413512 (BLCK)BUILDING PERMIT
1 :r--,
PERMIT NO.
413512
PERMIT No,
1512
-
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
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FIELD
OST
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL.
2ND. FL.
FOR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
50. FT. .@ $
UNITS
SO. FT. @
YARD SPKLR SYSTEM
SO. FT. @ MOBILEHOME SVC.
BAR SINK
50. FT. @ POWER OUTLET
ROOF DRAINS
SO. FT. @
DRAINAGE PIPING
50. FT. @ — .--.
DRINKING FOUNTAIN '
50. FT.
URINAL
VALUATION $ "
WATER PIPING
NOTE: Not to be used os property toz valuation
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
`, SWIM POOL, COMM
WATER SOFTENER
VENMYSTEM FAN EVAP. COOL HOOD
SIGN
WASHER (AUTO)(DISH)
APPLIANCE DRYER
R
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
— k
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.
SO. FT. @ a
BATH TUB
50. FT. @ a
WATER HEATER
-
S0. FT. RESID @ 1144
SEWAGE DISPOSAL
S0. FT. GAR @ z/4c
HOUSE SEWER
Demal. Fee g
Const. Lender
GAS PIPING
PERMIT FEE
Branch
PERMIT FEE
PERMIT FEE
DBL.
TOTAL FEESMOB.
HM. FEE
MICRO'FEE .
MECH. FEE PL. CK. FEE
I CONST. FEE ELECT. FEE
SMI FEE
FEE PLUMB. FEE
1 :r--,
PERMIT NO.
413512
lob Address _
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Mech. Fee Dblg�
PI. Ck. Fee g
%Set Bocks
lot Size
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Construction FeeDbl $
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Electrical Fee Dbl S
Zone R strictions Group Type
SMI Fee g
Plumbing Fee Dbl g
Boh Amt.
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PI ec er
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Fin I pector Unit
Sp. Insp. Fee S
$
Demal. Fee g
Const. Lender
Branch
Supplimentol Permit Numbers
Regior. Fee g
Mileage Fee g
Address;-,' ,. `- �\ City Zip
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Witness Fee g
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Reinsp. Fee g y '
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Tel. -
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Total Fees S
Address '""
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City -
Zip
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Trees requir
Sewage System
Address
City Zip
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N
T LL P THIS PERMIT, SHALL BECOME VOID IF WORK IS NOT' COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by:
Sewer District FOR 120 DAYS•SHALL ALSO CAUSE PERMIT TO.BECOME VOID.
.I HEREBY -AGREE THAT ALL WORK IN CONNECTIONWITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH s
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA.
A
EBY CERTIFY THAT THE INDIVIDUAL -:WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
Form 284-208 (Rev. 1/80) ,MACE. WITH SECTION •5541 OF THE BUSINESS AND PROFESSIONS CODE OF. THE STATE OF CALIFORNIA. i
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
u
BUILDING APPROVALS
MECHANICAL APPROVALS t' �?
1
Set Bock
33
Ventilation System
2
Figs & Frms
34
Plenums 8 Ducts 0
2A
Slab 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
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 (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
P/L P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 1 Final
a
STREET NAME
VI 1L✓ 1.4
COUNTY OF RIVERSIDE
SL1- :"0�, 14311 OWNER -BUILDER INFORMATION
7 .1,,ti....L I 1
Dear Property Owner_: ' _ _ _
An application for a building permit has been submitted in your name listingiyourself as the builder
of the property i7mprovements.-speci,fied-.!.5-t, , r,
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 personal-ly-performing-their-own work. -If-your work' -is -being performed -by -someone -other
than yourself, you may -protect --yourself, 'from -poss'ibl'e liabi•l-ity--- if--that-person-a-ppl-ies-.fo'r--the pro-
per permit in his -or-- her name.-
Contractors are required .by law. to .be l i censed and- bonded..by_ the -State of_Cal i forn .a _and.,._where
required, to have..a .bus.i ness l i cense .from. the city or county.. _ They are _al sc requi red _by_ 1 aw -to put
their license number,on.all,permi.ts 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 or otherwise engage any persons other than your -immediate fam1 y, and the work
(including materials and o°ther costs) is $200 or more for the.entire'project;!and'such-persons are
not.licensed as contractors or subcontractors, then you may be an employer.
If you are an employer,, you must register with the -state and •federal goJernnent`at'ah employer and
you are subject to several obligations including`state'and federal i.nc.ome'tax-withholding,,-federal
social security taxes, workers' compensation insurance, disability insurance costs, and unemploy-
ment compensation contributions.
There may be' financial risks for'you- if you do 'not carry out'these'obTigati+ns;'and--these•r'isks are
especially serious with respect to workers' compensation. insurance.._
For more specific"information about your obligations under federal'law, contact the Internal Revenue
Service (and, if'you wish, the U.S. Small Business Adminisiration�):.**For more specific information
about your obligations under state law, contact the Department of Benefit Payments and the Division
of Industrial Accidents...
If the structure is intended for sale, property owners who are not -licensed contractors are allowed
to perform their•work,,personal.l.y,or through their own employees, without a licensed contractor or
subcontractor., only under_limited conditions.
A frequent practice of unlicensed persons professing to be contractors is bD secure -an "owner -
builder" building-permit,'erroneous-1y implying that the property -'owner is;FroJiding his or her own
labor and material 'personal ly. • .Bui 1•di ng' permits are' not •requi red -to be -.signed �by_`property owners
unless they are performing their own work personally.
Informatiori.'Atou.t--1'icensed contractors may be obtained by ,contacting the Ccntractors,'j$tate License
Board :n;,your- community or at.,J 02Q_tN Street,; ,;Sacramento, -.Californi-a:9581-4.tr
Please complete and return the enclosed owner -builder verification 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'.�l
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Sincerely,
DEPARTMENT OF BUILDING AND SAFETY
Leopoldo Rojo, Jr.
Director ►t� .'+�' _I•�:'...
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284-2001 7/80 `
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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.
o) 2. I (have/have not) 4,9:I— 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 fiired-the following'
person to coordinate, supervise, and provide the major work:
Name Phone...
Address City,
Contractors License No.
5. I will provide some of the work but I have contracted (hi•eed);the fol'-
lowing persons to provide the work indicated: F
Name Address Phone. Type of work
Signa-ture,'Property..0"wner Date
'Social Security Number
284-2002 7/80 "
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NOTICE: THIS IS NOT A BUILDING PERMIT
DISTRICT
APPLICATION TO CONSTRUCT Permit No
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
284 199 9/74 1 CANARY—FILE, PINK—APPLICANT
Owner Architect Contractor -
Add
Addres .y �'� `a ' Address Address_
City uL City City-
ity_ --
�`�� Phone Phone
C
W
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 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 occ i d until I (we) have
complied with all laws of the County of Riverside and the State of California governing said propert
DATE SIGNATURE OF OWNER AND/OR AGENT
Approval by Signature from the Following Departmenh Listed Below
4315 Must Be Obtained Prior to the Issuing of a Construction Permit.
I SPACE N0.
Y�o � USE OF STRUCTURE
!/�/
JOB ADDRESS ('�`/ J
SINGLE FAMILY DUPLEX
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L GAL DESCRIPTIO OF PROPERTY
— APARTMENTS [� AGRIC.El
/
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1. COMMERCIAL ll--��
a- /1/ l_I INDUSTRIAL lr�
�
G C
Z
COMMUNITY4
TERATIONS n
NO. OF SUBMITTED PLANS --- USE OF PERMIT _
N a
/j!�
CASE NO.
p Z
NO. OF P KIN SPACES REQUIRED NO. OF BUILDINGS NOW EXISTING -.
a
ZONE SETBACKS: FRONT SIDE REAR
J
m
GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE
SETBACN NCE OF FEET REQUIRED ON STREET
DATE 7� SIGNATURE OF LAND USE OFFICIAL
t
DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET___
CURB AND GUTTER REQUIRED: YES ❑ NO ❑ STREET
H
i
CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑
W
HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET
ID
IMPROVEMENT? YES ❑ NO ❑
°C
DATE __ SIGNATURE OF ROAD DEPT. OFFICIAL
=
SWIMMING POOLS PUBLIC
H
W
SEWAGE DISPOSAL
_
FOOD ESTABLISHMENT _
_
WATER POLLUTION REMARKS
�n FLOOD CONTROL—
zAIR POLLUTION
DIV OF HWY
c a — YOUR PROPERTY MAY BE SUBJECT TO
0
o FLOOD. RIVERSIDE COUNTY ASSUMES
NO RESPONSIBILITY IN EVENT OF FLOOD.
284 199 9/74 1 CANARY—FILE, PINK—APPLICANT