CPWU (413164)52333 Avenida Martinez
413164
BUILDING PERMIT
PERMIT NO, DEPARTMENT OF BUILDING & SAFETY
1316 4 COUNTY OF RIVERSIDE FIELD _ nj
I
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEE.
1ST FL. SO. FT. .@ $
2ND. FL. SO. FT. @
POR. SO. FT. @
GAR. SO. FT. @
CAR P. SO. FT. @
WALL SO. FT. @
SO. FT. @
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC. -
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tote valuation
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM FAN _EVAP. COOL HOOD
SIGN
WASHER (AUTO)(DISH)
APPLIANCE DRYER
tri
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
ym
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.
SO. FT. @ a
BATH TUB
SO. FT. @ a
WATER HEATER
Construction Fee Dist S ego es ipti
S0. FT. RESID @ 1 1/4a
SEWAGE DISPOSAL
S R
S0. FT. GAR @ t/4a
HOUSE SEWER
------••• T--''''' ,+ '')
/ ,. ;(1
Zone Restrictions
Group
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL.
TOTAL FEESM
"_
OB. HM. FEE
I
MICRO FEE
MECH. FEE PL. CK. FEE
CONST. FEE ELECT. FEE
SMI FEE
FEE PLdVb- TEL=
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PERMIT NO.
413164
Job Address
T LL P
Space zip Owner
Sewer District
FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. ,
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V,
-/]
I HE Y CERTIFY THAT THE INDIVIDUAL WHO PREPARED•THE PLANS AND SPECIFICATIONS HAS DONE SO IN
MH Permit Fee $
DANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
S
tri
Micro Film Fee Cop S
ym
,
Parcel No. U
se/Cafe 100.
Mach. Fee Del $
Pl. Ck. Fee S
A
t
Lot Site
Construction Fee Dist S ego es ipti
F
S
S R
Electrical Fee Del S
------••• T--''''' ,+ '')
/ ,. ;(1
Zone Restrictions
Group
Type
SMI Fee S
r
Plumbing Fee Dist S
d'hi•
o No
41— Checker
Final
Inspector
Unit
Sp. Insp. Fee S
$
, z— II l — $b
Demol. Fee $
Const. Lender
Branch
Supplimental Permit Numbers
Registr. Fee S
Mileage Fee S Address City Zip
Witness Fee $
Reinsp. Fee $
Owner/Agent
Tel.
Zip
Total Fees E 011
Address
City
Zip
M.O. ❑ N.C. ❑ Cash ❑ Che
r•
Received by
Contractor ..
Y .,,„.
Tel.
Licensen
Trees requi"
4 -
s
Sewage System
Addra
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City
Zip
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,
verified by:
"_1TKLt?C 6VCCIAY5. 1C5eS
T LL P
S- 0ME VOID IF WORK IS NOT COMMENCED V*FI1 ?ION OF WORK
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
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THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA.
I HE Y CERTIFY THAT THE INDIVIDUAL WHO PREPARED•THE PLANS AND SPECIFICATIONS HAS DONE SO IN
Form 484.408 (Rev. 1/80)
DANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
verified by:
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE
INSKCTOR
i
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs 8 Frms
34
Plenums 8 Ducts
2A
Slab Grade
35
Furnace Comport.
3
Steel
36
Inlets & 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.
E
43
Final
10A
Fireplace T. 0.
❑
No
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior lath
12 I Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A I Walls (Batts)
12B 1 Ceiling (Batts)
12C { Ceiling (Blown)
14 Final
PLUMBING APPROVALS.
15 Ground Plumb
16 I 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 2^ l� _
Tank
Pit L. Line
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
P/L
P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
NOTICE: THIS IS NOT A BUILDING PERMIT
APPLICATION TO CONSTRUCT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
DISTRICT
'0�a
Permit No
284 199A 9/74 CANARY—FILE, PINK—APPLICANT
Owne/741-2/'/ k L4� T&= ✓ Architect __ _ Contractor
Address—� ,?_3 4''* Z C2Address___ Address
City -4 0U/_0L7_4'4 City--n—
Phone Phone
ce
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I (we) the undersigned, hereby certify and acknowledge that I (we) have read the application and agree that if Curb and Gutter, and
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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
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without an encroachment permit.
NOW, therefore, it is agreed that I (we) will not occupy said property and will not cause said property to be occupied until I (we) have
complied with /laws of the County of Riverside and the State of California governing said property.
.,all
DATE LG���-{�-- SIGNATURE OF OWNER AND/OR AGENT
` Approval by Signature from the Following Departments Li15a Below
Must Be Obtained Prior to the Issuing of a Construction Permit.
PACE N0.
JOB ADDRESS ,� GZ- USE OF STRUCTURE
SINGLE FAMILY DUPLEX
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L L DESCRIPTION OF PROPERTY // 3
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a�Z �G� APARTMENTS AGRIC.
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COMMERCIAL Ej INDUSTRIAL n
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COMMUNITY .
