Loading...
17253 (ELEC)'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 r 1_011ER-BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law for the told. reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to con- ' strudt, 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 penally of not more than five hunderd dollars ($500).): :-. -, Q.-1as 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 6l;.Law.does-not apply to an owner of property who builds or improves thereon, and who does such work himself or (herough his own employees. provided that such improvements are not intended or offered for sate. If, however, •"ttie building or improvement is sold within one year of completion, the owner -builder will have the burden of prov- e„ lhgythat he did not build or improve for, the purpose of sale.) F�.❑S. I: as owner at 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 cont(actors) licensed pursuant to the Con- tractor's License Law.) Of am exempt under Sec. . B.B P.C. (Attach Certificate). J Date Owner t WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure, ora certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Lab. C.). [S OCeilified copy is hereby furnished. eCertdied copy is filed with the County Building Inspection Department or County Department. E13;, APPLICANT NAME (L, F, MI) —' j W4 DEN, CORPORATION PERMIT APPLICATION ' CITYICOMMUNITYISTATEIZIP Lo QUINTA CA 922530000 JOB4I Ep DDRESSISPACE A4' 't- 4 AVE VISTA EBONXTA County of Riverside BOK 773 PAG 240 Department of Building and Safety C 9 4080 Lemon SI. 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 Hemel. CA 92343 Perris. CA 92370 Indio. :A 92201 Blythe. CA 92225 Ph: 787.6146 Ph: 849.7312 Ph: 658.4464 • Ph: 657.3898 Ph: 3.2.8271 Ph: 922.2670 This permit becomes void if work not commenced within 180 days from date of issuance. OR, it work has beer suspended or abandoned for a period of 180 days. 1 TRACT NAMEOW! '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 r 1_011ER-BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law for the told. reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to con- ' strudt, 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 penally of not more than five hunderd dollars ($500).): :-. -, Q.-1as 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 6l;.Law.does-not apply to an owner of property who builds or improves thereon, and who does such work himself or (herough his own employees. provided that such improvements are not intended or offered for sate. If, however, •"ttie building or improvement is sold within one year of completion, the owner -builder will have the burden of prov- e„ lhgythat he did not build or improve for, the purpose of sale.) F�.❑S. I: as owner at 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 cont(actors) licensed pursuant to the Con- tractor's License Law.) Of am exempt under Sec. . B.B P.C. (Attach Certificate). J Date Owner t WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure, ora certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Lab. C.). [S OCeilified copy is hereby furnished. eCertdied copy is filed with the County Building Inspection Department or County Department. E13;, APPLICANT NAME (L, F, MI) —' j W4 DEN, CORPORATION F ADDRESS 49?64 ,,AVE VISTA PONITA ' CITYICOMMUNITYISTATEIZIP Lo QUINTA CA 922530000 JOB4I Ep DDRESSISPACE A4' 't- 4 AVE VISTA EBONXTA CrrYI0, W�bI`(T�TEAIZIP 4.A 9222530000- BOK 773 PAG 240 PffR44C Q11 C 9 TWN RNG QQU SE QQ S 014496 0 2! 011 SB CA 1 TRACT NAMEOW! Nth'• ry �q y� App At � i�,F Lr4/RPORA ION PHONEe CONTRACTOR -FIRM NAME LICNC e ADDRESS CITYICOM MUN ITYISTATEIZIP D 'PHONE e - D OR F A AT r ARC/ENG FIRM NAME LICNC ADDRESS j CITYICOMMUNITYISTATEIZIP r PLAN aPLANS EXAMINER APPROVE DATE , .USE OF PERMIT . r1,00 AEP SERV TO LIGHTSBL i 'I '-00 R 2N FSB J SSBQ 00 QS� Q ��qq �y �y V VBf7 �►F®�/y 31�I JI! ZONE ORD II i LOT SZ END +'S E V �1jj CERTIFICATE OF EXEMPTION FROM WORKERS' OMPENSATION INSURANCE: This section need not be conn pleled it the permit is for one hundred ($100) or lecs. I certify that in the performance of the work for which this: permit is issued. 1 shall not employ any person in acy manner so as to become subject to the Workers' Compensa- tion Laws of California. Date Applicant NOTICE TO APPLICANT: IL after making this Certifrale 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: ❑I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will s be made in connection with work authorized by this )ermil, and that no building structure. scaffolding. falsework. or demolition or dismantling thereof. will be more Ih� thirty-six (36) feel high. (Chap. 3.2. Grp 2. Art 2. Sec 341, - Title B. C.A.C.). OAS owner -builder. I will not employ anyone to dr 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. (DDivision of Industrial Safety Permit No. CONSTRUCTION LENDING AGENCY: I hereby affirin that (here is a construction lending agency I* the perfor- mance of the work for which this permit is issued e3ec. 3097. Civ. C.). ' Lender's Name Lender`s.Address CERTIFICIIA E F COMPLIANCE AND AUTHORIZATICV OF ENTRY: I certify I have read this application and state that the in r tion gtve lI Correct. agree to c'ryply with all state laws and county ordinances relating to building co It ction, an aulhortze a epre'Mative;of jhe County of Riverside. Department of Building and Safety to enter u n e prope y for which �ha,✓e appli dPr this permit for the purpose of ma ing inspections. ' Signature of Applicant or Agent If Date Print Applicant/Agent Name 113 0 R 1 a PS DATE iQ Q°17 3 FPJ...2 7/8 �JJ n O3 ^ ELECTRICAL FEE1¢1121 Q Q TOTAL FEE CA CKX N CO TE COUNTER L.U.T. L-ECTRICAL PERMIT TOTAL. PERMIT CAST IS $21.00 ELECTRICAL FEE COMPUTATIONS * Permit Fee (if applicable) FEEL No of Unitst 37 Service Voltst Q FEEt Service AMP% --1 ; 100 Service Amps --21 Q Service Amps -3i 0 FEES INSPECTOR FORM 284.208 (11.81) $3.00 $13.00 $5.09 NO. OPERATION DATE INSPECTOR NO. OPERATION u DATE INSPECTOR , BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 figs 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. 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'Pl-umb 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 A&A 115P9 29B Bonding 30 Fixtures 31 Service 32 Final STREET NAME iKAf ,"7.PW, E I ddW RO # A T I ON 'Wffi�4 AVE VISTA FSE NIT -A pinCor l}IN�YAWAZIP 1."A 92:1253 0'0 Q 0 AVEY7 A iS IY IAVV .ARESSISPACE VXS.TA k�C1NITA � �IndcoA�A MAITFyIZIPCA r"'. ,� BBOKK 77:3 .PAG 'a p PRC Oi 1 C 9©()0 TWN FIND SE 100 S TRACT LOT fl14496 02.121 MOD Q1, SB TRACT NAME �'Q A f', O)9w#'7!✓l.:. �`3 y F WiJ FORA 1 ION PHONEp CONTRACTOR -FIRM NAME .. LICNC # ADDRESS CITY/COMMUNITYISTATEIZIP ' PHONE# - .BLDG. INSPECTOR FINAL DATE ARCIENG FIRM NAME LICNC # ADDRESS - CITYICOMMUNITYISTATEIZIP ' PLAN #PLANS EXAMINER APPROVE DATE USE OF PERMIT Id.Q• Agip. -sERV.,TO,ppr,LXG?�11�gS - �.�{ •. .. ,..,RN. - FSB• id Id10 OS6en �Sq �y 0 % ] '- 'ZONE ORD #, LOT SZ _ END 0 owh SIDE 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 IDA Fireplace T. 0. E] 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 zs 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