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404371 (RIV CNTY) BUILDING YtKMII PERMIT NO. DEPARTMENT OF BUILDING & SAFETY FIELD DST 404371 COUNTY OF RIVERSIDE 'RB M404,571 . Y5 t; CONSTRUCTION ESTIMATE ' NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ.FT. @ I Ai $ ^ ^{ UNITS4 . i 2ND.FL. SO.FT. @ V y ' YARD SPKLR SYSTEM; POR. SO.FT. @ 7fP MOBILEHOME SVC.- BAR SINK = GAR. SQ.FT. @ POWER OUTLET ROOF DRAINS CAR P. _ SO.FT.-@ rZTirj DRAINAGE PIPING V WALL SQ.FT..'@ - DRINKING FOUNTAIN e r SO.FT. @ URINAL ESTIMATED CONSTRUCTION VALUATION $ 4 E• _ WATER PIPING NOTE: Not to be used as property tot valuation SWIM POOL;,PVT FLOOR DRAIN MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER VENT.SYSTEM FAIJ EVAP. COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE J DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AY-HANDLING UNIT CFM IDLE METER KITCHEN SINK 52 ABSORPTION SYSTEM B.T.U.. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEMP/PERM I LAVATORY G�fl t HEATING SYSTEM FORCED GRAVITY' ,� A AMPERES SERV ENT SHOWER BOILER B.T.U.. , SQ. FT. @ a BATH TUB SQ. FT. @ a WATER HEATER .� _ rarplo. FT. RESID @I t/4a SEWAGE DISPOSAL 101 Sn 11 S0.•FT. GAR @ 1144 HOUSE SEWER • ' - GAS PIPING PERMIT FEE _ _ PERMIT FEErP irk PERMIT FEE TOTAL FEES MOB.HM.FEE MICRO FEE MECH. FEE PL.CK. FEE CONST.FEE ELECT. EE SMI FEE FEE PLUMB.FEE ._ !? x±' �ry • PERMIT NO. lob-Addross'> 5 1' 2 70 P ace S Zi � Om e i p 404.371 . 1, r r. � mnP Community Valuation Lala Dist. Off. F.C.C. MH Permit Fee $ S Micro Film Fee Cop S Use of Permit 6-rcel go. se/Case Noy- Ck. y + Mech.Fee Dbl $ DWIti .fL1.NG ATT CARPOR11 PI.Ck. Fee S �[ - of'Bocks Lot Size Construction Fee Dbl $ 1 A3 no Legal Description F SM A C- S17- R � 9 . Pi Electrical Fee Dbl $ - C},T ^ SEC I m 6 S v Cry Zone"Restrictions Group Type •` - - SMI Fee $ 24 UT S$ �7 lu ll'LJV Plumbing Fee Dbl S Bon Amt. Plan No. Plan Checker Fmu toInspe for • Unit - s Sp.Insp. Fee $ S Dam 11. Fee $ Const. Lender Branch tuppfimental Permit Numbers Regisir.Fee $ RB0404371 � . Mileage Fee $ Address City Zip �/// •. Witne!s Fee $ Reinsp.Fee $ Owner Tel. Zip - 569-5529 Total Fees $ !" Address City Zip / M.O. .0 r Cash❑ Check.8 WAV UT, -P P Receird Contractor Tel. - Licenser .'. SewSew quire I IIIIIII VIII III V age System Address � 06 , * City Zip r ii :, IE IIIII IN T LL (' P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK rarified by: Sewer District FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. psi I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY PrND THE STATE OF CALIFORNIA. + Alf/�r�'fi� I H EBY�ERTIFY THAT THE INDIVIQUAL WHO 1?REa'AUI5 THE PLANS AND-SPECIFICATION� S,yA�5,DQN�50 IN /1T! E WITH SECTION 5541 OF THZ BJSIN'ESS`•AND PROFESSIONS CODE OF THE STA Of CALIFORNIA. Form 284-208(Rev. 1/80) Y NO. OPERATION DATE INSPECTOR '' NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS _ 1 Set Back 2...2'., _ 33 Ventilation System 2 Ftgs & Frms 1 Z._'L – 34 Plenums & Ducts 2A Slob Grade 'L.. 35 Furnace Comport.,6 3 Steel 36 Inlets & Outlets OT 4 Grout