00019340 (SPIN)AVI'LIUAN I NAML (L• V. MI)
CR17- M A MRS
ADDRESS
54485, AVE MARTINEZ
CI TYICOM MU N ITYISTATEIZI P
LA_QUINT A CA 09242. 10000
JOB SITE ADDRESSISPACE
54485- AVE MARTINEZ
CITY/COMMUNITYISTATEIZIP '
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TRACT NAME
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OWNER NAME (L,F,MI)•
CRIB MV & MRS
PHONE #
CONTRACTOR:FIRM NAME
LICNC #
ADDRESS
CITYICOMMUNITYISTATEIZIP
PHONE#
BLDG. INSPECTOR
FINAL DATE
ARCIENG FIRM NAME
LICNC #
ADDRESS
CITYICOMMUNITYISTATEIZIP ,.
PLAN # <
PLANS EXAMINER
APPROVE DATE
USE OF PERMIT
REINSPECTION
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COUNTER B.I.
COUNTER La'J'�
APPLICATION FOR REINISPECTION
r fJ I s .5 A H A. P', P t, I C A T I C N 0 N L Y
i
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. Clearance
7
Framing
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Hcod
10
Fireplace P. L.
43
Final
IDA
Fireplace T.O.
No
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Loth
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
This permit becomes void if work not commenced within 180 days from date of issuance. OR, it work las beer suspended or abandoned for a perlbo of 180 days
us—
This
s
'1 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.
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-
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 penally of not more than live hunderd dollars ($500).):
❑ I, 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
.structure
does not apply to.an owner of property who builds or improves thereon, and who does such work himself 0r
I Through his own employees, provided (hat 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.)
et; as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
I"7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of properly who
11builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Con-
1110ractor's License Law.)
�~ ❑1 am exempt under Sec. . B.8 P.C. (Attach Certificate).
Date Owner
WORKERS' COMPENSATION DECLARATION: I hereby allirm that I have a certificate of consent to sell -insure, Ora
°ll 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
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be com-
pleled 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, 1 shall not employ any person in any manner so as to become subject to the Workers' Compensa-
tion Laws of California.
Dale Applicant
NOTICE TO APPLICANT: If, alter 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 lee[ 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, scaffolding, falsework,
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.).
❑As 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.
❑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 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�fhis permit lot the purpose of making inspections.
�- Signature of Applicant or Agent Date
Print Applicant/Agent Name
„FORM 284208 (11.81) INSPECTOR
REIINSP-ECix0N
TOTAL PERMIT COSI IS
F?ERMIi
$15.00
rtHMll ArruCArfuN
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 SI. 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: 922-2670
This permit becomes void if work not commenced within 180 days from date of issuance. OR, it work las beer suspended or abandoned for a perlbo of 180 days
us—
This
s
'1 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.
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-
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 penally of not more than live hunderd dollars ($500).):
❑ I, 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
.structure
does not apply to.an owner of property who builds or improves thereon, and who does such work himself 0r
I Through his own employees, provided (hat 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.)
et; as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
I"7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of properly who
11builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Con-
1110ractor's License Law.)
�~ ❑1 am exempt under Sec. . B.8 P.C. (Attach Certificate).
Date Owner
WORKERS' COMPENSATION DECLARATION: I hereby allirm that I have a certificate of consent to sell -insure, Ora
°ll 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
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be com-
pleled 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, 1 shall not employ any person in any manner so as to become subject to the Workers' Compensa-
tion Laws of California.
Dale Applicant
NOTICE TO APPLICANT: If, alter 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 lee[ 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, scaffolding, falsework,
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.).
❑As 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.
❑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 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�fhis permit lot the purpose of making inspections.
�- Signature of Applicant or Agent Date
Print Applicant/Agent Name
„FORM 284208 (11.81) INSPECTOR
REIINSP-ECix0N
TOTAL PERMIT COSI IS
F?ERMIi
$15.00
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE INSPECTOR
BUILDING APPROVALS
MKHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs & Frms
34
Plenums & 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 Detectior Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L.
43
Final
10A
Fireplace T. 0. 0
OP•N
NO.
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Loth
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts)
12B Ceiling (Batts)
12C Ceiling (Blown)
14 1 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