413432 (BLCK)BUILDING PERMIT
—�
PERMIT NO.
PERMIT No.
13 4.3 2
Job A dress — '— -
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
FIELD
DST
CONSTRUCTION ESTIMATE
413432
NO. ELECTRICAL FEES
NO. PLUMBING FEES 74
1ST FL.
2ND. FL.
POR.
GAR.
CAR P.
WALL —.
ESTIMATED CONSTRUCTION
SO. FT. .@ $
UNITS
SO. FT. @
YARD SPKLR SYSTEM
SO. FT. @ MOBILEHOME SVC.
BAR SINK
SO. FT. @ POWER OUTLET ',
ROOF DRAINS
SO. FT. @
DRAINAGE PIPING
SO. FT. @
DRINKING FOUNTAIN
SO. FT. @
URINAL
VALUATION $ 7✓
WATER PIPING
NOTE: Not to be used as property tax valuation
Construction Fee Del $
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
S
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM FAN EVAP. COOL HOOD
SIGN ,�
WASHER (AUTO)(DISH)
APPLIANCE DRYER
Type
I
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
No.
Plan Checker
LAUNDRY TRAY
AIR HANDLING UNIT CFM
Inspector
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
Demol. Fee S
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
mb s
t
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
Address City Zip
'
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. @ a
BATH TUB '
Zip
SO. FT. @ a
WATER HEATER
City
S0. FT. RESID @ 1 t/.a
SEWAGE DISPOSAL
M.O. C]N.C. ❑ Cash h k
S0. FT. GAR @ 3/4a
HOUSE SEWER
Received^
Contractor.,e"-% f/
1'
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL.
TOTAL FEES
�,v
MOB. HM. FEE
MICRO FEE
MECH. FEE
PL. CK. FEE
CONST. FEE ELECT. FEE
ao
SMI FEE
FEE PLUMB. FEE
—�
PERMIT NO.
-�
Job A dress — '— -
- -
Space Zips
Owner
'
413432
�'
unity
I
rS
,F.C.C.
MH Permit Fee $
Micro Film Fee Cop S
Us
/
Pa a o.
_
ei
c
/C ea o. Ck. By, _
Lot Size
Mech. Fee Dbl $
PI. Ck. Fee $
Construction Fee Del $
al ^e to 92951
S
S
R
Electrical Fee Obi $ VL
Zone Restrictions
Group
Type
SMI Fee S
Plumbing Fee Del S'I.
No.
Plan Checker
Fin a
Inspector
Unit
Sp. Insp. Fee
Demol. Fee S
Const. Lender Branch
Supplimentol Permit
mb s
t
Regisir. Fee $
Mileoge Fee S
Address City Zip
'
Witness Fee $
Reinsp. Fee S
Owner/Agent
Tel.
Zip
Total Fees S
Address
City
Zip
M.O. C]N.C. ❑ Cash h k
Received^
Contractor.,e"-% f/
1'
'
Tel.
Licensee
1�•i
Trees required t
yam, / ,P�
_.r�'"'"�� " �.,:;_ ,�,/ 1r.•
� /
,
•
Sewage System
"•Address! ._ '•. ._.._'- ; W, •�'''-
City ..
' /�
._. Zip ,.
G^^'..., �'• ��`^+
I LL P tno r nnai antro —.- a ..v ,. 1 . .— .... — — , , — ........ .c arvr.
Sower District
FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
.I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH
c THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA.
. I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE 50 IN t
Form 284208 (Rev. 1/80)
! (((��� ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.6f
„
t. '
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS -
1
Set Back
33
Ventilation System
2
Ftgs 8 FrmsJ-
2 �j
JJ
34
Plenums 8 Ducts ,
ID
2A
Slab Grade
35
Furnace Comport.
3
Steel
9
—l•
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 1
10A
Fireplace T.O.
°o
ADDITIONAL INFORMATION
_ . _- _-
- ---= - ---- .. __ _
f
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)
Z,
------->=w-------.PLUNl�hlG.ARP ROVALS:_..
