00022862 GradingERMIT APPLICATION""
County of Riverside
Department of Building and Safety
4080 Lemon SL 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 Hemel. CA 92343 Perris. CA 92370 Intro. CA 92201 Blythe. CA 92225
Ph: 787.6146 Ph: 8497312 Ph 658-4464 Ph 657.3898 Ph. 342.8271 Ph922.2670
This permit becomes void it work riot commenced within 180 days from date of issuance. OR. if work has beer suspended or abandoned for a period of 180 days
cCERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be com-
_ LOICENSED CONTRACTORS DECLARATION: I hereby alfirm That I am licensed under provisions of Chapter 9 (commenc- pleted if 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) of Division 3 0l 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 Calilornia.
�-O
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 lot such
permit to life 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 -
mil subjects the applicant to a civil penalty 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 sate (Sec. 7044, Business and Professions Code: The Contractor's License
Law does not apply to an owner of properly 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 lot the purpose of sale.)
``❑I, as owner of the property, am exclusively contracting with licensed contractors 10 construct the project (Sec.
7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of properly who
guilds 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 & P.C. (Attach Certificate).
Date Owner
WORKERS' COMPENSATION DECLARATION: I hereby allirm that I have a certificate of consent to self -insure, or a
certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800. Lab. C.).
❑Cerlified copy is hereby furnished.
❑Certified copy is filed with the County Building Inspection Department or County Department.
NII'�.�"`�rNdT, DEV CG
#012770 AVE DIAZ
ETY(cO WrATMAZIP
CA 922530000
ITUI R£"RESSISPACE AVE DIAZ
Y1S7[.T61ZIP CA 9225310000
1:°OiUfilk}iV
7113
311219i
13
S
TM VN
W50
VU
S
W0000 U16
I
V11
Is'
CA
7
AAmL A�Q� #
OL K —17CO
Q=TpVr �,.
L1
i'iYL•.1-1 EDCMSER 1 , DEV CO
PHONE#
CONTRACTOR -FIRM NAME
LICNC If
ADDRESS
CITYICOM MUN ITYISTATEIZIP
PHONE #
BLDG. INSPECTOR
FINAL DATE
ARCIENG FIRM NAME
LICNC If
ADDRESS
CITYICOMMUN ITYISTATEIZIP
PANM
PLANS EXAMINERU
// G
APPROVE DATE
=997G
lb0
RZYN 07D
0%&3
OW3
0RfE0
JFf1D
ZONE ORD If
LOT SZ
0 SNL 0
011.0
uate _.__ ----Applicant
NOTICE TO APPLICANT: If, alter makingthis Certilicate 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 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 That no buildingstructure. scallofding, 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.).
❑A5 owner -builder, I will not employ anyone Io do work which would require a permit from the Division of In-
dustrial Safely. 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 allum that [here 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 t0 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 Safely
to enter upon. Ih `properly for whichII have applied for this permit for the purpose of making inspections.
;Sianatu of Applicant or Agent Date
. Print ADDllcant/Aaent Name
11ri MtM.F.28til C% VG7/0LD V2
GRADING PLAN REVIEW IWILE
TOTAL
r FEE
7►
rA
Ir
CA
CI(X
NC
I COUNTER B.I. /
/
COUNTER L.U.T.
PERMIT FOR GRADING PLAN REVIEW
TOTAL PERMIT COST IS $15400
0 of Lotss 0 CU YDS --Cut i
Grading Plan Reruicw Feer (based
t..
i
t
Y w
FORM 284208 (11.81)
0 Fills 190 Total Moveds 190
on cubic_ yds Cut and Filled) ist $15.00
NU.'
S' 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. 0
43
Final
IDA
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 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
PERMIT APPLICATION
County of Riverside
Department of Building and Safety
>n40$1 IMiM. 2nd Floor 135 N Alessandro Rd A. 203 880 N State Street 227 North "0" Street 46.209 Oasis St Rm 310 160 N Broadway
Riverside. 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 9
This permit becomes void d work not commenced within 180 days from date of issuance. OR, it work has beer suspended or abandoned for a period of 180 days
n
LICENSED CONTRACTORS DECLARATION: I hereby altirm 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 penalty of not more than five 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
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.II, 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 far such projects with a contraclor(s) licensed pursuant to the Con-
tractor's License Law.)
❑I am exempt under Sec. _ -T ^ __ _ 8 & P.C. (Attach Certificate).
Date_ __Owner_
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a cerlificale 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.
❑Certified copy is filed with the County Building Inspection Department or County __Department.
