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414074, 417853, 426170 (SFD)BUILDING PERMIT PERMIT NO, DEPARTMENT OF BUILDING & SAFETY " 4074 COUNTY OF RIVERSIDE FIELD DST ;. .: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING IST FL. 76g7y 2ND. FL. FOR. GAR. CAR P. WAIL ESTIMATED CONSTRUCTION SO. FT. .@ < $ / UNITS S ace Zi 3, SO. FT. @ YARD SPKLR SYSTEM` si SO. FT. @ MOBILEHOME SVC. BAR SINK SO. FT. @ POWER OUTLET ROOF DRAINS r• SO. FT. @ DRAINAGE PIPING SO. FT. @ DRINKING FOUNTAIN " SO. FT. @ URINAL VALUATION $ ¢ 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 GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED MH Permit Fee LAUNDRY TRAY AIR HANDLING UNIT CFM IDLE METER -KITCHEN SINK Porcel No. ,i•'. ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET Ck. By COMPRESSOR HP POLE, TEMP/PERM LAVATORY Lot Size HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. @ c BATH TUB yp-.- - Electrical Fee Dbl S SO. FT. @ c WATER HEATER S0. FT. RESID @ 114c SEWAGE DISPOSAL S0. FT. GAR @ t/ c HOUSE SEWER SMI S • GAS PIPING PERMIT FEE --•..� PERMIT FEE PERMIT FEE DBL. TOTAL FEES MOB. HM. FEE MICRO'FEE MECH. FEE -P1. CK. FEEA CONST. FEE ELECT. FEE SMI FEE FEE r PLUMB. FEE T LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIh1,120 DAYS. CESSATION OF WORK verilied by: Sewer District FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. t .1 HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT'WILL BE DONE IN ACCORDANCE WITH ' S THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. 1 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN Form 284-208 (Ro0l/80) 'IACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. Job Address _ S ace Zi Owner PERMIT NO. 414074' God"ay } i,-; F.C.C. MH Permit Fee Micro Film Fee L Cop 5 se tf ` rmirr+ ��J �y,/V•1I C' , . C,...���_ f Porcel No. ,i•'. Use/ as N Ck. By Mech. Fee Dbl S PI. Ck. FeeS t c Lot Size Construction Fee Dbl S �..r.d Le'g,.. Description 111"-/ •y�' F S S. i! — e- e RQS(ictions ..., R - Grcl,p y yp-.- - Electrical Fee Dbl S Fee SMI S Plumbing Fee Dist S lbz�• Amt # -s a $ Pr.—nr-Na. k Fin nspect Unit Sp. Insp. Fee S Demol. Fee S Const. Lender .s;'.;'- Branch + Supplimentol Permit Numbers s I { 'i i• e L Regist, Fee E Mileage Fee $ Address City Zip s („ Witness Fee SL, Reinsp. Fee S Owner/Agent ^-�" - Tel. Zip Total Fees S Addreis` ~�s s' i...•.a"�:a.`••-:.: .1(, / % Cit y' 4 } j '✓• s Zi p ' "� M.O. ❑'N.0 ❑ Cash ❑ ec L.._.. T; •� - - �_ �( ..y _ Received by J acro i :=,;, .. �T: r: tirrl le 4 r / / AAs. Y.. ate: LicenseN j tR Treessreq 6",�'. Fr-�• Sewoge System - - s Address 4 City' - Zip ` T LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIh1,120 DAYS. CESSATION OF WORK verilied by: Sewer District FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. t .1 HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT'WILL BE DONE IN ACCORDANCE WITH ' S THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. 1 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN Form 284-208 (Ro0l/80) 'IACCORDANCE 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 Bock 33 Ventilation System 2 Ftgs 8 Frms 34 Plenums 8 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 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. P' ADDITIONAL INFORMATION ' I ' 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) I 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 REAR OF PROPERTY LINE ELECTRICAL APPROVALS P/L P/ 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 2.A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final STREET NAME PERMIT No. DEPARTMENT OF BUILDING & SAFETY 4 % `� COUNTY OF,RIVERSIDE FIELD �/ O,NST UCTION ESTIMATE _NO. ELECTRICAL FEES NO. PLUMBING FEES f' IST FL. y SQ. FT. @ $ ,;X, / jl / UNITS v . 