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00019666 (PLBG)County of Riverside Department o1 Building and Safely 4080 Lemon SI. zed Floor 135 N. Alessandro Rd. Am. 203 880 N. Slate Street 227 North -0- Street 46.209 Oasis St. Ran. 310 160 N Broadway Riverside, CA 92501 Banning, CA 92220 Hemet, CA 92343 ht 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 becdmee void it work not commenced within 180 days from date of issuance. OR. if work has beer suspended or abandoned for a period of 180 days D _ICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commenc- ng with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full force and effect. 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, 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 - 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 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. If, however. 111 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 ❑I, as owner of the properly, 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 properly who 1 builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Con- tractor's License Law.) [:)I am exempt under Sec. . B.B P.C. (Attach Certificate). WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure, or a f certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Lab. C.). EE` ❑Certified copy is hereby furnished. 1: ' ❑Certified copy is liled with the County Building Inspection Department or County Department. APPLICANT NAME (L, F. MI) ORA T SINTIAGO ADDRES52163 AVE HERRE±RA CITY ICOM MU N ITY ISTATEIZIP LA QUINTA CA 922530000 JOB SITE ADDRESS/SPACE 52963 AVE HERRERA C`ITY/IICOMPMUNIITTYIIS+T�A+TEIZIP p ,�y� �jy�`y {� {� �} LA TSI,UIN I A {. A 922530 V 0 a BOK 793 PAG 223 PRG 0XS C �; TWIN PING 000 SE as S TRACT LOT aaoaao oao7 TOTAL FEE MOD o99 SB CKv TRACT NAME SCAT VALELAO UNIT 10 BL.K 76 OWNER NAMEM1 WA�}SiNg7AGO PHONEN CONTRACTOR -FIRM NAME LICNC N ADDRESS CITYICOMMUN ITYISTATEIZIP PHONE N .BLDG. I P CTOR F AL DAT ARCIENG FIRM NAME LICNC N ADDRESS CITYICOM M U N ITV ISTATEIZI P PLAN PLANS EXAMINER APPROVE DATE USE OF PERMIT ADD GAS PIPING TO DUL9 BLZON 00 RZwi FSB SSB oao SSB 000 RSB 400 OFC Nm ZONEORDN LOT SZ END .SIDE 4444 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 perlormance 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 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 feet 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. fatsework. 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. ). OAS 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 building construction, and authorize a representative of the County of Riverside. Department of Building and Safety to enter upon the properly for which I h��have applied for this permit lot the purpose of making inspections. X I�� r /. +1t . /, " /� ! Signature of Applicant or Agen(�—� s(�y; ,�•.c� Date Print Applicant/Agent Name APPLIPRMT N ta�b PX ab/a'�/82 2732800019 ADD GAS PIPING 1*0 DW $6.50 TOTAL FEE �6 a CA CKv NC COUNTER B.I. COUNTER L.U.T. Vy rP E R M I T FOR ADD GAS PIPING TO DW TOTAL PERMIT COST IS ADD GAS PIPING TO DW FORM 284.208(11.81) INSPECTOR $6.50 $6.50 NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS I 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. 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 (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 23 Water Service 24 Gas Test r 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 1,S 4(PLICCAANN((T+�NACME )L, F W) f l A t 0 ADDRESS 52163 - AVE HERRERA 1 CITY/COMMUNITYISTATEIZIP ILA QUINTA CA 922530000 JOB SITE ADDRESSISPACE 52163 AVE HERRERA CITYICOMMUNITYISTATEIZIP LA QUINTA CA 922530000 BOK 773 PAG ? 3 PRC 01W C 5 TWN RNG 005 SE ail S TRACT LOT 000000 .0o07 MOD O11 SB TRACT NAME S�Ny,F//pp��qq'f(1�y VAk_(E L.6}�•tp�AlpJpPilI T 10 DL K 76 MWgE'1'7p g�MI)�.'7 N 1 dYY 9d{J PHONE# CONTRACTOR -FORM NAME LICNC # ADDRESS CITY/COMMUNITY/STATEIZIP PHONE # BLDG. INSPECTOR FINAL DATE ARCIENG FIRM NAME LICNC # ADDRESS CITYICOMMUNITYISTATE/ZIP ' PLAN # PIANS EXAMINER APPROVE DATE USE OF PERMIT ADD GAS PIPING TO DWL G BL 00P " RZ'^ 3 FSB oWb olo oWb i D ZONEORD# LOT SSZ.' END n nSI EE APPLIPRMT #ATE 0001'��.�6Ca daPS x 106/070/8,14 . 27327 i TOTAL FEE . so:.a a CA , CK NC I COUNTER B.I. COUNTER L.U.T. /+/ f 1 273271 APPLICATION FOR ADD tarts PIPING TO ACJ '•THIS IS AN APPL.ICAT 1 0 N tr NL.Y a t. ; FOAM 280-208 (11.81) INSPECTOR u NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS I Set Back 33 Ventilation System t 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 Garage Fire Wall 42 Commercial Hood 10 Fireplace P. L. 43 Final IDA Fireplace T. 0. NO. ADDITIONAL INFORMATION r ' SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath 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 23 Water Service 24 Gas Test 25 Final Tank Pit L.Line REAR OF PROPERTY LINE ELECTRICAL APPROVALS PSL P/ 26 Power Pole 27 Conduit•.: ". 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final STREET NAME