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403723 (PAT)DUILlJILYV rCKmll PERMIT NO. DEPARTMENT OF BUILDING & SAFETY FIELD FBTT 1403723 COUNTY OF RIVERSIDE CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. 2ND. FL. FOR. ! GAR. CAR P. WALL ESTIMATED CONSTRUCTION SO. FT. @ $ Dote j/ �C% u Gam'• UNITS Ol4- �i •Y SO. FT. @ - YARD SPKLR SYSTEM SO. FT. @ i T MOBILEHOME SVC. BAR SINK SO. FT. @ POWER OUTLET ROOF DRAINS SO. FT. @' DRAINAGE PIPING SO. FT. @ DRINKING FOUNTAIN SO. FT. @ L URINAL VALUATION $ L WATER PIPING r NOTE: Not to be used as property tax valuation 5 SWIM POOL,,. PVT. • FLOOR DRAIN MECHANICAL FEES Group SWIM POOL, COMM WATER SOFTENER VENT SYSTEM FAN EVAP. COOL HOOD Bond Amt. $ SIGN WASHER (AUTO)(DISH) APPLIANCE DRYER Insp Unit ' GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED Const. Lender Branchuppli ntol rmit Numbers •� . ' LAUNDRY TRAY f AIR HANDLING UNIT CFM Address City Zip IDLE METER KITCHEN SINK ABSORPTION SYSTEM B.T.U. Tel. Zip TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP City Zip POLE, TEMP/PERM LAVATORY t HEATING SYSTEM FORCED GRAVITY Tel. / AMPERES SERV ENT SHOWER BOILER B.T.U. Address SO. FT. @ a BATH TUB 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. f 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 C�LIFORP(iA.' I HER BY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE'? ANS AND SPECIFICATIONS HAS,DONE 50 IN i _ANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. Sewer District Farm 264-208 (Re, 1/80) 4 � SO. FT. @ a WATER HEATER S0. FT. RESID @1114c SEWAGE DISPOSAL S0. FT. GAR @ t/<a HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL.VTOIT t'f MOB. HM. FEE MICRO'FEE MECH. FEE PL. CK. FEE �C N T�.FEE ELECT. FEE rG/ SMI FEE .V - FEE PLUMB. FEE PERMIT NO. 4037 2 3 Job Address Space Zip J d; �.:�. �'/ - -17i a, � Owner ' CommunityValuation /✓ /r✓'r'C- f1G.. $ !' J ,%% �- Dote j/ �C% u Gam'• Dist. �/ Ol4- �i •Y F.C.C. J ' MH Permit Fee $ Micro Film Fee Cop $ Use of Permit � � �" �" / •^-i^�/,y Parcel No. f 1 ,./•�s'.s Use/Coke No. It. By 5 Mach. fee Dbl $ PI. Ck. Fee $��/,/(tJ- Set Backs Lot Size / /� `�'� .;� / 4: fv Construction Fee Dbl $ Lego] Descriptio 0 p r' :% ';r / / �Z" .'� ` U JvJ sial• F >l1 S �� 5 5 R / Electrical Fee Dial S Zone Restrictignit Y Group Type ' . SMI Fee $ Plumbing Fee Dbl $ Bond Amt. $ Plan No. Plan Checker F;' Q 80 Insp Unit ' Sp. Insp. Fee . S Demol. Fee $ Const. Lender Branchuppli ntol rmit Numbers •� . ' Registr. Fee $ Mileage Fee $ Address City Zip Witness Fee $ Reinsp. Fee $ Owner/Agent Tel. Zip Total Fees b Address t City Zip M.O. ❑ N.C. Q Cash Q Check _ Received by -� Contracts � �/ I' j •`�� Jo/1/, / .4J Tel. / License# Trees 9Yd�� ��.[' ;-'/ ,d-°"=,- s r�r Sewage System (//y4 7 LL':w` /y'L•V p Address City Zip 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. f 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 C�LIFORP(iA.' I HER BY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE'? ANS AND SPECIFICATIONS HAS,DONE 50 IN i _ANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. Sewer District Farm 264-208 (Re, 1/80) 4 � e NO. OPERATION DATE INSPECTOR NO. �. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Ser Back /0 /J 33 Ventilation System 2 Ftgs & Frms /OX�Jb 34 Plenums 8 Ducts 2A Slob 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 P Q� v � 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.O. °o ADDITIONAL INFORMATION ` ' 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 1 Final Q ED 619� PLUMBING A .P_R VALS 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 r P/ 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 298 Bonding 30 Fixtures 31 Service 32 Final STREET NAME NOTICE: THIS IS NOT A BUILDING PERMIT APPLICATION TO CONSTRUCT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE DISTRICT I Permit No 284 199A 9/74 CANARY—FILE, PINK—APPLICANT Owner Architect _. _—_. Contractor__CLG�It�✓ w.