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426619 (ELEC)1/UILUInG VCKMII PERMIT NO. DEPARTMENT OF BUILDING & SAFETY 426619 COUNTY OF RIVERSIDE FIELD M11 CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. 2ND. FL. FOR, SQ. FT. @ UNITS Owner -� SQ. FT. @ YARD SPKLR SYSTEM MOBILEHOME SVC. SQ. FT. @ BAR SINK GAR. SQ. FT. @ CAR P. SQ. FT. @ WALL SQ. FT. @ SQ. FT. @ ESTIMATED CONSTRUCTION VALUATION $ POWER OUTLET ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used as property tax valuation SWIM POOL, PVT FLOOR DRAIN MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER . VENT SYSTEM FAN EVAP. COOL HOOD SIGN WASHER (AUTO)(DISH) r APPLIANCE DRYER PI. Ck. Fee $ GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED �� LAUNDRY TRAY AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP. USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE,TEMP/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. ' @ c BATH TUB I .,pector SQ. FT. @ c WATER HEATER Dental. Fee SQ. FT. RESID @1'/.c SEWAGE DISPOSAL Branch SQ. FT. GAR @ '/. c HOUSE SEWER Mileage Fee $ Address City Zip GAS PIPING PERMIT FEE PERMIT FEE �q ; } - PERMIT FEE DBL. TOTAL•FEES MOB. HM. FEE MICRO FEE MECH. FEE PL. CK'. FEE CONST: FEE EL . FEE U SMI FEE FEE PLUMB. FEE PERMIT NO. - 426619 — Job Address �" `uLl&6c. Space Zip �,. ,,,3 Owner -� Community 14 /' 60 i % / Valuation $ Date` Ir -•' Dist. Off. .77 F.C.C. MH.Permit Fee $ Micro Film Fee Cop $ Use of Permit - < /4. (� ,�. Parcel No.�Ise/Cose 4 .Q-7 2, / 1 No. Ck. By ' Mech. Fee Dbl E PI. Ck. Fee $ Set Backs Lot Size Construction Fee Dbl $ Legal Description v r/ L v i1• / F S S R ElectricaLFee Dbl $ Zone Restrictions Group Type SMI Fee $P Plumbing Fee Dbl $ 'Bond Amt. $ Plan No. Plan Checker Fi al Do 6- I .,pector Unit Sp. Insp. Fee $ Dental. Fee $ Const. Lender Branch Supplimental Permit Numbers % r Registr. Fee $ Mileage Fee $ Address City Zip Witness Fee $ Reinsp. Fee $ Owner/Agent% 99 Tel. Zip i(_/J� Total Fees M.O. $ / N.C. /f/Cash . Chec Address / City r� // /j Zip 6 / / L- 51 - Received by ,�✓� 61 Contractor r„ ' ;r'-ij ,� •: Y,: f �./_.� Tel. License# Trees required- Sewage System Address w sem. City Zip T LL P Sewer District o m 284-205 (Re 8? /FHIS�HAIi BECOMEVOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. _ I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. X- by: J�--� �r-, NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS I 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. FI 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) M 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 DEPARTMENT OF BUILDING -AND SAFETY APPLICATION CERTIFICATE COUNTY OF RIVERSIDE PERMIT R Effective July 'l, 1980, Chapter 1301 Section 19825•of the Health and Safety Code requires the execu- tion of the following applicable declarations prior to the issuance of a building permit. Please• print'or type -.and sign,below:- [� LICENSED CONTRACTORS DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with -Section 7000) of Division 3 of.the Business and Professions Code and my license is in full force and effect. License Class License No. Date Contractor 0 OWNER -BUILDER DECLARATION I hereby -affirm that I am.exempt from the Contractor's License Law for the following reasons: [� 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. If I sell within one- year of completion, I understand I will have the burden of proving I did.not build or improve for,the purpose of sale (Sec. 7031.5;'B.&P.C.). [� I, as owner of the property, am exclusively contracting with licensed -contractors to construct the project'(Sec. 7044, B.&P.C.). t I am exempt under Section B.&P.C. for this reason: Date Owner �] WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a Certificate of Workers'. Compensation Insurance, or a certified copy thereof'(Sec. 3800, Lab. Code). Policy No. Insurance Q Certified copy is hereby furnished. Certified copy is filed with the County of Riverside, Department of Building and Safety. Date Applicant [� CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if permit valuation is for $100.00 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' Compensation laws of California. I further understand that if after making this Certificate of Exemption, I should become subject to the Workers' Compensation provisions of the labor code, I must forthwith comply with such provisions or this ,permit shall be deemed.revoked. 