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427176 (AR)PERMIT NO. DEPARTMENT OF BUILDING & SAFETY F/;/;] 427 17 6 COUNTY OF RIVERSIDE FIELD CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES. IST FL. SQ. FT. @ $ UNITS OC6 r"iT 6 J� 2ND. FL. POR. GAR. CAR P. WALL ESTIMATED CONSTRUCTION SQ. FT. @ MH.Permit Fee $ YARD SPKLR SYSTEM Use of Permit J / / // J� !G lr�U' 4 t'yrn" J 6/�—_ MOBILEHOME SVC. BAR SINK SQ. FT. @ Use/Case No. SO. FT, @ POWER OUTLET ROOF DRAINS Mech. Fee Dbl E DRAINAGE PIPING SQ. FT. @ Set Backs DRINKING FOUNTAIN SQ. FT. @ Construction Fee Dbl S SQ. FT. @ URINAL S VALUATION $ WATER PIPING R NOTE: Not to be used os property tax valuation SWIM POOL, PVT FLOOR DRAIN Type MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER Plan No. VENT SYSTEM FAN EVAP. COOL HOOD SIGN WASHER (AUTO)(DISH) Unit APPLIANCE DRYER Demol. Fee E GARBAGE DISPOSAL Supplimentol Permit Numbers FURNACE UNIT WALL FLOOR SUSPENDED Mileage Fee $ LAUNDRY TRAY Witness Fee $ AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET M.O. - N.C. Cash Checkid COMPRESSOR HP POLE, TEMP/PERM LAVATORY License# HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER City //� Zip BOILER B.T.U. SQ. FT. @ t BATH TUB SQ. FT. @ C WATER HEATER S0. FT. RESID @1''Ac SEWAGE DISPOSAL S0. FT. GAR @ 3/4 C 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 PERMIT NO.Job .42717 6 Address J Space Ola Zip Owne Com unity /� iJ r/� Valuation E Date 7-� Dist. Off. F.. C. MH.Permit Fee $ Micro Film Fee Cop E Use of Permit J / / // J� !G lr�U' 4 t'yrn" J 6/�—_ Parcel No. / j -2—c-10 Use/Case No. Ck. By j Mech. Fee Dbl E PI. Ck. Fee $ Set Backs I Lot Size Construction Fee Dbl S Legal Description F . V — ! , 4 a1+ �� r� S 5 R Electrical Fee Dbl E Zone Restrictions Group Type SMI Fee E Plumbing Fee Dbl E �0 Bond Amt. $ Plan No. Plan Checker Final Date �'� Inspector Unit Sp. Insp. Fee E Demol. Fee E Const. Lender 'Branch Supplimentol Permit Numbers Registr. Fee $ Mileage Fee $ Address City Zip Witness Fee $ Reinsp. Fee $ Owner/Agent Tel. Zip Total Fees $ Addi s .' AU� �•� t.(Jc�.wf.(,t%iG�;,t / ✓i� `� City Zip M.O. - N.C. Cash Checkid Received ' Contractor ! ri'.' �.'�%/ C rC� C/1./ Cliy,j /; /.L Tel. y "'� 1% Cf License# Trees qu` ed .�'L.�Gt^••�:' Sewage y is em Address City //� Zip T LL Pt, )(A0 Sewer District .1 A I kr-4614- Form 284-208 (Rev.8/78) @s THIS PERMIT SHALL BECOME VOID IF WORK IS NX COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by: FOR 120 DAYS SHALL ALSO CAUSE PEP^w'df 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 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. ,.�aM �._.s.�..�........�..n>.,.....__......�,..a,«.,.-..,...�...r.....a•,�4..,�..�1�,,....a��...._.e......�.�„_.. - ..,.-.,.,,:t.�-�...x......r:_c.....__...._,.�......i..�...t NO. OPERATION DATE INSPECTOR NO. OPERATION DATE )NSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 3.1 Ventilation System 2 Ftgs 8 Frms 34 Plenums & 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. 0 43 Final 10A Fireplace T. 0. El OP'N NO. ADDITIONAL INFORMATION SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath 12 Internal Lath 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Walls (Batts) 12B Ceiling (Batts) 12C Ceiling (Blown) 14 Final PLUMBING APPROVALS 15 Grouna 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 2-9 Tank Pit L.Line REAR OF PROPERTY LINE ELECTRICAL APPROVALS PSLV-114 P/ d- c �• � t � r/ . 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final STREET NAME NOTICE: THIS IS NOT %N- BUILDING PERMIT APPLICATION TO CONSTRUCT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE DISTRICT /I "I"i Permit No 284 199A 9/74 CANARY—FILE, PINK—APPLICANT Owner,4// C ) Architect -- --_ Contractor � Addres 6 Al7iv �Un'_S Address___ Address-o.'aUK City ec—p-o0w 17UNCS City_— _ City�Iry C�'t Phone Phone _ Phone— �2 �.. ._-� 7 4 WI (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 lawsof the County of Riverside and the State of California governing said property. �a DATE _l __ SIGNATURE OF OWNER AND/OR AGE F. Approval by Signature from the Following Departments Listed Below Must Be Obtained Prior to the Issuing of a Construction Permit. l'�41E0 I SPACE NO. I)USE OF STRU TURE JOB ADDRESS >' Z ~ - SINGLE FAMILY UPLEX LEGAL DESCRIPTIOr QF PROPERTYe- TSL All _ APARTMENTS AGRIC. El _ I o � —S o� -U—r/ -'- -- COMMERCIAL Ej INDUSTRIAL C] C O/ COMMUNITY ALTERATIONS n 2 Q N0. OF SUBMITTED PLANS - US PERMIT��_ C`L CASE NO. C 2 NO. OF