2ND. FL. POR. SQ. FT. @ Dist. All- YARD SPKLR SYSTEM SQ. FT. @ / MOBILEHOME SVC. BAR SINK GAR.-' • �;' a.� '.<• �• SQ. FT. @ POWER OUTLET ROOF DRAINS , ' CAR P. SQ. FT. @ WALL SQ. FT. @ SQ. FT. .@ ESTIMATED CONSTRUCTION VALUATION $ !� €9 Use/Case No. Ck. By DRAINAGE PIPING' 4"'F.( `...;. DRINKING FOUNTAIN -,y` ;• URINAL k...,;. WATER PIPING NOTE: Not to be used as property tax valuation Set Backs SWIM POOL, PVT FLOOR DRAIN MECHANICAL FEES' Legal Description.r � y [/'� "//•� //,' �yc�, — 1 �� I Z . /_/' ..f .• �'� SWIM POOL, COMM WATER SOFTENER VENT SYSTEM FAN EVAP. COOL HOOD Zone Restrictions � SIGN WASHER (AUTO)(DISH) APPLIANCE DRYER Plumbing Fee i• GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED Plan No. _, - PlonRpecker ( LAUNDRY TRAY AIR HANDLING UNIT CFM Unit IDLE METER KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER'CLOSET COMPRESSOR HP Regisir. Fee $ POLE, TEMP/PERM LAVATORY i y- ,t HEATING SYSTEM FORCED GRAVITY Reinsp. Fee AMPERES SERV ENT SHOWER BOILER B.T.U. Tel. SQ. FT. @ C BATH TUB Total Fees $ SQ. FT. @ t WATER HEATER City Zip L SQ. FT. RESID @It/.0 SEWAGE DISPOSAL SQ. FT. GAR @ 314 c HOUSE SEWER i Trees required Sewage System GAS PIPING PERMIT FEE ;, Address f/ .a• j` f/�j f PERMIT FEE PERMIT FEE DBL. `'-./TOTAL FEESr• / MOB.HM.FEE MICRO FEE . MECH. FEE PL. CK.. FEE., -CONST. FEE ELECT: FEE SMI FEE FEE PLUMB. FEE PERMIT NO. v 5 3 Job Address �•�" f Space I Zip AOwner 4�` Community r I"-` _` • Valuation $ Date Dist. All- F. C. MH.Permit Fee $ Micro Film Fee Cop $. Use of Permi f/`/k) 1'/ /%� 1 +^' r �' a(�. at L�) !' �'����. /'t"¢rtf..'f'=� C Parcel No. Use/Case No. Ck. By Mech. Fee Dbl $ -PI. Ck. FeeE , t5. Set Backs Lot Size 6® �"� ' 'Construction Fee Dbl $ Legal Description.r � y [/'� "//•� //,' �yc�, — 1 �� I Z . /_/' ..f .• �'� F�Q S ` S � R�� I Electrical Fee . Dbl $ Zone Restrictions � Group P` _ _ Type SMI Fee $ Plumbing Fee Dbl $ Bond Amt. $ Plan No. _, - PlonRpecker ( Final Date `/ ' Z `Q Inspector Unit Sp. Insp. Fee $ Demol. Fee $ Const. Lender Branch Supplim nto Permit Numbers r. ' Regisir. Fee $ Mileage Fee $ Address Cir Zi Y P Witness Fee $ Reinsp. Fee $ Owner/Agent Tel. - Zip Total Fees $ 6 ! Address � � � _ City Zip M. 0. C. Cash Chec Received by C P" /4 �� /"'•) ! t. J ��J ��, tom•^/ Tel.,ren �J r„'"� �J f �� �/ 1 License# ' Trees required Sewage System Address f/ .a• j` f/�j f City F� t/� +/ Zip/ T LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by: Sewer District �s 'FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. . t 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 JHAT,THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN t Form 284-208 (Rev 8/78) ©s `1• "`�' ` ACCORDANCE WITH SECTION 5541Y,OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF, CALIFORNIA t� - =moi_' - �..:, _ .- - -- _.., .«s .. .. , n. .., may„ t .:.h. ti,+•_---. .v .�sd. _ may. A:,��. ,. .�;: t..e,. -, 6i•:r 3�1 NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Ftgs 8 Frms 34 Plenums 8 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 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. C] 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 REAR OF PROPERTY LINE ELECTRICAL APPROVALS PSL t P/ _ 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 298 Bonding 30 Fixtures.. 