403957 (RPL)BUILDING PERMIT
PERMIT NO.
403957
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
4
FIELD
DST
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
Job A�d•-dress
J
Ad 3 — _ v!
NO. PLUMBING FEES
Zip
1ST FL.
2ND. FL.
POR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SO. FT. @ $
UNITS
Valuation
Dote
Dist.
'
SO. FT. @ YARD SPKLR SYSTEM
F.C.C.
SO. FT. @ MOBILEHOME SVC. BAR SINK
Micro Film Fee
SO. FT. @ POWER OUTLET ROOF DRAINS
Use of Permit Passel � Use/Case No. Ck. B
r I7r /,)j -(qo - '
Set Bock, Lot Size \
legal Description F 5 R/. .,.; IJ / %��•
Zone Restrict' Group Type
. ' ��e- J (� L/' ! ry !c r•_, `[ ~' '
SO. FT. @ DRAINAGE PIPING
PI. Ck. Fee S
SO. FT/ @ DRINKING FOUNTAIN
Electrical Fee Dbl S r
URINAL
Plumbing Fee
VALUATION WATER PIPING"t�
.
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
J`)
Ins <t r
-'
FLOOR DRAIN
'' -
MECHANICAL FEES
SWIM POOL, COMM
S
Const. Lender
WATER SOFTENER
VEN! SYSTEM - FAN EVAP. COOL HOOD
SIGN
Reghtr. Fee S
Mileage Fee S
WASHER (AUTO)(DISH)
Witness Fee S
APPLIANCE DRYER
S
ner nt s,
GARBAGE DISPOSAL
Tel.
FURNACE UNIT WALL FLOOR SUSPENDED
Total Fees
S 070
LAUNDRY TRAY
City /� �• q
AIR HANDLING UNIT CFM-
IDLE METER
Receive
('1�
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
LicenseR
WATER CLOSET
Sewage Systems
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 @0 1 t/ae
SEWAGE DISPOSAL
S0. FT. GAR @ V44
HOUSE SEWER
'
GAS PIPING
PERMIT FEE
PERMIT FEE
t,�_�
PERMIT FEE
DBI. -
{
TCXALjyv,
0.x
MOB. HM. FEE
MICRO'FEE
MECH. FEE 'PL. N. FEE -
CONST. FEE
ELECT. FFE7
SMI „E E .••'
� �
FEE PLUMB„sFE
PERMIT NO.
403957.
Job A�d•-dress
J
Ad 3 — _ v!
Space
z
Zip
Ownerf�'" Up
'
Communi
Valuation
Dote
Dist.
I.
F.C.C.
MH Permit Fee $
Micro Film Fee
Cop 5
Use of Permit Passel � Use/Case No. Ck. B
r I7r /,)j -(qo - '
Set Bock, Lot Size \
legal Description F 5 R/. .,.; IJ / %��•
Zone Restrict' Group Type
. ' ��e- J (� L/' ! ry !c r•_, `[ ~' '
Mech. Fee Dbl 5
PI. Ck. Fee S
Construction Fee Dbl $ :6(j
Electrical Fee Dbl S r
SMI Fee S %„
Plumbing Fee
Dbl 5
Bond Amt.PIon
g/
No.
Plan Checker
FYI ate
//
Ins <t r
-'
Unit
Sp. Insp. Fee S
Demol. Fee
S
Const. Lender
Branch
Supplimentol Permit Numbers
_
L
'
Reghtr. Fee S
Mileage Fee S
Address City Zip
^`
Witness Fee S
Reinsp. Fee
S
ner nt s,
Tel.
Zip
Total Fees
S 070
,.//J� �J /
• .Q4 l�r�.. -9
City /� �• q
) Zip
M.O. N.C. C sh Q Check
Receive
('1�
Contractor
Tel.
LicenseR
Trees required
Sewage Systems
s
Address
City Zip
T LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK
Sewer 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
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA.
REBY CERTIFY THAT THE INDIVIDl1;41 WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
Form 284-208 (Rev. 1/80) ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
verired by:
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS ;
1
Set Back
33
Ventilation System
2
Ftgs 8 Frms
1 - _Q —�(Jh
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.
Ej
43
Final ,
10A
Fireplace T. 0.
P' ADDITIONAL INFORMATION
Z7
SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal lath
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
—SEWAGE
M; --
Tank Pit L. line
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
P/L
P/
26 Power Pole
27 Conduit
I Z_
28 Service Entrance
29 Wiring
29A Grounding Wire
—/
29B Bonding
30 Fixtures
'
31 Service
32 Final
'
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 processJng 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) 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 J Phone—.------
Address
hone___Address � � ^ City
Contractors License No.
5. I will provide some of the work but I have contracted (hired) the fol-
lowing persons to provide the work indicated:
Name Address Phone Type of work
Signature•Property••Owner
Social Security Number
284-2002 7/80
Date
COUNTY OF RIVERSIDE
OWNER -BUILDER INFORMATION
Dear Property OW,ie'r:" qt !`:`_ "�-'.� ..�. ' 'r'-'
An application for a -building permit has been submitted in your name listing yourself as the builder
of the property mprovements� speei fi ed f,', ,- C 5to
For your protection you should be aware that as owner -builder you are the respon3ible 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 possible 1-iabi-l-ity- -if that--person.applies_.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_also relj&ed 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 �protecticn, ,' }b G': `.,s -P.
