413295, 413108 (SFD)PERMIT NO.
PERMIT NO.
DEPARTMENT
OF BUILDING & SAFETY
_5 -
/ 1, Z_ 104V
Community \
Its
� Valuation j Date
Dist. Off.
ff. F.C.C.
oo,
MH .Permit Fee
FIELD
DST
413 2 95
Cop S
DbI S
COUNTY OF RIVERSIDE
Part: 7.a.
73- 6691-011
Use/Case
�
No. %
Ck. By
Pi. Ck� Fee
Cc-,
Set Backs
CONSTRUCTION ESTIMATE
Construction Fee Dlel $ :Lagol Description
SC (0
NO -ELECTRICAL FEES
l 0 S C1
/
NO. PLUMBING FEES
1ST FL. SO. FT. @
Ole
UNITS
� , /
roup
2ND. FL. SO. FT. @
SMI Fee
Or;�
YARD SPKLR SYSTEM
I
2 FOR. so. FT. @
MOBILEHOME SVC.
Plumbing Fee
BAR SINK
d Amt.
GAR. W SO. FT.
Pion Checker
POWER OUTLET
JAnspecto,
ROOF DRAINS
Unit
CAR P. SO. FT. @
S
• DRAINAGE PIPING
WALL SQ. FT. @
DRINKING FOUNTAIN
$
SO. FT. @
Supplimental Permit Numbers
URINAL
S
ESTIMATED CONSTRUCTION VALUATION $
of
WATER PIPING
Witness Fee
NOTE: Not.,.be used as property tox volucstion
SWIM POOL I , PVT
FLOOR DRAIN
Reinip.. fee'
MECHANICAL FEES
Owner/Agent
SWIM POOL, COMM
Tel.
WATER SOFTENER
4
VENT SYSTEM FAN EVAP. COOL -HOOD
SIGN
WASHER (AUTO)(DISH)
S
—APPLIANCE tRYER
7cei
7
Zip
IGARBAGE DISPOSAL
tc. 0 Ch Q C!ck
!
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
T ert,all
JKITCHEN SINK
—ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
ATER CLOSET
COMPRESSOR HP
POLE, TEMP/PERM'
LAVATORY
HEATING SYSTEM /FORCED GRAVITYMPERES
0r, SERV ENT
-;SHOWER
BOILER B.T.U.
•SO.
FT. @ a
°�ATH, TUB
SQ. FT. @
T
WATER HEATER
Y
F1 RESID @ 11/44
SEWAGE DISPOSAL
C s
FT. GAR @ 3/4 c
40
HOUSE SEWER
AS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
'y
DBL.
TOTAL FEES MOB. HM. FEE
CRO*FE.E
MECH. FEE
PL. CK. FEE
CONST. FEE
ELECT. FEE
SM, FEE0 FEE
PLUMB. FEE
I'll
PERMIT NO.
Job Address
1 - / (7--s- Vrk
PaceN__ - 15P "er
-
Ah m �e 4 -1:, .
413295
_5 -
/ 1, Z_ 104V
Community \
Its
� Valuation j Date
Dist. Off.
ff. F.C.C.
oo,
MH .Permit Fee
$
rMicrc> Film Fee
-Mech.,'Fee
Cop S
DbI S
Use of Permit
Part: 7.a.
73- 6691-011
Use/Case
�
No. %
Ck. By
Pi. Ck� Fee
Cc-,
Set Backs
Lot, Size
30 x—
_I. 0o
Construction Fee Dlel $ :Lagol Description
SC (0
F
po1
l 0 S C1
/
Electrical Fee
DbI $
Ole
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roup
Type
SMI Fee
Or;�
I
Plumbing Fee
Dlel S
d Amt.
Plan No.
Pion Checker
Final Date I
'3
JAnspecto,
Unit
Sp. Insp. Fee
S
Derol. Fee
$
Const. tender Branch
Supplimental Permit Numbers
.'Registr. Fee
S
of
�Mileage Fee $Address City zip
Witness Fee
S
Reinip.. fee'
S
Owner/Agent
Tel.
-zip
4
'Total Fees,
S
Address
ty
Zip
M.O. 0
tc. 0 Ch Q C!ck
!
,Received by
ContAc
v
Tel.
T ert,all
Trees required
I .
.Sewage',Sy stem
L P
jSewer Dilict
Form 284208 (Re, 1/80)
dd, u r
City / Zip 2
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by:-
FOR
y:-FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME. VOID.
