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1,011106
€ inview.
EST11 , idOT9i -Hat 14 .'tae `vae.d .S Prapeyy, 441111.
i' ^-K:•,;r County'of
Riverside
Department of
Building and Safety
4080 Lemon St. 2nd Floor + 135 N. Alessandro Rd. Am. 203 880 N.Slate Street
227 North "D" Street 46209 Oasis St.Am. 310' ` 160 N. Broadway {
- Riverside, CA 92501 - Banning, CA 92220' Hemet, CA 92343.
-
Perris. CA 92370 Indio. CA 92201 Blythe, CA 92225 f
Ph: 187$146 Ph: 86,7312 , Ph: 6564464 t
Ph: 657-3898 Ph: 342-8271 Ph: 922.2670 1 `
!,
This permit becomes void it work not commenced within 180 days from date of issuance. OR, if work has been suspended or abandoned for a period of 180 days.
LICENSED CONTRACTORS DECLARATION: .I hereby affirm that I am licensed under provisions of Chapter 9 (commencing
` t CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed if the
with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.
permit is for one hundred (S1D0) or less.' I certify that in the performance of the work for which this permit is issued. I
-
•` x
shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California.
License Class. Lic. Number
-
-. - -;�"; •;
Date Applicant • •'
. .
Date Contractor of
NOTICE TO APPLICANT: If, after making this Certificate of Exemption. you should become subject to the Workers' i
OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law for the following
Compensatiisif the Labor Codmust fortcomply mply with such provisions or this permit shall be '
on provisions oe, you t
reason (Sec. 7031.5. Business and Professions Cade: Any city or county which requires a permit to construct. alter,
• deemed revoked. ;
improve• demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing
[-] I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be 1
with Section 7000) of Division 3 o1 the Business and Professions Cade) or that he is exempt therefrom and the basis for
for subjects the to
made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or
demolition dismantling thereof, be more than thirty-six (36) feet high. (Chap 3.2. Grp 2. Art 2, Sec 341, Title 8.
• the alleged exemption. Any violation of Section 7031.5 by any applicant a permit applicant a civil
Penalty of not more than five hundred dollars (5500).):
or will
C.A.C.) + 'I
I, as owner of the properly,. or my employees with wages as their sole compensation, will do the work, and the
IS�-I� As owner -builder. I will not employ anyone to do work which would require a permit from the Division of Industrial
�aiely as noted above, unless such person has a Dermic to do such work from that division.
r1,uccture is not intended. or offered for sale (Sec. 7044. Business and Professions Code: The Contractor's License Law
do not apply to an owner of property who builds or improves thereon, and who does such work himself or through
I
E] Division of Industrial Safety Permit No. '
! his own employees, provided that such improvements are not intended or offered for sale. It. however, the building or
Date " .Applicant
improvement is sold within one year of completion, the owner -builder will have the burden of proving that he did not
-
(,'build
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of j
or improve for the purpose of sale.):
v- ... .. __
the work for which this permit is issued (Sec. 3097, Civ. C.). j
❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec7044,
li
Lender's Name.
`•Business and Professions Code:. The Contractor's License Law does not apply to an owner of property who builds or,
-i
,improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors
Lender's Address .
License Law)
`
I certify that I have read this application and state that the above information is correct. I agree to comply with all
I am exempt under Sec •' - +'- +^"' �B.tB P.C. (Attach Certificate),
-
city and county ordinances and state laws relating to building construction, and hereby authorize representatives of
j
]
Date-. 1 '.r Owner!,�'\•� t'. .r'"kr i ! - .,n�'. • .;''
this county to enter upon the above-mentioned property for inspection purposes.
h f r ,. �_ve-a .^.1. .+.'"'.i %. , ..
-a
_
ature of Applicant or Agent Date
/ Signature
1. WOHNERS' COMPENS DECLARATION: I hereby'aflirm that I have a cerbhcate of consent to sell -Insure. or
'''certificate of Workers !Compensation Insurance, or a certified copy thereof (Sec. 3800. Lab. C.). •
g .
