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417563 (RER)PERMIT No DEPARTMENT OF BUILDING & SAFETY DST 417 63 COUNTY OF RIVERSIDE FIELD CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING TEES IST FL. 2ND. FL. FOR. GAR. CAR P. WALL_ /SQ. el, ESTIMATED CONSTRUCTION SQ. FT. @ $ UNITS 1 YARD SPKLR SYSTEM SQ. FT. @ MOBILEHOME SVC. BAR SINK SQ. FT. @ SQ. FT. @ POWER OUTLET ROOF DRAINS t> DRAINAGE PIPING SQ. FT. @ FT. @ DRINKING FOUNTAIN .A' SQ. FT. @ - URINAL r VALUATION $ T WATER PIPING l 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) k APPLIANCE - DRYER GARBAGE DISPOSAL I FURNACE UNIT-_ WALL FLOOR SUSPENDED LAUNDRY TRAY $, AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK*' ABSORPTION SYSTEM B.T.U. TEMP USE PER/AIT SVC WATER CLOSET COMPRESSOR • HIP POLE, TEMP/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. @ c BATH TUB SQ. FT. @ c WATER HEATER "^-- SQ. FT. RESID @1'/.c SEWAGE DISPOSAL SQ. FT. GAR @ '/. c HOUSE SEWER GAS PIPING PERMIT,FEE PERMIT FEE PERMIT FEE DBL TOT .-FEMOB.HM.FEE MICRO FEE MECH. FEE PL. CK. FE CONST. FE� E E �FEf_ SMI FEE FEE Yi PLUAWF;E 15 Ground Plumb 16 Water Piping i 17 Rough Plumb $� 18 Vents _ 19 Sewage Disposal 20 Sewer 21 Water Heater 22 Water Softener 23 Water Service „�►'� . _ �_ _ 24 Gas Test 25 Final ELECTRICAL APPROVALS 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring _ 29A Grounding Wire23714 29B Bonding 30 Fixtures 31 Service 32 Final „�►'� . _ �_ _ SEWAGE SYSTEM SIZE & LOCATION h' u" Tank Pit L.Line REAR OF PROPERTY LINE i; fi P/L P/L STREET NAME PERMIT NO. ` ✓{ 1 5��J - Job Address Space ji��T.,.�Owner �Qv Communis 1 `�.�„, Valuation E , • {� � Date -,i; +Dist 1 ` 'Ir F.C.C. MH.Permit Fee E - Micro Film Fee Cop $ Use of Permit r1\+'y1t!'�ni:'�j \ %�'v.f +J���..- �e', ��• ;,1 Cl �'tY'1 � +'"I�1 Parcel No. 3 f . /%0 �/}j411 `Seet'Backks, c..i�jff{ se'Case No} �''} i*. L i `"'Gk..fee CkMech. Fee Dbl $ $ LotllSize Construction Fee Dbl E Legal Description F s•! �.. > r S S R Electrical Fee Dbi $/At Zone R qtions ft ` . 1f i Group Type - SMI Fee E Plumbing Fee Obi $ / Bond Amt. $ Plan No. Plan Checker I! :jDo:)gj J I pector Unit Sp. Insp. Fee $ Demol. Fee $ Const. Lender Branch Supplimental Permit Numbers " Registr. Fee -_. $- Mileage Fee $ Address City Zip Witness Fee $ Reinsp. Fee $ Owner/Agent - w. Tel. Zip . Tot I Fees $ - 'Address, �r• f ,,.. , -f r• , City Zip •`' Y M.O. V.C.Cash Check Receive byCon Trees req• @,. _.. tact r 1 �' `C:� ,� 6J.,jtiy� "�ti+� i Tel. ✓ / L,. •. "vd •v License# Sewage System r Addr(B/Ss ,q[y / Cit Zi� • `+� ,�.Fr ] �j7� Ptl t7(` www' T LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK Sewer District LANIR 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 WS OF RIVERSIDE COUNTY AND THE SATE OF CALIFORNIA. TIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN Form 284-208 (Rev.8/78) 0s ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. verifei by: NO. 1 2 2A 3 4 5 6 Y, 8 9 10 l0A 11 12 12A 13 OPERATION I DATE I INSPECTOR BUILDING APPROVALS Set Back Thick R Value Figs 8 Frms Slab Grade Steel e— Grout Blocks Bond Beams Roof Deck Framing Vents Garage Fire Wall Fireplace P. L. Fireplace T.O. Exterior Lath Internal Lath Drywall Finish Grade INSULATION Thick R Value 7A Walls (Batts) 12B Ceiling (Batts) 12C Ceiling (Blown) e— 14 I Final & PLUMBING A ROVALS NO. OPERATION DATE INSPECTOR MECHANICAL APPROVALS 33 Ventilation System 34 Plenums 8 Ducts 35 Furnace Comport. 36 Inlets 6 Outlets 37 Combustion Air 38 Compressor 39 Appl. Clearance 40 Fire Damper 41 Smoke Detection Device 42 Commercial Hood 43 Final OP'N ADDITIONAL INFORMATION NO. e;rc elo 4i,1`1� v tar NOTICE: THIS IS NOT A BUILDING PERMIT APPLICATION TO CONSTRUCT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE DISTRICT Permit No 284 199 9/74 I CANARY—FILE, PINK—APPLICANT Owner - i C;� ) ' C 411 Architect T ' Contractor " f Address �l' — Address— Address—,, City , City City_ '•� u /" t — Phone f ' Phone Phone - ��` •�l% W 1 (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 1 (we) have complied with all laws of the County of Riverside and the State of California governing said property. f '� DATE SIGNATURE OF OWNER AND/OR AGENT � � - 3 Approval by Signature from the Following Departments Listed Below Must Be Obtained Prior to the Issuing of a Construction Permit. t / : I SPACE NO. f �I USE OF STRUCTURE f — `p JOB ADDRESS G -Z7 SINGLE FAMILY DUPLEX ❑ LEGAL DESCRIPTION OF PROPERTY f J APARTMENTS [� AGRIC. El C W6 H COMMERCIAL E] INDUSTRIAL L, N COMMUNITY ALTERATIONS n Z NO. OF SUBMITTED PLANS —_— USE OF PERMITul N Q CASE NO.'/r p Z NO. OF.PARKIIsIG SPACES REQUIRED NO. OF BUILDINGS NOW EXISTING Q ZONE'" SETBACKS: FRONT 455) SIDE REAR J m GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE SETBACK ORDINANCE N ___ OF FEET REQUIRED ON — STREET DATE?_" `__1/ SIGNATURE OF LAND USE OFFICIAL ��'_ t_ DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET__ CURB AND GUTTER REQUIRED: YES ❑ NO ❑ —STREET F- oe a CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑ W HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET O C IMPROVEMENT? YES C)NO [I cc DATE _ SIGNATURE OF ROAD DEPT. OFFICIAL Z SWIMMING POOLS PUBLIC WSEWAGE. DISPOSAL FOOD ESTABLISHMENT _ WATER POLLUTION REMARKS �n FLOOD CONTROL AIR POLLUTION W = I- DIV OF HWY IS a — YOUR PROPERTY MAY BE SUBJECT TO 0 o FLOOD. RIVERSIDE COUNTY ASSUMES NO RESPONSIBILITY IN EVENT OF FLOOD. 284 199 9/74 I CANARY—FILE, PINK—APPLICANT .— _; DEPARTMENT OF BUILDING AND SAFETY APPLICATION CERTIFICATE COUNTY OF RIVERSIDE PERMIT N 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•(comnencing with Section 7000) of Division 3 of the Business and Professions Code and my license is in full force and effect. License. Class / 7L censet.Z io. /1, / /4 Date - �i - / Contractor �"c,� t c , A, ui,,, Q� 6 -IA -r) U41 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.). [� I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, B.&P.C.). Q 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'.r 38__0,,0, Lab. Code). / �J 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 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. 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.) [� 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. Signature of Applicant/Agent Date 4 JFK A. 6.e / to != s Print Applicant/Agent Name 284-2000 7/80 k W� BUILDING PERMIT — PERMIT NO. DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE �DST 417563 COUNTY OF RIVERSIDE CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST Fl. 2ND. FL. POR. GAR. CAR P. WALL p ESTIMATED CONSTRUCTION SQ. FT. @ $ UNITS 7jp Owner SQ. FT. @ YARD SPKLR SYSTEM SQ. FT. @ MOBILEHOME SVC. BAR SINK SQ. FT. @ POWER OUTLET ROOF DRAINS SQ. FT. @ DRAINAGE PIPING SQ. FT. @ DRINKING FOUNTAIN SQ. FT. @ t URINAL VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation SWIM POOL, PVT O !�( FLOOR DRAIN MECHANICAL FEES SWIM POOL, COMM Lot Size WATER SOFTENER VENT SYSTEM FAN EVAP. COOL HOOD SIGN WASHER (AUTO)(DISH) APPLIANCE DRYER S R GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED Group Type LAUNDRY TRAY AIR HANDLING UNIT CFM IDLE METER Bond Amt. $ KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC Checker WATER CLOSET COMPRESSOR HP POLE,TEMP/PERM Sp. Insp. Fee $ LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT Branch SHOWER BOILER B.T.U. SQ. FT. @ C Registr. Fee $ BATH TUB Address City Zip SQ. FT. @ t Reinsp. Fee WATER HEATER Owner/Agent SQ. FT. RESID @1'ht r V SEWAGE DISPOSAL Zip SQ. FT. GAR @ '/. C To I Fees HOUSE SEWER "Add res / jJ �c 4--F ! GAS PIPING PERMIT FEE PERMIT FEE Receive by Frees req\utjtlA PERMIT FEE DBL. T�OTP�,F p MOB.HM.FEE MICRO FEE MECH. FEE Pl. CK. FEED NST. FES E E ,/f SMI FEE PERMIT NO. 41756 Job Address f{ N � Space 7jp Owner Communit Valuation? DatetDist. F.C.C. MH.Permit Fee $ Micro Film Fee Cop $ Use of Permit � �y\1� \ (`:I, �`,, ��'? '✓�;w.w '�� `�. y\, ,� /-' 4 vk, it�,CyC�j g .C•+�j� Por el No. /� j �'(J�/ Case No I O !�( CkJ/gy,,�J / Mech. Fee Dbl $ PI. Ck. Fee $ Set Backs Lot Size Construction Fee Dbl- $ Legal Description LM if — F S S R Electrical Fee Dbl $ Zone Plions Group Type SMI Fee $ Plumbing Fee Dbl $ Bond Amt. $ Plan No. Plari Checker Final Date Iln:pVecr Unit Sp. Insp. Fee $ Demol. Fee $ Const. Lender Branch Supplimentol Permit Numbers ' Registr. Fee $ Mileage Fee $ Address City Zip Witness Fee $ Reinsp. Fee Is Owner/Agent Tel. Zip To I Fees $ "Add res / jJ �c 4--F ! City Zip M.O. C. Cash Check Receive by Frees req\utjtlA Co rocs r 2—r,% , Tel./' LicenseR Sewage System Addrgss ^ !//P Ci Zip 73 T LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by: Sewer District ��R 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 TH WS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. TIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN Form 284-208 (Rev.8/78) ©s ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.