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. 3097, Civ. Code). Lender's Name Lender's Address DIVISION OF INDUSTRIAL -SAFETY PERMIT CERTIFICATION I hereby certify that no excavation five (5) or more feet in depth into which'a person is re- quired to descend, will be made i6 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.) [� 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. [l Division of Industrial Safety Permit No. Date Applicant 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 s 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 pro- perty or which I have applied for this permit for the purpose of making inspections. l 'rgnature;pp ica%/ ge� Date �r�Uit J Dint Applicant/Agent Name 284-2000 7/80 6UILDINU VCKMII T LL P11R9RNNYSHA/BECdME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by: Sewer District FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. Form. 284-208 (Rev. 8/78) ©s PERMIT NO. DEPARTMENT OF BUILDING & SAFETY Space U rz�-'Gr��v. Zip / �Zy DST 1.4266 Commuunity ///62 / A 6 v r �V � COUNTY OF. RIVERSIDE FIELD OFFICE J� CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES Off. NO. PLUMBING FEES MH.Permit Fee $ Micro Film Fee UNITS Use of Permit Parcel No. Use/Cose No. IST FL. SQ. FT. @ Mech. Fee $ rDb PI. Ck. Fee Set Backs Lot Size Construction fee/ Dbl E Legal Description F / `, / . %i f� - / Z— V /• � ! /�7/� //• / YARD SPKLR SYSTEM Electrical Fee Dbl $ - / 2ND. FL. SQ. FT. @ Group Type SMI Fee E Plumbing Fee MOBILEHOME SVC. Bond Amt. $ BAR SINK Plan Checker ' FOR. SQ. FT. @ Inspect Unit Sp. Insp. Fee $' Demol. Fee POWER OUTLET Const. Lender ROOF DRAINS Supplimentol Permit Numbers / � 2 � GAR. SQ. FT. @ Registr. Fee $ Mileage Fee $ Address City Zip Witness Fee $ Reinsp. Fee $ -. Owner/Agent D11+101 ;� 2 Al DRAINAGE PIPING Zip. CAR P:.. SQ. FT. @ Total Fees - $ Address V V /1( City (/�/7► �/f/� / / - • — �� �' �^ Zip ' M.O. N.C. i Cash Chec DRINKING FOUNTAIN or WALL SQ. FT. @ / .. Tel. - License# .l Trees required Sewage System URINAL SQ. FT. @ , . ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation SWIM POOL, PVT FLOOR DRAIN MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER VENT SYSTEM FAN EVAP.•000L HOOD SIGN WASHER,(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED 5'64(--)LAUNDRY-TRAY AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE,TEMP/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. '@ c BATH TUB SQ. FT. @ c WATER HEATER SQ. FT. RESID @1'/.c SEWAGE DISPOSAL Y, SQ. FT. GAR @ 114 c HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE (� PERMIT FEE L DBL. TOTAL FEES MICRO FEE MECH. FEE PL. CK. FEE CONST. FEE ELECT. FEE SMI FEE FEE PLUMB. FEE `w ]MOB.HM.FEEI pv T LL P11R9RNNYSHA/BECdME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by: Sewer District FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. Form. 284-208 (Rev. 8/78) ©s Job Address � 5 �G Space U rz�-'Gr��v. Zip / �Zy Ow der vIgIV PERMIT NO. 1426619 Commuunity ///62 / A 6 v r �V � Valuation $ Dote — / / 4 l Dist / / Off. ` F:C.C. MH.Permit Fee $ Micro Film Fee $ - Use of Permit Parcel No. Use/Cose No. Ck. By Mech. Fee $ rDb PI. Ck. Fee Set Backs Lot Size Construction fee/ Dbl E Legal Description F / `, / . %i f� - / Z— V /• � ! /�7/� //• / S 5 R Electrical Fee Dbl $ - / Zone Restrictions ' Group Type SMI Fee E Plumbing Fee Dbl $ Bond Amt. $ Plan No. Plan Checker ' Fina Date Inspect Unit Sp. Insp. Fee $' Demol. Fee $ Const. Lender Branch Supplimentol Permit Numbers / � 2 � ! Registr. Fee $ Mileage Fee $ Address City Zip Witness Fee $ Reinsp. Fee $ -. Owner/Agent D11+101 ;� 2 Al Tel. 6 a 4 Zip. Total Fees - $ Address V V /1( City (/�/7► �/f/� / / - • — �� �' �^ Zip ' M.O. N.C. i Cash Chec Received by-, or % / .. Tel. - License# .l Trees required Sewage System Address rw City Zip . T LL P11R9RNNYSHA/BECdME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by: Sewer District FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. Form. 284-208 (Rev. 8/78) ©s