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403905 (SOL)BUILDING PERMIT NO,�f� 4039i\� PERMIT NO Job Admire.- DEPARTMENT OF BUILDING & SAFETY t Space lip �l Owner ' __-_-----__--_PERMIT Community �Y .t FIELD as1 Date ,4 0 3 9 ll 5 I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH COUNTY OF RIVERSIDE Micro Film Fee Cop S _ CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO, PLUMB G FEES Llse,'Cew No, 1ST FL. SQ. FT. @ $ UNITS 41ry \,`• Sl cs 2ND. FL. SQ. FT. @ Construction Fee Dbl S YARD SPKLR SYSTEM _� FOR. 50. FT. @ MOBILEHOME SVC 1h4f04"K ^:_-�d ,,i Electrical Fee Dbl S GAR. SQ. FT, POWER OUTLET ROOF DRAINS SMI Fee S CAR P. SQ. FT, @ DRAINAGE PIPING Plan No WALL SQ, FT, Chnher DRINKING FOUNTAIN - SQ. FT. @ Sp, Insp. Fee S URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING Supplimental Permit Numbers !1 NOTE: Not to be used as property tax valuation SWIM POOL, PVT FLOOR DRAIN Witness Fee $ MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER VENT SYSTEM FAN EVAP. COOL HOOD SIGN WASHER (AUTO)(DISH) Total Fen S APPLIANCE DRYER A drys .. r,•��•«J GARBAGE DISPOSAL _ Y FURNACE UNIT WALL FLOOR SUSPENDED M. D N. C- E] th ❑ Check LAUNDRY TRAY ., AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK Tel. �. �� ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC I WATER CLOSET COMPRESSOR HP POLE, TEMP/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ, FT, @ c BATH TUB SQ. FL @ a WATER HEATER SO. FT RESID @ 1 Ac SEWAGE DISPOSAL SO FT GAR Civ s/ac HOUSE SEWER GAS PIPING _ PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES IMOB.HM.FEEICRO FEE MECH, FEE PL C� CONST, FEE ELECT FEE SMI FEE FEE au Ll NO,�f� 4039i\� p Job Admire.- verified by: r Space lip �l Owner ' __-_-----__--_PERMIT Community �Y .t Valuation S Date Ossr. I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH MH Permit Fee S Micro Film Fee Cop S _ Dtt c1 Permit - + Parcel No 7—) Llse,'Cew No, C>< Mech. Fee Dbl S PI, Ck. Fee Sl cs Lot Size Construction Fee Dbl S Legal Dmsc pti— 5 _� -Plan F S S R Electrical Fee Dbl S Zone Restnc! ons Group Type SMI Fee S Plumbing Fee Dbl S Sand Amt. $ Plan No Chnher Fi—I Date •a any Iq - 2, 1- v Inspector Unit Sp, Insp. Fee S Demol, Fee S Const. lender Branch Supplimental Permit Numbers !1 Registr. Fee S H Mileage Fee S Address City Zip Witness Fee $ Reinsp Fee S Owner/Agent Tel Zip Total Fen S A drys .. r,•��•«J ..- _ Y Gly Zip M. D N. C- E] th ❑ Check Received by ., iractnr - _ ,., ylClty Tel. �. �� License# Trees required' Sewage System Add ressmay, •Zip T LL p THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS, CESSATION OF WORK verified by: r 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 ' F _ THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. ERTIFY THAT THE INDIVIDUAL WHO $REPARED THE PLANS AND SPECIFICATIONS HAS DONE 50 IN + Form 284=208 (Rev. 1/80) ^C H SECTION 554' OF THE BtNNESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. T 1/d 3WVN EAKS 3NI1 A121 O id dO HV311 NOliV:)Ol V 3ZIS WRSAS 30VM3S 1/d N01IMHO3NI 1VN011IaaV: N I I Inu! j ZC I a�in,oS IE U 6wpuo9 96Z anM 6w Puno'J V61 6 -!'!Al, 66 _ V V01 Iou!3 ysa�njxy -1 d mold—� of POOP{ Io!DJawwo] aw O�lu3 .3—as 9Z linpuoJ LZ I 6 E aD!naQ uopalad aslowS alyd 1omod 96 S1VAOHddV 1VJ12117313 I f jadwOQ ai!j _ I 45a1 s°o - PZ — — 6uwio�j cz awoIoal] 'Iddv eau OS 1al°M ZZ — lalcyoaH ial°M 16 ,ossa,d-OD —3s oZ Iosodsi4 a6oMaS 61 �I 91 ` j!V uo!4mgwoJ sluaA �] gwnld y6-6 L1 ff s4alln0 8 slolul 9£ iI gwnld puno.ic) I SI - S1VA0HddV-9N19Wflld -- -i pOdwoD a�ownj SE Inu!j VL aPD1J 9°IS' VZ (um019) 6u!l!aD JZI sw,j g shy (IG -9) 6uq!a7 9L1 welsdS u0!M14u8A ££ (silos) sll°M VL t S1VAObddV 1VJINVHJ3W anlo% a V!41 � NOIlV1f1SNl 801D3dSNl 31V4 NOI1V213d0 . aPojO ys!u! j J CL 31V4 I NOI1V83d0 II°'n/'(1 VZI 41°1 lowayul 61 ylol iopajx3 11 N01IMHO3NI 1VN011IaaV: N 01 a:Olda,y V01 Iou!3 C17 -1 d mold—� of POOP{ Io!DJawwo] V, II°M an j O6.—E) I 6 E aD!naQ uopalad aslowS 1y — sluab jadwOQ ai!j op — — 6uwio�j 9 awoIoal] 'Iddv 6C — Ihap !ooa ,ossa,d-OD s£ swoas puos sspols holo S h j!V uo!4mgwoJ L£ s4alln0 8 slolul 9£ IaaIS I C pOdwoD a�ownj SE aPD1J 9°IS' VZ spnd F swnuald V£ sw,j g shy welsdS u0!M14u8A ££ sho9 las t S1VAObddV 1VJINVHJ3W S1VAOSddV ONlallfl9 801D3dSNl 31V4 NOI1V213d0 ON 801J3dSNl 31V4 I NOI1V83d0 NOTICE: THIS IS NOTA BUILDING PERMIT APPLICATION TO CONSTRUCT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE DISTRICT. Permit No ; 284 199A 9/74 C4NARY—FILE, PINK—APPLICANT Owner Architect __—. ____ Contractors!