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399286 (BLCK)BUILDING PERMIT ^; PERMIT NO. DEPARTMENT OF BUILDING & SAFETY 9 9 2 8 6 COUNTY OF RIVERSIDE FIELD Dsr CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST Fl. 2ND. FL. FOR. GAR. CAR P. WAIL 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 $ 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) APPLIANCE DRYER 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. SO. FT. @ a BATH TUB SO. FT. @ a WATER HEATER SO. FT. RESID @1144 SEWAGE DISPOSAL SO. FT. GAR @ t/<a 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 • V PERMIT NO. 399286 MH Permit Fee $ Micro Film Fee Cop S Mach. Fee Dbl S Pl. Ck. Fee $ Construction Fee Dbl $ Electrical Fee Dbl $ SMI Fee $ Plumbing Fee Dial $ Sp. Insp. Fee $ Demol. Fee $ Registr. Fee ' $ Mileage Fee $ Witness Fee $ Reinsp. Fee $ Total Fees $ M.O. 11 N.C. n Cash n Check Received by �.►� Trees regeed;;;:� Sewage System''✓" T LL P Sewer District Form 284-208 (Rev. 1/80) r Job Address s S Space I Zip I Owner Wins is . F.C.C. - Use of Permit Parcel No. Use/Case No. Ek. By "16;;x' 140 w117 d fence, SiT Backs Lot Size Legal Description F S Zone Restrictions Group Type lot 7 mlx-9� SCV 111 0-11 fi Bond Amt. Pion No. Plon Checker ns Insp for Unit Const. lender Branch r /Supplim;ntol Permit Numbers Address City Zip Tel. Zip Amh Cit _ Zip Star Route 8 L >,ata CA 92253 Contractor Tel. License# Address City Zip THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by: 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.c BY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO INi�eJ, CORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. s3� I- _ NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS' ;MECHANICAL :APPROVALS I Set Bock 33 Ventilation System 2 Ftgs & Frms - 34 Plenums 8 Docts t � 2A Slab Grade 35 Furnace Comport. 3 Steel 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 10A Fireplace T. 0. [j °O ADDITIONAL INFORMATION . e _ ' ` ` v ' SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath s 12 Internal Loth 12A Drywall 13 Finish Grade INSULATION Thick R .Value 7A Walls (Batts) 12B Ceiling (Botts) 12C Ceiling (Blown) PLUMBING A ON ALS 15 Ground Plumb 16 Water Piping 17 Rough Plumb f8 Vents 19 Sewage Disposal 20 Sewer t 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 298 Bonding 30 Fixtures 31 Service 32 Final ) STREET NAME A DEPARTMENT OF BUILDING AND SAFETY APPLICATION CERTIFICATL, COUNTY OF RIVERSIDE PERMIT 0 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 DECLAP,ATION 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 0IWNER-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.). Q 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 %- $-to Owner. C] WORKERS' COMPENSATION DECLARATION f 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 C7 Certified copy is hereby furnished. Q Certified copy is filed with the County of Riverside, Department of Building and Safety. Date Applicant CERTIFICATE OF EXEMPTION FROM WORKERS' CO114PENSATION INSURANCE (This section need not be completed if permit valuation is for $100.00 or less.) 'I certify that in the performance of the work for which this permit is issued. I shall not emplov r any person in any manner so as to become subject to the ''Workers' Compensation laws of California. I further understand that if after making this Certificate of Exemption, I should become subject to • __ the Workers' Compensation provisions of the labor code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Date Applicant CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. Code). Lender's Name I• Lender's Address DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION I hereby certify that no excavation five (5) or more feet in depth into which a person is re- quired to descend, will be made in connection with work authorized by this permit, and that no building, structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. [� As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from that division. Division of Industrial Safety Permit No. Date Applicant CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF EIITRY I certify I have read this application and state that the information given is correct. I agree to comply with all state laws and county ordinances relating to building construction, and authorize a representative of the County of Riverside, Department of Building and Safety to enter upon the pro- perty for which I have ap lied for this permit for the purpose of making inspections. %-$-&V Signa re of Applic'aht/Alerky Date vrinL i%ppiicant 284-2000 7/80 ti so, Owner Architect _ Contractor— �b NOTICE: THIS IS NOT A BUILDING PERMIT APPLICATION TO CONSTRUCT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE DISTRICT Permit No %-., I ;. ' 1 284 199A 9/74 CANARY—FILE, PINK—APPLICANT Owner Architect _ Contractor— Add��a 4 re Address— resp— ,— dd A 04 � City Q� � . — -- City--- -- Phone- _'� Phone _ Phone_ .