I HEREBY AGREE THAT ALL' WORK IN CONNECTION WIT.110HIS, PERMIT WILL BE DONE IN ACCORDANCE WITH
THE LAWS 0 IN
F RIVERSIDE COUNTY AND THE,;STATE OF CALIFORNIA.,
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO, PREPARED THE -PLANS AND SPECIFICATIONS HAS DONE SO IN
,.ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
7,.
NO.
OPERATION
DATE
INSPECTOR
r NO. OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
I
Set Back
/ y " A,
A
33 Ventilation System
2
Ftgs & Frms
f2
34 Plenums & Ducts Z/1
�(— `
2A
Slab Grade
_ Q /h
35 Furnace Comport.
3
Steel
36 Inlets 8 Outlets
4
Grout Blocks
37 Combustion Air —z
5
Bond Beams
Z .meg
38 Compressor _71-4
6
Roof Deck
, .. 3 Q _ ,
39 Appl. Clearance 3-7411
7
Framing
7 _ //�/
1
r -/...(J
40 Fire Damper
8
Vents
-�f{
Z
41 Smoke Detection Device -3-71-91
9
Garage Fire Wall
3-z g
U
42 Commercial Hood
10
Fireplace P. L.
Ix Z ���,
43 Final
10A
Fireplace T.O.(
Z
°oN ADDITIONAL INFORMATION
A
`- v ��
G !J
-----�.. _..--------
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior loth Z-15-5)
12 Interpol Lath
12A Drywall Q
13 Finish Grade 3--_0 A
•J
INSULATION Thick R
Value
7A Walls (Batts) " 11 `l -/U-
-
12B Ceiling (Batts) / �r O -9 -
l!
12C Ceiling (Blown)
14 Final 13-Z -ZS I
------------« ---PLUMBING APPROVALS---------------
15 Ground Plumb
16 Water Piping
17 Rough Plumb 2
18 Vents Z_
19 Sewage Disposal �_f1g
20 SewerZ�_g
21 Water Heater
-3-044k
22 Water Softener
23 Wdter Service'
24 Gas Test ' No
25
Final
_z _g
Tank �y� Pit 10 k T� L. Line
REAR OF PROPERTY LINE
� 5
J
P/L �! P/
-
ELECTRICAL APPROVALS
26 Power Pole
27 r Conduit
28 Service Entrance �.
29 Wiring
29A Grounding Wire
nV
29B Bonding - Z -g I
30 Fixtures 3-Z4-91
31 Service 3 Z 8
32 Final
STREET NAME/v m /,P/
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APPLICATION FAR TREE PLANTING
I (vie), the iundersigned, 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 sail! 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 g*.d by the County. Now, therefore, it is agreed that the prop-
erty owner shall cause the property lines to be surveyed in the event rro survey stakes can be found. Further, it is agreed that the County of
Riverside shall assume rrno
.. re`►s onsibility should trees have to be removed due to lot line errors. 1
9) 0 /
Owners Name w- Buildin Permit No.
Mailing Address /?City 'y'� o �r� Zip
Job Address v /6 6-65-x Community
Legal Description O r ZaKSr !ZJ
Assessor's Map, Book & Page Cs' '• z — '04 / — 0z 9 Type Structure O*e 14:;,, ,
Type of Soif Is water available—Road Dept. Plot Plan No.
Type of existing trees in road ri
Trees preferred by applicant (1)
Date /�)_' F___ o
Planning Commission Case No.
ROAD DEPARTMENT APPROVAL
Approved species L 14S,*)A1C17.7'1)A119 P L/�
Spacing of trees Distance from lot
Additional requirements,/A/5in,c
R,4(Cf#L/F.FAA/)DAG/1rl 1 Number of trees_
lines: Front:3 jAl'Sir-�,c ,6G, Side
Date Building and Safety notified 111S11AI Signatur.e%-�).,4.-7"a/ S/_
REQUEST FOR EXCEPTION
Reason
(attach additional page if necessary)
Request for hearing: YES F1
Owner's Signature
(Forward application to Planning Dept. if exception requested)
Planning Dept.
i
Concur ❑
Date
NO REQUEST FOR HEARING
Non -concur ❑ Explanation
Signature N
Road Dept. 4
Concur ❑ Non -Concur ❑
Date Signature
Date hearing"established
Approved ❑ . .Disapproved
Date Building & Safety notified .
