far sale (Sec. 7044, Business and Professions Code: The Contractor's License
- Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or
through his own employees, provided that such improvements are not intended or offered lot sale. If, however.
the building or improvement is sold within one year of completion, the owner -builder will have the burden of prov-
ing that he did not build or improve for the purpose of sale.) -
'
01, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who
.builds or improves thereon, and who contracts for such projects with a coniraclor(s) licensed pursuant to the Con-
Aractor's License Law.)
1L ❑I am exempt under Sec. . B.8 P.C. (Attach Cerhlicale).
Date Owner
x WORKERS' COMPENSATIONDECLARATION: I hereby affirm that I have a certificate of consent to sell -insure, or a
} certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800. Lab. C.).
Ce r,
copy is hereby turnished.t
❑Certified copy
fs filed with the County Building Inspection Department or County Department.
APPLICANT NAME (L, F, MI)
LANDMARK, LANE? CO
AP , 1000
+� nrytt
L.. 11i VI1j41tjY�l$T�TfIZIP GA 922530000
JQQ.$q-/Z)AESSiSPACE CLUB
1 A QUXN
•��T �i��°r
AVEV W1.r. VCA' iw92?530000
}1�JJ Y /TWIP
b� 1
l i V
V 1
!
$9.37
N
6`6 V
60
s
TUAf6'1136 �T013
Iy�Dq 1
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SB
TRACT NAME
�Li.W�EAV JAR , LANA CO
PHONE p
CONTRACTOR -FIRM NAME
LICNC M
ADDRESS
CITYICOMMUN ITYISTATEIZIP
PHONEII
BLD SPEC R LINA TE
ARCIENG FIRM NAME
LICNC 8
ADDRESS
CITYICOMMUNITYISTATEIZIP
PLAN 0
PLANS EXAMINER
APPROVE DATE
VEJPYUT COVER (TYPE: E0
to IR2-01
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END
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uate Applicant __
NOTICE TO APPLICANT: II, alter makingthis Certificate of Exemption, you should become subject t0 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 [hat no building structure. scaffolding, falsework,
or demolition or dismantling thereof, will be more than thirty-six (36) lee[ 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 Irom 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 lot 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 state
that the information given is correct. I agree to comply with all stale 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 properly for which I have applied for this permit for the purpose of making inspections.
Signature of Applicant or Agent Date
Print Applicant/Aaent Name
APPL/PRMT M PS DATE
U0000244" PD 09!03/Ci2
CONSTRUCTION FEE
40411
1 .t)u
PL/CN & AAS
$9.37
SMI FEE
$0.05
TOTAL .
FEE
$23,92
CA
I CI(,
I NC
COUNTER B.I.
COUNTER L.U.T.
D
STRUCTURAL1 4 U 4 171
( BUILDING ) P E R M I T
TOTAL PERM1'T COST IS
CONSTRUCTION ESTIMATE
Description
PRIMARY PATIO
'
Construction Fee based
SMI FEE
PL/CM & ADS
FORM 284.208(1181) !NSFECTOR
$23.92
(MOTEL Not to be used as property valuation)
FCC Group Typa Sq Ft Rate Valusti.on
329 M VWN 150 $4.90 $735
on Total Actual Valuation of $735 is$ $14.50
$0.05
$9.37
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
— 9-8
39 Appl. Clearance
7
Framing
9 S
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.
OP'N ADDITIONAL INFORMATION
NO.
CO (A)
# /� Rn ,
2(Z` `7�.{r. 60F/A79
SEWAGE SYSTEM SIZE & LOCATION
^'
r e
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick
Value
7A Walls (Botts)
12B Ceiling (Botts)
12C Ceiling (Blown)
14 Final 9.
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
IV
APPLICANT NAME (L, F, MI)
LANDMARK, LAND CO
ADDRESS
BOX 1000
t,.f1CO �K {J �i TY7ZIP CA 922530000
JQIj,�ST ,)t,RESSISPACE AVE CLUB LA QUIN
sI�TY�L/CLO�
(`3i� ��,�Y jfT ZIP CA 922530000
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TWN
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TRACT LOT
016186 001
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pT9RACCTgpN��NA�q�MtynEE7
►'..PIE��eII M"R , LAND CO
PHONE #
CONTRACTOR -FIRM NAME
LICNC #
ADDRESS
CITYICOM MUN ITYISTATEIZIP
PHONE#
.INSPECTOR
FINAL DATE
ARCIENG FIRM NAME
LICNC #
ADDRESS
CITYICOM M UNITYISTATEIZI P
PLAN#
PLANS EXAMINER
APPROVE DATE
USE OF PERMIT
PATIO -COVER (TYPE B)
0
R�°1OF
B14 022
0180
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END
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APPLICATION FOR Ti3ltf'TURAL PERMIT
TN I.9 1S A►N A P P L ICATx ON 0 N L Y
1�� `.1fr * • e•j•h` 1 • •
FORM 284208 (11.81) INSPECTOR.,
r
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 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.O.
P'
ADDITIONAL INFORMATION
t
i
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