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403919 (RPL)BUILDING PERMIT PERMIT NO. 403919 DEPARTMENT OF BUILDING & SAFETY FIELD rf;� COUNTY OF RIVERSIDE CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. 2ND. FL. POR. GAR. CAR P. WALL ESTIMATED CONSTRUCTION SO. FT. @ $ UNITS Ow/n(y'' q \..+�/7 /�� ^•r �l�/ Community (2 (_,k I Voluatidyr $ SO. FT. @ YARD SPKLR SYSTEM Dote SO. FT. @ MOBILEHOME SVC. BAR SINK Off. SO. FT. @ POWER OUTLET ROOF DRAINS MH Permit Fee $-� SO. FT. @ DRAINAGE PIPING VW SO. FT. @ DRINKING FOUNTAIN Use of Permit t / `" c) Y ( It i 1 l / ,iJ ( �� //� 1T SO. FT. @ URINAL Use/Cosa No. VALUATION $ WATER PIPING r Mech. Fee Dbl S NOTE: Not to be used as property tax valuation SWIM POOL, PVT pry FLOOR DRAIN f j `•" � MECHANICAL FEES SWIM POOL, COMM R �^ WATER SOFTENER Zone Restrictions Grou P VENT SYSTEM FAN EVAP. COOL HCOD SIGN Plumbing Fee WASHER (AUTO)(DISH) �"�.&and Am.t. $ APPLIANCE DRYER Plan Checker Final Dota GARBAGE DISPOSAL Unit Sp. Insp. Fee $ FURNACE UNIT WALL FLOOR SUSPENDED § LAUNDRY TRAY a 't Supplimentol Permit Numbers s AIR HANDLING UNIT CFM IDLE METER Reinsp. Fee KITCHEN SINK Owner/Agent �% �� % ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET S �•, ^✓ i COMPRESSOR HP POLE, TEMP/PERM City Zip LAVATORY Received by ' ( {" rte' HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER Licensest / Trees required BOILER B.T.U. SO. FT. @ a BATH TUB Ci L Zip SO. FT. @ a WATER HEATER r - SO. FT. RESID @ 1 t/.a SEWAGE DISPOSAL S0. FT. GAR @ V/a HOUSE SEWER ' GAS PIPING PERMIT FEE PERMIT FEE y_,.�.� PERMIT FEE _ DBL. TOTAL FEES MOB. HM. FEEMICRO FEE MECH. FEE Pl. CK. FEE CONST. FEE ELECT. FEE SMI FEE FEE PLUMB. FEE PERMIT NO. 403919y Job Address �' � � � Space �.it/ ��.r�t///L� �Zip ( i l Ow/n(y'' q \..+�/7 /�� ^•r �l�/ Community (2 (_,k I Voluatidyr $ Dote Dist. Off. I F.C.0 MH Permit Fee $-� Micro Film Fee Cop $ Use of Permit t / `" c) Y ( It i 1 l / ,iJ ( �� //� 1T Parcel No. Use/Cosa No. Ck. By Mech. Fee Dbl S PI. Ck. Fee S Set Backs Lot Size Construction Fee Dist $ Legal Description i j `•" � F S/ �.� S R �^ Electrical Fee Dbl S /� Zone Restrictions Grou P T Type SMI Fee Plumbing Fee Dbl S �"�.&and Am.t. $ Plan No. Plan Checker Final Dota Inspector Unit Sp. Insp. Fee $ Dental. Fee § Const F N C r Addr& r,. a 't Supplimentol Permit Numbers s Registr. Fee $ Mileage Fee § Witness Fee § Reinsp. Fee § Owner/Agent �% �� % Tel. Zip ., Total Fees S �•, ^✓ Address City Zip M.O. N.C.E] Cash ❑ Check Received by ' ( {" rte' Contractor , c../ ('i 7 �l f �_ All" Tel. •� Licensest / Trees required Sewage System Address / f Ci L Zip T LL p Sewer District Form 284208 (Rev. 1/80( THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verlfiesti by: - 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 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN k' ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. NO. OPERATION DATE INSPECTOR NO. OPERATION DATE IM14PECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 6 2 Ftgs 8 Frms 34 Plenums 8 Ducts 2A Slob Grade 35 Furnace Comport. 