____—.—.—. _ I (we) the undersigned, hereby certify and acknowledge that I (we) have read the application and agree that if Curb and Gutter, and C Lu Z Paving, and/or Dedication of right of way is required by the County of Riverside, the Riverside County Department of Building and Safety 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 4 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 occupied until I (we) have complied with all laws of the County of Riverside and the State of California governing said property. DATE 7—� SIGNATURE OF OWNER AND/OR AGENT�� ��si Approval by Signature from the Following Departments Listed elow Must Be Obtained Prior to the Issuing of a Construction Permit. iyn I SPACE N0. I .USE OF STRUCTURE JOB ADDRESS _, !/A7 rrSINGLE FAMILY DUPLEX H 11 0 EG DESCRIPTION OF PROPERTY Z gLu APARTMENTS AGRIC. 0 ��______�_J_ a —�C� --�F— COMMERCIAL INDUSTRIAL n '^ CALTERATIONS COMMUNITY G— n Z NO. OF SUBMITTED PLANS — USE OF PERMIT %C W Q 4A CASE NO. p Z NO. OF PARKING SPACES REQUIRED — NO. OF BUILDINGS NOW EXISTING Q _e ZONE SETBACKS: FRONT SIDE REAR J m GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE - SETBACK ORDINANCE OF FEET REQUIRED ON STREET DATE _ SIGNATURE OF LAND USE OFFICI Aa DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET_ w CURB AND GUTTER REQUIRED: YES ❑ NO ❑ STREET oe CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑ W HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET D C IMPROVEMENT? YES ❑ NO ❑ °C DATE SIGNATURE OF ROAD DEPT. OFFICIAI = SWIMMING POOLS PUBLIC Q W SEWAGE DISPOSAL FOOD ESTABLISHMENT _ WATER POLLUTION REMARKS rn FLOOD CONTROL! W AIR POLLUTION DIV OF HWY O ce a _ - YOUR PROPERTY MAY BE SUBJECT TO c FLOOD. RIVERSIDE COUNTY ASSUMES _ NO RESPONSIBILITY IN EVENT OF FLOOD. 284 199A 9/74 CANARY—FILE, PINK—APPLICANT BUILDING PERMIT PERMIT NO, 99286 DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE DST COUNTY OF RIVERSIDE CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. 2ND. FL. POR. GAR. CAR P. WALL ESTIMATED CONSTRUCTION SO. FT. .@ $ -UNITS Date 17-8-80 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 $ 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) APPLIANCE 'DRYER Plan Checker GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED Sp. Insp. Fee S 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 Sewage Systems � SO. FT. @ . a WATER HEATER S0. FT. RESID @ 1144 SEWAGE DISPOSAL 50. FT. GAR @ 3/4a HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL: TOTAL FEESMOB. (�J HM. FEE MICRO FEE MECH. FEE PL. CK. FEE CONST, FEE ELECT. FEE SMI FEE _F FEE PLUMB. FEE v PERMIT NO. 399286 Job Address Space - Zip Owner CEJA aa�bR. Community TA QUIAMS Valuation Date 17-8-80 Dist. 11 Ofl. F.C.C. MH Permit Fee S Micro Film Fee Cop S Use of Permit 6 X 14o wood feAC6 Parcel No. Q Use/Gose No. Ck. By W Mach. Fee Dbl S Pl. Ck. Fee S Set BacksLot Size Construction Fee Dbl S r Electrical Fee Dbl S Legal Description lo! % `ilk-/` WV UQ411 F S S R Zone Restrictions R-1 Group Type SMI Fee S Plumbing Fee Dbl S . Bond Amt. S Plan No. Plan Checker Final Dote RIO � Inspe or Unit e Sp. Insp. Fee S Demol. Fee $ Const. Lender Branch Supplimentol Permit Numbe - Registr. Fee S Mileage Fee S Address / City Zip Witness Fee S Reinsp. Fee S Agent` /` ' Air. ss - 1. tar out* 12,028 Tel. Zip City Zip TA QuintM*CA 9M3 Total Fees S M.O. ❑ N.C. Cash I] Check Received by or I Contractor Tel. License# Trees reqs a �+ Sewage Systems � Address City Zip 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 CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. I BY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN Form 284208 (Rev. 1/80) CORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. 1