- ®b!V Addres 1P1411_Q__-_ Address___ Address__ • City!_—_ City_- Phone Phone _ Phone— cc I (we) the undersigned, hereby certify and acknowledge that I (we) have read the application and agree that if. Curb and Gutter, and W 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 ocyWfi)e complied with all laws 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. 1 SPACE NO. �0,/ 1 USE OF STRUCTURE JOB �yPNDA� �LS �d/U I ADDRESS J SINGLE FAMILY DUPLEX LEG L DESCRIPTION OF PROPERTY ��� — APARTMENTS AGRIC. ❑ Z W J'- ` O Q�_ COMMERCIAL INDUSTRIAL n j In COMMUNITY . ALTERATIONS C G Z NO. OF SUBMITTED PLANS - USE OF PERMIT/42 CASE NO. Z NO. OF PARKING SPACES REQUIRED — NO. OF BUILDINGS NOW EXISTI G - Q ZONE/ SETBA(fKS: FRONT -go SIDE REAR J m - GRADING PERMIT REQUIRED? SETBACK ORDINANCE # OF FEET REQUIRED ON STREET DATE O SIGNATURE OF LAND USE OFFICIAL -- DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET__ H uZi CURB AND GUTTER REQUIRED: YES ❑ NO ❑ -STREET os a W CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑ 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 Qa. SEWAGE DISPOSAL - _ FOOD ESTABLISHMENT WATER POLLUTION REMARKS rn FLOOD CONTROL H W AIR POLLUTION W F ., DIV OF HWY c a — - YOUR PROPERTY MAY BE SUBJECT TO d UA 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 1, "I 1980, Chapter 1301, Section 19825,of the Hth and Safety Code requires the execu- tion of the following applicable declarations prior to the issuance of a bui,l:ding 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 Classes „�^� License No. %Gal .3Z Dante_ /13�q Contractor_ —e -4, /„�, rn-p�wv 41 /1^0 4rolc t OWNER -BUILDER DECLARATION I hereby affirm that I amexempt 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.). [� I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, B.&P.C.). M I am exempt under Section , B:&P.C. for this reason: Date Owner ?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. 1,no-530-);13e31/y Insurance 07 - Certified copy is hereby furnished. Certified copy is filed with the County of Riverside, Department of Building and Safety. Date Applicant n 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, should become subject to the Workers' Compensation provisions of the labo code, I must ort.w'W comply with such provisions or this permit sh�ll be deemed revoked. /(� Date' ) D P Applicant— CONSTRUCTIONILENDING AGENCY I hereby affirm that there is a construction lending agency for -the performance of the work for f,(1whic"h this .permit is Issued (Sec. 3097, Civ. Code). ✓ Lender's Name -7 �Ltdir's Address DIVISION OF INDUSTRIAL'SAFETY PERMIT CERTIFICATION y JI 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 i6 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. r-] Division of Industrial Safety Permit No. Date Applicant CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY 1 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'authorizela representa.ive of the Countypof ',Rigg ide, Department of Building and Safety to enter upon the pro- perty for which I hr'e�pplied fo his permit for the purpose of making insp ct'ons. 7 i� SignatureoyAppTicant gent " ` Date Print Applicant/Agent Name 284-2000 7/80 conk, lin, homes • work of our hearts P.O. BOX 912 LA QUINTA,'CALIFORNIA 92253 714-564-41017 DF)V COUNTY OF RIVERS194. DEPARTMENT OF BUILDING* SAFO M APPRO% JG �o �� IRV By�'; V1. E Approval of these plan'ds shall not con ed to bo permit for, , an ppa[ of, any violation of any ag theof the state or county laws. This @C9 =isions must b(D kGPt job until conwWtkm X 0. 0 Z ("n 0 LU co of L.0 Z' U, y < < a- 0' 1 i conklin work of our hearts P.O. BOX 912 / LA OUINTA, CALIFORNIA 92253 / 714 -564 - "FX/ S I)vq 14-564-,Lxis;i;Vq Jt;v�ie7 i BOUNTY OF _ DEPART GE &T OF SSE 13UILDI . P,PPRCw 3Y ans t be ns mt to � pproval of toeae app oval of, vola e sor tlon of es s pE'' r,v sons of thtate county laws. �I�fl mutt be keot on the lob ulD°"