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403478 (BLCK)BUILDING PERMIT PERMIT No. DEPARTMENT OF BUILDING & SAFETY FIELD DST 0 3P'" 7 8 COUNTY OF RIVERSIDE Fi / CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. 2ND. FL. POR. GAR. CAR P. WALL ESTIMATED CONSTRUCTION SQ. FT..@ $ UNITS MH Permit Fee SO. FT. @ YARD SPKLR SYSTEM SQ. FT. @ MOBILEHOME SVC. BAR SINK SQ. 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 VEM SYSTEM FAN EVAP. COOL HOOD SIGN WASHER (AUTO)(DISH) APPLIANCE DRYER Demol. Fee E 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 Receive by 1'..•,.. SO. FT. @ a WATER HEATER S0. FT. RESID @11/4c SEWAGE DISPOSAL Trees requir S0. FT. GAR @ s/.a HOUSE SEWER Is ` \ s, City Zip GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL. TOTAL FEES �j il— MOB. HM. FEE MICRO FEE MECH. FEE PL. CK. FEE CONST. FFEEEy ELECT. FEE / SMI FEE FEE PLUMB. FEE p—, PERMIT NO. 403478z Job Address Ca / u t Space Zip Owner 1,41 Dot t. ff. F.C.C. MH Permit Fee Micro Film Fee Cop E Use of •Per it t Parcel No. Use/Cos Ck. By SEt cks Lot Sire Mach. Fee Dbl E PI. Ck. Fee E Construction Fee Dbl E Electrical Fee Dbl E J lege ipi*4­1—jt nom,... f'F V 4�,� Zone RestrictionsGroup Type SMI Fee E Plumbing Fee Dbl E Bond'A-AT. I E Plan N Plan Z+eikWrl Final Da Gl > ' d InWqor or Unit Sp. Insp. Fee E Demol. Fee E Const. Lender Branch Supplimentol Permit Numbers - � .. Registr. Fee E Mileage Fee S Address City Zip ' Witness Fee S Reinsp. Fee S Owner/Agent Tel. Zip Total Fees S M.O.0 N.C.Q. Cash ck Address City Zip Receive by 1'..•,.. ;�""�•,,. Tel. i License# Trees requir Sewage System Address Is ` \ s, City Zip , T W- P THIS P MI'T'Si1A 8EC0 ID I RK IS NOT COMMENCED THIN 120 D YS C 01F WORK Sewer District FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. ,1 HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH v THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. % _ ` �j, I REB CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN Firm 28e•208 (`Re�v.�l/80) ANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. verified by: NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1Set I Back 33 Ventilation System 2 t Ftgs 8 Frms 34 Plenums 8 Ducts 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. No ___ _ ADDITIONAL INFORMATION -_ __, ____..__. __ __ _ _ __ _ --------- SEWAGE SYSTEM SIZE & LOCATION 11 '', Exterior Loth 12 Internal Lath 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Walls (Batts) 12B Ceiling (Batts) 12C Ceiling (Blown) 14 Final L �( _ ,P_LUMBING_APPROVALS__ 15 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 i _j STREET NAME NOTICE: THIS IS NOT A BUILDING PERMIT DISTRICT APPLICATION TO CONSTRUCT Permit No DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE 284 199A 9/74 CANARY—FILE, PINK—APPLICANT Owner-4)"ID l.(%t !_ v c K V ontractor—_ ddress_ — -- Address _—_ Address7_/ S^Q LB ,'Address--­ city City City��_��� City___---- Phone Phone�70���3 c� _ Phone------.--------- W 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 Building and Safety 3 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 O 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 slaws of the County of Riverside and the State of California governing said property. DATE _/ pl_._� _� SIGNATURE OF OWNER AND/OR AGENT _ Approval by Signature from the Following Departments Listed Below P Must Be Obtained Prior to the Issuing of a Construction Permit. �^7 PACE N0. J � / USE OF STRUCTURE JOB ADDRESS —_! D� � _ AIMILY DUPLEX LEGAL DESCRIPTION OF PROPERTY7 ^ — APARTMENTS AGRIC. O t- — // —der— Z' COMMERCIAL INDUSTRIAL G'^ � COMMUNITY . ALTERATIONS ❑ Z NO. OF SUBMITTED PLANS USE OF PERMIT N Q CASE NO. p Z NO. OF PARKING SPACES REQUIRED NO. OF BUILDINGS NOW EXISTING -- � Q ZONE/ ! SETBACKS: FRONT SIDE REAR J m GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE SETBAC RDINANCE # OF FEET REQUIRED ON STREET DATE — SIGNATURE OF LAND USE OFFICIAL —_ F, DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET— z CURB AND GUTTER REQUIRED: YES ❑ NO ❑ STREET. h a CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑ W HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET O C IMPROVEMENT? YES ❑ NO ❑ °L DATE SIGNATURE OF ROAD DEPT. OFFICIAL Z SWIMMING POOLS PUBLIC Q CL SEWAGE OISPOSAL su FOOD ESTABLISHMENT _ WATER POLLUTION _ REMARKS FLOOD CONTROL— z AIR POLLUTION � W _ DIV OF HWY c a — YOUR PROPERTY MAY BE SUBJECT TO 0 c FLOOD. RIVERSIDE COUNTY ASSUMES NO RESPONSIBILITY IN EVENT OF FLOOD. 