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426234, 427075 (SFD)pVILVInv rGRn111 Z. PERMIT NO. DEPARTMENT OF BUILDING & SAFETY FDSI426234 COUNTY OF RIVERSIDE "' FIELD CONSTRUCTION ESTIMATE NO.' ELECTRICAL FEES NO. PLUMBING FEES IST FL. '70 � 2ND. Fl. L - POR. 710 GAR. `?r CAR P. WALL ESTIMATED CONSTRUCTION � SQ. FT. �r �^ Ca / y UNITS Comm nity r SQ. FT. @ '" YARD SPKLR SYSTEM SQ. FT. @ Z p✓`A''�71 MOBILEHOME SVC. BAR SINK SQ @ ` Ly( ��,��✓ POWER OUTLET ROOF DRAINS SQ. FT. @ DRAINAGE PIPING SQ. FT. @ DRINKING FOUNTAIN SQ. FT. @ URINAL ` VALUATION S V_ / + WATER PIPING NOTE: Not to be used as property tax valuation B SWIM POOL, PVT FLOOR DRAIN MECHANICAL FEES' Lot Size ' Type SWIM POOL, COMM WATER SOFTENER VENT SYSTEM FAN EVAP. COOL HOOD Plumbing Fee SIGN WASHER (AUTO)(DISH) APPLIANCE DRYER Plan No. PI ec GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED Unit LAUNDRY TRAY AIR HANDLING UNIT CFM $ IDLE METER KITCHEN SINK ABSORPTION SYSTEM B.T.U. SupplimentaI P it Numbers _ TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP Address City Zip POLE,TEMP/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T:U. Zip SQ. FT. @ c BATH TUB �\ $ SQ, FT. @ c WATER HEATER Cite �+•�., • " ✓l/Y.�!}t:�'.. �/�",. Zip �"i "�... j SQ. FT. RESID @1'/.c SEWAGE DISPOSAL SQ. FT. GAR @ 1% c HOUSE SEWER Tel. License# 'GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL. t TOTAL FEES_ MOB. HM. FEE MICRO FEE MECH. FEE PL. CK. FEE CONST. FEE ELECT. FEE SMI FEE FEE PLUMB. FEE - — —PERMIT NO. — - 4 2 6 2 3 4 Job Address -- to — _ _ .. - - — — — — — — —. .. J— � 14/Vii Space Zip ----Cwner y� 0 - (- Comm nity r , Valuation Date Dist. Off. F.C.C, MH.Permit Fee $ Micro Film Fee Cop $ Use of Per^}ttj 6 ,p �-/ V /'','�) / f/T/ L. t'y G�/ O �'7 / Parcel No. �/ `�+ 07 dGi— ^"N— �� Use/Case No. jCk. B Mech. Fee Dbl $ PI. Ck. Fee $ �. ;f F 5 5 Set Backsp1roup Zone Restrictions Lot Size ' Type Construction Fee Dbl $ Legal Description / C_S p; ��?"1,( r Electrical Fee Dbl $ SMI Fee $ Plumbing Fee Dbl $ Bond Amt. $ Plan No. PI ec Final Dot Q' Irpeclor Unit Sp. Insp. Fee$ Demol. Fee $ Const. Lender Branch SupplimentaI P it Numbers _ Y Registr. Fee $ - Mileage Fee $ Address City Zip Witness Fee $ Reins#. Fee $ Owner/Agent Tel. .. - _-.,.-.-^"'-� Zip Total Fees �\ $ Address�%' 3 9 �ji / (.% /TT 4 Z:.. t. c-;— Cite �+•�., • " ✓l/Y.�!}t:�'.. �/�",. Zip �"i "�... j ._ - M.ON Ca3h Check Received by ' Contractor Tel. License# Trees requi ed+: Sewage System Address City Zip .F T LL P Sewer District 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 Ir -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 S—ATE OF CALIFORNIA. NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Ftgs 8 Frms 34 Plenums 8 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 Wali 42 Commercial Hood 10 Fireplace P. L. 43 Final 10A Fireplace T. 0. FI 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 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 PSL REAR OF PROPERTY LINE ELECTRICAL APPROVALS P/ 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final a STREET NAME PERMIT NO. DEPARTMENT OF BUILDING & SAFETY DST 426 ry COUNTY OF RIVERSIDE FIELD OFFICE CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES ' 3 �" $ '?.