Blocks 37 Combustion Air 5 Bond Beams 38 Compressor 6 Roo} Deck e3� 39 Appl. Clearance 7 Framing r –gI 40 Fire Damper • 8 Vents 41 Smoke Detection Device 9 Garage Fire Wall 42 Commercial Hood 10 Fireplace P.L. 43 Final 3�� • 10A Fireplace T.0. Ej °o ADDITIONAL IN� I MATION D 11 Exterior lath –'Z 2� � Cr,n�-2`� S'�pA✓ Q 12 Internal loth 12A Drywall 13 finish Grade INSULATION Thick R Q'� Valve 7A Walls (Boos) 6;`r 128 Ceiling (Batts) 12C Ceiling (Blown) 14 Final /�Ey� .___-P"MBLNG_Ae_ROYALS-------- ---- 15 Ground Plumb Z-2 4 16 Water Piping ?r 3 , 17 Rough Plumb ✓� �g 18 Vents 19 Sewage Disposal �� t 20 Sewer 21 Water Heater 22 Water Softener 23 Water Service �3 24 Gas Test 25 Final �, SEWAGE SYSTEM SIZE & LOCATION Tank —�t�O Pitto L. Line ELECTRICAL APPROVALS REAR OF PROPERTY LINE ' - 26 Power Pole 27 Conduit 28 Service Entrance 1 �+ 29 Wiring 1�� ` am • 29A Grounding Wire �� P/L ` P/L 29B Bonding I l� 30 Fixtures I, 31 Service 32 Final 7-71 014 STREET NA vAL r J DEPARTMENT OF BUILDING AND SAFETY . COUNTY OF RIVERSIDE OFFICE DATE TIME 3_9 PERMIT NUMBER IV�� INSPECTION REQUESTED ADDRESS I SPACE NO. FOR: I 2 v - I ❑ A.M. OWNER COMMUNITY (� BUILDING PLUMBING ELECTRICAL MECHANICAL. ❑ WON TUES WED REMARKS: THUR FRI OWNER/CONTRACTOR TEL.NO. 28146 /1/IS DEPARTMENT OF BUILDING AND SAFETY . COUNTY OF RIVERSIDE OFFICE DATE TIME PERMIT NUMBER INSPECTION ADDRESS v (SPACE N0. FORUESTED ` �,-z 5�6� - 0 A.M. OWNER COMMUNITY P.F . L 0 11 BUILDING PLUMBING ELECTRICAL MEC ANICAL ❑ M'ON 0(. TUTS cl WE REMARKS: THUR G ^`••/ FRI . V y�� OWNER/CONTRACTOR TE 0. 281-M 11/75 �1 DEPARTMENT OF BUILDING AND SAFETY . COUNTY OF RIVERSIDE OFFICE DATE TIME PERMIT NUMBER aa3 INSPECTION REQUESTED ADDRESS SPACE NO. FOR: A.M. OWNER COMMUNI Y P.M. BUILDING PLUMBING ELECTRICAL MECHANICAL a MON/ ®TUE S / Wm REMARKS: ❑THUR a FRI OWNER/CONTRACTOR TEL.NO. - 281-M 11/75 DEPARTMENT OF BUILDING AND SAFETY . COUNTY OF RIVER-SIDE OFFICE DATE TIME 1 PERMIT NUMBER INSPECTION ADDRESS (SPACE NO. REOURUESTED ❑ A.M. OWNER COMMUNITY P.M. BUILDING PLUMBING ELECTRICAL MECHANICAt a - a TU>ES' WED REMARKS: TH FRI OWNER/CONTRACTOR TEL.NO. 12U46-tl/IS DEPARTMENT OF BUILDING AND SAFETY . COUNTY OF RIVERSIDE OFFICE DATE TIME PERMIT NUMBER / INSPECTION REQUESTED ADDRESS I SPACE N0. FOR: A.M. OWNER COMMUNITY ❑P.m. BUILDING PLUMBING ELECTRICAL MECHANICAt IRON TU>ES, WED REMARKS: THUR / Fl OWNER/CONTRACTOR TEL.NO. . 2"-" ►Iq5 DEPARTMENT OF BUILDING AND SAFETY . COUNTY OF RIVERSIDE OFFICE DATE TIME ��� PERMIT NUMBER / (Q p INSPECTION REQUESTED ADDRESS I SPACE NO. FOR: AX OWNER COMMUNITY t P.M. BUILDING PLUMBING ELECTRICAL MECHANICAIL • MON TOES a WED REMARKS: THUR F� OWNER/CONTRACTOR TEL.NO. • 2i�-M ►Iq3 DEPARTMENT OF BUILDING AND SAFETY . COUNTY OF RIVERSIDE OFFICE DATE (% TIME PERMIT NUMBER n (ccs / INSPECTION ADDRESS 'I SPACE NO. FORUESTED A.M. OWNER COMMUNITY P.M. BUILDING PLUMBING ELECTRICAL MECHANICAt a KION TUES REMARKSWED : ��< �I V� (Y� �THUR FP-4 OWNER/CONTRACTOR TEL.NO. DEPARTMENT OF BUILDING AND SAFETY . COUNTY OF RIVERSIDE OFFICE DATE TIME z C PERMIT NUMBER INSPECTION REQUESTED ADDRESS --7SPACE NO. FOR: El A.M. OWNER COMMUNITY P.M. BUILDING PLUMBING ELECTRICAL MECHANIC TUES a WED REMARKS: I THUR OWNER/CONTRACTOR TEL.NO. 281-41 {1/75 DEPARTMENT OF BUILDING AND SAFETY . COUNTY OF RIVERSIDE -1 OFFICE DATE TIME ,3 PERMIT NUMBER INSPECTION ADDRESS ISPACE N0. FORUESTED � � A.M. OWNER COMMUNITY F] P.m. BUILDING PLUMBING ELECTRICAL MECHANICAL NON. �RTUES J WED REMARKS: QTHUR MF04 OWNER/CONTRACTOR TEL.NO. 284-1 tl/15 DEPARTMENT OF BUILDING AND SAFETY . COUNTY OF RIVERSIDE OFFICE DATE TIME PERMIT NUMBER INSPECTION REQUESTED ADDRESS I SPACE N0. FOR: OWNER COMMUNITY P.M. BUILDING PLUMBING ELECTRICAL MECHANICAt a MON // TUES. LVED REMARKS: THUR ' FRI OWNER/CONTRACTOR TEL.NO. 2Y�-M 11//S DEPARTMENT OF BUILDING AND SAFETY . COUNTY OF RIVERSIDE OFFICE DATE �f, TIME _ I PERMIT"NUMBER 3 7/� INSPECTIONREQ ADDRESS I SPACE NO. FORUESTED A.M. UW..NER COMMUNITY �/'Y P.M. BUILDING PLG:L6ING ELECTRICAL MECHANICAL 11 NION / I Or,-,VVY�p WED REMARKS: THUR FW . OWNER/COP!TRACTOR TEL.NO. ` 28A-M tl/IS, J RIVERSIDE COUNTY DEPARTMENT OF BUILDING AND SAFETY' CORRECTION NOTICE To: Permit No. Address: ::5:/.2?_2k2 ��//12d0 d Dat ?,S FINAL STRUCTURAL INSPECTION -U.B.C., 1976 EDITION © Slope finish grade away from building%"per foot for 3'from building [Ord.4571. 2. Finish grade to be 6 inches below wood 12907(a)]. 3. Counterflash chimney. [32081. 4. Firewall:door to be solid core 1 3/8"and self-closing. (503). 5. Glass not fixed.Door not self-closing. (Sec.1412). 6. Hand rail or guard rail. Intermediate rails 9"Max.apart. (17161. �l v,rr 4 T 444"r ,Ooo/L FIN ����CAJ. INSPECT -N.E.C., 1975 EDITION 1. 'Install missing blanks in main service or subpanel dead fronts [230-62). Place circuit identification on panel bo r 110- 21. � 7 �TItT' Fixtures or plates shall be installed i room. [410-121. 4• Provide disconnect for AC and/or airhandlers. [430-1021. 5• Install corre t ire s If apppyI'T s (Article 10 A-1INAL P ULMBSPECT1 U P.C.,19MMD TION 1. Permanent water supply to be connected to building before final. [10011. 2 Hot and co},d water upplies are c�°ssed. 1) Trap leaks/�7�C d� u ! �t NLS-'!- (318). No more than one approved slip joint on outlet side of trap.[703). 5. Clean breather holds on vent buckets. [13151. 6. Shower enclosure not watertight at walls. [909). A 7. Water heater burners or heating elements shall be 18"from floor. [1 8. Water heater shall have protective barrier in front. [13101. 9. Separate combustion air and return air intakes by 10'Min. (706 U.M.0/1 10. Gas gauge down;must hold 10 Lb.pressure for 15 Min. [1206). �G 11. Gas gauge defective;replace. [12061. 12. Seal floor and door of furnace room. [706 U.M.C.-1. 13. Full way gate valve to be readily accessible on service line and at water heater. (10051. 14. Support conductor vent pipe on water heater furnace [1315). 15 Toilets to be sealed water tight at floors. [9071 1 Anti-syphon Ball cock required on toilet. [10031. 17. No appliance or equipment permitted in lot setback. [Ord. 3481. 18. More combustion air required for water heater ( 1, Furnace ( )top( ),bottom( ), [1307). 19. Furnace compartment too small. [704 U.M.C.1 oV XIO&rd' u.� d,t, ,�vStnLG � r Ci2cuzT L�7' "Oins ,,aGG �A-' � y Inspector CORRECT THE ABOVE CIRCLED I EMS A CALL FOR RE-INSPECTION ,aev, le�,���� 284-236 Rev 3/77 RIVERSIDE COUNTY.DEPARTMENT OF BUILDING AND SAFETY CORRECTION NOTICE To: _ Permit No. Address: • Z.l " Z �d f/e ALVAP-P4p _ Date: Z " ?-4-2 FINAL STRUCTURAL INSPECTION -U.B.C., 1976 EDITION 1. Slope finish grade away from building 1/2"per foot for 3'from building [Ord.4571. 2. Finish grade to be 6 inches below wood [2907(a)). 3. Counterflash chimney. [3208). 4• Firewall:door to be solid core 1 3/8"and self-closing. (5031. 5. Glass not fixed.Door not self-closing. [Sec.1412). 6. Hand rail or guard rail.Intermediate rails 9"Max.apart. [17161. FINAL ELECTRICAL INSPECTION-N.E.C., 1975 EDITION 1. Install missing blanks in main service or subpanel dead fronts [230-621. 2 Place circuit identification on panel board [1 10-221. Fixtures or plates shall be installed in 1<1T room. [410-12). Provide disconnect or an or air andl`e ss. [430-1021. 5• Install correct wire size for appliances. [Article 310 a''^' FINAL PLUMBING INSPECTION -U.P.C. -1976 EDITION 1. Permanent water supply to be connected to building before final. [10011. 2• Hot and cold water supplies are crossed. [3211. 3. Trap leaks. [318). 4. No more than one approved slip joint on outlet side of trap.[7031. 5• Clean breather holds on vent buckets. (13151. 6. Shower enclosure not watertight at walls. (9091. 7. Water heater burners or heating elements shall be 18"from floor. (13101. 8. Water heater shall have protective barrier in front. [13101. 9. Separate combustion air and return air intakes by 10'Min. [706 U.M.C.]. 10. Gas gauge down;must hold 10 Lb.pressure for 15 Min. [12061. 11. Gas gauge defective;replace. [12061. 12. Seal floor and door of furnace room. [706 U.M.C..]. 13. Full way gate valve to be readily accessible on seryice line and at water heater. [10051. 14. Support conductor vent pipe on water heater furnace [1315). 15. Toilets to be sealed water tight at floors. [907) 16. Anti-syphon Ball cock required on toilet. [1003). 17. No appliance or equipment permitted in lot setback. [Ord. 3481. 18. More combustion air required for water heater ( 1, Furnace ( )top( ),bottom( ), [1307). 19. Furnace compartment too small. [704 U.M.C.]. Ga&l NCCT 146T WA TCI . HGfI TGZ Inspector CORRECT THE ABOVE CIRCLED ITEMS AND CALL FOR RE-INSPECTION 284-236 Rev 3/77 APPLIC'ATIOK4�0R TREE-PLANTING I (we), the undersigned, hereby certify and acknowl4e that I (we)have read the application and agree that if trees are required under River- s side County Ordinance No. 457, the applicant agrees to install said trees prior to final inspection. It is understood that no final inspection will be given until said requirements hove been met or exc`aption has been gl nted by the County. Now, therefore, it is agreed that the prop- erty owner shall cause the property lines to be surveyed'in the event no survey stakes can be found. Further, it is agreed that the County of Riverside shall assume no responsibility should trees have to be removed due to lot line errors. - Owner's Name T �a i'� Building Permit No. / Mailing Address 042 A Ny ?,1C—jt;­ Stat2n_ ip 7 Job Address Q munity o Legal Description Assessor's Maapp, Book & Page — Type Structure LU Type of Soil� s water available ood Dept. Plot Plan No. Z ioType of existing trees in road right-of-way Trees preferred by applicant(1) (2) (3) ` /V //'' • Date ( � d �y Owner's Sig azure Planning Commission Case No. ROAD DEPARTMENT APPROVAL Approved species /'t,/ 0/: p!�/i.�I/d ��-f[Q(�/Z/[[6n n(I'j"n Number of trees ow Spacing of trees Distance from lot lines: Fr lines: (W)9/L Side Wo Additional requirements 1' 404 Date Building and Safety n tified Signature Q/' REQUEST FOR EXCEPTION Reason 0>- Z t- LU C LL J w (attach additional page if necessary) mad Request for hearing: YES❑ Owner's Signature (Forward application to Planning Dept. if exception requested) NO REQUEST FOR HEARING Planning Dept. aConcur ❑ Non-concur ❑ Explanation W = o Date Signature Z J .4 \Road Dept. IL Z Concur ❑ Non-Concur ❑ Date Signature REQUEST FOR HEARING AND COMMITTEE DECISION z . FDate hearing established Date hearing notice mailed to owner Jp Approved F-1Disapproved ❑' Date Owner notified of decision IL Date R.ildina& Safetv notified Signature RIVERSIDE COUNTY DEPAAI`MENT OF BUILDING AND SAFETY CORRECTION NOTICE To: Permit No. Address: h f— 'L.76 A VE ALVC-UZA DO Date: LATH INSPECTION —U.B.C., 1976 EDITION 1. Backing wire shall be stretched taut. Maximum spacing 6 inches vertically attached every 32 inches horizontally. 2. Add furring nails, maximum spacing 6 inches apart vertically, 16 inches apart horizontally. [4706]. 3. Wire shall lap one full mesh at all joints [4705(c)]. t 4. Building paper shall cover all wood. [1707(a)] [4706(d)]. j 5. Wire on'exterior corners shall be pulled out minimum'% inch. [4706(e)]. 6. Re-check gyp.lath nailing. [Tables 47-b,47-c]. 7. -Lap cornerite minimum one mesh. [4705(c)]. 8• Self-furring stucco wire to be attached at indicated places only. Use furring nails around all openings. [4706). 9. Fire wall to be perforated type lath or an approved equal. [4302]. 10. Area around shower and tub with shower to be approved materi of s(1711 (a)1 11. Use metal lath over joints where two or more are together. Use on voids 3/8' or more. [4705(b)]: DRY WALL INSPECTION 1. Maximum spacing single nails: Ceiling seven inches;walls eight inches. [Table 47-g], [4705(b)]. 2• 5/8" type X gyp. board used for 1 hr.firewall; nails to be 7" o.c. Joints taped and finished. [Table 43-b,Sec.47111. y 2Y tr1l (_C_ 1doZ 1ZAEW Y F6)Z I N5P�K 770A( Inspector l CORRECT.THE ABOVE CIRCLED ITEMS AND CALL FOR RE-INSPECTION 284-235 REV 3/77 RIVERS-I1 UMUNTY DEP OF BUILDING AND SAFETY CORtlELT10rl 'NOTICE To: /� Permit No. Address: .7v 404 t,044) Date1-_2 1. A40 FRAME INSPECTION -U.B.C., 1976 EDITION �otT,o ' Ti�e711 Approved plans shall be on job for inspeCtl5 .i 2. Changes from approved plans must be made on all plans and approve in Plan Check. [302(a)). 3. Add shots where indicated per Research Recommendation Card. 4. Maximum spacing of studs 24"o.c. [2518(f)31. 5. Horizontal stabilizing blocks to be placed in all stud walls over 6' in height to conform to Ordinance 457. 6. Double top plate joints at least 4'apart. [2518]. 7. Ceiling joist overspanned. [2518(h)2]. 8. 3-8d nails joist to plate.Nail top plates together-16d 16"o.c. [2518] Table 25-P. 9. 3-8d nails rafters to plate. [2518].Table 25-P. 10. Nail corner studs 16d-24"o.c. (25181.Table 25-P. 11. Rafters overspanned at [2518(h)21. 12. Purlin overspanned at [2518 (h)51. 13. Slope of struts not to be less than a 45° angle from the horizontal. [2518(h)51. 14. Add backing at (4706(c)]. 15. Rafters do not fit ridge-fix. [2518(h)3I. 16. Nail ceiling joist to rafters.Add cross ties,Max.4'o.c. [2518(h4)]. 17. Add brace at [2518&Ord.457). 18. Shim and nail trimmers. [2501(b)I. 19. Metal strap on studs and plate where pipes-are located. [2518(g)8]. 20. 1 nstal I windows as per approved plan. (14041. 21. Fasten post to concrete.Use"T"strap post to beam. [2310(e)]. 22. Attic access minimum 22"x 30" [3205(a)]. 23. All plywood exposed to weather to be exterior grade (3202). 24. Replace short trimmers in [2518(g)71. 25. Foundation ventilation. (2517(c)61. 26. Install sway braces in garage. (2312(a)). 27. Provide flashing and counter-flashing at junction of roof and vertical surface. [3208]. 28• Secure chimney straps at ceiling line to frame [3704(c)]. 29• Install solid sheathing and 15 Ib. felt between masonry and wood studs at planter. [2517(c)7] 30. Plumb all walls [:2309(a)]. 31• Install screened attic ventilation ratio 1 to 150. [3205(c)]. 32• Bath requires vent to outside air.[1405(a)]. 33. Provide adequate space for comfort heater. neo d/ `�►do�a� F 94401l" LZ Ipp ECTOR �Zo" (&IX Ee e�s� �T CORK THEA VE CIRC ITEMS AND ALL FOR RE-INSPECTION. 284-231 REV.3/17,x-- Cao 2/° ^ 0-Apelaci.r INTER—DEPARTMENTAL LETTER e w /fF1' ti. G °°UCOUNTY OF RIVERSIDE - RIVE I o' e November 25, 1980 TO: Building and Safety FR: Warren R. Stallard, Road Department RE: Grading at 51-270 Avenida Alvarado, La Quinta Our district road maintenance supervisor has advised me that the builder at the above referenced location has scraped decomposed granite from the County maintained road and he used it to construct his building pad. We estimate that he has taken approximately 75 cubic yards from the County roadway. We would appreciate it .if you would stop any further construction until the owner makes .,proper amends with the Road Department. W RS/tf } li NOTICE: THIS IS NOT A BUILDING PERMIT DISTRICT APPLICATION TO CONSTRUCT Permit No DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE Owned' C 141��A/S Architect Contractor Address✓ QU JA,'70 (z 4AYgddress Address_ City��e_-/4, i.>C—SCA-7 City— City_ Phone ` '7r� Phone Phone W I (we) the undersigned, hereby certify and acknowledge that I (we) have read the application and agree that if Curb and Gutter, and Z Paving, and/or Dedication of right of way is required by the County of Riverside, the Riverside County Department of Building and Safety 3 shall not make a Final Inspection.until said requirements have been met. I am also aware that no work is to be done within the County R/W O without an encroachment permit. , NOW, therefore, it is agreed that I (we) will not occupy said property and will not cause said pf4perty to be occupied unci I (we) have complied with all laws of the County of Riverside and the State of California governing sa' prop rty /�' DATE Z Gly 0 SIGNATURE OF OWNER AN D/O f4�iENT �� i Approval by Signature from the Following Depart enh fisted Below Must Be Obtained Prior to the Issuing of a on coon Permit. 7 ` I SPACE NO. —STRUCTURE JOB ADDRESS �—•r FAMILY DUPLEX LEGAL DESCRIPTION OF PROPERTY K/ 114. 'Set--d. 6S SI GL O I � APARTMENTS AGRIC. 13z 4,P Zit �LLO ERCIAL -A INDUSTRIAL j '^ COMMUNITY L, Z NO. OF SUBMITTED PLANS _ USE OF PERMIT �firJC E�G.�nr _ ALTERATIONS n 4 Q CASE NO. �.A`1'/✓)�/fix-S�----� _ l! / �f / O Z N0. OF PARKING SPACES REQUIRED N0. O+F UILDINGS NOW EXISTING a 10 ZONE - SETBACKS: FRONT-- 210 SIDE REAR J m GRA ING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE SETBACK ORDINAN.CCEE ## __ OF FEET REQUIRED ON TREET DATE � SIGNATURE OF LAND USE OFFICIAL 1 DEDICATION ,REQUIRED: YES ❑ NO I10. OF ET___ �l 1 CURB AND GUTTER REQUIRED: YES ❑ NO v u 0dt[de %riI.Gl STREET W CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO-E3 Iv"f HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET IMPROVEMES Cg, 0 ❑/� °C DATE SIGNATURE OF ROAD DEPT. OFFICIAL C Z M7oId —3o . o QW SEWAGE DISPOSAL _ i Q� \ WATER POLLUTION REMARKS �n FLOOD CONTROL W x AIR POLLUTION DIV OF HWY I.- a — YOUR PROPERTY MAY BE SUBJECT TO v c FLOOD. RIVERSIDE COUNTY ASSUMES t NO RESPONSIBILITY IN EVENT OF FLOOD. 284 .199 9/7.4 CANARY—FILE, PI,NK—APPLIC DEPARTMENT OF BUILDING AND SAFETY APPLICATION CERTIFICATE COUNTY OF RIVERSIDE PERMIT N Effective July 1, 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 R 41 (!�J 4) License No. 2 7 7 7 Date / / f) A (-Z� Contractor n t 0 OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reasons: 0 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.). I am exempt under Section B.&P.C. for this reason: Date Owner Q 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 -- —� ��. Certified copy is hereby furnished. Certified copy is filed with the County of Rivers,ide, Department of Building and Safety. Date /l / lC/C) Applicant+-- . Jy 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.) 0 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. 0 Division of Industrial Safety Permit No. Date Applicant CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY I certify I have read tfiis application and state that the information given is correct. I agree to comply with X1'7 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 for�w(h`ich=I�-hha�ve``a'p'plied for this permit for the purpose of making inspections. ignatuL o.f- PP scant gent Date x nt pRicant/ gent Name 284-2000 7/80