APPLICANT NAME (L, F. MI)
PALM DESERT, DEV CO
ADDRESS
52970 AVE DZAZ
CITYICOMMUN ITYISTATEIZIP
LA QUINTA CA 922530000
JOBL, I9V0 AESSISPA" AVE DZAZ
.CRY/COM
MU N I7Y/STAT E/ZI P
LA QUINTA CA 922531000
BOK
773
I PAG
312
PRC
011
C
3
TWN
0000
RNG
SE
00
S
00!1000 0016
1
1 60T
SB
TRACT NAME
SCN�F�VyN�LAAI gry*17y, BL�Kw17�r0�-
MAV_ "/♦/ ERT, DEV CO 1PHONE#
CONTRACTOR -FIRM NAME
LICNC #
ADDRESS
CITYICOM M U N ITY ISTATEIZ I P
PHONE N
BLDG. INSPECTOR
FINAL DATE
ARCIENG FIRM NAME
LICNC #
ADDRESS
CITYICOMMUN ITYISTATEIZIP
PLAN #
PLANS EXAMINER
APPROVE DATE
USE OF
•//
�� �gV/�(g�Z
1! BL
V R i0N
022
1 b
n/ (IgyIl
0 t ti JIM
Ti
7prkG7
iF"�
ZONE ORO N
LO7 SZ
0 dgu
n 1 sn
IN
T H 15
ASSESSOR
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 cattily that in the performance of the work lot which This
permit is issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensi
tion Laws of California.
Date - -- ------ - - - - --- - — - Applicant ---
NOTICE TO APPLICANT: If, after makingthis 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 feet in depth into which a person is required to descend. will
be made in connection with work authorized by this permit, and Thal no buildingstructure, 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.).
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- 1 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 slate 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 lot this permit for the purpose of making inspections.
X
Signature of Applicant or Agent Date
Print Applicant/Agent Name
oii'bRTifma _J7208/01- l2 39833
TOTAL .
FEE
CA CK NC COUNTER B.I. COUNTER L.U.T.
APPLICATION FOR GRADING PLAN REVIEW
I S A N A P P L I C A T Z C N
O N L Y
APPLICANT NAME (L, F, MI)
PALM DESERT, DEV CO
52970 AVE DIA;
C4COWafa! EZIP CA 922530000
fflS odRESSISPP�APE AVE 'DIAZp
�y �y y. }�
cAOuil�TaTrAZIP CA 7262530000
` YP9RC
BOYYK''//
77-31312
PAG
011
C
3
TWN
RNGSE
00 (1
oo
S
TRACT ILOT
CT
47{y1�y�Y�A�p{MLM'Yfii�g4*'�'�17 � BL i�+— i�I
CO
PAT- IMEDLI RTO DEV O
PHONE#
CONTRACTOR -FIRM NAME
LICNC #
ADDRESS
CITYICOMMUNITYISTATEIZIP ,.
PHONE#
BLDG. INSPECTOR
FINAL DATE
ARCIENG FIRM NAME
LICNC #
ADDRESS
CITY ICOM MU N ITY ISTATEIZIP
PLAN #
PLANS EXAMINER
APPROVE DATE
USE OF PERMIT "
GRADING
BL
V
RJ{ N
®
��yy �9�gY'
B0 0 li
ZONE ORD#
LOT SZ
I
lo 05^
l ID„
00
APPLICATION FOR, GRADING tgER@IfIT
T, N. I S I S- A N A P P L I C A T 1 0 N G N L Y
F6RM284.208(11.81) INSPECTOR
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 1
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.
P'
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
PSL
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
r,
lki
IIW,
Im
APPLICANT NAME (L, F, MI)
PALM KSERT, DEV CO
ADDRESS
52970 AVE DIAZ
CITYICOM MUN ITYISTATEIZIP
LA QUIN*rA CA 922530000
JOB SITE ADDRESSISPACE
5123970 AVE DIAZ
CITYICOMMUNITYISTATEIZIP
LA QUINT A CA 9225 30 000
rBOK ••yy
li7 Sa
PAGy
titA2
P�tRC a
V•1 A
•C
�:7
TWN
RNtGe ft
000
SE1�
00
S
TRACT LOTMOD
000000 0016
tl33
SB
TRACT NAME
SCCVypqq��LAhQ•M�01,f"Sly, FsyLK-170
�
r"W�NI'1MEU�IER 7•, DEV CC
PHONE#
CONTRACTOR -FIRM NAME
LICNC #
ADDRESS
4
'CITY/COMMUNITY/STATE/ZIP
PHONE#
SLOG. INSPECTOR
FINAL DATE
'ARCIENG FIRM NAME
LICNC #
ADDRESS
CITYICO M M U N ITYISTATEIZI P
PLAN #PLANS
EXAMINER
APPROVE DATE
GRADING l %d c
BL
0 '1J
OZ
OF;0
J
OO�
'1
UU�'.J
9RiB(!�}iq
ZONE ORD #
LOT SZ
0 6 D 0
APPLICATION FOR GRADING PLAN REVIEW
THIS x S. AN A P P L I C A T 1 0 N QNLY
I
i 4
i,
INSPECTOR
FoaM zea zoalit s,i
It
NO.
OPERATION DATE
INSPECTOR
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. C:]
43
Final
IDA
Fireplace T.O. 0
P'
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