—_ 0 1Q Addres 1Af- Q,vAddress___ Add s_ City�c? Sl` City-- _ City_ Phone Phone _ Phone__ I (we) the undersignedhereby certify and acknowledge that I (we) have read the application and agree that if Curb and Gutter, and W Z Pav g, and/or Dedication of right of way is required by the County of Riverside, the Riverside County, Department of Building and Safety 3 s not make a Final Inspcction'until said requirements have been met. 'I am also aware that no work is to to done Within the County R/W O it ou - chment permit. .' f NOW, therefore, it is agreed that 1 (we) will not occupy said property and will not taus said property to be occupied until I (we) have ' complied with all laws of the County of Riverside and the State of California governing said property. ' i DATE ____--_— 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. G� I SPACE. NO. 'CF USE S�CTURE '-� > JOB ADDRESS -C - SINGLE FAMILT DUPLEX LEGAL DES RIPTION OFPROPERTY ! �"7 8Z 0 _ APARTMENTS AGRIC. Cr- � um INDUSTRIAL LJ '^ COMMUNITY V G C'ALTERATIONS Z NO. OF SUBMITTED PLANS _-- USE OF PERMITQ, jCASE NO. Z NO. OF RK NG SPACES'REQUIRED _— – NO'. OF BUILDINGS NOW EXISTING Q � ZONE SETBA(fKS: FRONT SIDE REAR J m GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE SETBACK ORDINANCE # OF* FEET REQUIRED ON T DATE 2-0SIGNATURE OF LAND USE OFFICIAL DEDICATION REQUIRED: YES ❑ NO ❑ NO. FEET -- — .OF z CURB AND GUTTER REQUIRED: YES ❑ 'NO ❑ STREET 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 °L DATE SIGNATURE OF ROAD DEPT. OFFICIAL = SWIMMING POOLS. PUBLIC QW SEWAGE DISPOSAL _ FOOD ESTABLISHMENT WATER POLLUTION r REMARKS vt FLOOD CONTROL 1– W AIR POLLUTION ag _ DIV OF HWY c a — YOUR PROPERTY MAY BE SUBJECT TO d c FLOOD. RIVERSIDE COUNTY ASSUMES NO RESPONSIBILITY IN EVENT OF' FLOOD. 284 199A 9/74 C4NARY—FILE, PINK—APPLICANT M07 ' "^' S hs' ��' : GL•�70 . Iry Qy C--7 Cary 71y) fin/ . 007/ 4%v� LZ C-41al fu/7 ©S COUNTY OF R VERSIDE -b`7051 DEPARTMENF BUILD &SAFETY PP cD / Approval of theseDAE plans shall not beTconstrued to b� `T n ptrmit. for, or an:approval of, any violation of any of Me Provisions of. the state orcounty laws. This m of a m be MA the job until completion. C% I N , N •NOISIAI00 a 3Sn 0N`� a3A0bddy r i4 )NI 90 tf� a.1-191.?' ' a Q G'vD3 -- v3v ONIAI 3NOZ i 32iNR bd32i i ':,.ON < , . /LCT?� l.�DcrJ •>.?�i�i>1�. - , w4F16:-x4 3 7-0 v COUNTY OF RIVERSIDE DEPARTMENT OF BUILD & SAFETY ". APPD BY DATE r Approval of these plans,shalh not be construed to bo GO� a e Permit for, or an approval of, any violation of any Of of the state or county laws. Thle 811 { �, 'the rovisions. e ,f owns must be kept on. the lob urM a0et91tflon 4 IQ 1 vJU A //00 (Oki T ht)L To T L. CO11 UNTY":OF IVEI2SLDR :. R DEPA . EN OF BUI AFETY q'/ =D } Stews �a Approval of thse pla e permit for, or an ap 0e p v'm t�hee�e PF., DATE ^- . .,. a ,shall not, be construed to by val of, any.violation of any Of or county' laws. This ell the lob until compW"um . 70, "rto z � w✓r�� Ur7 ice/ £TJ N w /% G�'-Z�'L ��1-Y�-�'�7aL. i DEPARTMENT OF BUILDING AND SAFETY APPLICATION CERTIFICATE COUNTY OF RIVERSIDE PERMIT # Effective July 1, 1980, Chapter 1301, Section 19825'of the Health 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. Date Contractor Q OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reasons: [� 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.). [:1 I am exempt under Section B.&P.C. for this reason: Date Owner. ID 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 _ 0 Certified copy is hereby furnished. Certified copy is filed with the County of Riverside, Department of'Building and Safety. Date Applicant 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 in 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. i C] Division of Industrial Safety Permit No. Date Applicant f 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 represen,tatjY.e 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. tgnature of Applicant/Agent Print Applicant/Agent Name 284-2000 7/80