404280 (BLCK)BUILDING PERMIT '-
PERMIT No, DEPARTMENT OF BUILDING & SAFETY
O 42 H O COUNTY OF RIVERSIDE FIELD MDS.T
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES,
1ST FL.
2ND. FL. _
FOR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SO. FT. .@ $
UNITS
Zip
SO. FT. @
YARD SPKLR SYSTEM
SO. FT. @ MOBILEHOME SVC.
BAR SINK
SO. FT. @ POWER OUTLET
ROOF DRAINS
SO. FT. @
DRAINAGE PIPING
50. FT. @ ..i
DRINKING FOUNTAIN
SO. FT. @
URINAL_
VALUATION $
WATER PIPING -
NOTE: Not to be used as property tax voluotion
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
^dse/C 'woo.
LAUNDRY TRAY
FAIR 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.
SO. FT. @ a
BATH TUB
Type
SO. FT. @ a
WATER HEATER
S0. FT. RESID @ 1'/<a
SEWAGE DISPOSAL
S0. FT. GAR @ 3/4a
HOUSE SEWER
GAS PIPING
PERMIT FEE
Bond Amt.
PERMIT FEE -
PERMIT FEE ,
DBI.
TOTAL FEES
_
i'
MOB. HM. FEE
MICRO*FEE
MECH. FEE PL. CK. FEE
I CONST. FEE ELECT. FEE
1
C7- �I
SMI FEE
FEE PLUMB. FEE
PERMIT NO.
404280
Job Address
Space
Zip
Owner
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Valuation
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MH Permit Fee $
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Mach. Fee Dbl S
PI. Ck. Fee S
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Lot Size a'
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Construction Fee Dbl S <7
Legal Description
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Electrical Fee Dbl 5 1y vJ
Zone Restrictions
Group
Type
SMI Fee S
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Plumbing Fee Del S
Bond Amt.
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Plan 6 esker
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In}Pastor
Unit
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Sp. Insp. Fee
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$/
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Demol. Fee $
Const. Lender
Bronsh
Supplimentol Permit Numbers
60/
,
Registr. Fee $
Mileage Fee S
Address City Zip
Witness Fee
Reinsp. Fee S
Owner/Agent
Tel.
Zip s
Total Fees EC
address
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M.O. ❑ N.C. ❑ Cash ❑ Checky
Received by � .�'
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Tel. f`-� y Y
License'
Trees re it i�t.,4
Sewage System
Address
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City Zip
T LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK
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.
I HE Y CERTIFY THAT.THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
Form 284-208 (Rev. 1/80)
'-DANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
verified by:
i'
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
%! _,4 _ O
11-14,K0
33 Ventilation System
2
Ftgs 8 Frms
-
_l I 9--9-0-
LL--1
34 Plenums & Ducts
2A
Slab Grade
35 Furnace Comport.
3
Steel
Zr 3i� .�
36 Inlets 8 Outlets
4
Grout Blocks
! 2 Z �.
37 Combustion Air
5
Bond Beams
B� `
38 Compressor
6
Roof Deck
�qLG
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.O.
P'
---------------------------------------
ADDITIONAL INFORMATION
,
- --
/
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)
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
N
Tank Pit L. Line
P/L
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
P/
l
26 Power Pole
-� 27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
DEPARTMENT OF BUILDING AND SAFETY . COUNTY OF RIVERSIDE
OFFICE DATE TIME L/ PERMIT NUMBER
-7' 12-1 1 INSPECTION
ADDRESS
�,�2 -`1
OWNER
BUILDING PLUMBING
REMARKS:
0,-/Tk)a�/v
OWNER/CONTRACTOR TEL.NO
COMMUNITY
ELECTRICAL
SPACE NO.
I
I
MECHANICAL
REQUESTED
FOR:
a A.M.
P.M.
F] mm
Im TUES
WED
aTHUR
FRI
28446 11/75
DEPARTMENT OF BUILDING AND SAFETY . COUNTY OF RIVERSIDE
OFFICE DATE TIME ,, / PERMIT NUMBER
L / ! - C4 S INSPECTION
ADDRESS
OWNER
BUILDING PLUMBING
a,
REMARKS:
())
Qjo
OWNER/CONTRACTOR TEL.NO
ISPACE NO. FORUESTED
COMMUNIT
ELECTRICAL I ME HANICAt
a A.M.
P.M.
284-" tl/75
DEPARTMENT OF BUILDING AND SAFETY . COUNTY OF RIVERSIDE
OFFICE DATE y TIME s PERMIT NUMBER
-j //�/O //' I INSPECTION
ADDRESS
OWNER
BUILDING
REMARKS:
"li e
PLUMBING
// --TSPACE NO. FORUESTED
I
A.M.
COMMUNITY
Q ❑ P.M.
ELECTRICAL MECHANICAIL
ElIN01� '-
G
TUE S
THUR
❑ FRI
OWNER/CONTRACTOR TEL.NO.
28146 $14S
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
OWNER -BUILDER INFORMATION
^ r c
Dear Property Owrier:_..__
An application for a building permit has been submitted in your name listing yourself as the builder
of the property improvements specified.
For your protection you should be aware that as owner -builder you are the responsible party of re-
cord on such a permit. Building permits are not required .to be signed by property owners unless
they are personally -performing their own work.--If-your-work is--being-performed-by-someone-otherthan yourself, you -may protect -yourself -from pos-sible•-liabi-lity if -that -person -app -lies -for ----the pro-
per permit in his --or her -name. --
Contractors are required -by-law to..be licensed .and bonded by-the.State_of California-_and.,_where
required, to have -a .business, -license_ from..the city -or. county.. They.are_a_.1so-required by law_, to put
their license number -on all-permits.for which they_apply.__
If you plan to"do your own work, with the exception of various trades that you plan to subcontract,
you should be aware 'of the following information for your benefit and protection. -
If you employ orjotherwise engage•anypersons other -than your immediate family, and the work
(including materials and `other costs) is $200 or -more for the•entire project,••andlsuch"persons are
not licensed as contractors or subcontractors, then you may be an employ(r._
If you are an employer, you must register with the state and federal government as'an-empl-oyer and
you are subject to..severaT-obl-igations including state and-federal.,income tax withholding,- federal
social security taxes, workers' compensation insurance, disability insurance costs, and unemploy-
ment compensation .contributions..
There may be financial•risks for you if you do'not•carry•out these obligWti•ons,'and these risks are
especially serious. with respect to workers compensation -insurance.,---
I. - L
For more specific''info`rmation-about your obligations under federal'law, contact the Internal Revenue
Service (and, if:you wish, the U.S. Small Business Administration), .For more speciflc information
about your obligations under state law, contact the Department of Benefit Payments and the Division
of Industrial Accidents;c
If the structure is intended for sale, property owners who are not licensed contractors are allowed
to perform their work personally,,or.through their own employees, without a licensed contractor or
subcontractor, only under limited conditions.
A frequent practice,rof unlicensedpersons professing.to be contractors is to secure an."owne.r.7
builder" building*permit, erroneously'implying that the•property ownertis'providing his or her own
labor and material` personally. -.Building permits are not'requi'red)to be signed'by•property owners
unless they are performing their own work personally.
Information,about•�licensed+tcontractors may be obtained by,contacting the Contractors'..State License
Board .i:nj.your_.-comml1unity For .at 1020 %N •Street, Sacramento.,-. Cal ifor.nia• 95814. •:, +. , . ;, , :,
irl.�.<f> �.4'.Ji•,y:.�il*I iy`'r 1 'J- .�_�. 4J, , rq+ : � ":,..�,f!', �.1.•.;t)•.Y 1, J�ilr
Please complete and return the enclosed owner -builder verif ication form so that we can confirm that
you are,,aware;of these matters. The building permit will not be issued until the verification is
returned. t
Sincerely,
DEPARTMENT OF BUILDING AND SAFETY
I c K � �- � c. -, 7-0,A
\ Leopoldo Rojo, Jr.
