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BLCK (403236)DVFLUML7 rCKMII PERMIT NO, DEPARTMENT OF BUILDING & SAFETY FIELD �DST]03236 COUNTY OF RIVERSIDE CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES, IST FL.-' 2ND. FL. FOR. GAR. CAR P. WALL v�J J % ESTIMATED CONSTRUCTION SO. FT. .@ $ UNITS 1_ SO. FT. @ YARD SPKLR SYSTEM SO. FT. @ MOBILEHOME SVC. BAR SINK SO. FT. @ POWER OUTLET ROOF DRAINS SO. FT. @ •• DRAINAGE PIPING SO. FT. @ DRINKING FOUNTAIN SO. FT. @ URINAL VALUATION $ ,� WATER PIPING NOTE: Not to be used as property tax valuation U SWIM POOL, PVT FLOOR DRAIN MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER VENT SYSTEM FAN EVAP. COOL HOOD SIGN WASHER (AUTO)(DISH) t APPLIANCE DRYER SMI Fee S�J GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED Pion No. 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 ;s HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER r r BOILER B.T.U. SO. FT. @ a BATH TUB Total Fees $ SO. FT. @ a WATER HEATER M.O. ❑ N.C. Cash ❑ Check S0. FT. RESID @11/.4 SEWAGE DISPOSAL Tel. 50. FT. GAR @ 3/44 HOUSE SEWER at ` GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE D8L.OTAL FEES LT !7 l✓ MOB. HM. FEE MICRO FEE MECHIFEE PL:CK. FEE CONST. FEE ELECT. FEE ;, SMI FEE FEE PLUMB. FEE ' /J PERMIT NO. 403236 Job Address- -- --- _ - Space ZipOwner - -- —�-- '" Ca iy" '� +. Valuation jv $�� Dote's ^, Dist' Off. F.C.C. MH Permit Fee $ Micro Film Fee Cop $ Us�f P`errtfit"" "• " ' •" F rcel No. - Use/Ca o. Ck. By Mach. Fee Dbl $ PI. Ck. Fee $ ,j :J a BgSki '` Lot Size " Construction Fee Dbl $ el— Legal Description F S S R Electrical Fee Doi $ Zone Restrictions Group Type t SMI Fee S�J Plumbing Fee Dbl S Bond Amt. Pion No. Plan Checker Fi o r� Inspe or Unit A.- Sp. Insp. Fee $ Demol. Fee $ Const. lender Branch - Supp ntaaIIIPPermit Numbers ' 6741 ' � s r Regisig Fea. $ Miledge;Fee. E Address Cit Zi y p Witness Fee $ Reinsp: Fee $ Owner/Agent Tel. Zip ' Total Fees $ Address - f ,,,wrr>r^ +t t :.J ` .+r'" .+s•' City Zip M.O. ❑ N.C. Cash ❑ Check fj y Received by-.-. ! �%, Ctof:+/%"Ya!:v •..�i`v+✓+ syr. i.,F'` A� - y Tel. Licensels ~,]Sew ,. / j Trees re9u .dv�'/•'!)'fJ.r.••�. at ` T LL Is THIS PERMIT SHALL BECOMTVOID IF WORK IS NOT COMMEtXEG0ITfIIN146 DAYS. CESSATION OF WORK Sewer District FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO, BECOME VOID. c ,1 HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH Y THE LAWS OE RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. ' I HEREBY CERTIFY TM AT: THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN Form 284-208 (Rev. 1/80) vZ,/ T �CsE���W__ITH �ECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. -verified by: s'1. NO. OPERATION DATE INSPECTOR NO. OPERATION 'DAt'E INSPECTOR i BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back.� 33 Ventilation System 2 Ftgs & Frms Z. 0 34 Plenums 8 Ducts 2A Slab Grade 35 Furnace Comport. 3 Steel �- 36 Inlets 8 Outlets 4 Grout Blocks /1' 37 Combustion Air 5 Bond Beams _'L ... 