� ALTERATIONS
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NO. OF SUBMITTED PLANS _ USE OF PERMIT S
Lu a
CASE NO. -
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NO. OFR RKIN SPACES REQUIRED NO. OF BUILDINGS NOW EXISTING
Q 0
ZONE ��' ETBA(fKS: FRONT SIDE REAR
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GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE
SETBACK OR INANC 90 1— FEET REQUIRED STREET
DATE SIGNATURE OF LAND USE U2--
DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET__— _
W
CURB AND GUTTER REQUIRED: YES ❑ NO ❑ STREET
i
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oc
a
CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑
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HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET
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IMPROVEMENT? YES ❑ NO ❑
O
o9
DATE SIGNATURE OF ROAD DEPT. OFFICIAI
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SWIMMING POOLS PUBLIC
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SEWAGE DISPOSAL
_
FOOD ESTABLISHMENT
WATER POLLUTION REMARKS
to FLOOD CONTROL
H
W AIR POLLUTION
W
= DIV OF HWY
f.
c a — YOUR PROPERTY. MAY BE SUBJECT TO
a
c FLOOD. RIVERSIDE COUNTY ASSUMES
NO RESPONSIBILITY IN EVENT OF FLOOD.
284 199A 9/74 CANARY—FILE, PINK—APPLICANT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
APPLICATION CERTIFICATE
PERMIT k
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 ,(' _ _ ? (
Date /7/',,„ /r,. Contractor
[� OWNER-BUILDE DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the fol('lowing 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.).
[:] I am exempt under Section , B:&P.C. for this reason:
Date Owner
M 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.
EJ Certified copy is filed with the County of Riverside, Department of Building and Safety.
Date Applicant
Lrltl CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE
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(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/p,t Applicant
ON 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.
[_] 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 fon which I �ha e� applied for this permit for the purpose of making inspections.
Zp
igna� re of p� an�ti�ent Date
Print"Applicant%Agent Name
284-2000 7/80
9VILVIIVb rCKmn
PERMIT NO."
413164
PERMIT NO.
4 1316 4
'
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
FIELD OFFICE
DST
CONSTRUCTION_ ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
- Va uotio
S
1ST FL.
2ND. FL.
FOR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. .@ $
UNITS
is
SQ. FT. @ YARD SPKLR SYSTEM
MH Permit Fee $
SO. FT. @ MOBILEHOME SVC. BAR SINK
SQ. FT. @ POWER OUTLET ROOF DRAINS
-
i
SQ. FT. @ DRAINAGE PIPING
Parcel No.juse/Cd"e
ttI
SO. FT. @ t DRINKING FOUNTAIN
Ck. By
SQ. FT. @ r URINAL
PI. Ck. Fee $
VALUATION F' $ WATER PIPING
NOTE: Not to be used as property tax$koluotion
SWIM POOL, PVT
FLOOR DRAIN
MECHA CAL FEES
SWIM POOL, COMM
WATER SOFTENER
Electrical Fee DbI S
VENT SYSTEM FAN COOL HOOD
SIGN
WASHER (AUTO)(DISH)
SMI Fee S
APPLIANCE DRYER
Q
GARBAGE DISPOSAL
FURNACE UNIT WAIL FLOOR SUSPENDED
LAUNDRY TRAY
Inspector
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
Dental. Fee S
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET .
COMPRESSOR HP
POLE, TEMP/PERM
LAVATORY
Mileage Fee $
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. @ a
BATH TUB
Tel.
Zip
SQ. FT. @ a
WATER HEATER
Address
S0. FT. RESID @ 1 t/<a
SEWAGE DISPOSAL
City
Zip
S0. FT. GAR @ 1/<a
HOUSE SEWER
C°mrat
t
a
Tel.
GAS PIPING
LicensaR
PERMIT FEE
Sewage System
PERMIT FEE
PERMIT FEE
DBL.
TOTAL FEES
MOB. HM. FEEMICRO
FEE
MECH. FEE PL. CK. FEE
CONST. FEE ELECT. FEE
SMI FEE
FEE PL B. rtP'^^
sv
PERMIT NO."
413164
'
Job Address
Space
Zip Owner
ommuni y
- Va uotio
S
to
is
F.taf
MH Permit Fee $
Micro Film Fee Cop $
e Vfyfmi
-
i
Parcel No.juse/Cd"e
No. `'
Ck. By
Mech. Fee Dbl S
PI. Ck. Fee $
t cli
Lot Size
Construction Fee Dbl S/
Legal DescriptioK
F IS
S
R
Electrical Fee DbI S
Zone Restrictions
Group
Type
SMI Fee S
Plumbing Fee Dbl $
4
Q
Ofion Am .-Pict
$
n Checker
Final to
Inspector
'
Unit
9C
Sp. Insp. Fee $
Dental. Fee S
Const. Lender
Branchti`
supplimentol Permit Numbers
Register Fee S
Mileage Fee $
Address City
Witness Fee $
Reinsp. Fee $
Owner/Agent
Tel.
Zip
Total Fees $
M.O. E] N.C.E] Cash Q Chea
Address
City
Zip
Received by
C°mrat
t
a
Tel.
LicensaR
Trees requ a
Sewage System
Address
City
Zip
T LL P THIS "PERM *SRALL`SECUME VOID IF WORK IS NOT COMMENCED' r/SrrRIIN I ZDWS. rCE4eA ION 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 H Y CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE .PLANS AND SPECIFICATIONS HAS DONE SO IN
Form 284-208 (Rev. 1/80) RDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.