❑■
REQUEST FOR HEARING AND COMMITTEE DECISION
Date hearing notice mailed to owner
'Date Owner notified of decision
Signature
-Al -
.` 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. CANARY — FILE, PINK — APPLICANI;-")
Sr G iwE` � i�J.�
Owne Architec Contracto
Addres O2s>TGJDC7Q
Cir .%%�Ls�.df% Ciry�!/ESi%E� i4..City
/.4'�.
Phone .If4f' �`� — G�f� Phone 7 / GUr�'f2 '4—,^
_ Phone?
W
I (vie) the undersigned, hereby certifyand acknowledge that I (we) have read the application and agree that if Curb and Gutter, and
Z
3
Paving, and/or Dedication of right of way is required by'the County of Riverside, the Riverside County Depa,rrt.�tm of 8uilding,'nd Safety
shall not make a Final Inspection until said requirements have been met. I am also aware that no work is t 4 don within�th`e C unty' R/W
O
without an encroachment permit. _
NOW, therefore, it is agreed that 1 (we) will not occupy said property and^will not cause said pro e o be occyj -ed unt' I (we) ave
-
complied with all laws of the County of Riverside and the State of California governing said proper /�
"
DATE SIGNATURE OF OWNER AND/OR AGE
`
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 FAMILY DUPLEX
Z F
LEGAL DESCRIPTION F PROP RTY.
' I APARTMENTS AGRIC.,
r
N Q
5�Fj ----6�( COMMERCIAL INDUSTRIAL
'^
Z
COMMUNITY'.
ALTERATIONS []
NO. OF SUBMITTED PLANS: -- USEOF PERMIT / r""
a
CASE N0.
p Z
NO. OF PARKING SPACES REQUIRED , NO. OF BUILDINGS NOW ISTING
Q
ZONE SETBACKS: FRONT O SIDE REAR
J m
GRADING PERMIT REQUIRED? YES ❑' NO Q LOT SIZE
SETBACK ORDINANCE # _— OF,`' -FEET REQUIRED ON _ STREET
'
DATESIGNATURE OF LAND USE OFFICIAL
4
F
DEDICATION .REQUIRED: YES ❑ NO: NO.' FEET.__
W
/OF
CURB AND GU7TER-REQUIREDi YES ❑NO, d4 STREET
W
CAN• CURB AND GUTTER FEASIBLY BE INSTALLED? YES NO ❑
ATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET
HAS AN" ACCEPTABLE-;��N!O
IMPROVE N ? . YES ❑
of
DATE % y/ 0 SIGNATURE OF ROAD DEPT. OFFICIAL
_
SWIMMING^lLLLL—
W
SEWAGE DISPOSAL F ZD T f c
FQQD ESTABLISHMENT
_
WATER POLLUTION REMARKS
FLOOD CONTROL
Z'. t i
AIR POLLUTION.
DIV OF HWY '
o a — YOUR PROPERTY MAY BE SUBJECT TO
c FLOOD. RIVERSIDE COUNTY ASSUMES
-NO RESPONSIBILITY IN EVENT OF FLOOD.
284 199-. 9/74. CANARY — FILE, PINK — APPLICANI;-")
0
RIVERSIDE COUNTY DEPARTMENT OF PUBLIC HEALTH
DIVISION OF ENVIRONMENTAL HEALT
Food Establishment Sewage Disposal
b
Trailer Park Septic Tank Gal. p
Motel, Apt., Hotel I_ -- Sq. Ft. 9f Leach Line
Dwelling x Seepage Pit
Commercial Building Connection to Sewer
Swimming Pool
No on-site regenerating water softening devices may be discharged` into the individual sewage disposal
system herewith approved without clearance from the Water Q•Zality Central Board,
Water supply serving this installation must be from an approvc-d source,
Ail sewage disposal installation must ccnfprm with requirtmcnts of current Un)I'orm PlUmbl bode:
Ail
cutting, grading, or filling in execs-. of f_-ur (4) feet will nullify scwage dispctal .ZPPMVBi,
Approval has been obtained from the Regional Water Quality Control Board far intiail8titr+l Of the YeW'
age disposal -.•,+stem.
This is to certify that the Riverside County Departme Public Health appro 's far bs J
or installation the Item(s) checked above.