31 Service '* 32 Final STREET NAME oailrtulw rr RI�I • 'PERMITNo, DEPARTMENT OF BUILDING & SAFETY 4261 � _� 1 7 0 COUNTY'OF RIVERSIDE FIELD DST. PERMIT NO. CONSTRUCTION ESTIMATE- + ' " 4 2 6'17 NO ELECTRICAL FEES NO. PLUMBING FE ;gr ;, IST FL. • 2ND. FL. POR. -• GAR. } SQ. FT. @ . $ _ ' e 4 UNITS ' Off. FF.C.C.• MH.Permit Fee $ YARD SPKLR SYSTEM SQ. FT. @' 3 1 6Y _j SQ. FT. @ MOBILEHOME SVC. , BAR SINK ' 4 POWER OUTLET ROOF DRAINS ' SQ>FT. @ Use of Permit _ CAR P. WALL s '' W Ij. SQ: FT. @ - Ck. By - DblMech.Feex $. DRAINAGE PIPING 17312023 8 SQ. FT. DRINKING FOUNTAIN r . URINAL SQ. FT. @' . -= - e ESTIMATED CONSTRUCTION VALUATIONjs� $ Set Backs - NQ7E:`,Not to be used as property tax valuation 010 Electrical Fee SWIM POOL, PVT T �j[�} �+ /'! q+ fi ��} ! 5 'AOT 10 B�_+ ', �_ • "•r' SC y��++'�017 FLOOR DRAIN Zone Restrictions - Group MECHANICAL FEES ASMI Fea "- $ SWIM POOL, COMM WATER SOFTENER W `• VENT SYSTEM 'FAN / EVAP. COOL - .1 HOOD 3110 Plan No. SIGN 2 WASHER (AUTO)(DISH) ; ty .. APPLIANCE DRYER is 0 •• GARBAGE DISPOSAL FURNACE UNIT WALL- FLOOR' SUSPENDED $ • - Const. Lender, "' Branch Supplliimyen�ttjjal Permit Numbers/ LAUNDRY TRAY ..' AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK 2, ABSORPTION SYSTEM B.T.U. / TEMP USE PERMIT SVC Mileage�Fea g Address C", Zip -2. WATER CLOSET +( COMPRESSOR 550 HP 50 � POLE,TEMP/PERM. Reinsr.: Fee - -: `�, LAVATORY HEATING SYSTEM FORCED GRAVITY 4 J•Qjh 100 AMPERES SERV ENT- � ,� �• `SHOWER BOILER - B.T.U. P f $. SQ. FT. @ c BATH TUB -0 . ... }/��' q rg 44`70x 1.63 '..� .. - SQ. FT. @ .c' WATER HEATER Q% '� Check -.�.®,• . SQ. FT. RESID @ 1114 c .- 'SEWAGE DISPOSAL 0 Tel. License#. ' Trees required' S0. FT. GAR @ '/. c 0, ' HOUSE SEWER ' 3-l1 36 Sewage SystemAddress , , City Zip iy` ' 'GAS PIPING ' PERMIT FEE PERMIT FEE r. PERMIT FEE DBL. - TOTAL FEES tZlrC: � VFr MOB. HM. FEE MICRO FEE -MECH. FEES}. 0".L 50 IPL. (CCK. FEE ,r+ s' CONST. FEE (y�L •����, �i ELECT. FEE ::J�v' SMI FEE �G -� �.i FEEFEE I —� PLUMB. FEE (- t -s 50 PERMIT NO. Job Address 7 4 �+1 --- - - - - $ace Zi -Owner p ' " 4 2 6'17 0 s A VENIDAr 9 10 - 2253 DAff- ORN •. . Communityr -Valuation Date_ Dist. Off. FF.C.C.• MH.Permit Fee $ ggQ JIAA 3 1 6Y 5 'Micro Film Fee Cop $ Use of Permit _ Parcel No. t Use/Cole No. .2ms Ck. By DblMech.Feex $. + WLG &"ATT 17312023 4 PI. Ck. Fee $ Set Backs - Lot Size - - 05.1 1.0� 000 Construction Fee Dbl $ G`'. LegalllDescription. ' - � 00 005 010 Electrical Fee Dbl $ T �j[�} �+ /'! q+ fi ��} ! 5 'AOT 10 B�_+ ', �_ • "•r' SC y��++'�017 Zone Restrictions - Group Ty ASMI Fea "- $ R1 " Ie N f. Plumbing Fee Dbl $ Bond Amt. . Plan No. Plan Checker F' of Date Ins Unit - 'Sp. Insp. Fee is $ •• Demob. Fee $ • - Const. Lender, "' Branch Supplliimyen�ttjjal Permit Numbers/ Registr. Fee. / Mileage�Fea g Address C", Zip .Witness Fee $ ..••y f f }'.�..%�•'el-+".. -• - Reinsr.: Fee - $ .. O`w�n}er/ATg-ent - Tel. -" Zip �}' Total Fees $. Address" T . - . city :'= .� __Zip_ -_ ... }/��' q rg 44`70x 1.63 '..� .. - ��tL AM O,t ost.RT, M. 0. .NtE^ .•C Check -.�.®,• . Received b .- 4a.•t. i„' Contractor Tel. License#. ' Trees required' - 3-l1 36 Sewage SystemAddress , , City Zip ' T LL PRTHIS PERMIT. SHALL. BECOME VOID`IF WORK IS NOT COMMENCED WITHIN 120 DAYS.7!CESSATION OF WOK veli led by: fs, Seyver District ' FOR 120 DAYS SHALL• ALSO CAUSE PERMIT TO BECOME VOID: • ` ' ^ P” .• "get. t-� + �'. I HEREBY AGREE THAT ALL WORK IN.ONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH t THE LAWS OF RIVERSIDE COUNTY AK"O THE STATE -OF -CALIFORNIA. r >! I HEREBY CERTIFY THAT THc &N 1'U`tJ��HO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN ACCORDANCE,WITH SECTION 55.