If you employ or otherwise -engage any -persons other than-youriimmediate family, and the work
(including materials ,and other costs) is $200 or•more for the"entire.-,�projectill .snd1 such,tpersons 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`government'as-an-employer and
you are subject to; several obligations 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 ri'sk`s'for you if'you do 'not carryout these�obTigation;i-and=these risks are
especially serious with respect to workers' compensation insurance._.
For more specifi'c'info'rmation about your obligations under .fe-deral.'M aw, coni�&t the Internal Revenue
Service (and, if,you wish, the. U.S. Small Business Administration);.,.tFor more specific information
about your obligations under state law, contact the Department of Benefit Payments and the Division
of Industrial Accidents..+
If the structuris intended nd
ed for sale,'proper.ty owners who are not'lic'ensed -ontractors are allowed
to perform their work,personally or through their own employees, without a licensed contractor or
subcontractor, on.ly under limited conditions. ,
A frequent practice of unlicensed persons professing,to be contractors is to secure -an "owner -
builder" building permit,' erroneously implying that,the property -'owner• -is "pro Ji -di ng his or her own
labor and material' personally. ' .Building+ permits- are not required .3to, be; si g ied -by Lproper•ty owners
unless they are performing their own work personally.
:-CP C, ; Ar fI'
Information'about.;I:icensed•,contractors may,;be obtained by,contacting the, Crntractors-;State License
Board in your; community}or, at-1020,,R.St.reet,-,Sac*ramento )CAIifornia;.9581._4.yc,
.9 1 AV11L0 ;L`. _' tLr0Uli' •!jt 1t., I:e H+'AGj.'t�+v �7>._ri,:tt'r S;r
Please complete and return the enclosed owner -builder verification form so that we can confirm that
you arePaware,'of",these matters. The building permit will not be issued un-:il the verification is
returned. ,+ ° } ; , ,ti •, i }t 47 i. a + rV(.'o ` t'C, ; 'l tOti .' H �,N, G 131,q -1)G9,- } Ud
Sincere4ly,
DEPARTMENT OF BUILDING AND SAFETY
Leopoldo Rojo, Jr. ;
Director r�" k-�, �Fb r,t rtt
284-2001 7/80
���.t,�
NOT:CE: THIS IS NOT A BUILDING PERMIT
APPLICATION TO CONSTRUCT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
DISTRICT
Permit No
284 199A 9/74
CANARY—FILE, PINK—APPLICANT
Owner, t�/��/C/tj0a�v Arc�hitect —. --._ Contractor___ ---
� �(9 �aXdd'dress___ Address
K
Addres.5-7-' 9 —---_-
CitX�_&City_-- _ City -
C
Phone o `1' 3-3 OR- -3 V6 , P3Wne _ Phone—
C
W
I (we) the undersigned, hereby certify and acknowledge that I e) hav 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 ''erside, the Riverside County Department of Building and Safety
3
shall not make a Final Inspection until said requirements have been 1 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 sai property an will not cause said property to I}e occupied un '1 1 (we) have
complied with the. County of Riverside and the State of California g verning said property.
/laws
hall
soof
DATE _— SIGNATURE OF OWNER AND/OR AGEN --
Approval by Signature, from the Following Departments Li d Below
Must Be Obtained Prior to the Issuing of a Construction Permit.
PACE NO.
USE OF STRUCTURE
JOB ADDRESS �
.�_ - SINGLE FAMILY DUPLEX 0
LEGAE RIP OF PROPERTY
SZAPARTMENTS AGRIC. [�
O
COMMERCIAL E] INDUSTRIAL,
Lj
COMMUNITY
ALTERATIONS ❑
Z
NO. OF SUBMITTED PLANS USE OF PERMIT _ r
UA N Q
CASE NO.
_
O 47
Z
o
NO. OF PARKING SPACES REQUIRED _ — NO. OF BUILDINGS NOW 5XISTING -
ZON — ETBAeKS: FRONT 4 SIDE REAR Z
J
m
_
GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE
SETBACK ORDINANCE # OF FEET REQUIRED ON STREET
DATE T� ' �� SIGNATURE OF.LAND USE OFFICIAL
DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET-
--W
CURB AND GUTTER REQUIRED: YES ❑ NO ❑ STREET
d
CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑
W
HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FCR DRIVEWAY AND STREET
IMPROVEMENT? YES ❑ NO C3
O
°C
DATE SIGNATURE OF ROAD DEPT. OFFICIAL
2
SWIMMING POOLS PUBLIC
W
SEWAGE DISPOSAL
Q
_
FOOD ESTABLISHMENT
WATER POLLUTION REMARKS
vt FLOOD CONTROL
H
Z AIR POLLUTION
� W
W I H
2 DIV OF HWY
I
a — YOUR PROPERTY MAY BE SUBJECT TO
a
c FLOOD. RIVERSIDE COUNTY ASSUMES
NO RESPONSIBILITY IN EVENT OF FLOOD.
T
284 199A 9/74
CANARY—FILE, PINK—APPLICANT