- -.- - - - -
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/
r
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
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A-� y SIJi�VEYING ICO., INCL
Poo
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1 73-400 HIGHWAY 111
PALM DESERT, CALIFORNIA 92260 y IIt' - ��•; +
PRESIDENT 1 2 �, ' -- r TELEPHONE.
4
JERRY-DENNINGTON ,. r .(714)346-0335
REG. CIVIL ENGINEER �•+..• • �'•
•• VICE PRESIDENT_ •�.•�, _ _ .,,. f CONSULTANT
+ JOHN A.ALFORD Imo'""' - .LEO L. STRECKER'
REG. CIVIL ENGINEER LIC. .-.--!.�•r•%:•L- .--�...• L'.-'!�."-..,..,.. LIC. LAND SURVEYOR
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r CIVIL ENGINEERING LAND SURVEYING PARCEL MAPS SUBDIVISIONS - MASTER PLANNING
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MEMBER: COACHELLA VALLEY CIVIL ENGINEERS'AND LAND SURVEYO RSASSOCIATION
NOTICE: THIS IS NOT A BUILDING PERMIT
APPLICATION TO CONSTRUCT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
l
DISTRICT
Permit No
284 J99 9/74 CANARY—FILE, PINK—APPLICANT
Owner GENE Architect �'�,�� �^� Contractor
Addres �1� s �T�� �ry�`��c
Addres Addressz7�«'�i'�
/QE. city .Ql/vT G�� CitY/��EyjOl%�TA���l
Phone 0—�� 7fo Phone��� ->>Q� " �� �f Y� 7
. Phone���
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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 Buil in and Safety
3
O
shall not make a Final Inspection, until said requirements have been met. , I am also aware that no work is to o e wi in th County R/W
without an encroachment permit.. -
NOW, therefore, it is agreed that 1 (we) will not occupy said property and will not+cause said prop y t e ccupied ntii I (w ) have
-complied with all laws of the County of Riverside and the State of California governing said property
4� ��
DATESIGNATURE 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.
a,�45� I USE OF STRUCTURE
r
JOB ADDRESS , SINGLE FAMILY- DUPLEX.
_
Q
t-
LEGAL DESCRIPTION OF PROPERTY; 3-� ���
- APARTMENTS AGRIC.
Z
O`
�/� .�
` COMMERCIAL Q INDUSTRIAL '
j `n
COMMUNITY - r ALTERATIONS [�
NO..OF SUBMITTEDPLANS_USE OF PERMIT
_
CASE N0. (- 7
p .Z
NO. OF RKING S ACES REQUIRED NO. OF BUILDINGS NOW EXISTING -
Q 0 _
ZON SETBACKS:. FRONT SIDE REAR
m.
jV
GRADING 'PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE-
SETBACK_ORDINANCE a -- OF - FEET REQUIRED ON !' STREET
DATE V. SIGNATURE OF LAND USE 0F.ICIAjL - "
s
F
DEDICATION REQUIRED: YES ❑ NO ❑. NO. OF FEET---
z
CURB AND GUTTER REQUIRED: YES ❑ NO ❑ - —STREET
H
m
d
CAN, CURB, AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑
ME
HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET
C
IMPROVEMENT? YES E3NO ❑
°C
DATE SIGNATURE OF ROAD DEPT. OFFICIAL `2
S
SWIMMING POOLS PUBLIC 4
Q,W
SEWAGE DISPOSAL/ --7, _
FOOD,ESTABLISHMENT
_
WATER POLLUTION REMARKS
�► FLOOD CONTROL—
z AIR POLLUTION
= g DIV OF,HWY
I`
o a — YOUR PROPERTY MAY BE SUBJECT TO
FLOOD.,- R.IVERSIDE COUNTY ASSUMES
NO RESPONSIBILITY IN EVENT OF FLOOD.
284 J99 9/74 CANARY—FILE, PINK—APPLICANT
DEPARTMENT OF BUILDING AND SAFETY APPLICATION CERTIFICATE
COUNTY'OF RIVERSIDE PERMIT #
Effective July1, 1980, Chapter 1301 Section 19825,of the Neilth 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 ,f - 1License No.;, 71A?