-I OF Thi BUSINESS•AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. Form 284-208 (Rev.8/78). P / - f ; � s t �, r i ya .z, G.._1_n ..__1...._..�.-..r _.k,..o: t_,,.. _.,.. ,_..-_.J._...i.:•+- _....a.v...__,.._. .._.._...t r� t._,._. �.: ..:_ __,�.___�4�..__✓.�._._.i _LL..-- c _n _41 NO. OPERATION DATE r W�S�ECTO NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 17 1 2 Set Back Figs & Frms /1 33 34 Ventilation System Plenums & Ducts 2A Slab Grade 35 Furnace Comport. 3 Steel 36 Inlets & Outlets 4 Grout Blocks 37 Combustion Air 5 Bond Beams 38 Compressor O -� 6 Roof Deck _'Z _ 39 Appl. Clearance 7 Framing / 40 Fire Damper 8 Vents ✓ ��% Q 41 Smoke Detection Device 9 Garage Fire Wall ✓ `' 42 Commercial Hood 10 Fireplace P. L. 43 Final - 10A Fireplace T.O. ❑ No ADDITIONAL INFORMATIO _ n- 1-1,VA/ �?,qh D/NG t V9,4 3A117 "e-r" A" 13y T. :7)0-A,1Af•NG-7G:N -7 e) ��i!✓R �C'd p��l'�l SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath 12 Internal Loth 12A Drywall _ 13 Finish Grade INSULATION Thick R Value 7A Walls (Batts) 12B Ceiling (Batts) 7 12C Ceiling (Blown) 14 Flnal PLUMBING APPROVALS 15 Ground Plumb V �/ 16 Water Piping 17 Rough Plumb 18 Vents W Sewage Disposal 20 Sewer 21 Water Heater 22 Water Softener 23 Water Service �8- 24 Gas Test q"- - 25 Final Tank/000 Pit GX/y L.Line REAR OF PROPERTY LINE r - 0�6 �O� PIL i P/ ELECTRICAL APPROVALS 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring ✓ 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final STREET NAME �� �� 9X w z O c �. O yLLj Co 0 >- Z � W 0 LL J Q =;,n MD a6 a z w Z z a J O IL = V z . Z r- za Q W J � IL -APPLICATION FOR . ". 1 TNG I (we), the undersigned, hereby certify and acknowledge that I (we) have read the application and agree that if trees are required under River- side County Ordinance No. 457, the applicant agrees to install said trees prior to final inspection. It is understood that no final inspection will be given until said requirements have been met or exception has been granted by the County. Now, therefore, it is agreed that the prop- erty owner shall cause the property lines to be surveyed in the event no survey stakes can be found. Further, it is agreed that the County of Riverside shall assume no responsibility should trees have to be removed due to lot line errors./�O Owner's Name DAN HORN Building Permit No. Mailing Address BOX 1 j Ci�alm Desert State CA 260 Job AddressCo munjoty ia Quinta Legal Description +- a� #� Assessor's Mop, Book & Page_77:3��� �`�� Type Structure dwelling Type of Soil sandIswater available yes Road Dept. Plot Plan No. Type of existing trees in road right-of-way none Trees preferred by applicant (1) (2) Date 26-81 Owner's Signature Planning Commission Case No. ROAD DEPARTMENT APPROVAL Approved species pinus halepensis(Aleggo gine) 15 gal. size Number of trees 1 Spacing of trees Distance from lot lines: Front Side Additional requirementsStreet tree should be 2' inside right of way and a minimum of 10' from driveway. Date Building and Safety notified 5/22/81 Signature D.M. REQUEST FOR EXCEPTION Reason (attach additional page if necessary) Request for hearing: YES ❑ Owner's Signature (Forward application to Planning Dept. if exception requested) NO REQUEST FOR HEARING Planning Dept. Concur ❑ Non -concur ❑ Explanation Date Signature Road Dept. Concur ❑ Non -Concur ❑ Date Signature REQUEST FOR HEARING AND COMMITTEE DECISION Date hearing