26985 (GRD)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.
OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt Irom the Contractor's License Law for the
following reason (Sec. 7031.5, Business and Professions Code: Any city or 1, ly which requires a permit to con-
struct, alter, improve, demolish, or repair any struclure, 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 ady applicant for a per-
mit subjects the applicant to a civil penalty 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 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 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 contractor(5) licensed pursuant to the Con-
tractor's License Law.)
Of am exempt under Sec. B.& P.C. (Attach Certificate).
Date Owner
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell -insure, or a
cerlificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800. Lab. C.).
❑Certified copy is hereby furnished.
❑Certified copy is filed with the County Building Inspection Department or County Department.
APPLICANT NAME (1., F, MI)
LA CJI.INTA. COUNTRY ASSOC
rtHMll ArrLIGNIIUN
CITYICOMMUNITY/STATE/ZI P
LA QUINTA CA 922530000
JOB SITE ADDRESS/SPACE
75520 HWY 111
CITY/COM MUN ITYISTATE/ZIP
LA QUANTA CA 924530000
County of Riverside
413
PRC
013
C
8
Department of Building and Safety
RNG
4080 Lemon St. 2nd Floor 135 N. Alessandro Rd. Rm. 203
880 N. Slate Str�� , a 227 North "D-' Street
46.209 Oasis St. Rm. 310
160 N. Broadway
Riverside, CA 92501 Banning, CA 92220
Hemet. CA 92340 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: 922.2670
This permit becomes void if work not commenced within 180 days from dale of issuance. OR, it work has beer suspended or abandoned for a period of 180 days.
CITYICOMMUNITYISTATE/ZIP
PHONE#
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.
OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt Irom the Contractor's License Law for the
following reason (Sec. 7031.5, Business and Professions Code: Any city or 1, ly which requires a permit to con-
struct, alter, improve, demolish, or repair any struclure, 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 ady applicant for a per-
mit subjects the applicant to a civil penalty 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 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 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 contractor(5) licensed pursuant to the Con-
tractor's License Law.)
Of am exempt under Sec. B.& P.C. (Attach Certificate).
Date Owner
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell -insure, or a
cerlificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800. Lab. C.).
❑Certified copy is hereby furnished.
❑Certified copy is filed with the County Building Inspection Department or County Department.
APPLICANT NAME (1., F, MI)
LA CJI.INTA. COUNTRY ASSOC
ADDRESS
78520 HWY 111
CITYICOMMUNITY/STATE/ZI P
LA QUINTA CA 922530000
JOB SITE ADDRESS/SPACE
75520 HWY 111
CITY/COM MUN ITYISTATE/ZIP
LA QUANTA CA 924530000
BOKPAG
613
413
PRC
013
C
8
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TRACT NAME
OWNELAR QU !NAME L N, COUNTRY ASS PHONE Ir
CONTRACTOR -FIRM NAME
LICNC N
ADDRESS
CITYICOMMUNITYISTATE/ZIP
PHONE#
BLDG. INSPECTOR
FINAL DATE
ARC/ENG FIRM NAME
LICNC q
ADDRESS
CITYICOMMUN ITYISTATEIZIP
PLAN R
PLANS EXAMINER
APPROVE DATE
USE OF PERMIT
(ALAN CHANGE
BLZON
ai
CPS
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END
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0000
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 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' Compensa-
tion Laws of Calilornia.
Date _Applicant
NOTICE TO APPLICANT: Il, alter makingthis 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 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 buildingstructure. scaffolding. lalsework,
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 Irom 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
Ihal the information given is correct. I agree to comply with all state 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 property for which I have applied for this permit for the purpose of making inspections.
X
Signature of Applicant or Agent
Print Applicant/Agent Name
Date
APPLIPRMT N
a0a17490
AZ
GATE I� r8n �,
04/30/92 (�/
TOTAL .
FEE
CA
CK
NC
I COUNTER B.I.
COUNTER L.U.T.
APPLICATION FOR PLAN CHANGE
T H I S I S A N A P P L I C A T I 0 N
0 N L Y
.APPLICANT NAME (L, F, MI)
CA QUINTA, COUNTRY ASSOC
ADbESS 52 0 HWY III
CITY COMMUN faT AZIP
�Y 0l1INiA CA 922 30000
I%LU DdREESSISPACE nWY i
f l Y
' CITY m'.0 far�TAZIP
j� CA ?22530000
BOK
(aid
PAG
413
PYYRYYC
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R7E
SE
1910
S
TRACT LOT
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SB
TRACT NAME
UNp Y p @,
MKRI5 tVn q a COUNTRY G7
' HONE p
CONTRACTOR -FIRM NAME
LICNC p
ADDRESS.
CITYICOM M U N ITY ISTATEIZI P
PHONE p
BLDG. INSPECTOR
FINAL DATE
ARCIENG FIRM NAME
LICNC p
ADDRESS
. �CITYICOMMUNITYISTATEIZIP '
PLAN p
PLANS EXAMINER
APPROVE DATE
USE OF PERMIT
'PLAN CHANGE
{J J{
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APPLIPRMT p
PS
D00017490 ATE - - 2 6 9 8 5
TOTAL
FEE '
CA
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COUNTER B.I.
COUNTER L.U.T.
r
,APPL.ICA'rioN' FOR PLAN CHANGE
�,._ 1'N' 5 IS 'AN APPL.ICAT-10N UNL.Y
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
I
Set Back
33
Ventilation System
2
Ftgs B 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. C]
43
Final
IDA
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 Wolls (Botts)
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
PSL
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
298 Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
WHITES CUSTOM ELECTRIC
74-991 VELIE WAY, SUITE 1 s
PALM DESERT, CALIFORNIA 92260 a
(714) 346-8562 '
January 4, 1982 -
County of Riverside
Building & Safety Dept.
'Room 310--
46209
10. 46'209 Oasis
Indio, CA 92201
Gentlemen:
iPlease be advised the following people are authorized to
sign for and pick up permits and plans as needed:
t
1. Gene t ehotsky
- 3. Connie VerKuilen
4. Georgiana White
5. 'John Batista
The above listed people are employees of the General L
Partnership of J&H Electric and John M. Batista operating
ung de the license C-10 411428
very tp_-,r)!.y yours -
�P
air 4 ectric
/John Batista, General Partner
lvk
C��
STATE OF CALIFORNIA
ss.
COUNTY OF RIVERSIDE
ON JANUARY 4 , 1982 ,
before me, the undersigned, a Notary Public in and for said State, personally appeared
GENE T,FgOTSKY, CONNTF. VERNUTLEN,
GEORtr TANA WHITR , TC)HN RATT:S'TA
known to me,
"��r��+rur�+��,�.�.,�,.,a.,»,»,,.,_,•• to be the persons whose name—S ARF subscribed to the within Instrument,
OFMAL gA and acknowledged to me that Zhe-.executed the same.
JUNE E. DAVIS WITNESS m hand and official seal.
NOTAPY PUBLIC -CALIFORNIA y
tbilHry1tRIVE'R,SIDE COUNTY
f4 ExplrUAu&.Zl.UU
(0
ACKNOWLEDGMENT-6eneroL—Wolcottf Form 231—R.. 344 Notary Public in and for said