`Director
284-2001 7/80
LF•.,i. -Fray! r ,..�7•. �..' _i ..
6.
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
OWNER -BUILDER VERIFICATION
Owner
Address
An "owner -builder" building permit has been applied for in your name and bearing
your signature.
Please complete and return this information in the envelope provided at your
earliest opportunity to avoid unnecessary delay in processing and issuing your
building permit. No building permit will be issued until this verification is
received.
1. I personally plan to provide the major labor and materials for con-
struction of the proposed property improvement (yes or no)
2. I (have/have not) r-�QE signed an application for building permit
for the proposed work.
3. I have contracted with the following person (firm) to provide the pro-
posed construction:
Name Phone
Address City_
Contractors License No.
4. I plan to provide portions of the work, but I have hired the following
person to coordinate, supervise, and provide the major work:
Name
Address
Contractors License No.
Phone
ty
5. I will provide some of the work but I have contracted (hired) the fol-
lowing persons to provide the work indicated:
Name
Address
• i ! 1
1 L J
Signature Property Owner
Social Security Number
284-2002 7/80
Phone Type of work
Date
NOTICE: THIS IS NOT A BUILDING PERMIT
APPLICATION TO CONSTRUCT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
DISTRICT 14
Permit No
284 199A 9/74 CANARY—FILE, PINK—APPLICANT
Owner ,-J KN Ec HJr Architect —. _ Contractor___.. _
Address- IRd6(O —_—_ Address___ Address— — --
City Aj-, City-- City—
Phone Phone _ Phone—
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W
I (we) the undersigned, hereby certify and acknowledge that I (we) have read the application and agree that if Curb and Gutter, and
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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
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without an encroachment permit.
NOW, therefore, it is agreed that I (we) will not occupy said property and will not cause said pro pc y to be occupied until I (we) have
complied with all laws of the County of Riverside and the State of California governing said property.
DATE — -Q--- 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.
SPACE NO.
( USE OF STRUCTURE
JOB ADDRESS SINGLE I
— SINGLE FAMILY DUPLEX
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LEG L DESCRIP ION OF PROP RTY,e�"
/!� APARTMENTS [] AGRIC.
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—Y�— --'—--+� — COMMERCIAL E] INDUSTRIAL n
'^
COMMUNITYv`" `!!
� ALTERATIONS
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NO. OF SUBMITTED PLANS USE OF PERMIT
CASE NO. �a�
:3,
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NO. OF PAR!yjGG PACES REQUIRED — NO. OF BUILDINGS NOW EXISTING
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ZONE 1—SETBA(fKS: FRONT SIDE REAR
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GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE
SETBACK,, O,,R''DINyANE OF FEET REQUIRED ON STREET
DATE SIGNATURE OF LAND USE OFFICIAL --
DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET-_
W CURB
AND GUTTER REQUIRED: YES ❑ NO ❑ STREET
t—
a
CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑
W
HAS AN' ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET
Q
IMPROVEMENT? YES ❑ NO ❑
O
ox
DATE SIGNATURE OF ROAD DEPT. OFFICIA`
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SWIMMING POOLS PUBLIC
QW
SEWAGE DISPOSAL
S
FOOD ESTABLISHMENT
WATER POLLUTION REMARKS
H FLOOD CONTROL
t—
W AIR POLLUTION
w I_ DIV OF HWY
I- ce YOUR PROPERTY MAY BE SUBJECT TO
—
c FLOOD. RIVERSIDE COUNTY ASSUMES
NO RESPONSIBILITY IN EVENT OF FLOOD.
:a
284 199A 9/74 CANARY—FILE, PINK—APPLICANT