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00017440 (PLBG)PERMIT APPLICATION `. County of Riverside Department of Building and Safety 4080 Lemon SI. 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 J 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 date of issuance. OR. it work has beer suspended or abandoned for a period of 180 days. - R;� Q CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be :om- -, LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter (cdmmenc pleled it the permit is for one hundred ($100) or less. I certify that in the performance of the work for whicY this .. Ing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in lull force and effect permit issued. I shall not employ any person in any manner so as to become subject to the Workers' Compl lsa- ` V 50 tion laws of California. WO Date Applicant OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt Irom the Contractor's License Law lot the NOTICE TO APPLICANT: II, after makingthis Certificate of Exemption, you should become subject to the WorPefS" Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be following reason (Sec. 7031.5. Business and Professions Cade: Any city or county which requires a permit to con- deemed revoked. slruct, 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ..,(Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Prolessions Code) or that he is ex- ❑I hereby certify that no excavation live (5) or more feel in depth into which a person is required to descend. will empl therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a per- m it subjects the applicant to a civil penalty of not more than five hunderd dollars ($500).): _ be made in connection with work authorized by this permit, and that no building structure. scaffolding, falsevrork,. ❑ I. • or demolition or dismantling thereof, will be more than thirty-six (36) leer high. (Chap. 3.2, Grp 2. Art 2. Sec .41, Title 8. C.A.C.). . 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 allered for sate (Sec. 7044. Business and Professions Code: The Contractor's License ❑ As owner -builder. I will not employ anyone to do work which would require Irom the Division In 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. that such improvements are not intended for II, however, a permit of - dustrial Safety. as noted above. unless such person has a permit to do such work from the division. 1- provided or offered sale. the building or improvement is sold within one year of completion• the owner -builder will have the burden of prov- ❑ Division of Industrial Safely Permit No. • ing Ihat he did not build or Improve for the purpose df safe.) ;.*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 contraclor(s) licensed pursuant to the Con- tractor's License Law.) 01 am exempt under Sec. B.& P.C. (Attach Certificate). Date Owner 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.). 1:. ❑Certified copy is hereby lurnished. SoCertilied copy is filed with the County Building Inspection Department or County Department. MI) ADDRESS 81610 MWY 111 • CITY/COMMUNITY/STATE/ZIP. IMDIO CA 922010000 �•. JOB SITE ADDRESS/SPACE :1 ,78435 SINGING PALMS "]L cDQUIINTAIP LACA 122530000 '•9 BOK PAG PRC C TWN RNG SE S 617105 022 6 000 00 TRACT LOT MOD SB 002043 100201 011 OWNER NAME (L, �MI) M PHONE p WdAJII.•/hLA'EY4VIM�'t»i:1MBING� COMPANY LI253088 .. ADDRESS p�ryy C Y . O a BOX 665 e 0 pSi CIIITYICOMMUNITYISTATE/ZIP INDIO CA 922010000 HgOgNE # r ^ q 0 c P714-345- BLD SPEC R. FINAL DATE r ARC/ENG FIRM NAME .1 LICNC f1 ADDRESS 1 CITY/COM MUNITY/STATEIZIP V 50 1! _ ZONE ORD p A PLAN p UPLANS EXAMINER APPROVE DATE CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the peelor. 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 sate' that the information given is correct. I agree to comply with all state laws and county ordinances relatin.t to building construction, and authorize a representative of the County of Riverside. Department of Building and Sanely to enter upon the property for which I havve, p ed for this permit for the purpose of making inspections. ('^'.Signature of Applicant Agent j Date ,r �' �— � (� 0017440 pp ' gqPrint Applicant/AgentGme AP p 104/2.11 _ u 26976T 7 PL iit'i91NGn FEE $6+ts0 1 GAS RELOCATE e 0 z o FSB (i S V©Q �l�i II TOTAL 0 V 50 _ ZONE ORD p LOT SZ END SIDE. CA I CI�, NC I COUNTER B.I. I COUNTER L.U.T. , pI AV 1 259 . p� `. (' L. �y(j U Y•/ y� j C, p� y( �p E 8 ch F'6 G i lR M I T TOTAL. PERMIT COST IS PLUMBING; FEE COMPUTATIONS * Permit Fee (if applicable) FEET • 4,00 CRAB .PIPING SYSTEM- 1 To 5 OuTlE tsi1 6 or More OuTletst 0 F"SE.i $2.50 FORM 284.208(11-81) INSPECTOR NO. OPERATION DATE INSPECTOR r NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Ftgs 8 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 Detection Device 9 Garage Fire Wall 42 Commercial Hood 10 Fireplace P. L. 43 Final IDA Fireplace T. 0. No ADDITIONAL INFORMATION SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Loth 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 Disposgl 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 29B Bonding 30 Fixtures 31 Service 32 Final STREET NAME DEPARTMENT OF BUILDING AND SAFETY . COUNTY OF RIVERSIDE OFFICE DATE= TIME, r. _� PERMIT NUMBER 1 �-- INSPECTION REQUESTED ADDRESS I SPACE NO. FOR: o - y�S OWNER BUILDING PLUMBING REMARKS: OWNER/CONTRACTOR TEL.NO I A.k. COMMUNITY - a P.AU ELECTRICAL MECHANICAt a Iq'OT1 aTUE: aWED Q THUre FRI 284-" 11/7: 'APPLICANT NAME (L, F, MI) klAl I FY'.2,141KATHP.r0 ADDRESS ' 01610 ° 4wy 1.11 CITYICOMMUNITYISTATEIZIP INDIO CA 922010'000 r JOB SITE ADDRESSISPACE - > C3�b SINGINGN. PALMS, 8 :CITYICOMMUNITYISTATEIZIP ;1 C3iirNTA GA 922530000 'BOKPAG bi! 1Ei, PRC ape C b - N TW11000 RINGSE loo ,S TRACT LOT 820204.3 OO�a MOD 011 SB ' TRACT NAME -. {'Y'{.�U-{�'MI)9'► PHONEp.,. CONTRA VAL � RM 096. UMS•.9r l�Gl9. ie i"lf-f"1NY ApyDDREESSS--• BOX665 CITYICOMMUNITYISTATE/ZIP � CA •922010000 9of W -3,W ,.w ta.1 SLI BLDG. INSPECTOR FINAL DATE , slt ARC/ENG FIRM NAME LICNC p y; ''ADDRESS CITY/COMMUNITYISTATEIZIP .PLAN p PLANS EXAMINER APPROVE DATE USE OF PER$iMIT GAS EL6:iCAYE Y d BL ZON FSB SSB SSB RSB' O.0 00 Rz- l 00p Una 000. D hZONE ORD p - x - LOT S2 I END SIDE x000 APPL/PRMT p 00017�84o PS IAP DATE i� �' �a�ao29/92 (Jd 697 t TOTAL . FEE CA CKNC COUNTER B.I. COUNTER L.U.T. ' 1 269AP S G nt7N FOR -'PLUMBING PERMIT NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Figs & 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 M Smoke Detection Device 9 Garage Fire Wall 42 Commercial Hood 10 Fireplace P. L. 43 Final IDA Fireplace T. 0. 0 P' 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 ¢lsposal 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