�� s UNITS Date �`�� a .s',IST FL. SQ. FT. Off. '�"^• F.C.C. MH.Permit Fee $. 2ND. FL. SQ. FT. @ Use of Per // ;V. ( )•� �rs fe -a'`/ « r- " '� Parcel No. YARD SPKLR SYSTEM / / ^� ! / MOBILEHOME SVC. BAR SINK + FOR. SQ. FT. @ GAR. 4Z, SQ. FT. @ "�` POWER OUTLET - ROOF DRAINS CAR P. SQ. FT. @ • Bond Amt. $ PIaa No. �3 DRAINAGE PIPING WALL SQ. FT. @ Inspector ". Unit. DRINKING, FOUNTAIN Dental. Fee $ Const. Lender . Branch Supplimenial Permit Numbers ` URINAL SQ. FT- @ Address City Zip Witness Fee $ Reinsp. Fee $ ESTIMATED CONSTRUCTION VALUATION ,{{ ` /J%� ' WATER PIPING NOTE: Not to beused as property tax valuation Zip S'^✓t,v 60 � •-�'% SWIM POOL, PVT FLOOR DRAIN MECHANICAL FEES Tel. SWIM POOL, COMM WATER SOFTENER VENT SYSTEM FAN EVAP. COOL HOOD Address 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. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP . POLE,TEMP/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER «ry B.T.U. SQ. FT. @ c BATH TUB SQ. FT. @ c WATER HEATER SQ. FT. RESID @1'/.c SEWAGE DISPOSAL t a SQ. FT. GAR @ 3%t 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 rye, 'PERMIT NO. 14262341. Job Address - Space Zip Owner /li,�� niy/a,`r� t • `'/./ ls%-W'�/i� / i''T Valuation . $ Date �`�� a Dist. / Off. '�"^• F.C.C. MH.Permit Fee $. Micro Film Fee Co $ Use of Per // ;V. ( )•� �rs fe -a'`/ « r- " '� Parcel No. Use/Cose No. C Mech. Fee Dbl 8 PI. Ck. Fee $ • YJ Set Backs - Lot Size F f S f/ / C.J S /� R ` Zone Restrictions - Group Type - " Construction Fee Dbl $ legal DescriptionD ! �4��E%�' �,[ Electrical Fee Dbl $7"' SMIFee $ Plumbing Fee Dbl $ Bond Amt. $ PIaa No. �3 Plan Ch Final Date Inspector ". Unit. Sp. Insp. Fee$ Dental. Fee $ Const. Lender . Branch Supplimenial Permit Numbers ` Registr. Fee , $ Mileage Fee , rf. $ Address City Zip Witness Fee $ Reinsp. Fee $ O Agent Tel. Zip Total Fees 8 J Address% _ q.3 9� 1!i � Gi /LO �..4iC9' Zip S'^✓t,v 60 � •-�'% M.O. Cash Check Received by Contractor Tel. License# Trees requir Sewage System T LL P c Sewer District - 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 Wlll BE DONE IN ACCORDANCE WITH THF IAWS nF OWFQSIM: rf) MTV Alur) TLIF STAT; r1F r•AI IFr1DNIA , ' Form 284.208 (Re,8/78) ©s 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. OUILVEnv reams PERMIT NO. 1.427075 DEPARTMENT OF BUILDING & SAFETY COUNTY OF RIVERSIDE FIELD RR 0&27075 DST 41 CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. 2ND. FL. SQ. FT. @� • $ 3. G UNITS 107-20-81 11 Of. 5 1 F.C.C. 01 YARD SPKLR SYSTEM SQ. FT. @ •Micro Film Fee POR. 316 SQ. FT. @ 4.10 295.6S MOBILEHOME SVC. ParcelNo. �y �{ �.71G% G �1J K7J"'•s�'• Use/Cose No. ks BAR SINK � . sci� GAR. CAR P. WALL 0 SQ. FT. @ a1. rW • POWER OUTLET LegoollfDescription �}t •�• `y ry1 C rP T DESERT JO •+ 31 D EJ ER l,. 4 LU B ESA #5 ` t 5 ROOF DRAINS A ju DRAINAGE PIPING" SQ. FT. @ +%w T _N SQ. FT. @ DRINKING FOUNTAIN y _ �gt SQ. FT. @ 1.901 ESEIMATED CONSTRUCTION VALUATION $ '278r. 0 4.2,•KItdJ . G0 Bond Amt. Plan NF�o.p{] )��!rtL!