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 10A Fireplace T. 0. No 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) 14 Final - A_ 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 ELECTRICAL APPROVALS P/L P/ ,rr .f 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 298 Bonding 30 Fixtures 31 Service 32 Final i" STREET NAME NOTICE: THIS IS NOT A BUILDING PERMIT DISTRICT r / APPLICATION TO CONSTRUCT Permit DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE 284 199A. 9/74 CANARY -FILE, PINK -APPLICANT Owner Architect-- — --_ Contractor A _ - ` p- -� ►� �'�' Address�J-dam! dress_--- Address-- -22��d- City— City-- City_.r�ppl - Phone" Phone _ Phone—�._D�—__ 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. 1 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 1 (we) will not occupy said property and will not cause said property'to be occupied until I (we)*have complied with a I laws of/t'he County of Riverside and the State of California governing said property. ��✓✓�� DATE•���/--t�-r—�� SIGNATURE OF OWNER AND/OR AGENT— Approval by Signature from the Following Departments Listed Below Must Be Obtained Prior to the Issuing of a Construction Permit. SPACE NO. i���.' / USE OF STRUCTURE JOB ADDRESS✓`� lV � , SINGLE FAMILY F� DUPLEX ❑ LEGAL DESCRIPTION OF PROPERTY Z t o �� APARTMENTS AGRIC. N Q COMMERCIAL INDUSTRIAL ❑ COMMUNITY Z/' ALTERATIONS n o O Z NO. OF SUBMITTED PLANS - USE OF PERMIT � CASE NO. _ Z NO. OF PARKING SPACES REQUIRED — NO. OF BUILDINGS NOW EXISTING - Z ZON ETBACKS: FRONT SIDE REAR J Co GRADING PERMIT REQUIRED? YES❑ NO ❑ LOT SIZE SETBACK ORDINANCE # OF FEET REQUIRED ON TREET / DATE—Z el SIGNATURE OF LAND USE OFFICIAL DEDICATION YES ❑ NO ❑ NO. OF FEET ---- _REQUIRED: z CURB AND GUTTER REQUIRED: YES ❑ NO ❑ STREET . F- rx a CAN CURB AND, GUTTER FEASIBLY BE INSTALLED? YES [I NO ❑ W HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY. AND STREET Q IMPROVEMENT? YES ❑ NO ❑ O °C DATE SIGNATURE OF ROAD DEPT. OFFICIAL— x SWIMMING POOLS PUBLIC QW SEWAGE DISPOSAL FOOD ESTABLISHMENT _ WATER POLLUTION REMARKS H FLOOD CONTROL I - Z AIR POLLUTION � W _ DIV OF HWY 0 a _ YOUR PROPERTY MAY BE SUBJECT TO c FLOOD. RIVERSIDE COUNTY ASSUMES NO RESPONSIBILITY IN EVENT OF FLOOD. 284 199A. 9/74 CANARY -FILE, PINK -APPLICANT DEPARTMENT OF BUILDING AND SAFETY APPLICATION CERTIFICATE COUNTY OF RIVERSIDE f PERMIT N .P 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 ^ IQ 1; License No. Z?(-- % 3P/— Date _.4r4 JA 7 Contractor Q v OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reasons: Q 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.). Q I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, B.&P.C.). [:I 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).``t Policy No. to 41 a I— Insurance [] Certified copy is hereby furnished. Q Certified copy is filed with the County of Riverside, Department of Building-,' and Safety. Date-4� ,14 Applicant �2n.