00018120 (PLBG)"'�— ' �1 RMIT APPLICATION
County of Riverside
Department of Building and Safety
4080 Lemon St. 2nd Floor 135 N. Alessandro Rd. Rm. 203 880 N. State Street 227 North "D" Street 46.209 Oasis St. 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: 6584464 Ph: 657.3898 Ph: 342.8271 Ph922.2670
This permit becomes void it work not commenced within 180 days Irom date of issuance. OR. it work has beer suspended or abandoned for a period of 180 days.
r ❑
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.
O
L'*OWNEA-BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law lot the
1111 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
yrI(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 -
Tit subjects the applicant to a civil penally 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 ollered 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. It, 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 properly who
builds or improves thereon, and who Contracts for such projects with a contractors) licensed pursuant to the Con-
tractor's License Law.)
❑I am exempt under Sec. . B.B P.C. (Attach Certificate).
Date Owner
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure. or a
certilicale of Workers' Compensation Insurance. or a certified copy thereof (Sec. 3800. Lab. C.).
❑Certified copy is hereby furnished.
t ❑Certified copy is filed with the County Building Inspection Department or County Department.
APPLICANT NAME (L, F, MI)
CITYICOMMUN ITY/STATEIZIP
LA QUINTA CA 922530000
JOB SITE ADDRESS/SPACE
T 52821 EISENHOWER Det
CITY/COM MUNITYISTATE/ZIP
LA'QUINTA CA 922530000
BOK PAG I PRC C TWIN RING SE S
77 326 016 1 0000 010 0 0
TRACT LOT MOD SB
000000 0004 011
TRACT NAME
SCV LAD 016BLK-161
OWNER NAME (L,F,MI) PHONE #
GARCIA , PETCR 3R
CONTRACTOR -FIRM NAME LICNC N
ADDRESS
CITY/COM MUN ITY/STATEIZIP
OAT
IlI PHONEX - ��FjrT10IFI
ARC/ENG FIRM NAME w/%� LICNC #
:7Tr ADDRESS
.CITY/COMMUNITY/STATE/ZIP
Y
PLAN # PLANS EXAMINER APPROVE DATE
�l
USE OF PERMIT
D GAS LINE TO DWLG
r BL ZON FSB SSB SSB RSB OFC
00 R1 000
000! 0001 ND,
ZONE ORD# LOT SZ END SIDE
0000
T ( r
-W
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be com-
pleted it the permit is for one hundred ($100) or less. 1 certify 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' Compensa-
tion Laws of California.
Date Applicant
NOTICE TO APPLICANT: It. after 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, 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.).
0 A owner -builder. I will not employ anyone to do work which would require a permit from the Division of In-
dustrial Salely. 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 slate 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 the properly for which I have applied for this permit for the purpose of making inspections.
Signature of Applicant or Agent Date
P L U M B I N G ■" E R M i T
TOTAL PERMIT COST IS O6o50
PLUMBING FEE COMPUTATIONS * Permit Fee (if ap glicable) FEE: $4.00
GAS PIPING SYSTEM— 1 to 5 Outlets i l b or ore Outlets t 0 F'EE 3 $2.50
FORM 284.208 (11.81) INSPECT -OR
t
ME
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
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.O.
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
25
Gas Test
Final � � i
Tank Pit L.LiM` 4.e
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
APPLICANT NAME (L, F, MI)
k
ADDRESS
52821 EISENHOWER DR
CITYICOM MUNITYISTATEIZI P
LA QUINTA CA 922530000
JOB SITE ADDRESS/SPACE
52521 EISENHOWER DR.
CITYICOMMUNITY/STATE/ZIP
LA QUTNTA CA 922 530000
BOK
C
q
TWN
RNG
ONI/7GA
SEO
Q
S
TRACT
000000 N0004
D
M0011S
B
TRACT NAME q �/
SCV LAD 4,16 RLK-1.61
OWNER NAME (L,,F,MI) ypJq�R
EiER
WR0IA PETER
PHONE #
CONTRACTOR -FIRM NAME
LICNC #
ADDRESS
CITY/COM M U N ITY/STATE /ZIP
PHONE #
BLDG. INSPECTOR
FINAL DATE
ARCIENG FIRM NAME
LICNC #
ADDRESS
'CITY/COMMUNITY/STATE/ZIP
PLAN #
i
PLANS EXAMINER
APPROVE DATE
USE OF PERMIT
r.AS LlN� '0 AWLQ
BLZON
00
Rl
FSR SSB
000
SSB
000
RSB
000
OFC
ZONE ORD #
LOT SZ
END
SIDE
0000
APPLIPRMT #
000 18120
PS DATE /�
5/11/02 W( J,(
TOTAL .
FEE
CA
CK
NC
COUNTER B.I.
COUNTER L.U.T.
od-
347
' - APPLICATION FOR PLUMBING PERMIT
THIS x S AN A.PPL.X CAT x ON ONLY
T
Y
FORM 28d 208(1181) INSPECTOR
ti- i I t14
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
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L.
43
Final
10A
Fireplace T. 0.
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