3 Steel 36 Inlets 6 Outlets 4 Grout Blocks 37 Combustion Air ' 5 Bond Beams 38 Compressor 6 Roof Deck 39 Appl. Clearonce 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. Ej °o ADDITIONAL INFORMATION SEWAGE SYSTEM SIZE & LOCATION 11 Exterior lath 12 Internal Lath 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Walls (Batts) 128 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 Finalf1� Tank Pit L. Line REAR OF PROPERTY LINE ELECTRICAL APPROVALS P/l P/ 26 Power Pole 27 Conduit 28 Service Entrance y� (�V 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final - sJ CFrnceeff-latching �, before t. poo) NOTICE: 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 E (�1>C%%fi/��-Z� Architect —. f,41 !vSZ%�CL�T! Address_5Rog_ address___ Add ress�lny 3 En,? City City--- City_1/�.�Q/vr(�/ Phone Phone 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, ana/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 o ed until I (we) have complied with all lawns of the Countv of Riverside and the State of California governing said property.. 6.- DATE `� • — -- SIGNATURE OF OWNER AND/OR AGENT�y�-- --- - Approval by Signature from the Following Departments Listed B ow Must Be Obtained Prior to the Issuing of a Construction Permit. 4qi SPACE NO. S -3 7;> � z� C*Ve4 _v.Z� USE OF STRUCTURE J08 ADDRESS _— SINGLE FAMILY DUPLEX % O uj LEGA OESCRIPTIOA OF PR ERTY �_/ f2� 0 �__ �PQ�` y21 y�O Q ��� - APARTMENTS AGRIC. /oP�/ `�+ J- V _' � H Q `v-- COMMERCIAL INDUSTRIAL L, C COMMUNITY - rJl w�Y ALTERATIONS n NO. OF SUBMITTED PLANS _ USE OF PERMIT -- uj uj Q CASE NO. _ p Z NO. OF AR ING SPACES REQUIRED .- NO. OF BUILDINGS NOW EXISTING - /� Q ZONE ETBACKS: FRONT SIDE �- -'REAR . J m GRADING FERMIT REQUIRED.' YES ❑ NO ❑ LOT SIZE SETBACK ORD NANCE __— OF FEET REQUIRED ON - STREET `# DATE I Y - I-0 SIGNATURE OF LAND USE OFFICIAL-- DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET -- — I z CURB AND GUTTER REQUIRED: YES ❑ NO ❑ STREET Cc oe a CAN CUR3 AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑ W HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET D IMPROVEMENT? YES ❑ NO ❑ 09 DATE SIGNATURE OF ROAD DEPT. OFFICIAL— I SWIMMING FOOLS PUBLIC Q W SEWAGE DISPOSAL FOOD ESTABLISHMENT S WATER POLLUTION REMARKS FLOOD CONTROL - H z AIR POLLUTION ; _ 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 APPLICATION CERTIFICATE COUNTY OF RIVERSIDE PERMIT N Effective July 'I, 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 z, 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 e " :53 License No. Date li T i 19' irD Contractor 5//�/ SN R/�' T�� cr�li✓ ro , �✓ - .�/ ( fes` 0 OWNER -BUILDER DECLARATION I hereby affirm that I amexempt 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.). 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 V1� 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. 139J• L?3- A?.3 C Insurance i�:�A/Y?F'P,'-ly-':� UPPAII •/= 4Pf9u k) 0Certified copy is hereby furnished. f If 12 Certified copy is filed with the County of Riverside, Department of Building and Safety. Date f"11f I/ 19F0 Applicant J�A'SN//V4_ �✓ySTJiG/�977r1 � CERTIFICATE OF EXEMPTION•FROM WORKERS' COMPENSATION INSURANCE (This section need notbe completed if permit valuation is for $100.00 or less.) I certify that,in the performance of the work for which this permitfis 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 cod {I must forthwith comply with such provisions A or this permit shall be deemed revoked. // Date (�j_ . i'/ / Zfi/ Appl icant CONSTRUCTI�L'ENDIN6�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 