00017790 (SFD)APPLICANT NAME (L,
qpp
ADDRESS -
544Q$ AVE, fiiBaR' INE -Z
CITYICOMMUNITYISTATEIZIP.�
tA'.QUlNTA CA 092140.501)00
JOB SITE ADDRESS/SPACE _
Z4485 AVE MARTINEZ
CITYICOMMUNITYISTATEIZIP '
LA QUINTA Chi 01?t 53000
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TRACT NAME -
aCV LAQ 027 OLK-300 LOTS 11 3 1v
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PHONE p
CONTRACTOR -FIRM NAME
LICNC p
ADDRESS
y
'CITYICOMMUNITYISTATEIZIP
PHONEp
.BLDG. INSPECTOR
FINAL DATE
1 ARCIENG FIRM NAME - - -
+t
LICNC p
ADDRESS
CITY/COMMUNITYISTATEIZIP
PLAN p
PLANS EXAMINER
APPROVE DATE
USE OF PERMIT -
PLO1R p [9 ry S
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TOTAL' ..
FEE
CA
CK
NC
COUNTER B.I.
COUNTER L.U.T.
"
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
39
Appl. Clearonce
7
Framing
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L. C]
43
Final
10A
Fireplace T.O.
OP'N
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 He6ter
22 Water Softener
23 Water Service
24 Gas Test
zs
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
PERMIT APPLICATION
County of Riverside
Departmv^, of f?uildtja.g 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 Indio. CA 92201 Blythe. CA 92225
Ph: 787.6146 Ph: 849.7312 Ph: 658.4464 Ph: 657.3898 Ph: 342.8271 Ph: 9222670
This permit becomes vOld it work not commenced within 180 days from date of issuance. OR, it work has beer suspended or abandoned for a period of 180 days.
❑
LICENSED CONTRACTORS DECLARATION: I hereby allirm 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.
OWNER -BUILDER DECLARATION: 1 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-
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-
empl 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).):
❑ 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 safe (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 himsell'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 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 contractor(s) licensed pursuant to the Con-
tractor's License Law.)
01 am exempt under Sec. 8.8 P.C. (Attach Certificate).
Date Owner
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate ol.consent to sell -insure, or a
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 if, F, MI)
r� r . airA, MRS
ADDAil 3 A, 1 A T I,t
EZ
CITY/COM MUN ITY/STATE/ZIP
LA QUINTA CA 092,250000
JOB SITE ADDRESS/SPACE
4485
1MARTINEZ
zxtryAAppp5AVE
CITYICOMMUNITY/STATEIZIP '
LA QUINTA CA 092253000
BOK
774
I PAG
253
PRC
022
C
8
TWN
006S(06E
RNG
SE
1310
S
TRACT LOT
000000 0011
1
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011
1
CA
TRACT NAME
SCV LAO 027 BLK-300,LOTS 1.1 & 12
OWNER NAME (L,F,AMI) y,�{�
lr#'LIZ, MR & MRS
PHONE #
CONTRACTOR -FIRM NAME
LICNC #
ADDRESS
CITY/COMMUNITY/STATE/ZIP
PHONE# _
BLDG. INSPECTOR
FINAL DATE
ARC/ENG FIRM NAME
LICNC #
ADDRESS
CITYICOMMUNITYISTATEIZIP /
PLAN
PLAN E AMINERAPPRD
EDATE V
USE OF PERMIT
PLAN 90:VISIONS
BLZON
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SSB
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RSB
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END
SIDE(() 0 0 0 U
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be com-
pleted it 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: If, alter makingthis Certificate of Exemption, you should become subject to the Workers'
Compensation provisions of the Labor Code. you must lorthwith 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 feel in depth into which a person is required to descend, will
be made in connection with work authorized by this permit. and Thal no building structure. scaffolding. 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.).
E) As owner -builder. I will not employ anyone to do work which would require a permit from the Division of In-
duslriat 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 state
that the inlo�a .on given is correct. I agree to comply with all state laws and county ordinances relating to
building cor Iru ion, and authorize a representative of the County of Riverside. Department of Building and Safety
to enter uV"J property for which I have apip If for this permit for the purpose of making inspections.