established Date hearing notice mailed to owner Approved ❑ Disapproved ❑ Date Owner notified of decision not. B..ildiee R .Safety .,.tified A c I J NOTICE: THIS IS NOT A BUILDING PERMIT APPLICATION TO CONSTRUCT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE DISTRICT 11 _ Permit No Owner 'D= HArn Architect Contractor 'Addres,BOX. Lb 1f Address Address— Palm 1�esertCA ` City f City City_ r Phones Phon`e Phone NOTICE: THIS IS NOT A BUILDING PERMIT APPLICATION TO CONSTRUCT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE DISTRICT 11 _ Permit No 284 199 9/74 — y CANARY—FILE, PINK—APPLICANT Owner 'D= HArn Architect Contractor 'Addres,BOX. Lb Address Address— Palm 1�esertCA ` City f City City_ r Phones Phon`e Phone 01W 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 isto 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 lawns o0the County of Riverside and the State of California governing said property. - �2�v1 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. 2253 1 SPACE NO. USE OF STRUCTURE JOB ADDRESS (�"r� SINGLE FAMILY DUPLEX El 75" 31ZOZ3 Z H LE L ESCRIPTION OF PROPERTY;/- — APARTMENTS AGRIC. O N N 6 IO �� ZQ SW La Qty. # /:z — ilirLtB COMMERCIAL INDUSTRIAL L� > 0 Z COMMUNITY .UinALTERATIONS dLJ NO. OF SUBMITTED PLANS —_— USE OF PERMIT �eg & att. image CASE NO. — 4 0 Z NO. OF PARKING SPACES REQUIRED NO. OF BUILDINGS NOW EXISTING Q ZONE. SETBACKS: FRONT /O m SIDE REAR01 GRADING PERMIT REQUIRED?YES ❑ NO ❑ LOT SIZE SETBACK ORDINANCE # OF FEET REQUIRED ON / 4 STREET DATE 3-226-81 SIGNATURE OF LAND USE OFFICIA _ DEDICATION. REQUIRED: YES ❑ NO ❑ NO. OF FEET-- Wj CURB AND GUTTER REQUIRED: -YES ❑ NO [3 � -e LSTREET d CAN CURB' AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑ HAS AN ACCEPTABLE APPCATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET ' 0 IMPROVEMENT? YES /NO ❑ %^` J� -�,> -2 1 DATE 6 L SIGNATURE OF ROAD DEPT. OFFICIAL r t r S LIC d SEWAGE DISPOSAL ��IALo� = 0 BLISHMENT D NIX' �j Up t WATER POLLUTION _ REMARKS FLOOD CONTROL ` W AIR POLLUTION W2 DIV OF HWY •0a — YOUR PROPERTY MAY BE SUBJECT T-0 FLOOD. RIVERSIDE COUNTY ASSUMES ` NO RESPONSIBILITY IN EVENT OF FLOOD. 284 199 9/74 — y CANARY—FILE, PINK—APPLICANT DEPARTMENT OF BUILDING AND SAFETY APPLICATION CERTIFICATE COUNTY OF RIVERSIDE ♦ PERMIT k c Effective July 1, 1980, Chapter 1301° Section 19%25 -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: a 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. -3 Date ) W'•- 5-c-1 Contractor r )AA) AVAA I ! AJ Q 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;'6.&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 �] 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'(Sec3800 r�Lab. Code). Policy No. 6ZZ-fry) Insurance L 0 Certified copy is hereby furnished. M Certified copy is filed with the County of Riverside, Department of Building and Safety. / Date Jam' /� Applicant Ae2"i 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 Issue(Sec. 3097, Civ. Code). Lender's Name 4 - Lender's Address / DIVISION OF INDUSTRIAL'SAFETY PERMIT CERTIFICATION I hereby certify that no excavation five (5) or more feet in depth into whicha person is re- quired to descend, will be made iii 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.) [3 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 Indtstrf-4TSafety 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 wwhiicch,I have applied for this /permit for the purpose of making inspections . SiTdat;,re ofApplicant/Agent Date �i4L 014b43t__4r r nt Applicant/Agent Name 284-2000 7/80