284 199A 9/74 CANARY—FILE, PINK—APPLICANT DEPARTMENT OF BUILDING AND SAFETY APPLICATION CERTIFICATE COUNTY OF RIVERSIDE PERMIT N Effective July 1, 1980, Chapter 1301, Section 19825 of the Health and Safety Code requires the execu- 1= 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 C — 112 % License No. 40- ,,20F.0 Date 4. y -4_ k Contractor eVkyii/ A x=/-Aic.4 C0 0 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.). Q 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 ®® 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./D/— "%'/,p 9/,1r/ — _-Z. Insurancej&l� 7-A (.lJeO <7', Q Certified copy is hereby furnished. ® Certified copy is filed with the County of Riverside, Department of Building and Safety. Date ,9- 7 P o 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 Q 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.) Q 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. [7 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 wh/icFi I`haav''e applied for this permit for the purpose of making inspections. Qv:�L —/ice✓ (�Gl/!/J/ 9 7.3-RO $Fgnature bf pp is ht gent Date Print Applicant/Agent/Name 284-2000 7/80 .f BUILDING PERMIT PERMIT NO. ' 03478 DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE DST COUNTY OF RIVERSIDE 7D CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. 2ND. FL. POR. GAR. CAR P. WALL ESTIMATED CONSTRUCTION SQ. FT. .@' $ UNITS SO. FT. @ YARD SPKLR SYSTEM SQ. FT. @ MOSILEHOME SVC. BAR SINK SQ. FT. @ POWER OUTLET ROOF DRAINS SO. FT. @ DRAINAGE PIPING SQ. FT. @ DRINKING FOUNTAIN SO. FT. @ URINAL VALUATION $ WATER PIPING NOTE: Not to be used as property tax voluotion SWIM POOL, PVT FLOOR DRAIN MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER VENT SYSTEM FAN EVAP. COOL HOOD SIGN WASHER (AUTO)(DISH) APPLIANCE ` DRYER Use/Cas No. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED PI. Ck. Fee S LAUNDRY TRAY AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR His POLE, TEMP/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER. BOILER B.T:U. SO. FT. @ a BATH TUB SQ. FT. @ a WATER HEATER SMI Fee S S0. FT. RESID @ 1 t/.a SEWAGE DISPOSAL Pion No. S0, FT. GAR @ t/aa HOUSE SEWER Final Dote GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL. TOTAL FEES An MOB. HM. FEE MICRO FEE MECH. FEE PL. CK. FEE I CONST. FEE , ELECT. FEE �Ci SMI FEE FEE PLUMB. FEE I— PERMIT NO. 403478 Job Address Space Zip Owner 1 Co iDate if. F.C.C. t 7r.ati;n' -r MH Permit Fee S Micro Film Fee Cop S Use of Permit IN _ Parcel No. r Use/Cas No. Ck. By Mech. Fee Dist 4 PI. Ck. Fee S bet Bocks Lot Size F S 5 R Construction Fee Dist S Legal a 'Pt, P dz) Zone Restric' s ' Group 1 Type Electrical Fee Dist S ""� SMI Fee S Plumbing Fee Dist S Bond mt. I Pion No. Pion C ecker I Final Dote Inspector Unit 3'_51 c Sp. Insp. Fee S S L!/ Demol. Fee S Const. Lender Branch Supplimantol Permit Numbers Registr. Fee S . Mileage Fee S Address City Zip Witness Fee $ Reinsp. Fee S Owner/Agent Tel. Zip Total Fees S Address . `� City Zip .C. Cash C ck .O. �, N11� 1 Received y C r " /' Tel. License# Trees d r/ ^ req.ir¢ I . . Sewage System , Address 52C City Zip !� N — �� lel� T " _ / t P THIS.PERMIT SHALL BECOMI WD I�NbRK IS NOT COMMENCED WITHIN 120 DAYS,. CESIFA 0 F WORK verified by: Sewer District FOR 12Q -DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. + .1 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. R'CERTIFY THAT THE INDIVIDUAL 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.