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SFD (351499)54725 Avenida Madero 351499 BUILDING PERMIT ; DEPARTMENT OF BUILDING '& SAFETY digi, FIELD OFFICE PERMIT NO. 'l Supp: Permit 3 514 9 PEV IT NO. [35-1-499 I COUNTY OF RIVERSIDE. - Dote/% / a9 Dist. 0! DST CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES Use of Permit 1ST.FL._ 2ND FL. 4 • POR.. GAR. SQ. CAR P. t WALLSQ. 1lV ESTIMATED CONSTRUCTION SQ. FT. Q O $ sb UNITS Mech. Fee Dbl $ I Set Backs SQ. FT. @ YARD SPKLR SYSTEM Construction Fee SQ. FT., ® ' MOBILEHOME SVC. BAR SINK F Oi Q FT. @ 41 ,a POWER OUTLET ROOF DRAINS S. SQ. FT. 8 DRAINAGE PIPING Electrical Fee 710 ET. DRINKING FOUNTAIN Grp SQ. FT. URINAL Unit VALUATION $ a% WATER PIPING SMI Fee NOTE: Not to be used as property tox voluotion SWIM POOL, PVT Plan No. FLOOR DRAIN Date Inspector 'MECHANICAL FEES SWIM POOL, COMM Const. Lender ., Branch +I certify that in the performopce 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 workmen's com• pensotion lows of California." Address Cir Zi Owner Signature Builder Signature WATER SOFTENER Mileage Fee Witness Fee VENT SYSTEMa ❑ FAN ❑ EVAP. COOL ( HOOD SIGN Tel. Zip WASHER (AUT ISH) Total Fees Address ^ - T ' .J 3 % APPLIANCEDRYER M.O. ❑ N.C. ❑i.Cosh C)Chep . Received by GARBAGE DISPOSAL Tel. -- License,4 FURNACE ❑ UNIT' ❑ WALL ❑ FLOOR ❑ SUSPENDED Sewage System - .. . '1%, fl • f .% Address - LAUNDRY TRAY Workers' Comp. yes.❑ no ❑ AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR" a" HP POLE, TEMP/PERM LAVATORY HEATING SYSTEM JR FORCED ❑ GRAVITY. AMPERES AMPERES SERV ENT SHOWER BOILER E:1 B.T.U. SQ. FT.Cja ¢ BATH TUB SQ. FT. J WATER HEATER <y,6SQ. FT., RESID @ 1'/.¢ SEWAGE -DISPOSAL i saw SQ. FT. GAR G 1A HOUSE SEWER R GAS PIPING PERMIT FEE PERMIT FEE 3' PERMIT FEE '`►.d DBL I TOTAL FEES -- MOB. HM. FEEJ MICRO FEE - MECH. FEE PL CK: FEE aa 8 CONST: FEE /C:2/ ELECT.'FEE _3o'p SMI FEE1.FEE / PLUMB. FEE 3 ter✓ PERMIT NO. 'l Supp: Permit 3 514 9 Job Address -` - - Space Zip. - y- gas, z Owner ,L.,J s - - Commun/ity /"•± :s/rr ;,; ion - 7$1! 7 9.37 `=° Dote/% / a9 Dist. 0! Off. F.G. oa/ MH Permit Fee '.' $ Micro Film Fee Cop $ Use of Permit Parcel No. 7 7,1 ` Use No. - Ck.by Mech. Fee Dbl $ Pl. Ck.Fee p. $- .. Set Backs Lot Size Construction Fee Description // / n , • i t7 % /,3,L 7 L✓ S F Oi Q S , ' S. R Electrical Fee 710 Zone / Grp Type dy Unit SMI Fee Plumbing Fee Sp. Insp. Fee Bond Amt. - $ Plan No. Plan Checker - .Final Date Inspector 2DbLegal Demol. Fee Const. Lender ., Branch +I certify that in the performopce 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 workmen's com• pensotion lows of California." Address Cir Zi Owner Signature Builder Signature Reg istr. Fee Mileage Fee Witness Fee Reinsp. Fee Owner/Agent Tel. Zip Total Fees Address ^ - T ' .J 3 % Y Zi Cit - P M.O. ❑ N.C. ❑i.Cosh C)Chep . Received by Contractor - Tel. -- License,4 Trees required +w +• Sewage System - .. . '1%, fl • f .% Address - city - Zip Workers' Comp. yes.❑ no ❑ I LL t' Sewer District it Form 284-208 (Rev. 477) ©s P . IHIS PERMIT SHALL BECOME VOID IF. WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF-rifiedby: WORK FOR 120 DAYS SHALL AUS ERMIT TO BECOME VOID. I HEREBY AGREE THAT A IN ON ITH THIS PERMIT WILL BE DONE IN ACCORDANCE _ WITH THE LAWS OF R1V6RSIDE COUNTY A D 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. NOTICE: THIS, IS •NOT A lBUILDING •PERMIT APPLICATION TO CONSTRUCT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE DISTRICT Permit No 284 199 9/74 CANARY—FILE, PINK—APPLICANT s Owner r 4104/Architect Contractor -� Addres ' �L!�7CCtlfess Address 7 �!/ City u City Phone f r Z% Phone Phone6 �� d . o 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 .; 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 properI to be occupied until I (we) have - complied with all laws of the County of Riverside and the State of California governing said property.. DATE SIGNATURE OF OWNER AND/OR AGENT Approval by Signature from the Following Departs Listed Belo. Must Be Obtained Prior to the Issuing of a Construction Permit. I SPACE NO. / I USE OF STRUCTURE 7h JOB ADDRESS J ,� SINGLE FAMILY DUPLEX Ej Z W LEG&L DESCRIPTION OF PROPERTY ❑ ti -t APARTMENTS AGRIC. N NCOMMUNITY T E COMMERCIAL INDUSTRIAL ). . �. Z LTERATIONS NO. OF SUBMITTED'PLANSUSE OF PERMIT WA N a ✓ CASE N0. 13 p Z NO.. OF PARKING SPACES REQUIRED NO. OF BUILDINGS NOW XISTING jZONE ` % SETBACKS: FRONT ���SIDE ! ¢ REAR m GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE SETBACK ORDINANCE # OF FEET REQUIRED ON STREET /� DATE SIGNATURE OF LAND USE OFFICIAL / • _ tip DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET-- z CURB AND GUTTER REQUIRED: YES ❑ NO ❑ STREET ac d CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑ W HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET C IMPROVEMENT? YES ❑ NO ❑ at DATE SIGNATURE OF ROAD DEPT. OFFICIAL = SWIMMING POOLS PUBLIC WSEWAGE DISPOSAL FOOD ESTABLISHMENT _ { WATER POLLUTION REMARKS �rr FLOOD CONTROL— z AIR POLLUTION at W' _ DIV.OF HWY I.- a 1 - YOUR PROPERTY MAY BE SUBJECT T'0 0 o FLOOD. RIVERSIDE COUNTY ASSUMES -NO RESPONSIBILITY IN EVENT OF FLOOD. r 284 199 9/74 CANARY—FILE, PINK—APPLICANT s .. R ...: ; r .._ •r i i : ` i ,, s; ..., s" .?tee ; _ DEPARTMENT OF/BUILDING-AND SAFETY APPLICATION CERTIFICATE - COUNTY -OF RIVERSIDE 0PERMIT N Effective July1, 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: 0 LICENSED CONTRACTORS DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Busines and Professions Code and my license is in full force and effect. License Class { License No. Date /1 /— Contractor_ 4 Q 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;•6.&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 0 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. 38800,, Lab. Code). Policy No. Insurance Q Certified copy is hereby furnished. G C/n Certified copy is filed with the County of Riverside, Department.9if B ilding and Safety. Date / 7 T Applicant /(5 ,cJ';Z/n 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 permi't•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 Q 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. ( 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 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 for/ which,I have applied for this permit for the purpose of making inspections. Signature ofpp icant/, gent Date r nt pplicant/ gent Name 284-2000 7/80 ;'•'