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418589 (BLCK)PERMIT NO. 5 is(� PERMIT NO., Q Q 418 41$ 5tJ ea Job AddressSpacer S- — T 3 tx �`�E.v /a , �► 7 DEPARTMENT OF BUILDING & SAFETY COUNTY OF RIVERSIDE FIELD- DST t� ! CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. 2ND. FL. POR. GAR. CAR P. WALL ESTIMATED CONSTRUCTION SQ. FT. @ $ UNITS Useof Permit `�,� ,r ' yNf�f +y. f �.iiJ/ / (� fes. SQ. FT. @ YARD SPKLR SYSTEM MOBILEHOME SVC. SQ. FT. @ BAR SINK POWER OUTLET SQ. FT. @ ROOF DRAINS SQ. FT. @ DRAINAGE PIPING % )p SQ. FT. @ DRINKING FOUNTAIN SQ. FT. @ 5; URINAL At VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation SWIM POOL, PVT FLOOR DRAIN n MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER t VENT SYSTEM FAN EVAP. COOL HOOD SIGN WASHER (AUTO)(DISH) APPLIANCE DRYER Sp. Insp. Fee $ GARBAGE DISPOSAL ' FURNACE UNIT WALL FLOOR SUSPENDED Supplimentol Permit Numbers ow 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 Trees requir(C.: +. �.r SQ. FT. @ c WATER HEATER Ci •,/ �* Zip w/ / /;, 7)1 r Z -t-, S' SQ. FT. RESID @I'/, c SEWAGE DISPOSAL S0. FT. GAR @ s/. c HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL. TOTAL MOB. HM.FEE MICRO FEE MECH. FEE Pl. CK. FEE CONST. FES ELECT. FEE SMI FEE FEE PLUMB. FEE PERMIT NO. 5 is(� Job AddressSpacer S- — T 3 tx �`�E.v /a , �► 7 Zip 2? -J J3 Owner iC•� .`�� 7 S./� Community '� ��'L� s'�J �" Voluation $' Dote J r/ - Dist. Off. F.C.C. MH.Permit Fee $ Micro Film Fee Cop $ Useof Permit `�,� ,r ' yNf�f +y. f �.iiJ/ / (� fes. Parcel No. / .r^ ,�J Use/Case No. ',ILk. _' By Mech. Fee Dbl $ PI. Ck. Fee $ Set Backs Lot Size Ftp' i I Construction Fee Dbl $ egol Description j{'/� F S S RI Electrical Fee Dbl Zone Restrictions - Group Type SMI Fee $ Plumbing Fee Dbl $ Bond Amt. $ Plan No. Plan Checker Final Date 00, Ins ctor Unit Sp. Insp. Fee $ Demol. Fee $ Const. Lender Bronch Supplimentol Permit Numbers ow Registr. Fee § Mileage Fee§ Address City Zip Witness Fee $ Reinsp. Fee $ Owner/Ageni f� Tel Zip Total Fees $J_Z Adc��t� /� �^'1 `' / //"'/ /+''! t, ,,.• City Zip M.O. N.0 Cash Check Received by ' Contractor, •� fQ`J G�4V,,,d 6 /l �i+�i �f✓�/i/ /d /G`41' ll ._ Tel.{ °�1 ".— License d Trees requir(C.: +. �.r Sewage System Addressj/ // f Ci •,/ �* Zip w/ / /;, 7)1 r Z -t-, S' 3 T LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified byt'y Sewer District -� FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. 1411 rI HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH E 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 9— Form 284-208 (Rev.8/78) ©s 10 ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. �,A, NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back % 33 Ventilation System 2 Ftgs & Frms i 34 Plenums 8 Ducts 2A Slab Grade 35 Furnace Comport. 3 Steel i� 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 FireplaceT. 0. 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) 14 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 l+ t P/L P/1 ELECTRICAL APPROVALS 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final! 1, STREET NAME NOTSCE: THIS IS NOT A BUILDING PERMIT APPLICATION TO CONSTRUCT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE DISTRICT / •' Permit No 284 199A 9/74 - CANARY—FILE, PINK—APPLICANT �d UJU� IS�� Architect Contractor-Zl-__h!�!/�liJ�� Owner . _—. _ 4yC1_1fX"L)6�4 ST• ���5 Addres-6H8�359 Address___ Address � _— City �ilu ""4 City-- — - City --— Phone Phone _ Phone --'5- 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 proper to be occupied until I (we) have complied with all la sof te County of Riverside and the State of California governing said property. �`� / r. DATE __ SIGNATURE OF OWNER AND/OR AGENT Approval by Signature from the Following Departments ListedBlow Must Be Obtained Prior to the Issuing of a Construction Permit. ISPACE NO. ^` '•-�' i USE OF .STRUCTURE y �� JOB ADDRESS L- C>�-- _I - "`SINGLE FAMILY `'vj� DUPLEX El J� ? -vim >_ Z t- LEGAL DESCRIPTION OF PROPERTY / - APARTMENTS AGRIC. O COMMERCIAL INDUSTRIAL n j 'n COMMUNITY . _ G`- 5Z2 ALTERATIONS Q NO. OF SUBMITTED'PLANS - USE OF PERMIT �- --r , r"i✓ •!ice'-%.•/ G✓c..,... �1� ...... _ _ 6 a.�� W _ J _bH �— O Z PA SPACES REQUIRED NO. OF BUILDINGS NO w� r:N 0�=0 FW Q � ZONE/ % SETBACKS: FRONT SIDE REAR J m GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE SETBACK ORDINANCE # OF FEET REQUIRED ON STREET DATE j - SIGNATURE OF LAND USE OFFCI DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET__ W CURB AND GUTTER REQUIRED: YES ❑ NO ❑ STREET a CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑ W HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET Q IMPROVEMENT? YES ❑ NO ❑ O of DATE SIGNATURE OF ROAD DEPT. OFFICIAI Z SWIMMING POOLS PUBLIC QW SEWAGE DISPOSAL — Au 0 FOOD ESTABLISHMENT WATER POLLUTION REMARKS rn FLOOD CONTROL— z AIR POLLUTION _ DIV OF HWY c a — YOUR PROPERTY MAY BE SUBJECT TO o. UJ 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 PERMIT # 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 Clss , License No.�s9xa Date 5��1 Ff/ Contractor 2�.�l6fOs�,E;` Glcf��G 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.). 0 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 �] 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. 0 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 thabor code, I must forthwith comply with such provisions or this permit shall be deemed revoked. , Date S/y lel Applicant 511V 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 '0 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 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.) [� 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. 1140 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- pertyifor which I have applied for this permit for the purpose of making inspections. ignat0,e of Applicant/Agent Date Print Applicant/Agent Name 284-2000 7/80 PERMIT NO. 4185891 PERMIT NO. 4 Q 9 Job Address S _ S'3 a �,� z DEPARTMENT OF BUILDING 8r. SAFETY COUNTY OF RIVERSIDE FIELD OFFICE . DST CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES Date I. X— IST FL. 2ND. FC POR. GAR. CAR P. WALL ESTIMATED CONSTRUCTION SQ. FT. @ UNITS Micro Film fee Cop g. YARD SPKLR SYSTEM SQ. FT. @ No. MOBILEHOME SVC. BAR SINK SQ. FT. @ Ck. BBy If SQ. FT. @ POWER OUTLET ROOF DRAINS, PI. Ck. fee $ � SQ. FT. @ DRAINAGEpIPING Lot Size r DRINKING FOUNTAIN SQ. FT. @ Construction Fee Dbl Ej� ° URINAL SQ. FT. @ S VALUATION WATER PIPING R NOTE: Not to be used as property tax valuation SWIM POOL, PVT FLOOR DRAIN i MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER Bond Amt. $ VENT SYSTEM FAN EVAP. COOL HOOD SIGN WASHER (AUTO)(DISH) or APPLIANCE DRYER GARBAGE DISPOSAL Demol. Fee FURNACE UNIT WALL FLOOR SUSPENDED Const. Lender Branch _ LAUNDRY TRAY AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK Witness Fee $ ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET Tel. COMPRESSOR HP POLE,TEMP/PERM LAVATORY $ HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT s SHOWER M.O. N Cash Check BOILER B.T.U. SQ. FT. @ c BATH TUB Te�l.(�''y [� V G7 7 a,73,o License# SQ, FT. @ c WATER HEATER Sewage System SQ. FT. RESID @1''Ac SEWAGE DISPOSAL k� SQ. FT. GAR @ 3/4 c HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL. TOTAL MOB. HM. FEE MICRO FEE MECH. FEE PL. CK. FEE CONST. FEL ELECT. FEE SMI FEE FEE PLUMB. FEE PERMIT NO. 4185891 Job Address S _ S'3 a �,� z SpaceZip - t x-6.3 Owner WO % L r-sk Community iG► //{/ r/ d � Valu�attiiioo+n+°yyy G.� - $ t./ / Date I. X— Dist. Off. F.C.C. MH.Permit Fee $ Micro Film fee Cop g. Use ofPermitParcel ✓ / ' j'/ , / � fG}�1:133-toa'H W �— 4C) fd/� ff",'"�....rs !� i�•� //" /G.+� No. Use/Case No. Ck. BBy If Mech. Fee Dbl $ PI. Ck. fee $ � Set Backs Lot Size r Construction Fee Dbl Ej� egal Description F C.�.% / T� /�- S S R Electrical Fee Dbl $ Zone Restrictions / Group Type SMI Fee $ Plumbing Fee Dbl $ Bond Amt. $ Plan No. Plan Checker Final DateL3) �'Z or Unit Sp. Insp. Fee $ Demol. Fee $ Const. Lender Branch _ Svpplimental Permit Numbers - Registr. Fee $ Mileage Fee $ Address City Zip Witness Fee $ Reinsp. Fee $ Owner/Agent Tel. Zip Total Fees $ Ad t,City Zip M.O. N Cash Check Received by Coo/ntractor.� /� Il i/!1✓�67/lJ lie (r... Te�l.(�''y [� V G7 7 a,73,o License# r Trees requir �" Sewage System .Address / Ci (/j Zip k� T LL a 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 BECOME VOID. I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH T E LAWS � OAF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. t' I'RL5iP6Y 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 Y