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BLCK (403134)BUILOING PERMIT PERMIT NO. DEPARTMENT OF BUILDING & SAFETY FIELD 0 3134 COUNTY OF' RIVERSIDE [_j_DST / CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. .@ $ 2ND. FL. SQ. FT. @ FOR. SO. FT. r@ GAR. SQ. FT. @ CAR P. SQ. FT. @ WALL / SQ. FT. @J SO. FT. @ ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET r Li j r YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL - f WATER PIPING , NOTE: Not to be used as property tax 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 Ck. By GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED i •.l 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 Sp. Insp. Fee E SQ. FT. @ a WATER HEATER S Supplimentol Permit Numbers " 50. FT. RESID @ 1 t%4 SEWAGE DISPOSAL Address City Zip SO. FT.'GAR @ z/aa HOUSE SEWER Owner/Agent Tal. Zip GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBI. TOTAL FE,FS s MOB. HM. FEE MICROFEE MECH. FEE Pl. CK. FEE CONST. FEE ELECT. FEE SMI FEE FEE PLUMB. FEE .<. PERMIT NO. 403134. Job Address s Space :.f Zip Owner K A, Com nify /^ / c� I Valuation ! S / —j Dote "� "` �/ • - Dist: "Off: F.C.C. t MH Permit Fee S Micro Film Fee Cop $ 'se of Pennilt t. 16l r� !i �T �!.•f is J�,j -.�i 7Bock oal No. tip •/ i .. Us./CofeAo. Ck. By Mech. Fee Dbl S PI. Ck. Fee S i •.l Lot Size - Construction Fee Dbl $ Legal Description '� J�./• !''• �� / /� � �s^• � � �f � F S S R Electrical Fee Dbl $ Zone Restrictions r; Group Type • SMI Fee $ Plumbing Fee Dbl E Bond Amt.Plan E No. Plan Checker If.nN D.Gili 41, //'�� Inspector Unit Sp. Insp. Fee E Demol. Fee S Const. Lender Branch Supplimentol Permit Numbers " e. r- Fee $ Mil Mileage Fee g Address City Zip Witness Fee S Reinsp. Fee S Owner/Agent Tal. Zip Total Fees S •� Address -' City Zip M.O. N.C. ❑ Cosh Q Chec Received /t•' -Y` v`"/ r •. ..:.... ,., .,- Controcior /C- /' i.i� -, Tel. /f' ;/ licenses _ Sews '0J y m .r A d /- •'s `1 Cly ".. Zip i T LL `J P1�. .TF&WRI iX SkALL''�EC M6 f6t&tf- WORK IS NOT COMMEN61ED WITHIN 120'CAYS.`''Cd ATION OF WORK—,,verified by: Sewer District FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. f ;o •1 HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH r _- THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. > r 00IJ5; CERTIFY THAT THE INDIVIDUAL WHO�PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN Form 284-208 (Rev. 1/80) f31(�CE WITH SECTION 5541 0F THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. ` NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS I Set Back 33 Ventilation System 2 Ftgs 8 Frms z v 34 Plenums 8 Ducts 2A Slab Grade 35 Furnace Comport. 3 Steel q-? .. 36 Inlets 8 Outlets 4 Grout Blocks --ffLyp 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 loA Fireplace T. 0. No ADDITIONAL INFORMATION — ti SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath 12 Internal Lath 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Walls (Botts) 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 ELECTRICAL APPROVALS P/L P/ 1 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final STREET NAME • tir NOT:CE: 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 Owner '` 1% A h e -_ _ Contractor�C�"--g .yam—�—s Address 4"Y Address_.__ Address--n!V I' Ad City QU_L� City—_— City----/. Phone Phone _ Phone-74--k—� 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 0 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 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 Departments Listed Below Must Be Obtained Prior to the Issuing of a Construction Permit. � 3 1 SPACE NO. 7-2USE OF STRUCTURE 'J � ADDRESS �—/ J /_S _QI_i�� %� I _ 5— SINGLE FAMILY yQl DUPLEX LEPA'L DESCRIPTION OF PROPERTY Q ' 0-0 /�— Z W .172 APARTMENTS AGRIC. C1 /�6 �- f/�- -+i Q � �/ ---' — COMMERCIAL E] INDUSTRIAL n j '^ COMMUNITY TE ATI NS ❑ Z NO. OF SUBMITTED PLANS — USE OF PERMIT dae,6nz/� jCASE NO. --- C Z NO. OF PAR KI G SP CES .— NO. OF BUILDINGS NOW EXISTING 0 �RE�Q--U�I�RED s Q ZONE E FRONT SIDE REAR J -m GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE SETBAC RDINANCE # OF FEET REQUIRED ON STREET DATE CJ SIGNATURE OF LAND USE OFFICIAL DEDICATION REQUIRED: YES O NO ❑ 'NO. OF FEET__ F uZ, CURB AND GUTTER REQUIRED: YES ❑ NO ❑ STREET t— 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 °C DATE SIGNATURE OF ROAD DEPT. OFFICIAL = SWIMMING POOLS PUBLIC JW SEWAGE DISPOSAL — = G FOOD ESTABLISHMENT WATER POLLUTION REMARKS H FLOOD CONTROL F- W AIR POLLUTION S DIV OF HWY c 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 # —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. 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 Business and Professions Code and my license is in full force and effect. License Class (License. No. Date, ContractorX `i/,,,,, Q OWNER Bs UILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reasons: �Q. Date 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 imp"rove 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.). am exempt under Section Owner B.&P.C. for this reason: Q I 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 t0 Certified copy is hereby furnished. Qi Certified copy is filed with the County of Riverside, Department of Building and Safety. Da�te- Applicant\! �,. /�.a.,..-•-� [J CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE i fes. (This section need not be completed(if permit valuation is for $100.00 or less.) I�cert�fy that in the performance of the work for which this permit is issued, I shall not employ anywper--son in any manner so as to become subject to the Workers' Compensation laws of California. I% Aher understand that if after making this Certificate of Exemption, I should become subject to the QWorkers'.Compensation provisions of the labor code, I must forthwith comply with such provisions or Ah,is permit shall be deemed revoked. Datte4 � Applicant CONSTRUCTION LENDING AGENCY \,IF ereby 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 [7 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. �__57ig%nature of Applicant/Agent Date -Print Applicant/Agent Name 284-2000 7/80 BUILDING PERMIT " PERMIT NO. 40 313.4 a PERMIT NO. 'F 0 n Job Address, - ! _ Space '. - y .` ,,r,re •gym DEPARTMENT OF. BUILDING &' SAFETY' - 'COUNTY OF RIVERSIDE �... FIELD OFFICE; t DST. CONSTRUCTION ESTIMATE Date NO. ELECTRICAL FEES OIL `NO. .PLUMBING FEES. T 1ST FL. 2146. FL. FOR. •• GAR. C AR P. WALLSO. ESTIMATED CONSTRUCTION SO. FT. .@ - •� $ r UNITS' . - ( SO. FT. @' YARD SPKLR SYSTEM SO. FT. @ _ - MOBILE HOME. SVC. 7 BAR SINK SO.,FT: @ - POWER OUTLET `y ROOF -DRAINS- l • SO. FT. @ 'DRAINAGE PIPING FT. @ - DRINKING FOUNTAIN _ - - SO. FT. @ ' URINAL Y _ �•••.�+' ,VALUATION ' $' �,c - .� WATER PIPING S NOTE: Not to be used as property tan valuation, . Electrical Fee", �Dbl 5 - SWIM POOL, 'PVT. - FLOOR DRAIN') • MECHANICAL:` FEES . y. ` SWIM -POOL, COMM ' WATER SOFTENER VENT SYSTEM . FAN , EVAP. COOL' HOOD.• Checker - {+ 1 SIGN _ WASHER (AUTO)(DISH). APPLIANCE - `- DRYER' • t - _ Demol. Fee S GARBAGE DISPOSAL FURNACE UNIT - WALL '" FLOOR '. SUSPENDED Supplimenlol Permit Numbersy - LAUNDRY TRAY AIR .HANDLING UNIT, v CFM Address- City Zip s IDLE METER Reinsp. Fee 5 •KITCHEN SINK ABSORPTION SYSTEM � B.T.U. TEMP USE PERMIT SVC � WATER CLOSET - COMPRESSOR HP c J POLE, TEMP/PERM LAVATORY HEATING SYSTEM • • FORCED GRAVITYAMPERES M.O.s' Q N.C.Cosh Check',i�-;,,. SERV ENT 1 SHOWER. 'BOILER B.T.U. ' '•i Tel. -. - SO. FT. ' @ - a License# . _ BATH TUB Sew ys em (j ''00 � SO. FT. @ a WATER HEATER Zip SO. FT. RESID @,1 /a¢ SEWAGE DISPOSAL' • - . S0. FT. GAR. @. t/a¢ HOUSE SEWER - .'r r ,. GAS PIPING PERMIT FEE ~ .cs PERMIT' FEE PERMIT FEE DBL. .Ad, TOTAL FbEy7 MOB.'HM. FEE. MICRO*FEE MECH., FEE PL CK. FEE _ CONST. FEE ELECT. FEE .�^ SMI FEE FEE PLUMB. FEE - " PERMIT NO. 40 313.4 Job Address, - ! _ Space '. - y .` ,,r,re •gym Zip ,� Owner a�T,•� - Co unity 4 A y �� �..' Valaotion $ Date 'Dist. OIL F.C.C.4 MH Permit Fee S - Micro Film Fee Cop S Use. of Permit. / 1 - ,1 L .�»�iS.:.��/�G'4 ��j✓N VV IIJJ - - Parcel No. - --� Use/Case o. Ck. Bey\^�'r ` J. Mech. Fee Obl 5 PI. 6. Fee S Tet Backs , Lor Size . Construction Fee Dbl S Lego1 Description • ,. - - .. F. _ S S R , Electrical Fee", �Dbl 5 - Zone Restrictions ,Group. Type SMI Fee 5 - Plumbing Fee Dbl- g Bond Amt. .' S No.-Plan - F-Pl Checker - {+ 1 Final Dore - /y�/.. ��//HCl Inspector '0 1 Unit Sp: Insp. fee S Demol. Fee S - Const. Lender. • Branch - - r Supplimenlol Permit Numbersy Regist, Fee, 5 Mileage Fee - $ Address- City Zip s Witness Fee, S. Reinsp. Fee 5 Owner/Agent Tel. ., - •' Zip. Total Fees S- c J Address - - -s s City•, , s • Zip • S M.O.s' Q N.C.Cosh Check',i�-;,,. Received - 1 . ontr for 1' r Tel. -. , License# . _ Trees Sew ys em (j ''00 � Address - City - - Zip T LL '�H P "THKfER10QfT SHALL BECOME- VOID IF WORK IS NOT COMMENCED WITHIN 120" DAYS. CESSATION OF WORK 't . verified by: FOR 120 DAYS SHALL ALSO. -CAUSE PERMIT TO BECOME VOID. Sewer District •1 HEREBY AGREE THAT ALL•WORK IN CONNECTIONtWITH THIS PERMIT WILL S& DONE W'ACCORDANC_E WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. •RE ERTIFY THAT THE INDIVIDUAL.WHO PREPARED'THE.PLANS AND SPECIFICATIONS HAS DONE SO'IN - Form 284.208 (Rev. 1/80). C ANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA, '