X t A'
//If,.
t,Sig"dal leo ppli nT drAd'edf pate
Print Applicant/Agent Name
�
APPUPRMT#PS DATE 34610
00017790. pi Oa/06/82
PLAN REVISIONS $15.00
TOTAL .
FEE
1
CA
CK
R
NCNC
COUNTER B.I(
COUNTER L.U.T.
1 346
P I- R M I T FOR PLAN REVISIONS
TOTAL PERMIT COST IS
PLAN REVISIONS
FORM 284.208(11,81) INSPECTOR
NO.
OPERATION I DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs & Firms
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
Final
IDA
Fireplace T.O. E]
OP'N
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 Watef Heater - - -
22 Water Softener
23 Water Service
24 Gas Test
25
Final
Tank Pit L.Line .
P/L
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
�-. , 0, (r
PERMIT APPLICATION
C0001V of RLyerside
Departm&t ofi Build#g and Safety
4080 Lemon St. 2nd Floor 135 N. Alessandro Rd. Rm. 203 880 N. Slate Street 227 North -D- Street 46.209 Oasis St. Rm. 310 16O'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. 658.4454 Ph: 657.3898 Ph: 342.8271 Ph: 9222670
This permit becomes void 11 work not commenced within 180 days from dale of issuance. OR, it work has one 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 alfirm that I am licensed under provisions of Chapter 9 (comment- - pleted it the permit is for one hundred (5100) 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 issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensa-
tion Laws of California.
D
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, after, 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 exempliori. 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).):
❑ 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 or offered for 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.)
01, as owner of the property, am exclusively contracting with licensed contractors to cons(rucl 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 contractor(s) licensed pursuant to the Con-
tractor's License Law.)
01 am exempt under Sec. B.& P.C. (Attach Certificate).
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 furnished.
❑Cerlified copy is filed with the County Building Inspection Department or County Department.
APPLICANT NAME (L, F, MI)
CRIZ. MR & MRS
ADDRESS
54485 AVE MARTINEZ
CITYICOM MUNITY/STATEIZIP
L.A •QUINTA CA 092250 00
JOB SITE .54485 AVE i,4
CIJITYICI^OTTM�yM{U�NIIT�YISTAATEIZIP P'6VARTIN Z
�w yy may{ y f't�
LA QUINTA. CA �7�LsJ Ill ii�
BOK
774
PAG
A.
PRC
0��
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8
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0068
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06E
SE
13
S
0
TRACT LOT
OOgAL10 O0
It
MOD
011
SB
TRACT NAME
BCV LAO. #27 BLK-3001LOTS 11 At 12
OWNER NAMEF,MCR I Z , (L Mi & MRS
PHONE p
CONTRACTOR -FIRM NAME
LICNC #
ADDRESS
CITYICOMMUNITYISTATEIZIP
PHONE#
BLDG. INSPECTOR
FINAL DATE
ARCIENG FIRM NAME
LICNC #
ADDRESS
CITY ICOM M U N ITYISTATEIZI P
PLAN #
PLANS EXAMINER
APPROVE DATE
USE OF PERMIT
PLAN REVISIONS
BL
00
ZON FSB
iii
SSB
000
SSB
000
RSB
010
OFC n
INA
ZONE ORD#
LOT SZ
END
ry\! V n SnIIDEE
{!- O
Late Applicant
NOTICE TO APPLICANT: If, after making this 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 five (5) or more feet in depth into which a person is required to descend, will
be made in connection with work aulhorized by this permit, and that no building structure, scaffolding, lalsework,
or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2. Grp 2. Art 2. See 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 state
that the information given is correct. I agree to comply with all stale laws and county ordinances relating to
builifing 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 pPS DATE 34606
00017790 Ax a��o6/8
TOTAL .
FEE p
CA CK NC COUNTER B.I. COUNTER L.U.T.
APPLICAi ION FOR PLAN REVISIONS
1• W 1 8 I O A N A P P L I C A? 1 0 N
FORM 284.208(11.81) AS-SFSSOR
0 N L y