i DIVISION OF INDUSTRIAL -SAFETY PERMIT CERTIFICATION 0 I hereby certify that no excavation five (5) or more feet in depth into whicha person is re- quired to descend, will be made id 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.) Q 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. i �t M Division of Industrial Safety Permit No �/ _ k' Date -, 21 / Ci 9) Applicant "I-/- CERTIFICATE /l CERTIFICATE OF COMPLIANCEPAND" AUTPORIZATION 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 fdr—whith/f have applied for this permit for the purpose of makingrispections. 02 ianature/of a scant/ oent Date Print Applicant 284-2000 7/80 PERMIT NO, 03919 DEPARTMENT OF BUILDING & SAFETY COUNTY OF RIVERSIDE FIELD OFFICE PERMIT NO. 403919 CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES v 1ST FL. 2ND. FL. POR. GAR. CAR P. WALL ESTIMATED CONSTRUCTION SQ. FT. @ $ UNITS CiQ / +G//�ell SQ. FT. @ YARD SPKLR SYSTEM , SO. FT. @ MOBILEHOME SVC. BAR SINK Voluoti S SO. FT. @ POWER OUTLET ROOF DRAINS Date i ^ � SQ. FT. @ DRAINAGE PIPING SQ. FT. @ DRINKING FOUNTAIN F. C. SQ. FT. @ URINAL Micro Film Fee Cop S - VALUATION $ WATER PIPING •�"' NOTE: Not to be used as property tax valuation SWIM POOL, PVT oo FLOOR DRAIN Ck. Fee S Construction Fee Dbl S Set Backs MECHANICAL FEES SWIM POOL, COMM •� F S/ g R WATER SOFTENER Zone Restrictions VENT SYSTEM FAN EVAP. COOL HOOD SIGN SMI Fee S WASHER (AUTO)(DISH) APPLIANCE DRYER Plan Checker GARBAGE DISPOSAL Inspector FURNACE UNIT WALL FLOOR SUSPENDED Sp. Insp. Fee S LAUNDRY TRAY AIR HANDLING UNIT CFM IDLE METER Supplimentol Permit Numbers KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC Witness Fee $ -WATER CLOSET. COMPRESSOR HP POLE, TEMP/PERM Tel. LAVATORY Zip HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT Address SHOWER BOILER B.T.U. SQ. FT. @ a M.O. [3 N.C. ❑ Cash Check BATH TUB Contractor SO. FT. @ c Tel,jj `/ 3 - / o WATER HEATER License# Sewage System S0. FT. RESID @ 1 '/c Address SEWAGE DISPOSAL Cit ) /nom l'] Zip ' 50. FT. GAR @ 3/4a HOUSE SEWER GAS PIPING "PERMIT FEE PERMIT FEE O PERMIT FEE Q DBL. TOTAL FEES MOB. HM. FEE MICRO FEE MECH. FEE PL. CK. FEE CONST. FEE ELECT. FEE SMI FEE FEE PlU B. FE�E PERMIT NO. 403919 - - _�_ sdurria l v - " X�, - - gpuce Zip Owne / +G//�ell mu , Voluoti S Date i ^ � 1Dist. OII. F. C. MH Permit Fee g Micro Film Fee Cop S - Use of Permit I ! i kur i, ( �!t - /7 legal Description S /y a+/� u / 0 r ""' Gr^ Parcel No. Use/Cole / / 00 No. Ck. By Mech. Fee Dbl S Ck. Fee S Construction Fee Dbl S Set Backs Lot SizePI. •� F S/ g R Electrical Fee Dbl g Zone Restrictions Group Type SMI Fee S Plumbing Fee Del $ Bond Amt. S Plan No, Plan Checker Final Date /I //J/3 (SO Inspector Unit Sp. Insp. Fee S Demol. Fee $ • Const. Lender Branch Supplimentol Permit Numbers Regisir. Fee S Mileage Fee g Address City Zip Witness Fee $ Reinsp. Fee $ Ov,rw Agent / Tel. - Zip Total Fees S Address City Zip M.O. [3 N.C. ❑ Cash Check Received by Trees require Contractor Tel,jj `/ 3 - / o License# Sewage System Address 'J` Cit ) /nom l'] Zip T LL P Sewer District Form 284208 (Rev. 1/80) THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by: 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 r THE 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 ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA_