403495 (ELEC)BUILDING PERMIT
PERMIT No, DEPARTMENT OF BUILDING & SAFETY FIELD DST
4034 9 5 COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
Jab Address
NO. PLUMBING FEES
1ST FL.
2ND. FL.
POR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SO. FT. @ $
UNITS
'
Community
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
Mech. Fee Dbl $
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM FAN EVAP. COOL HOOD
SIGN
WASHER (AUTO)(DISH)
APPLIANCE DRYER
R,
Electrical Fee Dbl $
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
C
SMI Fee $
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
Bond Amt.
$
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEMP/PERM
Sp. Insp. Fee $
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
Const. Lender
SHOWER
BOILER B.T.U.
SO. FT. @ a
Supplimentol Permit Numbers
BATH TUB
Registr. Fee $
SO. FT. @ a
Address" fir''""y.�Ci(y�..,.•'"` Zip
.�
WATER HEATER
Reinsp. Fee
50. FT. RESID ca 1 /4a
SEWAGE DISPOSAL
f
S0. FT. GAR Qa z/44
HOUSE SEWER
r'zip ,.
Total Fees -
GAS PIPING
PERMIT FEE
PERMIT FEE
.� n..
PERMIT FEE
DBI.
LjAL FEES ?
Q
MOB. HM. FEE
MICRO'FEE
MECH. FEE PL. CK. FEE
CONST. FEE ELECT. fyEs�
CVJ
SMI FEE
FEE PLUMB. FEE -
PERMIT NO.
4034-1
95
'
Jab Address
t`\
:1 N !�A %- �, ;
Space
Zip - t
Owner
'
Community
_
Valuatione
$
(�
A G iQ
K
Dist.
Off. F.C.C. `s
MH Permit Fee $
Micro Film Fee
Cop $
Use of "ermit
S sem, \.•. -r
Parcel No.
—�s� d
Use/Case o.
Ck. l
Mech. Fee Dbl $
PI. Ck. Fee S,•K�
Sat Backs
Lot Size
Construction Fee Dbl $
Legal Description f;
, ^ ^, y. `\i
T^[..+"C ' , V
F
S S
R,
Electrical Fee Dbl $
Zone Resti2fions
J`d..
Group
Type
SMI Fee $
Plumbing Fee
Dbl $
Bond Amt.
$
Plan No. F
Plan Checker
Final Dote ®
— l ^ 66 v,J
Inspector
Unit
f
Sp. Insp. Fee $
Demol. Fee
$
Const. Lender
Branch
Supplimentol Permit Numbers
.7
Registr. Fee $
Mileage Fee S
Address" fir''""y.�Ci(y�..,.•'"` Zip
.�
Witness Fee $
Reinsp. Fee
$
Ow Agent
f
Tel.
r'zip ,.
Total Fees -
$
/
Address
7
.� n..
gnx
City Zip
' �. "•��
MIP. I0 N.C. Cosh Check `Q
Received b N,
Trees. required
I
Contractor
Tel. N
Lcense#
Sewage System
{ f 4.°.JLs
Address
City Zip
T LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by:
Sower District
FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME' VOID.
' C%
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 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN r�
Form 28A•208 (Rev. 1/80) JCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilaticip System '
2
Figs 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
4'1
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L.
43
Final
IDA
Fireplace T. 0.
°o
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Loth
12 Internal Loth
12A Drywall
13 Finish Grade
INSULATION
Thick
R
Value
7A Walls (Batts)
12B Ceiling (Botts)
12C Ceiling (Blown)
14 Final
----__.____.P1l1MBING-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
Tank Pit L. Line
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
P/L
P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
x
29A Grounding Wire / 2 _ Z 1 400
V
29B Bonding
30 Fixtures
31 Service
32 Final U,
STREET NAME
V LI /11\11'1L1\1 VI -Lu 11\V Ill\V
COUNTY OF RIVERSIDE
OWNER -BUILDER INFORMATION
Dear Property Owner.:_'
An application for a building permit has been submitted in your name listing yourself as the builder
of the property i. pnovementsi specified':_...- _
For your protection you should be aware that as owner -builder you are the responsible party of re-
cord on such a permit. Building permits are not required to be signed by property owners unless
they are personally -performing -their -own work. --If your -work is--being-performed-by someone—other
than yourself, you -may -protect -yourself from-possible-liability-if-that-person-appl-ies-for--the pro-
per permit in his or her -name
Contractors are required by law_to-be-licensed and_bonde.d.by..th.e_State_of.Cal.ifo,rnia,._and.,_where
required, to have_ a business. ,l i cense .from .the .city-or_county,,They are._al so required red 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 protection.
If you employ or otherwise -engage any persons other, -than your immediate family, and the work
(including materials and other costs) is $200 or more for the entire."project, and,such�per.sons are
not licensed as contractors or subcontractors, then you maybe 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. 6
There may be financial risks for you if you-do'not carry out these'obligations,`end these risks are
especially serious with respect to -workers' compensation insurance...
For more specific'information about your obligations under federal"klaw, contact the Internal Revenue
Service (and, if you wish, the U.S. Small Business Administration),!rliFor more specific information
about your obligations under state law, contact the Department of Benefit Payments and the Division
of Industrial Accidents.J,
If the structure is intended for sale, property owners who are not licensed contractors are allowed
to perform theirwork personally or through their own employees, without a licensed contractor or
subcontractor, only 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, owne'e'is providing his or her own
labor and material personally. Building permits are not—required.—to be'signed by property owners
unless they are performing their own work personally.
. ! R , 1
Informati:on.about licensed,contractors may be obtained by -contacting the"Contr..ac.tors;,State License
Board in,you.r.,,pommun,ity-or;at�1.020,oN Street; Sacramento„ Cal ifor.ni_aj95814.9:T
Please complete and return the enclosed owner -builder verification form so that we canconfirmthat
you are aware ofathese matters. 'The building permit will not be issued until the verification is
returned.
Sincere1y,�,.�
DEPARTMENT OF BUILDING AND SAFETY
Leopoldo Rojo, Jr.
Director
284-2001 7/80
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
OWNER -BUILDER VERIFICATION '
e
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 processing 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) ti
2. I (have/have not) s 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 Phone
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 Date
Social Security Number
284-2002 7/80
NOTICE: THIS IS NOT A BUILDING PERMIT
APPLICATION TO CONSTRUCT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
DISTRICT N�
Permit No
284 199A 9/74 CANARY—FILE, PINK—APPLICANT
Owner , Architect —. --_ Contractor—__--_ _
Address 7���,F�ss--- Address----- --
City..6/1 City_ City--- —
Phone —��6� Phone _ Phone— --_--.—_._
cc
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
0
without an encroachment permit.
NOW, therefore, it is agreed that 1 (we) will not occupy said property and will not cause said property to beupied u
r'lave
complied with all laws of the County of Riverside and the State of California governing said property.
DATE SIGNATURE OF OWNER AND/OR AGENT
Approval by Signature from the Following Departments Listed Bel
Must Be Obtained Prior to the Issuing of a Construction Per it.
I SPACE NO.
�� I USE OF STRUCTURE
6-7
}
Z ~
(D
JOB ADDRESS / aSINGLE FAMILY DUPLEX
LEGAL DESCRIPTIO F PROPE TY _ Q v / �_
APARTMENTS AGRIC.
a-
a
- —-'-- - COMMERCIAL INDUSTRIAL []
tat —
'
5:'^
COMMUNITY ALTERATIONS
G G
Z
NO. OF SUBMITTED PLANS — USE OF PERMIT �
a
CASE NO.
--
� l7
Z
NO. OF PARKIN SPACES REQUIRED -- NO. OF BUILDINGS NOW•EXISTING
Z
ZONE SETBACfKS: FRONT SIDE REAR
J m
GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE
SETBACK ORDINAN E H OF FEET REQUIRED ON TREET
DATE SIGNATURE OF LAND USE OFFICIAL
DEDICATION REQUIRED: YES O NO ❑ NO. OF FEET --
F
z
CURB AND GUTTER REQUIRED: YES ❑ NO ❑ _ STREET
F
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
°C
DATE — SIGNATURE OF ROAD DEPT. OFFICIAL
a
=
SWIMMING POOLS PUBLIC
WSEWAGE
DISPOSAL
_
FOOD ESTABLISHMENT
WATER POLLUTION — REMARKS
H FLOOD CONTROL
H
W AIR POLLUTION
W DIV OF HWY
c 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