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state that the
•: 1 �! -
informatio�l-given is correct. 1 agree to comply,with all state laws and county ordinances relating to building con -
"uthorize
Poky No. y - Company
strucli0o; and a representative of the ounly of Riverside, Department of Building and Safety to enter upon
{ ! -
hQ}Certified copy"is hereby turnished.i
the p(operly f r which l'h3 pplied fo a is rmit for the purpose of making inspections.
•� r
\
Certified copy is filed wilh'the County Building Inspection Department or County Department.
_
,,../ Siga� re of App icon r All 1
Applicant
t 'u Prim AOpibrWAgedr Nardi ,! f•l - i
APPLICANT NAME (L F MI)
APPIJPRMT f!��� PS DATE 0.1110:6.
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CITY/COMMUNITY/STATE/ZIP-
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^ TRACT NAME • • ' ' - V
OWNER NAME (I., �FF. MI)
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CONTRACTOR -FIRM NAME
ADDRESS
C i n'!COMM UN I TY/STATE/ZI P
PHONE 4
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ARC/ENG FIRM NAME (-
ADDRESS ,
CITY/COMMUNITY/STATE/ZIP '
PHONE q
LICNC 1
USE OF PERMIT
TO ULA,
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FORM 284-208 (2/81{ 1 -
+ Jr 1 1
.,, n�
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
39
Appl. Clearance
7
Framing
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
Gaioge Fire Wall
42
Commercial Hood
10
Fireplace P. L.
43
Final
10A
Fireplace T.O.
[f
OFN
- - -
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall -- — —
*13- Finish Grade—
rade
INSULATION
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
ELECTRICAL APPROVALS
P/L
,
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
APPLICANT. NAME (L, F, MI) -
,qIS 1
�
p
CITY/COMMUNITY/STATE/ZIP
QUXN k A
JOB SITE 'ADDRESS/SPACE
46735 AASy ANCON,
CITY/COMMUy!NYYITY/yuS�TATE/ZIP
BOK
161
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TRACT NAME-' -
OWNER NAME (L, F M1). R
ESMON
CONTRACTOR -FIRM NAME • -
ADDRESS j''• S
CITY/COMMUNITY/STATE/ZIP
PHONE p
LICNC #
'
ARC/ENG FIRM NAME
ADDRESS
CITY/COMMUNITY/STATE/ZIP
PHONE p
LICNC N
USE OF PERMIT
ADD FAMILY ROOM T8 DWL G
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FORM.284-208 (2/81)
SJ •. wr. .-. ._ .__ i;, i.+ -, � ....: - ,.+.
.,i�:...-_. . --.<. .... :± _ ....,..6 ..... .U. ._. ,...•.. i.F.,•_...t .. E
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_.. - ..._.. ,n_ .. .E
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Figs 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
10A
Fireplace T. o.
Ej
°o
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 (Botts)
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
-^s
23 Water Service
24 Gas Test
25 Final
•
Tank Pit L. line
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
P/L
'
P/
26 Power Pole
27 Conduit `
28 Service Entrance
29 Wiring
2 9 A Grounding Wire
29B Bonding
30 Fixtures '
31 Service
32 Final
STREET NAME
;APPLICANT. NAME, (L. F, MI)
5 0Kik ;--1,e....%. ✓. �. a,.:" .. w..,. t ..-n w .r-r--
ADDRE S 7_ "" -•
CITYY/STATEA/ZIP r _ �n+/1, �•�{ +�±��g
+`NtIT
,/{�,OMMU
,pIC
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JOB'SITE ADDRESS/SPACE 'l,p r •'
CITY/COMMUNITY/STATE/ZIP �!-+•+� - ....
CA 901253004d' .