/ +Plan Checker E F �3W Const. Lender Branch Address • City 1. URINAL WATER PIPING I y 01 ` NOTE: Not to be used as property tax valuation_ Registr. Fee $ ' SWIM POOL, PVT Witness Fee $ Reinsp. Fee FLOOR DRAIN MECHANICAL FEES SWIM POOL, COMM Zip ' ....tr WATER SOFTENER $ VENT SYSTEM FAN EVAP. COOL I HOOD � ;� . SIGN City I W 6 PA 2 WASHER (AUTO)(DISH) Received by- APPLIANCE DRYER 1 300 . Gastroc i 1 GARBAGE DISPOSAL 2 50 FURNACE UNIT WALL FLOOR SUSPENDED Isewoge System S J� 1 Address • / LAUNDRY TRAY Cl y Zip AIR HANDLING UNIT CFM )�, IDLE METER KITCHEN SINK 2 50 ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC 2 WATER CLOSET 50W COMPRESSOR . HP POLE,TEMP/PERM 3 LAVATORY Qj HEATING SYSTEM Z FORCED GRAVITY 40W__ .CAS 0 AMPERES SERV ENT 700 1 SHOWER 250, BOILER B. T. SQ. FT. @ c BATH TUB 250 SQ. FT. @ c WATER HEATER 250 •� SQ. FT. RESID @I,/.,: 1 a SEWAGE DISPOSAL 1 0 5 gig SQ. FT. GAR @ % c 377 HOUSE SEWER ' GAS PIPING 250 PERMIT FEE PERMIT FEE �, PERMIT FEE & 0 DBL. TOTAL FEES 382•' MOB. HM. FEE MICRO FEE MECH. FEE 2?,�i0 PL. CK. FEE 11.'70 CONST. FEE 251.50 ELECT. FEE ,32.�7' SMI FEE G.-5 FEE PLUMB. FEE 62. 901 PERMIT NO. • 42707,5- Job Address -T J. tL RONDOValuation Space • C{2 Zip elt Owner 1C�D MO `f CommunityJLL2 3if, 5 N � $ 42200 .20 107-20-81 11 Of. 5 1 F.C.C. 01 MH.Permit-Fee $ •Micro Film Fee Cop $ Use y�off fe��rmitYit �� fiRe. p ,t, h4 y /s o 1 F4..L 1:1 N' _AND AT WAGE I ParcelNo. �y �{ �.71G% G �1J K7J"'•s�'• Use/Cose No. ks k..By Mech. Fee Dbl $ •) PI. Ck. Fee $'IF I Set Backs Lot Size 125 000 -Construction Fee Dbl $ + ^ LegoollfDescription �}t •�• `y ry1 C rP T DESERT JO •+ 31 D EJ ER l,. 4 LU B ESA #5 ` t 2J U 11-3 1 R' 1 IM Electrical Fee Dbl $ � MT) Zone Restrictions '�'� Group ,yType� S +%w T _N '- 'SMI Fee $ • `) 76-'S••�' Plumbing Fee Dbl E Bond Amt. Plan NF�o.p{] )��!rtL!/ +Plan Checker E F �3W Const. Lender Branch Address • City Finn 'yf ! Ins Unit '�/�/ VG - /�—v.-• Suppli ental Permit Numbers 80427075 Zip Sp. Insp. Fee $ Demol. Fee $ Registr. Fee $ ' Mileage Fee $ Witness Fee $ Reinsp. Fee $ Owner/Agent .Tel. Zip ' ....tr Total Fees 1l $ TTryry J VG� Address 1 City I W 6 PA Zip M.Q. rhNAM Cash 171 Chec Received by- � Gastroc i Tal. .� LicenseN Trees required'- Isewoge System S J� 1 Address • / Cl y Zip " �V T U. P;0 THIS PERMIT SIJALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK ,Sewer DFOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. ,. e {I+'' I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH TF!:S PERMIT -WILL BE DONE IN ACCORDAN � �Ct�WITH a tV THE LAWS'OF RIVERSIDE COUNTY AND Th*.r TATE.0 CALIFORNIA. , I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN Form 284-208 Rev.B/ZB) ©s ACCORDANCE WITH SECTION 5541 OF T14E BUS)NkSS Atm PROFESSIONS CODE OF THE STATE OF CALIFORNIA. verified by: NO.* OPERATION DATE INSPECTOR NCS. OPERATION y D9j E INSPECTOR BUILDING APPROVALMECHANICAL APPROVALS 01 Set Back g �y !A 33 Ventilation System /1 17 ,f� 2 2A Figs 8 Frms Slab Grade %� I' n� _ _., 34 Plenums. Ducts 35 36 Furnace Comport. s Inlets 8 Outlets 3 Steel 4 Grout Blocks 37 Combustion Air Ey 5 Bond Beams 38 Compressor J 6 Roof Deck 39 Appl. Clearance 0/1 7 14Framing �1��8 40 Fire Damper 8 Vents 41 Smoke Detection Device 9 Garage Fire Wall 42 Commercial Hood 10 Fireplace P. L. C] 43 Final 10A Fireplace T. 0. NO ADDITIONAL I O ATION i -------------------- -- - — SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath _ 7-/- g i 12 Internal Lath 12A Drywall 13 Finish