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413870 (PLBG)DUILUlma, rCKmn PERMIT NO. 413 8 7 0 PERMIT NO. 3870 DEPARTMENT OF BUILDING & SAFETY COUNTY OF RIVERSIDE FIELD ' DST CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES `>t 1ST FL. 2ND. FL. POR. GAR. CAR P. WALL EA ESTIMATED CONSTRUCTION SO. FT. .@ $ UNITS Dist. SO. FT. @ R fs K R SIS 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 Unit 1 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. @ c BATH TUB SO. FT. @ a WATER HEATER - 50. FT. RESID @ 1 'Aa SEWAGE DISPOSAL Zip - S0. FT. GAR @ 3/aa HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEESMOB. HM. FEE MICRO FEE MECH. FEE PL CK. FEE CONST. FEE ELECT. FEE SMI FEE FEE Pl B. PERMIT NO. 413 8 7 0 Job Address • Z e,v 12o,7 --o Spoce Zip Own �o G L, / � t.•• Commumty Valuation S Date - /s Dist. Off F.C.C. MH Permit Fee $J Micro Film Fee Cop S Use of Permit 1 �� �, 4GJ ,�C�J%,•(1 „/,_ Parcel No. F 5 S Use/Case No. Ck. By Lot Size i sPI—P Mech. Fee Dbl S PI. Ck. Fee $Set Construction Foe Dbl $ legal Description 'Z T,'//ro _ /� C.x.' ,Zone G Electrical Fee Dbl S Restrictions Type ' _ SMI Fee S Plumbing Fee Dbl g 5p. Insp. Fee $ Bond Ami. r^ $ Plan No. Plan Checker Fidoll 8 2 ^: Z' S I Inspector Unit 1 Demol. Fee $ Const. Lender Branch Supplimental Permit Numbers Registr. Fee $ Mileage Fee i $ Address City Zip Witness Fee $ Reinsp. Fee, $ Owner/Agent Tel. ZiplI•,a /Total Fees S ' M.O. ❑ N.C. (] ,�mh ❑ C ck Address - - - r City Zip - ,Received by Contract�'r�`•r Tel. 42i licensee Treas raqu� ' :Sewage system A City Zip I/'" .T P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION'OF WORK jSewer 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 L THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF' CALIFORNIA. __I HEREBY C RTIFY THAT -THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN Form 284.208 (Rev. 1/80) K/f/�,(�et!Wqe WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. J1r verified by: N NO. OPERATION DATE INSPECTOR NO. OPERATION -& TE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Bac,. 33 Ventilation System 2 Figs & 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. 43 Final 10A Fireplace T. 0. °o s ADDITIONAL INFORMATION i 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 PLUMBING APPROVALS 15 Ground Plumb 16 Water Piping 17 Rough Plumb 18 Vents 19 Sewage Disposal PJI 20 Sewer 21 Water Heater 22 Water Softener 23 Water Service 24 Gas Test 25 Final Z_Z_$, y`T Tank Pit /k O L. Line REAR OF PROPERTY LINE ELECTRICAL APPROVALS ' i P/L Q P/ �f 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final STREET NAME C :U10 67-4 rw DEPARTMENT OF BUILDING AND SAFETY . COUNTY OF RIVERSIDE OFFICE DATE TIME PERMIT NUMBER INSPECTION REQUESTED FOR: A.M'. ADDRESS _ I SPACE N0. OWNER COMMUNITY a P.M. BUILDING PLUMBING ELECTRICAL MECHANICAL MON / TUES E WED THUR REMARKS: ' �F OWNER/CONTRACTOR TEL.NO. 29446 11/7$ DEPARTMENT OF BUILDING AND SAFETY APPLICATION CERTIFICATE COUNTY OF RIVERSIDE PERMIT M 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;. Q 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 (_ T1 Contractor Ft);_i__,'t_.`_°�) L — ;1 Q 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.). 0 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 ) — ;� �? - d' 1 Owner T Q 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. Insurance 0 Certified copy is hereby furnished. CM Certified copy is filed with th%unty of Riverside epartment of Building and Safety. Date �% -7 - F ' Applicant ' \ A kI f qA 4a-9 ,J 0 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 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 16 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 resentative of the Count of Riverside, Department of Building and Safety to enter upon the pro - r for whic have ap1 ed for this permit for the purpose of making inspections. St nature o pp can e'nt/ / 5 Le— _ � �v�usr nt PP cant/ gent Namb -2000 7/80 NOTICE: THIS IS NOT A BUILDING PERMIT APPLICATION TO CONSTRUCT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE DISTRICT Permit No - 0,v 4 o 284 19� 9/74 -. CANARY—FILE, PINK—APPLICANT Own �oZC7G ��-�-�� Architect Contract o/ /2) _ggj % c6d/ST Addresa7 6 7,9 �/y1/ NOAddress_ Addres/D—�_ Cite• City Cif Phone Phone Phone SZ ¢�y 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 laws of the County of Riverside and the State of California governing said pr - DATE? SIGNATURE OF OWNER AND/OR AGE^ V Approval by Signature from the Following Departments Listed Below Must Be Obtained Prior to the Issuing of a Construction Permit. I SPACE NO. ZlGG , 1 -� I USE OF STRUCTURE JOB ADDRESS /7 J yw, EC� I - SINGLE FAMILY DUPLEX El >_ LEGAL DESCRIPTION OF PROPERT — Q 3 W - APARTMENTS. AGRIC. �. l N N ` ! •r COMMERCIAL` INDUSTRIAL LJ COMMUNITY 0 C Z ALTERATIONS CJ NO. OF SUBMITTED PLANS --__ USE OF PERMIT CASE NO. p Z NO. OF PARKING SPACES REQUIRED NO. OF BUILDINGS NOW EXISTING _. Q ZONE SETBACKS: FRONT SIDE REAR .j Co GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE SETBACK ORDINANCE ___ OF FEET REQUIRED ON __ ST�{�T DATE SIGNATURE OF•LAND USE OFFICIA y DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET--- z CURB AND GUTTER REQUIRED: YES ❑ NO ❑ -STREET IL CAN CURB AND GUTTER 'FEASIBLY BE INSTALLED? YES ❑ NO ❑ W HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET CIMPROVEMENT? YES. [:1 NO [I 00 DATE _ SIGNATURE OF ROAD DEPT. OFFICIAL = SWIMMING POOLS PUBLIC s SEWAGE DISPOSAL W Q = FOOD ESTABLISHMENT CoNn/. To EX/S% SfATiC P7 V' 'Iht #,I -r & .1 ! i:oe Eh/lr WATER POLLUTION _ REMARKS �n FLOOD CONTROL— z AIR POLLUTION At � _ F DIV OF HWY o a — YOUR PROPERTY MAY BE SUBJECT TO o. o FLOOD. RIVERSIDE COUNTY ASSUMES NO RESPONSIBILITY IN EVENT OF FLOOD. 284 19� 9/74 -. CANARY—FILE, PINK—APPLICANT