Date_
DEPARTMENT OF BUILDING -AND SAFETY APPLICATION CERTIFICATE
COUNTY OF RIVERSIDE PERMIT N
Effective July 1, 1980, Chapter 1301, Section 19825•of-the NQalth 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 License No., 'SAF_'_) 1/ 4=>
Date/.4 Contractor,
Q OWNER -BUILDER DECLARATION
I hereby affirm that I am.exempt from the Contractor's License Law for the following reasons:
Q 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. 1031.5;•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
® r 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. Insurance /
Q Certified copy is hereby furnished. /� /
Certified copy is filed with the Countyo.'f9Riverside,/IDeepa`rtment of Bu/ildi/n�g and Safety.
Date %� Q Applicantl;1` 0,/�- c -V-
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE
(This section need not be completed if permit valuation is for $100.00 or Tess.)
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 Issued (Sec. 3097, Civ. Code).
Lender's Name
Lender's Address
DIVISION OF INDUSTRIAL'SAFETY PERMIT CERTIFICATION
1__.J 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 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.)
0 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.
[-1 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-
perty for which I have applied for this permit for the purpose of making inspections.
Signature of Applicant/Agent Date
7rint Applicant/Agent Name
284-2000 7/80
BUILDING PERMIT
kPERMIT NO. DEPARTMENT OF BUILDING & SAFETY
13 1 0 8 COUNTY OF RIVERSIDE FIELD M11
CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES
1ST FL.
2ND. FL.
FOR. W4 rA
GAR.
CAR P.
WALL '
ESTIMATED. CONSTRUCTION
SQ. FT. .@
V-3 $ D'u : I.% -J. UNITV`i "MIA -
SQ. FT. @
`"` YARD SPKLR SYSTEM
SO. FT. @ `. 'e!�)° " 'nJ MOBILEHOME SVC. BAR SINK
SO. FT. @ 40POWER OUTLET ROOF DRAINS
SQ. FT. @ DRAINAGE PIPING
SQ. FT. @ _ DRINKING FOUNTAIN
SO. FT. @ URINAL
VALUATION _� $ WATER PIPING
NOTE: Not to be used as property tax valuation v SWIM POOL, PVT S 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 ! jc• 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
SO. FT. @ a WATER HEATER
SO. FT. RESID @11/44 SEWAGE DISPOSAL
SO. FT. GAR @ 3/aa HOUSE SEWER
GAS PIPING
PERMIT FEE
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
PERMIT NO.
413108
..�
lob Address
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MH Permit Fee $g
Micro Film Fee Cop $
Use of P ' „-f(' •. -
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Parcel No.
or..'
Use/Ca o.
] 'Ck. By
Mech. Fee Dbl
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Lot Siae
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Pl. Ck. Fee $ �„
Construction Fee Dbl 8 V
Leg _ 'p n �. N�!71 ; -
b
-
Electrical Fee Dbl $
SMI Fee
Plumbing Fee Dbl $
Bo ,� ., .. Plo '
- on
Final Do
Inspector
Unit
S .9 '- •
-
�/ --���
Sp. Insp. Fee $
Demol. Fee S
Const. Lender - ! « _
if
Branc
i'
*
Supplimen/Jttol /Permit
i4/%fie
Numbers
• r
Regisir. Fee $
Mileage Fee $ .
Address City Zip
f
Witness Fee $
Reintp. Fee $
Owner/Agent
Tel.
Zip
Total Feas S
Address
Gty
Zip
M: ❑ N.C. Cash Q C
ec
f,r
-...
Received by _
o .. ,7 e, ,:.M1 /; f�,.
F
(f,
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_ Tel.
Li<ensep
Trees required
- ' -
Sewage System - '-
-
Address ......-�
•�•
'L/
Cit .
Y
Zip
Z'
-lie
T LL P TWS PERMIJ S)7A�BEt6MT-SOID IF WORK IS NOT C0MMENCEDPWIfAII4 -f6( F)AM ' E SATIBN OF WORK verified by:
Sewer District FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME^:VOID. U
.I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT -WILL BE DONE IN ACCORDANCE WITH
r
THE LAWS OF,RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO. PREPARED THE. PLANS AND SPECIFICATIONS HAS DONE SO IN
Form 284.208 (Rev. 1/80) ACCORDANCE WITH SEC1ION•5541.OF THE'. BUSINESSAND 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 & 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.
°o
ADDITIONAL INFORMATION
_
SEWAGE SYSTEM SIZE & LOCATION
.11 Exterior Loth
. 12 Internal Loth
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Botts)
128 Ceiling (Botts)
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 Final
i i STREET NAME