Grade / INSULATION Thick R Value 7A Walls (Batts) 12B Ceiling (Batts) Rlu, /1 —,%% G, 12C Ceiling (Blown) 14 Final PLUMBING APOROVALS -------9; / 0 -- - 15 'Groun-J umb-------- 9;U 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 9 _ Tank /00,;,D Pit L.Line REAR OF PROPERTY LINE 1 PSL Py S� ELECTRICAL APPROVALS 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring —// 1/ 29A Grounding Wire/ fJ /'f 298 Bonding 30 Fixtures 31 Service 32 Final STREET NAME . k.4:..':.'d1:13i v aNOTICt- THIS IS NOT A tUILDING. PERMIT DISTRICT /E f f APPLICATION TO'CONSTRUCT h � Permit No DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE 284 199 9/74 ' L CANARY—FILE, PINK—APPLICANT Owner s/%//4 /2ei Q . 1'42'?Ei, "Architect :�•: • �5 �" -, r• -,(Contractor C' 4 4r1l r/. G �Cq . A%C1L!', Address es ?24� ' 22'0-11 t/s ! "'I ! Address! %' �" iFyf f A / ,� .,Address_ 't` �� /1 `; �s •r //Jf%/^ c.-4 . City : c- -A 1^4': City ity— " City_ Phone "- ! ' r .2 1 Phone - 4 7 - ' ` 2 / Phone ' --- 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 40 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 4!57 /6:� O SIGNATURE OF OWNER AND/OR AGENT � � " it I Approval by Signature from the Following Departments Listed Below Must Be Obtained Prior to the Issuing of a Construction Permit. Y I SPACE NO. 1 e USE OF STRUCTURE �� JOB ADDRESS 't �4- ` 1 ` - SINGLE FAMILY f�I DUPLEX Z 1--r LEGAL DESCRIPTION OF PROPERTY , t --�:. _ - APARTMENTS AGRIC. , ,,` ` �� 0 z� r �.�- C:-- Q COMMERCIAL INDUSTRIAL '^ COMMUNITY f� ; ALTERATIONS 0 0 LJ NO. OF SUBMITTED PLANS USE OF PERMITma = !- "�'. 4 a CASE N0. ( s NO. OF PARKINGPACES REQUIRED °� NO. OF BUILDINGS NOW EXISTING - 0 Z Q ZONE .. SETBACKS: FRONT - SIDE - A-1-4- R E A R r to GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE SETBACK ORDINANCE # OF FEET REQUIRED ON - STREET rr / DATE {/� •' SIGNATURE OF LAND USE OFFICIAL' H DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET --- z CURB AND GUTTER REQUIRED: YES ❑ NO ❑ / STREET t- - d CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑ W 0 HAS AN ACCEPTABLEA PLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET r r IMPROVEMENT? YES NO p-.- r r_ , K °C " �1-1( f DATE ��- -f SIGNATURE OF ROAD DEPT. OFFICIAL •--�• � t } _ a s C SEWAGE DISPOSAL 00f,_ i -V` _ A- %OC vZ. —ate wtT4� I� / +}OtGzt•�z c- t�y•L' + �� y�/'�►•./.` '• WATER POLLUTION rREMARKS �n FLOOD CONTROL`_"" z AIR POLLUTION = F DIV OF HWY 0 a = YOUR PROPERTY MAY BE SUBJECT TO o FLOOD. RIVERSIDE COUNTY ASSUMES NO RESPONSIBILITY IN EVENT OF FLOOD. 284 199 9/74 ' L CANARY—FILE, PINK—APPLICANT YouwUl rte%d approvals from the following agencies: Land Use ' I Bldg Div Requirement Requirement ro , COUNTY AND STATE 0 Flr,&S Riverside Offices Room If Phone County of Riverside Administrative Center 4080 Lemon Street Planning Commission 9th Floor 787.6181 Road Department 8th Floor 787-6111 Building and Safety t 9th Floor 787-6146 land Use Division 9th Floor 787-2011 Health Service Building 357511th Street 92501 En<ironmental Health Basement 787.6543 Flood Control District 787-2015 1995 Market St. 92501 Weights and Measures 787.2620 2950 Washington 92504 State of California Regional Water Quality Control Board 6809 Indiana, Suite 200, Riverside 