�r�. .r•-, - ,� [-1 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 in 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. X ignature of Applicant/Agent - ' - Date" Print Applicant/Agent Name 284-2000 7/80 -BUILDING PERMIT 'Y . . + , • PERMIT NO. 403236 vERMIT NO. 032.36 - DEPARTMENT OF BUILDING & SAFETY COUNTY OF'RIVERSIDE :FIELD OFFICE DST - CONSTRUCTION, ESTIMATE, , m nity •Z/,/ /�/, NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. a 2ND. FL. POR. GAR., CAR P. '',• WALL " ESTIMATED CONSTRUCTION SO. FT, .@ $ UNITS + ' SO. FT. @ _ YARD SPKLR",SYSTEM' SO. FT. @ + MOBILEHOME SVC. BAR SINK SO. FT. @4 + POWER OUTLET '• ROOF DRAINS SO. FT. @ r. DRAINAGE PIPING SO. FT. @ GL DRINKING FOUNTAIN ' , F.. _' SO. FT. @ r .. r_ . URINAL VALUATION- $ di - ,WATER PIPING ' • .NOTE: Not to beused 'as property tax valuation - SWIM POOL, PVT" FLOOR DRAIN MECHANICAL FEES Inspector SWIM POOL, COMM .` ' WATER SOFTENER VENT SYSTEM FAN ' EVAP. COOL1 . HOOD Demol: Fee g - ,. SIGN WASHER (AUTO)(DISH) APPLIANCE,_ DRYER •, A - ••• - _ . Registr. Fee .+ ti S GARBAGE DISPOSAL FURNACE ._.UNIT WALL FLOOR • SUSPENDED Witness Fee Reinsp. Fee S' d LAUNDRY TRAY . AIR HANDLING UNIT r - ' ' • CFM Tel. ,r ID,LE,METER KITCHEN SINK ABSORPTION SYSTEM B.T.U. Address � TEMP USE PERMIT,SVC WATER CLOSET COMPRESSOR HP. ` M.O. 0 N.C. E3 Cosh E)CheckCOK ` `POLE, TEMP/PERM LAVATORY •"' r HEATING SYSTEM FORCED, GRAVITY. Tel. — �% AMPERES SERV ENT - _ .SHOWER ` BOILER •" + ' B.T.U. - sewn System ,. - SO: FT. @ a BATH TUB ' .City ^` Zip SO. FT. @ a WATER HEATER - S0. FT. RESID @ 11144 SEWAGE DISPOSAL ' .s`. } S0. FT. GAR, ^@ a/<a` - HOUSE SEWER , - - --GAS PIPING PERMIT FEE ti- PERMIT FEE PERMIT FEE DBL. TOTAL FEESM OB. HM, FEE MICRO'FEE MECH. FEE PC CK. FEE CONST. FEE ELECT. FEE SMI FEE FEE PLUMB. FEE • PERMIT NO. 403236 Job- Address •, ,,4-7a Spoce _ Zip ��� Owner �- m nity •Z/,/ /�/, _ Valuotion S � DoteDist. .9 Off. F.C.C. MH'Permit Fee 5 Micro Film Fee - Cop S - U& of Permit , Pcircel - No. Use/Cde 'No.• Ck. By Mech. Fee �•� Dbl' S PI.'Ck. Fee S' Set s S . - S Zone Restrictions Group - Lot. Size R • ' 7 e r. p YP - ' Construction Fee Dbl S Electricol Fee. Dbl S _ Legol Description' /9 `F -.. �/�7 K �` �W� V �6% 64 SMI Fee Ss S • Plumbing Fee Dbl $ , - Bond Amt. S .Plori No. .. . Pion Checker - -Finc;rVq#6- ^ _ Inspector Unit r' Sp`. Insp. Fee S., j - Demol: Fee g - ,. Const. Lender i Branch , - Supp'IiimmenntClol Permit Numbers -- A - ••• - _ . Registr. Fee .+ ti S Mileoge Fee S f' 'Address - 1 City .Zip Witness Fee Reinsp. Fee S' d Owner/Agent ` r Tel. ,r Zip Tocol Fees '$. - 'r •� Address � � City •' " • . r - - r Zip • r ` M.O. 0 N.C. E3 Cosh E)CheckCOK ` Received ' O nt ctb �' - - Tel. — �% ,. + •^ LicenseR Trees. ,� sewn System ,. Less - .City ^` Zip _ P - THIS PERMIT SHALL BECOME VOID IF WORK -IS NOT COMMENCED WITHIN 120 DAYS. ,CESSATION OF WORK verified by:' •Sewer District FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOMEVOID. - .1 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. `. •1 s � • I HEREBY' ERTIFY THAL7HE,INDIVIDUAL WHO PREPARED THE PLANS AND•SPECIFICATIONS HAS DONE'SO IN. Form 284-208 (Rev. *1/80) NCE WITH SECTION 5541.01` THE BUSINESS AND PROFESSIONS'CODE OF THE STATE OF CALIFORNIA. s