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SPIN (374669)BUILUING PERMIT PERMIT NO. DEPARTMENT OF BUILDING & SAFETY MDS374669COUNTYOF RIVERSIDE FIELD CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. 2ND. FL. FOR. GAR. SQ. FT. @ $ UNITS SQ. FT. @ YARD SPKLR SYSTEM SQ. FT. @ MOBILEHOME SVC. BAR SINK SQ. FT. @ POWER OUTLET ROOF DRAINS CAR P. SQ. FT. @ _ WALL SQ. FT. @ SQ. FT. @ ESTIMATED CONSTRUCTION VALUATION $ MH.Permit Fee $ Micro Film Fee DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used as property tax valuation Use of Permit t : A-9 4 z 0 +j """ 7- ,? , . : SWIM POOL, PVT FLOOR DRAIN J MECHANICAL FEES Mech. Fee Dbl E SWIM POOL, COMM WATER SOFTENER ' VENT SYSTEM FAN EVAP. COOL HOOD Lot Size SIGN WASHER (AUTO)(DISH) APPLIANCE DRYER Legal Description _ J� j ate'" 0 2 4 Electrical Fee Dbl $ GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED Type LAUNDRY TRAY AIR HANDLING UNIT CFM - Dbl $ IDLE METER KITCHEN SINK ABSORPTION SYSTEM B.T.U. Plan Cjkecker TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP Unit POLE,TEMP/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY $ AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. @ c BATH TUB Fee g Mileage Fee $ Mileage e SQ. FT. @ c WATER HEATER Reinsp. Fee $ SQ. FT. RESID @1'/4c SEWAGE DISPOSAL Tel. y' SQ. FT. GAR @ 3/. c HOUSE SEWER Total Fees M.O. Is -C. n Cash n Chec s Address _ GAS PIPING PERMIT FEE Zip PERMIT FEE PERMIT FEE DBL. TOTAL FEES MOB. HM. FEE MICRO FEE MECH. FEE PL. CK. FEE f CONST. FEE ELECT. FEE SMI FEE FEE PLUMB. FEE PERMIT NO.Job 374666 Address Space Zip Owne Community Z A 1 Valuation $ Dote r Dist. !✓ Off. -- F.C.C. MH.Permit Fee $ Micro Film Fee Cop $ Use of Permit t : A-9 4 z 0 +j """ 7- ,? , . : Parcel No. ,tIf Use/Case No. Ck. By Mech. Fee Dbl E PI. Ck. Fee $ �- Set Backs F S 5 R Lot Size Construction Fee Dbl E Legal Description _ J� j ate'" 0 2 4 Electrical Fee Dbl $ Zone Restrictions Group Type SMI Fee $ Plumbing Fee Dbl $ Bond Amt, $ Plan No. yGJ lr Plan Cjkecker Final Datea/q� g / 7 Inspector Unit Sp..Insp. Fee $ Demdl. Fee $ Const. Lender Branch Supplimental Permit Numbers , ' Fee g Mileage Fee $ Mileage e Address City Zip Witness Fee $ Reinsp. Fee $ Owner/Agent Tel. Zip Total Fees M.O. Is -C. n Cash n Chec s Address _ City Zip Received by _ / Contractor,f" r v Tel. rr�, LicenseM Trees required Sewage System Address 17( "A re3,1'N F (Air h, X= City t Zip T LL P Sewer District gForm 284-208 (Rev.8/78) Ds THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK 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. 4 1 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. 21 verified by: NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Ftgs & Frms 34 Plenums & 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. C] 43 Final IDA Fireplace T. 0. OP'N 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 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 PSL REAR OF PROPERTY LINE ELECTRICAL APPROVALS P/ 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final STREET NAME 7 - NOTICE: THIS IS NOTgA BUILDING PERMIT -- APPLICATION TO CONSTRUCT DEPARTMENT OF BUILDING AND SAFETY t COUNTY OF RIVERSIDE DISTRICT Permit No ° 284 li0' 9/74 CANARY—FILE, PINK—APPLICANT TV ti * Ir' A r") f Owner rL Architect Contractor_ 'fir f Address _ Address_ Address_ City S C /i u : ! .t i . !) ; J City City_ 1 Phone ` ' ; `r f r Phone Phone -- 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 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. g r �� DATE ! SIGNATURE OF OWNER AND/OR N&EN-T ` ti Approval by Signature from the Following Departments Listed Below Must Be Obtained Prior to the Issuing of a Construction Permit. iSPACE NO. USE OF STRUCTURE JOB ADDRESS 1 IV es t� v . f+V I SINGLE FAMILY DUPLEX r� -./ } Z W LEGAL DESCRIPTION OF PROPERTY —CJ. APARTMENTS AGRIC. h Q i � lo.� / / � /% COMMERCIAL INDUSTRIAL LJ '^ COMMUNITY .� l� iX I N 7 r1 1. ALTERATIONS ❑ Z NO. OF SUBMITTED PLANS _—___ USE OF PERMIT_— N Q CASE N0. p Z NO. OF. -PARKING SPACES REQUIRED NO. OF BUILDINGS NOW EXISTING -- Q ZONE SETBAC'KS: FRONT SIDE ~REAR J m / GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE SETBACK ORDINANCE _— OF FEET REQUIRED ON—,—/�_L— STREET '� ' DATE _ - SIGNATURE OF LAND USE OFFICIAL F DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET-_ CURB AND GUTTER REQUIRED: YES ❑ NO ❑ i STREET H oc - W CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑ HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET IMPROVEMENT? YES ❑ NO ❑ S °L DATE __ SIGNATURE OF ROAD DEPT. OFFICIAL i S I SWIMMING POOLS PUBLIC i WSEWAGE DISPOSAL 3 FOOD ESTABLISHMENT j 1 _ WATER POLLUTION REMARKS �n FLOOD CONTROL— ONTROL i AIR AIR POLLUTION W DIV OF HWY o a — YOUR PROPERTY MAY BE SUBJECT TO d o FLOOD. RIVERSIDE- COUNTY ASSUMES f NO RESPONSIBILITY, IN EVENT OF FLOOD. 284 li0' 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 Class License No. Date Contractor TX7 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, 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 Owner1—arc., Q 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 0 Certified copy is hereby furnished. Certified copy is filed with the County of Riverside, Department of Building and Safety. Date Applicant Q 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. Q Q Date T S 8U 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. Q Division of Industrial Safety Permit No. Date ��� U Applicant %41. CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY r 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. 14 Signature of Applicant/Agent Date 14 IJ L, 1<11LA)v E� Print Applicant/Agent Name t 284-2000 7/80 DEPARTMENT OF BUILD D SAFETY COUNTY OF RIVERSIDE OWNER -BUILDER INFORMATION Dear Property Owner:_ --J_ An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements - speci,.fi ed 'r; . For your protection you should be aware that as owner -builder -you are the responsible party of re- cord on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. ---If your work -is be-i.ng--performed-by someone -other than yourself, you may-protect--yourself-from possible liability -if -that person -applies for the pro- per permit in his- or' her -name, - - -- -- ---- - --- __ .. _ Contractors are required by -law -to be.licensed_and_bonded -by_the-State-.,of_ California._ and.,_ where required, to have a -business license from the_city.or county.._. They_are also_ reguired_by law to put their license number on all,permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information'for your benefit and'•protection."I _ °'-* If you employ or otherwise engage any persons other than your"immediate family, and the work (including materials and other costs) is $200'or more, for the, en tire,(prajectj,Iand, such= -persons are not licensed as contractors or subcontractors, then you may be an employer. If you are an employer, you must register with'the state and federal government"as an'employer and you are subject to several obligations including state and federalU'income tax withholding, federal social security taxes, workers' compensation insurance, disability•insurance costs, and unemploy- ment compensation-contribut,ions... - There may be'financial risks for you if you do not carry out thesetobli0i'i ons;"and`these-risks are especially serious with respect to workers' compensation insurance.. For more specific information about your obligations under fede"rW law, contact the Internal Revenue" Service (and, if'you wish, the U.S. Small Business Administration);:'etFor more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. - if the structure is intended for sale, property owners who are'not`licensed contractors are allowed to perform their work personally or,through their own employees, without a licensed contractor or subcontractor, only.under limited condi-tions. ( t0' r. 0 _ i ;• Lief . t A frequent practice of unlicensed persons professing,to be contractors is to secure an." owner - builder" building permit; erroneously implying that the property;'owner•is providing his or her own labor and material'personally. Building'permits are not'required`lto be'signedcby property owners unless they are performing their own work personally. Information ,about licensed:contractors may.be obtained by contacting the; Contractors,,,',, State License Board iinf.your communi,ty;GorFat,•1:02.O;,N. Street,.Sacramento; ,,Cal•,iforni'a;,9581.4. 1,. 0u"",i";.6 t7tlS4 r:.14: a0UAC 000,A4�- �,C1o4}.. Please complete and return the enclosed owner -builder verification -form so that we can confirm that you areo;a are,off,,these matters. The building permit will not be issued until the verification is ♦I. returned. ~- ., r }q p 1 "r Di.. !>1 n.U!t 07tilG 4L16 Poi` k,qa t;F'l;F ii t 7" j i'7 ) ,_� 1 C y 6; t:( l F Sincerely, DEPARTMENT OF BUILDING AND SAFETY -� Leopoldo Rojo, Jr. Director C 2001 7/80 ffbvv�i!Eoi OE 1, tJit', Vf ,D Cf",_ to DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE OWNER -BUILDER VERIFICATION Owner Address An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for con- struction of the proposed property improvement (yes or no) 2. I (have/have not) signed an application for building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the pro- posed construction: Name ► Phone Address City Contractors License No. 4. I plan to provide portions of the work, but I have hired the following person to.coordinate, supervise, and provide the major work: Name Phone Address City Contractors License No. 5. I will provide some of the work but I have contracted (hired) the fol- lowing persons to provide the work indicated: Name I`.! t Address Phone Type of work Signature Property Owner Date Social Security Number 284-2002 7/80