92506 684-9330 Transportation Dept. of Calif. CALTRANS Dist 8 247 W. 3rd St., San Bernardino, CA 92401 383-4536 State Fire Marshal 303 W. 3rd St. San Bernardino, CA 92401 282 888-9255 South Coast Air Management Dist. 22850 Cooley Drive Colton, CA. 824.2660 Indio Offices Administrative Center 46.209 Oasis 92201 Planning Commission 304 342-8277 Road Department 313 342.8267 Environmental Health 203 342.8287 Air Pollution Control 205 342-8402 Building and Safety & Land Use Div. 310 342-8271 Coachella Valley Water District 85.820 Coachella Hts. R.O. Box 1058 398-2651 Coachella,CA 92236 Water Quality Control Board (State) 73-271 Hwy 111, Palm Desert 92260 346-7491 Calif. Division of Forestry 46.209 Oasis, Indio, CA 92201 308 347.1929 Hemet Offices Administrative Center 880 N. State St., Hemet, CA 92343 Building and Safety 658-4464 Health Department 658-5102 Perris California Division of Forestry 210 San Jacinto St., P.O. Box 248, Perris 82370 657-3183 San Diego Transportation Dept. of Calif-CALTRANS, Dist 11 297-4501 4075 Taylor, P.O. Box 390 92212 Regional Water Quality Control Bd. M9 ':, 286-5114 (State) 6154 Mission Gorge Rd. Sacramento Dept. of Aeronautics Sacramento Executive Airport _ .1 Sacramento, CA 95822 S � Land Use ' I Bldg Div Requirement Requirement ro , i-4 • DEPARTMENT OF BUILDING AND SAFETY APPLICATION CERTIFICATE COUNTY OF.,RIVERSIDE PERMIT Effective July 1, 1980, Chapter 1301, Section 19825 of the Health and Safety.-Co'de requires the execu- tio.n 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 �4zSr_ S-:,l —Contractor 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 comp'en'sa--ion, 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 b)ild or improve for the purpose of sale (Sec. 7031.5, B.&P.C.). V I 1,:as owner.;of thelproperty, 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 y 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¢ �/� �� "c� .Insurance [� Certified copy is hereby shed. 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 le.;s.) I certify that in the performance of the work for which this permit is issued, I shall iot employ. any person inanymanner 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 cod,-el, 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. :3097i Civw. Code). Lender's Name Lender's Address DVISION._QF.DUSTRdAL SAFETi,. PERMIT C-ERT'IFICAT-ION r 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 therecf, 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 perinit from the Division of Industrial Safety „as noted above, unless such person has a permit :o do such work from that division. Division of Industrial Safety Permit No. Date- Applicant N CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY I certify kI have read this application and state that the information given is correct. 