00019896 (PC)APPLICANT NAME (L, F, MI)
ADDRESS
P 0 BOX 164
CITYICOM MUNITY/STATEIZIP
PALM DESERT CA 922600000
7$p3SARESSISPACE A` V`E • 50
CIITYICOMMUNITYISTATEIZIP
LA QUINTA CA 9225,150000
BOK
631
PAG
390
PRC
009
C
i
TWN
0053
RNG
06E
SE
36
S
0
TRACT LOT
000000 0000
MOD
Oit
SB
TRACT NAME
POR S1/2 ,rmli4
ONAME
WNER COUNTRY CLUD
LA
PHONEp
CHARLES N AME F WHXTE
LI��0368
ADDRESS
BOX 164
CITY/COMMUN ITYISTATEIZI P
PALM DESERT CA 922608000
PHONE N
714-346-6002
BLDG. INSPECTOR
FINAL DATE
ARCIENG FIRM NAME
LICNC N
ADDRESS
CITY/COMMUNITY/STATE/ZIP
PLAN#
PLANS EXAMINER
APPROVE DATE
USE OF PERMIT
ENC/EXI8 PATIO 6�jADD BEAM
EIL
001
'f W
RZNOI
FSB
Oou
ORR
]
OOQ
ZONE ORD N
LOOT SZ
END
0 O l Dn
APPL/PRMT p PS DATE A /'�
Otl(119896 AB 06/10/8 4 2 7 4 2
TOTAL .
FEE
[CA CK NC I COUNTER B.I. COUNTER L.U.T.
15
16
17
18
19
20
Ground Plumb `
Water Piping
Rough Plumb
Vents
Sewage Disposal
Sewer
21
Water Heater
22
Water Softener
23 •,
Water Service
r 24
Gas Test
25
Final
ELECTRICAL APPROVALS
26 '
Power Pole
27
Conduit ..
28
Service Entrance
29
Wiring
• . 29A '.
Groi Wiling_ ire..
t. �29B
Bonding tr
30;
Fixtures
31
Service
32
Final '
SEWAGE SYSTEM SIZE & LOCATION
Tank Pit L.Line
REAR OF PROPERTY LINE
P/L P/L
STREET NAME
APPLICATION FOR STRUCTURAL PERMIT
r H x 6 1 S A By A P P L I C: A T T q N
0 N L Y
9lBM284-208(11•81) INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2,
Ft6s 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.O.
OP'N ADDITIONAL INFORMATION
NO.
1
11
Exterior Lath
12
Internal lath
12A
Drywall
13.
Finish Grade,
INSULATION
Thick
Value
7A
Walls (Batts)
In
Ceiling (Batts)
12C
Ceiling (Blown)
14
Final
PLUMBING APPROVALS
c..+- it e ,. 4... ....•r,_ 2 w. � j..— #..: ,.. .... . renmrr; nrruonrwn _ . - _ .. _ .: _ ;: , - ,. ,,:. r
i s County of RiOrside
Dep
* arrt ment of Building and Safety
4080 lemon St. 2nd Floor 135 N. Alessandro Rd. Rm. 203 890 N. State Street rs 227 North "D" Street - 4fr209 Oasis St. Rm. 310 160 N. Broadway
... Riverside. CA 92501 Banning, CA92220 Hemet; CA 92343',;3,, Perr4S: CA 92370- Indio, CA 92201- ' Blythe, CA 92225 a
ray Ph: 787-6146 • Ph: 849-7312 .r _ Ph: 658-4464 , `; !,. Ph-� 657.3898 - Ph: 342-8271 - Ph 922.2670 '
This permit becomes void if work not commenced within 180 days from date of issuance OR if work hasibe7en suspended or abandoned for a period of 180 days.
'. LICENSED CrRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing'. •'t:,y,CERTIFITE OF EXEMPTION FROM: WORKERS' COMPENSATION INSURANCE: This section need not be completed if the
with`Sectio �7000) of Division 3 of the Business. and Professions Code, and my license is in full force and effect. , permit isC.Afor one hundred ($100) Si less. I certify that in the performance 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' Compensation Laws of California.
License Class Lic. Number
Dale Contractor
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 construct, after,
jmprove, 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 exempt therefrom and the basis for
the alleged exemption. 'Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil
penalty of not more than five hundred dollars ($500).):
AI, as owner of the property. or my employees with wages as their sole compensation, will do the work, and the
ru lure 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 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 proving 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. e C7044,
Business and Professions Code: The License Law,y_oes not apply to an owner of property who builds or
^improves thereon, and who contracts•for such prof cfsw�p.a`-contraclor(s) licensed pursuant to the Contractor's
'License Law )'•. ',,;' Y ✓�
(� 'I am exempt under Sec>'. +, :�� iM` B. 8 P.C. (Attach Certificate).
''� w•:r�.w�'P'.:.!'��.x`�.
�.
Da ^
WORKERS•rCOMPENSATION DECLARATION:+l hereby affirm have a certificate of consent to sell -insure, or a
certificate of Workers' Compensation Insurance, or,a'certified copy thereof (Sec. 3800, Lab. C.).
Policy No. - Company
.Q Certified copy is hereby furnished.
,•Q. Certified copy is (fled with* the County Building Inspection Department or County Department.
DateApplicant
NOTICE TO APPLICANT: IL 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:
❑ I hereby certify that no excavation five (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, fafsework, 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.)
As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial
Safety, as noted above, unless such person has a permit to do such work from that division.
❑ Division of Industrial Safety Permit No.
Date Applicant
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of
the work for which this permit is issued (Sec. 3D97. Civ. C.).
Lender's Name
Lender's Address '
I certify that I have read this application and state that the above information is correct. I agree to comply with all
cf y and county ordinaneWarld�state laws relating to building construction,\and hereby authorize representatives of.
thcounty, to" enter upon the above -mentioned property,,for inspection purpo es. 1••
-'A «SlanStture,dt Applicant or Agent Date R,
CERTIFICATE OF COMPLIAFCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state that the
information, given *dorrect. I agree to comply with all state laws and county ordinances relating to building con-
str Ofon., and: authorize a representattve�of9he County of Riverside, Department of Building and Safely to enter upon
the\ ,', erty Toi"which.l h2've-apphRetl, q0A permit for the pur I a of maki spections. �7
-`Signatffe ofrApplicant or Agent - 7 Date
Date ` Applicant
Name