BOOK • 'PAG PRC
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CHESS -Mr, It
CONTRACTOR -FIRM NAME -
ADDRESS
CITY/COMMUNITY/STATE/ZIP
PHONE #
LICNC N
'
ARC/ENG FIRM NAME
t
ADDRESS
t
CITY/COMMUNITY/STATE/ZIP
• PHONE # - _
(
LICNC
`'USE OFgxPPERM�hT�,y.,,, ..ry p� pA�y�q �• 'p y p► r "
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APPi,.xGAi:ON ��"O 31'NLi�iPl�iRA PLA-! RAW' i616
TOTAL' i
FEE '
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INSPECTOR'S COPY
'I
.�.�._.�.�.,:-•_--
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a
,
FORM 284-208 (2/81)
.�. __- .. t_. --`- —
v
�- .. ... ��^ .�., _ ... w ,..1 _ a,. .,:': ..: t: .....4t 0.n..., .. .... s'•_. _
. ... s: ... ✓t ... i
i ....— .�. �...... ., x• . ... ...... ...
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.
43
Final
IDA
Fireplace T. 0.
°oN
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick "RIS
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 Woter.Softener
23 'Water Service '
24 Gas Test
25 Final
Tank
Pit L. Line
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
P/L
P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
. "4 v
APPLICANT NAME (L. F. MI)
armawaffit 0 it
ADDRESS
WASHI-NOTON
CITY/COMMUNITY/STATE/ZIP
LA .1113INTA CA "U.514000
JOB SITE ADDRESS/SPACE
46735 WASHINGTON
CITY/COMMUNITY/STATE/ZIP
LA QUINTA CA 922t3QQ0Q
BOK
*PAG
0641
PRC C�
0
TWN
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Do
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0
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TRACT
0 0211
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TRACT NAME
OWNER NA.F. g
MESSk�G R PON
CONTRACTOR -FIRM NAME
ADDRESS
CITN'!COMMUNITY/STATE/ZIP
PHONE#
LICNC #
ARC/ENG FIRM NAME
ADDRESS
CITY/COMMUNITY/ST ATF/ZIP
PHONE #
10%RMXT
LICNC #
-7
USE OF PERMIT
ADD FAMILY ROOM TO OWLG
BL
DO
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I
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e
0,
SSB
00
SSB
01
RSB
1 01
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1
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ZONE ORD #
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END
SIDE
APPUPRMT # Ps•
0 0191 INS 4 ri I P � i i )i; * 1141
CONSTRUCTION -059
0.11108
$06.150
smi FEE
STRUCIWAL. 4 )WILDINC
10%RMXT
TOTAL I FEE
-7
73.s 1011108 1
�.4 5 T A U C T U R A L ( BUILDING P E -It M I T
TIDTAL PERMIT COST I'S $96.23
CONSTRUCTM MOTIMATE, (NOT11rt Not to be used as proporiv v4RIUation)
0 .. #-'rlipti n 0.46 group T.30 6y Fl Role valuatlon
PRIMARY D:..La to 0 1 R-3 V�"' ISO- $247,60 6104ft
`C0W61PvCtt(YA Foe based on Total, ACTUal Valuation of *10488 ist $6640
VL9'C'T-R1CAL FU COMPUTA71ONS * * of Permt.-ts: I at $3.00 Each ME - $3. 00
KWT Unilzt 0 Amp/Volt 9rvC1 0 of Amp/V0111 0 FEE; $6.50
wmi nak $6 '13
ti.
FORM 284-208(2/81)
NO.
OPERATION
DATE
INSPECTOR
- NJ.
^ ✓ OPERATION _
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS I
1
Sat Back
'ltGd J
33
Ventilation System
2
Ftgs & Frms'
34
Plenums 8 Ducts Z.
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
B
Vents
41
Smoke Detection Device
9
Gatoge Fire Wall
42
Commercial Hood
10
Fireplace e P. L.
43
Final
10A
Fireplace T. 0.
°o ADDITIONAL INFORMATION -
----- - -•--------------_� -- r-�---------_=—'
-
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath—
12 Internal Lath
12A Drywoll
•1'3 Finish Grade
INSULATION
Thick „RIS
Value
7A Walls (Batts)
128 Ceiling (Batts)
12C Ceiling (Blown)
14 Final
__--r.,-..,,.y_..--- 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
P/L
-
i
-
P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring 2
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final.
STREET NAME