1,ragree to comply with all state laws and county ordinances relating to building construction, E.nd aot ' horiip a representative of the County of Riversi.de, Department of Building and Safety,to enter upon,the pro- perty for which I have applied for this permit for the purpose of making i.nspie�ct'ibA I Signature-of Applicant/Agent Date AAA Print Applicant/Agent Name f 284-2000 7/80 Yv PERMIT NO. `^ DEPARTMENT OF BUILDING A SAFETY COUNTY OF RIVERSIDE FIELD OFFICE 41,23 0 7 5 x 0427075 F T CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES Zip IST FL. 2ND. FL. FOR. GAR. CAf? P. WALL ESTIMATED CONSTRUCTION SQ. FT. @Z;� • $ i54 UNITS Voluation $ r�. h�(�{�y r�/� *2200 4 (..Y1 Date 107-20-81 Dist. 11 Off. 5 YARD SPKLR SYSTEM SQ. FT. @ MH.PermitFee $ . SQ. FT. @ 5 • CO MOBILEHOME SVC. BAR SINK Cop $ SQ. FT. @ • POWER OUTLET ROOF DRAINS . io DRAINAGE PIPING SQ. FT. @ Parcel No. 69076005-8 SQ; FT, @ DRINKING FOUNTAIN No. URINAL SQ. FT. @/�LLr `Mech. Fee Dbl $ . + VALUATION $ 0 • ZO S WATER PIPING " {� NOTE: Not to be used as property tax valuation Construction Fee Dbl $ SWIM POOL, PVT -Zone q 2� • 1 v ,{, 5 FLOOR DRAIN Electrical Fee Dbl E MECHANICAL FEES «`3 SWIM POOL, COMM SMI Fee• $ WATER SOFTENER Dbl $ ' 2 k VENT SYSTEM 1 FAN EVAP. COOL 1 HOOD 500 SIGN Date 2 WASHER (AUTO)(DISH) 500 Sp. Insp. Fee $ APPLIANCE DRYER 1 300 _ Const. Lender - 1 GARBAGE DISPOSAL 250 r FURNACE UNIT WALL FLOOR SUSPENDED Registr. rFee $ Mileage Fee $ Address City Zip - Witness Fee $ LAUNDRY TRAY $ AIR HANDLING UNIT CFM _ IDLE METER Tel. 2;5-5959 KITCHEN SINK Z �' ABSORPTION SYSTEM B.T.U. • �i: TEMP USE PERMIT SVC STS; 210A 2 WATER CLOSET. Zip ' COMPRESSOR 5 0 HP Received by POLE,TEMP/PERM Contractor LAVATORY I� HEATING SYSTEM FORCED GRAVITY LicenseN AMPERES SERV ENT Tree; required 1 SHOWER 250 Address BOILER B.T.U. SQ. FT. @ c Zip 1 BATH TUB SQ. FT. @ c WATER HEATER oo SQ. FT. RESID @1'/,c 8 SEWAGE DISPOSAL 0 502 SQ. FT. GAR @ %t 3 7 HOUSE SEWER 1. GAS PIPING 2 f7 . 6 PERMIT FEE 3qO PERMIT FEE 3( 10 PERMIT FEE 0 DBL. TOTAL FEES 382..?2 MOB. HM. FEE MICRO FEE MECH. FEE 22.50 PL. Cl FEECONST. 11.70 FEE 251.50 ELECT. FEE 32.X17 SMI FEE 2.95 FEE PLUMB. FEE 62.00 PERMIT NO. 4 2 0 7 5 Job Address CALLY, RONDO - - Space • S12253 Zip Owner IGH&RD MORENO Ciommunity*Wry A U I NJtA Voluation $ r�. h�(�{�y r�/� *2200 4 (..Y1 Date 107-20-81 Dist. 11 Off. 5 �F{.Ct.C. ?C/ .k MH.PermitFee $ . Micro Film Fee Cop $ Use of P•ATT p I� y."P LL ING AND 's GARW Parcel No. 69076005-8 Use/Case No. Ck. By S `Mech. Fee Dbl $ . PI. Ck. Fee $ Set Bocks lot Size ry� / / 96 125 1000 Construction Fee Dbl $ L[e'�gal Descrigption j� l CLUB ❑ if1 O 3j• D"E'r� •�•� CLUB ES #5 -Zone q 2� • 1 v ,{, 5 10 Electrical Fee Dbl E RestrictionsGroup ' iii. «`3 Type SMI Fee• $ Plumbing Fee Dbl $ ' 2 k Bond Amt. Plan No. e� /�{ $ . 28200 PlanCheckerFinal 111—,174121 Date Inspector Unit. '1. Sp. Insp. Fee $ Demol. 'Fee $ _ Const. Lender - Branch t Supplimentol Permit Numbers -A 042707 5 r _ Registr. rFee $ Mileage Fee $ Address City Zip - Witness Fee $ Reinsp. Fee $ Owner/Agent tMUEL SN0MASS _ Tel. 2;5-5959 Zip . Total Fees $ • �i: Address S PALM ctiNYON STS; 210A City ALM SPRINGS Zip ' .'f00i M:O. N.0 Cash ' Chec Received by Contractor Tel. „ LicenseN Tree; required Sewage System I', _,j Address City Zip * T LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK Sewer District FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS•PERM9 WILL BE DONE IN ACCORDANCE WITH JiLQg6d' THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS ASID SPECIFICATIONS HAS DONE•SO IN Form 284-208 (Rev.8/78) ©s ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. verified by: