SOLAR-------------------------------------------------------------------
V
t,ity uf Eastvale
B.'Iding Saftty Di,,Wum
12363 Limunite Ziff., Stu. 910, EatiNdle, CA 91752
1951) 703-4450
vy VV Vw. Uastvdl—uc—a: A-U—V
uail
umr)inatiun S-im
. a u Permit Property A.P.N.
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:--5treet Name
Number
Property
f Sb3 wai erline FoaU. Easivale CA �JZBSU';
Eastvale. CA
Property
Mame GEDEON ESPLANA
Phone * 909-815-1t tO
Address (K diffewt f mm pw1mrt-,j
t863 Waterline Road, Easivale, CA vzaiou
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Name (ir not awneri
--------- - ------ '�--Phtp
#
ISMAEL TORRES
Applicant
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Conxractor
3080'12TH STREET, RIVERSIDE CA 92507
State Contractor's
License # 9 / zlou
Description
IVA I M Nel I Z!
Of
worR
10--mcr ApplivaRt
C)tn.r (pl.rs. piw.ide beldw-)
ApplicanL'S Signature: t-rurrup Date: 11/25/2019
For is Use On!y
Project tame
Project Permit # --Date Received Date Issued
?MT1? - 9Y.Y,'5- /--1Lfflq—
Permit Fee SMIP Fee Green Fee Amount Paid
— ek� 4 -
valuation $ Square Footage
= Kespaentia
C.Mmorcial i Limiung arago
Revised: March 31, 2014
%fry Di c,astvare
c
tirilai,.g safety D"muR
fir* (951) 703440
_
Lx%tc a®3c v Lein 1 rtA+ ■ ixn'3 yr a Lt�icr� i ivir 1 nereoy avium mat i am licenseii under p .IS:a..m or Gna ts.- Y
/U09) oI U:®:Zion 3 oI Ilio t3ar:.®vry ..� 8 Y vIc.,.,:v. Codc, ....A my 1 cc ®3c 13 ®-. Tull 6nX a „ttcci.
Liczn.c Glass C46 Lic. Nw 97A48 vale; 11/L�)%dui`!
Contractor Signature: l !P
v.. riG - uxLtvL yr CLnxv. i i-Av f nerevy auirm mat i am exempt uom me Contractor's L'-Z;5 La Iv- m®
Ilry:®o.z .-.0 r Iv7aly.-.3 Cvga: Aj, city oa w®.-,ty which m-z;i.... u p.-,r-.::it to VU173u ucy alit®, u®®Nibac., dcu®ol6h, o® repair any structure, prior to its
issuance, also requires the applicant for such permit to file a signed statement mat ne or sue is licensee pursuant to me provisions or me C,ontractor's
License Law TCnapter v i'commencing -m s-t ®. 113 0) eI Li-ivivA 3 of tn. Cmc) ow tn.,t no 3hc :3 r_ dpi thc®wtTOM
w.a the b..�:3 t�.. iFic �Ilcge3 e.e,a-psi®n. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civic penty o® not
more uean uve uunurm uonars (3Jlav)J'
c i, m u-mr or ME p rYertT, v, ®T a ®rloyV1 m ...a e. M ME. 301c w ei ..�..teo a, -.'I] do the —sk, -A the 3uwktu.v is not intended or offered
for sale (Sec, 7044, Business and Professions Code: The Contractor's License Law'uoes not apply to an owner of property wno ouiles or improves
mercon, ane wno hoes s---_vm K'nowif a.- n® r®it or m---gh nk: v- nv.- o— c �YloycC�, , ro Ass tout vftn a...Y., we c. wr nal irv;mdcd di
vttc.cd for 500. It, Flowcgor, IF. ba ld:.-®s o,- rapmv mmi-t is sold .within one year of completion, the owner-builder will have u,e uwuen or proving
urat ue or sue W-0 not'uuha or improve for ate purpose of sate)..
o 1, ®v.:..a.- rt tna p -party, — onolas..o17 ..tr..atib.g ...ui l:ca.-.5-.a cv.®.travto..a t- vo;--tract the pmj'vci ()cc. 7U44, Hmina,a3 and Professions
Code: The Contractor's License Law does not apply to an owner of property who buitus or improves utereon an'a wno contracts for sucn projects
wim a contractorts) licenses pursuant to me Contraeto.'s Lice.-.se La-..).
is 1 ..Ri cwa yt R;. e,- S.c S & P.C.Ivi tFri-a rea3vu
Date: U-wner's signature
Wil �ItS' COWENSATIUN DECLARATION I hereby affirm under penalty of pcqury one of the following, declarations:
(„R l have an'u Win Maintain a certincate of consent to seli-insure for woncers' compensation, as provieee Ior Dy section i t0l) or me Lao®: Cow, ic.-
tno p®pro..—w.w of trio Eon Iv: -nacfl mi., i.c.-at :r .Se its.
In i have and will maintain workers' compensation insurance, as required by Section 370U of we -nMr 7—Me, for we performance of uie worK for
wnicn mis permit is issues, my wor ers' compensation ins..-anm ®--.®r m,a
STATE FUND Folies No. 90®031116
`This section need not be comptetcu if ute permit is tor one nunurcu 'uotiars `a r'u'in or less).
C .i rt.fym,.t in mo ... lfI......�. or a `e:1Z Io: wn-on Min a 't imacu I Aiall :.ot a Io - vr..o...n .... .........®c.- So w w drew c 3llb vc�
P �P cm."Joy ®sP r r
the W�kc.�' ev.®-pt�-Saaion laws of Cahibmia, and ay.e that if i should become subject to the workers' compensation provisions of Section :) iUU of
ufe "15Gr Cewe, f ffiiaf f im—mwim comply wim arose provisions.
u„tc 11/25/19 Ar,<u�r-.t'v ss zootrrc
WARNING: FAILURE TO SECURE WORKERS' CO PE,.Snitviv C.Ovrru-LZrr, 13 UrNLnwruL, t%i-Av 3r®nLL 3uninl.f %iN rrvtrL7Uirn
iv CrumiavnL rmNALiic.5, ANU CIVIL rn4r.5 ur iv Vrvn rtuivuKV_V 1 HOUbAlvv ui3LLAKb (1113U,000), IN AUul11i7N IU 117it CUbl
Ur COMPENSAIIUN, uAMAUES AS YKuvIllED rUK IN sEC. 3706 OFTHE LABOR CODE, INTEREST, & ATTORNEY'S FEES.
CONST UC x xOry GENvxNG PtUr rq . ■ i nereuy affirm un'uer penFaty of perjury mat Mere is a construction lensing agency ror me performance
or m® �rrK rv.- _n' on utiv pv .t .v ivvwca (Nov. 3(19 1, C®::c C.).
Nat Lender's Address
nrw-Li i%i-4.'3 &UrV7i i u i certify mat f nave reau mis appiication anu state mat me aw-. a iwormati®. mot,. i - to ov-q.iy ...tn an
o:ty —a t e®tT ®.-din ®-ca -u -talc 1... s ariat>m.g to br:l8:.-g eorOtruction, ....0 he-by wwthv®:G. Awpaw..-..wi®rc3 of the City of Easivale to ermz upJ®-
the above-mentioned propeny for inspcction purposes.
� TVTI_ ismael Torres 11/25119
S%ar wi-. otApplicant (Cuiaraczur or ncr) print Name Date