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404319 (BLCK)BUILDING PERMIT PERMIT No. DEPARTMENT OF BUILDING & SAFETY 4 0 4 319 COUNTY OF RIVERSIDE FIELD DST n CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES., 1ST FL. SQ. FT. @ $ UNITS Space 2ND. FL. SO. FT. @ Owner , YARD SPKLR SYSTEM POR. SQ. FT. @ MOBILEHOME SVC. BAR SINK GAR. SO. FT. @ POWER OUTLET ROOF DRAINS CAR P. SQ. FT. @ Micro Film Fee DRAINAGE PIPING WALL SQ. FT. @ Uie of Permit % �['1 t{ / /P ©P /`` �✓ (R lfr GdfN/ C,a•,MLs(� '� DRINKING FOUNTAIN 1 SO. FT. @ r.�•-�r i� Ck. By 1� i . URINAL ^' 'ESTIMATEII CONSTRUCTION VALUATION $ t Back, Set Backs 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 Plumbing Fee GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED Bond Amt. S 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. SQ. FT. @ a BATH TUB Reinsp. Fee SQ. FT. @ a WATER HEATER Owner/Agent S0. FT. RESID @111A4 SEWAGE DISPOSAL SO. FT. GAR @ 3/<a HOUSE SEWER ')'JA. ddsress 1 ,:d, r.. � �•P.re �_ �:+�i,.. •; k-�•:,,� GAS PIPING PERMIT FEE Received �•Y„„.'� PERMIT FEE PERMIT FEE DBL. TOTAL FEES � MOB. HM. FEE MICRO FEE MECH. FEE PL. CK. FEE CONST. FEE ELECT. FEE SMI FEE FEE PLUMB. FEE Address - .- .,. .,/'� *f' e_C- ?C ra c. 1 P� PERMIT NO. 404319 Job Address J r�=. Space Zip �- Owner , Community n >r- �"^ Valuation t Date Dist. Off. F.C.C. ;. MH Permit Fee S Micro Film Fee Cop S Uie of Permit % �['1 t{ / /P ©P /`` �✓ (R lfr GdfN/ C,a•,MLs(� '� Parcel No. +q• "'` •. S � F _•. .�' J ...i Use/CaseNo. Ck. By 1� i . Fee Dbl S Pl. Ck PI. Ck. Fee S t Back, Set Backs lot Size t, Construction Fee Dbl $ it gal Description / ✓ % Gw w /� y� /^ �� /si / / �. /t::. L..- 4�/ F S S R Electrical Fee Dbl $ Zone Restrictions 4 Group Type { t SMI Fee S Plumbing Fee Dbl $ Bond Amt. S Pion No. Plan Checker Final Dote .Inspector 1 I ^ Unit Sp. Insp. Fee $ Demol. Fee S Const. Lender Branch fPmit Supplim� NumbersRegistr. r i Fee S Mileage Fee $ Address City Zip Witness Fee g Reinsp. Fee $ Owner/Agent s Tel. Zip Total Fees S ')'JA. ddsress 1 ,:d, r.. � �•P.re �_ �:+�i,.. •; k-�•:,,� City Zip M.O. Q N.G � Cash Q Check Received �•Y„„.'� Contractor Tel. License# Treesy�fT�� Sewage System y!r Address - .- .,. .,/'� *f' e_C- ?C ra Cityy s Zip a/lt 1 T LL 41-111111P THIS PERMIT SHALL BECOME VOID IF WORK IS.NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK ,� ytrilied-by: FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. Sewer District 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. J' J I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN Form 284.208 (Rev. 1/80)J( lO ANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Ftgs 8 Frms 34 Plenums & Ducts 2A Slab Grade 35 Furnace Comport. 