Date % 9 Contractor
[� OWNER -BUILDS DE
CLARATIPN
I hereby affirm that I am exempt from the Contractor's Licensse Law for the following reasons:
[3 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.).
[::] I am exempt under Section , B-.&P.C. for this reason:
Date Owner
Q 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 Cou ty of Riverside, DDeepvrtment o Building and Safety.
Date _/,% �%�—�(J Applicant,g /), �T— N• /f i2J�F���
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 Issued (Sec. 3097, Civ. Code).
Lender's Name
Lender's Address
DIVISION OF INDUSTRIAL -SAFETY PERMIT CERTIFICATION
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 iri 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 appl,i�cation and state that the information given is correct. I agree to
comply with a1+1 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-
'per,ty`'for" whi-ch I have,applied for this permit for the purpose of making inspections.
ianature of DD scant/ gent �' / / /
'Da'te
Print App n cant
284-2000 7/80
..
PERMIT NOi
4.3432
PERMIT NO.
1413432
r
DEPARTMENT OF BUILDING `& SAFETY
COUNTY -OF RIVERSIDE
FIEID OFFICE
DST
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
• IST FL.
2ND. FL,
POR.
GAR.
CAR P' l
WALL J
ESTIMATED CONSTRUCTION
SQ. FT. .@ $
UNITS
$
•
SO. FT. @
YARD SPKLR SYSTEM
SQ. FT. @ - MOBILEHOME SVC.
BAR SINK
SQ. FT. @ POWER OUTLET
ROOF DRAINS
SO. FT. @ •
DRAINAGE PIPING
SQ. FT. ' @ - J
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) s
APPLIANCE DRYER
Group Type
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
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
•
SO. FT:- @ a
WATERHEATER
`
S0. FT. RESID @ 1 /aa
SEWAGE DISPOSAL '
SO. FT. GAR @ 3/4a
HOUSE SEWER
`
Tel.
GAS PIPING
PERMIT FEE
Total Fees ". $
PERMIT FEE
PERMIT FEE
DBL.
TOTAL FEESMOB._HM+FEE
dr
City
MICRO "FEE
MECH.'FEE PL. CK. FEE
CONST. FEE ELECT. FEE
p0
SMIFEEFEE
PLUMB. FEE
..
PERMIT NOi
4.3432
-
lob Address
r
Space 2ip
Owner
_
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. ' s
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPAN- IJ THE PLANS AND SPECIFICATIONS HAS DONE SO IN
"SECTION
--
m umry[Vblum—..n—-/7
$
F.C.C.
MH Permit Fee $
Micro Film Fee Cop S
Us of r
/ 2f7O'7
Parcel No.
01-
et Bock
se/Ca a o. Ck. By
Lot Size - -
Mech. Fee Dbl S'
PI. Ck. Fee $
Construction Fee' Dbl $
legal escnption-
S
R '
Electrical Fee Dbl g
JC
(,/ �-. • �,%
Zone Restrictions
Group Type
SMI, Fee $
Plumbing Fee Dbl $
nd mt.
P13No. -tf
Plan Checker
Fi.61eMe X�+
Inspector
Unit
Sp. Insp. Fee g
Dental. Fee S
Const. Lender '
Branch
c
Supplimentol Permit Numbers
-
Registr. Fee g
Mileage Fee $
Address City .•Zip
Witness Fee - g
Reinsp. Fee g
Owner/Agent
-
_
Tel.
Zip.
Total Fees ". $
Address
City
Zip'
M.O. Ej N,C.❑ ..Cash h ck
Receive y
Contractor
`
Tel. «
Licensed'
Trees required
Sewage System „ a,.y�
Addreu'— is
-
,%'� � t
_
Ci y '° i
c- 2ip -
� "*•
"T LL P
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK - `v`erifled'Fiy:
FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
Sewer District
s"
F
,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. ' s
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPAN- IJ THE PLANS AND SPECIFICATIONS HAS DONE SO IN
"SECTION
ACCORDANCE WITH 5541 OF THE BUSINESS ANP PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
Form 284-208 (Rev. 1/80)