PARKING SPACES REQUIRED -- NO. OF BUILDINGS NOW EXISTING _ a O ZON�SETBACK'S: FRONT SIDE REAR m GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE SETBACK ORDINANCE -_ OF FEET REQUIRED ON STREET DATESIGNATURE OF LAND USE OFFICIAL -- DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET - — t z CURB AND GUTTER REQUIRED: YES ❑ NO Cl STREET i H a W CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑ ' HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET Q C M IMPROVEMENT? YES E3NO C3 cc DATE SIGNATURE OF ROAD DEPT. OFFICIAL c Z -A x Q w` SEWAGE DISPOSALS FPG/�cE L-X/S%-7�E4�/4 t/ Li/ f/'6 6 ,f W C T C O Nyfryl4x. x WATER POLLUTION' REMARKS FLOOD CONTROL -2 CC Lu AIR POLLUTION Will DIV OF HWY o a YOUR PROPERTY MAY BE SUBJECT TO - 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 S Effective July 1, 1980, Chapter 1301, Section 19825 pf 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 C 42 License No., Date /7 Contractor_A4,x=xi ))�7/l6G So, j (6Aj c; 7T 1A3- /mac. Z / ei rw 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.). �] I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, B.&P.C.). Q I am exempt under Section ,,B.&P.C. for this reason: Date `7 `ab'','/ Owner M 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. !ate jam—O�57 Insurance r/il2T/S / �t�.�•� /�/i2L �G� 7��� 0 Certified copy is hereby furnished. 0 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 Exemptiop, I should become subject to the Workers' Compensation provisionsfof-the labor cod�e,ypI,m�us)t forthwith comply with such provisions or this permit shall be deemed revo4d.1� Date '7 Applicant CONSTRUCTION LENDING AGENCY V 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.) [] 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. Q 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 which I have applied for this permit for the purpose of making inspections. / Ig/n�ature(o Applicant/Agent ate Print Appl cant/ gent Name 284-2000 7/80 BUILDING PERMIT PERMIT NO. 427176 DEPARTMENT OF BUILDING & SAFETY FDTCOUNTY OF RIVERSIDE FIELD OFFICE I CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES Owne4 4l—�o.�� 1ST FL. 2ND. FL. POR. GAR. CAR P. WALL SQ. FT. @ $ UNITS : c -N A)" `(.j f-0 SQ. FT. @ YARD SPKLR SYSTEM .PermitFee E SQ. FT. @ MOBILEHOME SVC. BAR SINK Use of Permit �/ / '//� r 4 rri I• 14 [- e Iq C/h'� jr" / / SQ. FT. @ POWER OUTLET ROOF DRAINS Use/Case No. DRAINAGE PIPING SQ. FT. @ Mech. Fee Dbl $ I DRINKING FOUNTAIN SQ. FT. @ Set Backs SQ. FT. @ URINAL Construction Fee Dbl S ESTIMATED CONSTRUCTION VALUATION $ F WATER PIPING R NOTE: Not to be used as property tax valuation SWIM POOL, PVT. FLOOR DRAIN Type MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER Pion No. VENT SYSTEM FAN EVAP. COOL HOOD SIGN WASHER (AUTO)(DISH) Unit APPLIANCE DRYER Demol. Fee $ GARBAGE DISPOSAL Supplimental Permit Numbers. FURNACE UNIT WALL FLOOR SUSPENDED Mileage Fee $ LAUNDRY TRAY Witness Fee $ AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET Received COMPRESSOR HP POLE,TEMP/PERM LAVATORY Trees qu' ed HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER Sc BOILER B.T.U. SQ. FT. @ c BATH TUB SQ. FT. @ c WATER HEATER SQ. FT. RESID @1'/.c SEWAGE DISPOSAL SQ. FT. GAR @ HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE © D DBL_ TOTAL FEES MOB.HM.FEE MICRO FEE MECH. FEE PL. CK. FEE I CONST. FEE ELECT. FEE SMI FEE FEE PLUMB. FEE PERMIT NO. 17 Job Address Spacekp`)�J- �(, - 64s C1"'S i� 3 Owne4 4l—�o.�� Community u � Valuation EM Date 17-,z A Dist. Off. F.C.C. .PermitFee E Micro Film Fee Cop $ Use of Permit �/ / '//� r 4 rri I• 14 [- e Iq C/h'� jr" / / Parcel No. �" v Use/Case No. C�y Mech. Fee Dbl $ I PI. Ck. Fee $ Set Backs Lot Size Construction Fee Dbl S Legal Description / F� S � '2 F S S R Electrical Fee Dbl $ Zone Restrictions Group Type SMI Fee $ Plumbing FeeDbl S / Bond Aml. $ Pion No. Pian Checker Final Dote Inspector Unit Sp. Insp. Fee $ Demol. Fee $ Const. Lender Branch Supplimental Permit Numbers. Registr. Fee $ Mileage Fee $ Address City Zip Witness Fee $ Reinsp. Fee $ Owner/Agent Tel. Zip Total Fees is M.O.--N-.C. Cash Check Ad s City Zip Received Con/'tractor ,rJ /➢^ •i%b�*G�eSd t/ eows Tel. License# Trees qu' ed Sewage ystem / Address Cit Zip ( nil 15 17 Sc T LL Pb XI Sewer District /9 Form 284-208 (Rev.8/78) @s 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 a 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 ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.