3 Steel 36 Inlets 8 Outlets 4 Grout Blocks 37 Combustion Air 5 Bond Beams 38 Compressor 6 Roof Deck 39 Appl. Clearance 7 Framing �l. 40 Fire Damper 8 Vents 41 Smoke Detection Deice 9 Garage Fire Wall 42 Commercial Hood 10 Fireplace P. L. 43 Final IDA Fireplace T. 0. No - ---- ADDITIONAL INFORMATION ----- - ---------------------- SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Loth 12 Internal Lath 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Walls (Batts) 12B Ceiling (Batts) QC Ceiling (Blown) 14 Final �2 i 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 P/L P/ ` ELECTRICAL APPROVALS 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 298 Bonding 30 Fixtures 31 Service 32 Final STREET NAME 0 DEPARTMENT OF BUILDING AND SAFETY APPLICATION CERTIFICATE COUNTY OF RIVERSIDE' PERMIT N Effective July 1, 1980, Chapter 1301, Section 19825'of the Hiralth 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 L5 —/ S C►'— /.3 License No. Date //—/ri' ..FYy Contractor s"d/e .�.crnnit 0 OWNER -BUILDER DECLARATION I hereby affirm that I am exempt 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.). Q I am exempt under Section , B.&P.C. for this reason: Date Owner 0 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. VVI. 4.7 .<9 417 Insurance 6"1;,o ("ax., Certified copy is hereby furnished. Certified copy is filed with the County of Riverside, Dep ra tment of Building and Safety. Date //—/ �— 9e) APpl i cant -Y P- sG.�ra �_ �fn s 1,4_ Is -P,. -., 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. _ ..1 A Date //— 'l —eU 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 rJ 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.) [� 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- Dertv,for which I have appli„ed for this permit for the purpose of making inspections. Print Applicant ..r 284-2000 7/80 can .I.J 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 Il�ier) Architect !/ Address?a � �� 6* Az& y lc(.4ddress___— Address/��/��� City lkl Ct.� 65i- City_— City_J1�yG G�,�=���_Gi�._ Phone Phone _ Phone <'� K 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 sa' erty to be occupied until 1 (we) have complied with all laws of the County of Riverside and the State of California governing said P,9 --,.y perty. , 14-7 DATE /1111L=/f--L�a E SIGNATURE OF OWNER AND/OR AGEN — Approval by Signature from the Following Departments Listed Below Must Be Obtained Prior to the Issuing of a Construction Permit. I SPACE NO. Z/•i�S`J . `` ��� �/��� � I USE OF STRUCTURE I JOB ADDRESS ✓-.�`�._�4J1�7� -SINGLE FAMILY � DUPLEX r Lu,DESCRIPTION _ OF PROPERTY Z" �l �_ LEGALAPARTMENTS AGRIC. �• 7 \�) / /,/'�/ I�1 0 U. Y— COMMERCIAL INDUSTRIAL n '^ COMMUNITY ' ❑ CALTERATIONS Z NO. OF SUBMITTED PLANS _— USE OF PERMIT r' �°/n Lu Q CASE NO. K__4 -L-- ___ _4 Z NO. OF PARKING SPACES REQUIRED — NO. OF BUILDINGS NOW EXISTING ' Q ZONE SETBACKS: FRONT SIDE REAR J m GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE SETBACK ORDINANCE # OF FEET REQUIRED ON SIRE r- DATE L SIGNATURE OF LAND USE OFFICIAL _ DEDICATION REQUIRED: YES ❑ NO ❑ NO: OF FEET__— t- W CURB AND GUTTER REQUIRED: YES ❑ NO ❑ - STREET H cc a CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑ W HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET IMPROVEMENT? YES ❑ NO ❑ O °L DATE SIGNATURE OF ROAD DEPT. OFFICIAI Z SWIMMING POOLS PUBLIC QW SEWAGE DISPOSAL us FOOD ESTABLISHMENT WATER POLLUTION REMARKS vt FLOOD CONTROL' W AIR POLLUTION W DIV OF HWY c a YOUR PROPERTY MAY BE SUBJECT TO — c FLOOD. RIVERSIDE'COUNTY ASSUMES NO RESPONSIBILITY IN EVENT OF FLOOD. 284 199A 9/74 CANARY—FILE, PINK—APPLICANT