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418020 (SOL)PERMIT NO. DEPARTMENT OF BUILDING & SAFETY MD18 0 2 0 COUNTY OF RIVERSIDE FIELD4 CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. 2ND. FL. POR. SQ, FT. @ $ SQ. FT. @ UNITS D PKL SST M MOBILEHOME SVC. SQ. FT. @ BAR SINK GAR. SQ. FT. @ POWER OUTLET ROOF DRAINS CAR P. SQ. FT. @ WALL SQ. FT. @ SQ. FT. @ ESTIMATED CONSTRUCTION VALUATION $ —j`Date Or Dist. E. DRAINAGE PIPING DRINKING FOUNTAIN URINAL 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 Mech. Fee 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. SQ. FT. @ c BATHTUB Type SQ. FT. @ c WATER HEATER SMI Fee J SQ. FT. RESID @1'/ c SEWAGE DISPOSAL SQ. FT. GAR @ s/. C HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DEIL. TOTACFEES MOB. HM. FEE MICRO FEE MECH. FEE PL. CK. FEE FCONST. FEE r ELECT. FEE SMI FEE P .FEE FEEOd L'fl PERMIT NO. Job Address_ Space Zip Owner 41810i om oily 4 aluatton E✓' —j`Date Or Dist. E. F.C.C. MH.Permit Fee E Micro Film Fee Cop $ se it Xlto/'^p•� arcel No. se/Case No. Ck. By Mech. Fee Dbl E ✓(; -4 PI. Ck. Fee E Set Backs orLot Size Construction Fee `r Dbl E Lego ascription J F S S R Electrical Fee Dbl E Zone Restrictions Group Type SMI Fee J E Plumbing Fee Dbl E 44 BoncllfffF an o.Plan i Che • Final Date Ins ctor Unit $p. Insp. Fee E E � Demo!. Fee E Const. Lender Branch SupPlimenta Permit Numbers / Regisir. Fee, E "Address Mileage Fee E city Zi P Witness Fee E Reinsp. Fee E Owner/Agent Tal. Zip Total Fees E Addres / I City Zip M.O. N.C. cr- Cash Chec Received by/ °A °C9�r ,r'` Tel. LicenseN Trees re uir Sewage System dres V� Ci Zip T LL P ei - e..� ' THIS PERMIT SHALL BECOM D IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESS ION OF WORK verified by: Sewer District FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. 1 I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH 0-7 LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. SS, RTIFY THAT THE INDIVL`UAL WHO PREPARED THE PLANS AND 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. NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR ' BUILDING APPROVALS MECHANICAL APPROVALS I Set Back _ 33 Ventilation System 2 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. E] 43 Final 10A Fireplace T. 0. Ej No ADDITIONAL INFORMATION D SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath 12 Internal Loth 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 e 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 311 ` Service 32 Final STREET NAME DEPARTMENT OF BUILDING AND SAFETY +� APPLICATION CERTIFICATE COUNTY'OF RIVERSIDE PERMIT N Effective July -1, 1980, Chapter 1301 Section 14825•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: LICENSED CONTRACTORS DECLARATION Ihereby 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 45- ' -- C� Li opme-No. 67— Date D — 9Contr ctor , 0 OWNER -BU LDER DECLARATION I hereby affirm that I amexempt 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. 1031.5;'6.&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 I , 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, La . Code). Policy No. !'C IO7ZZZ_ Insurance 2&-L G A4045d fA/� [� Certified copy is hereby furnished. Certified copy is filed with the of ve sid art e t of B ding and Safety. Date 4 tq A Applicant Q CERTIFICATE OF EXEMPTI N FROM WORKOIr COVINSURANCE (This section need not be completed if permit valuar $100.00 or less.) I certify that in the performance of the work for which this pssued, 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 i6 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. [� 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 representativ the County of River de, Department of Building and Safety to enter upon the pro- per r ch hav a i for s permit for the purpose of making inspections. ig a ure o a t/ Date a A&Zlm $ Print Applicant/Agent Naine 284-2000 7/80 Y NOTICE: TMS ISNOT A.BUILDING'PERMIT' APPLICATION TO CONSTRUCT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE DISTRICT Permit No 284 199 9/74 CANARY—FILE, PINK—APPLICANT Owner/AK 44L,44, • can Aln ,;,y Architect Contractor &, -nom/rni •1" }i n• ' Address ZZ 206 -SOLA/ 7L.IA L::2 Address Address City Z /1 f ,!/ .?re i City Cityc_, Phone Phone .3.:44 ) 4 W I (we) the undersigned, hereby certify and acknowledge that 1 (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 ofRiverside, 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 encroachmeriL permit. NOW, therefore, it is agreed that I (we) will not occupy said property and will not cause said property to a occupied until I (we) have complied with all/laws of the County of Riverside and the State of California governing said property. %I T DATE V SIGNATURE OF OWNER AND/OR AGEN Approval by Signature from the Following Departments Listed Below ✓ i�� Q Must Be Obtained Prior to the Issuing of a Construction Permit. I SPACE NO. I USE OF STRUCTURE �} JOB ADDRESS A��V �-?/ll J fAj �i I SINGLE FAMILY DUPLEX > LEGAL DESCRIPTION OF PROPERTY % Ct G/ Z t- �"`-` �� - APARTMENTS AGRIC. O N COMMERCIAL INDUSTRIAL �] N G COMMUNITY ��' ALTERATIONS CJ . Z W Q NO. OF SUBMITTED PLANS — _ USE OF PERMIT t NO. f r• - finCASE _ /te ANO. p Z NO. OF PARKING SPACES REQUIRED OF BU1LDINGSNOW EXISTING Q ZONE —SETBACKS: FRONT SIDE REAR J m GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE _ SETBACK ORDINANCE # _— OF FEET REQUIRED ON, - —� TREET DATESIGNATURE OF LAND USE OFFICIAL+011 DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET___. zCURB AND GUTTER REQUIRED: YES ❑ NO ❑ STREET t- oe d CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑ W HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET O IMPROVEMENT? YES ❑ NO ❑ cc DATE _ SIGNATURE OF ROAD DEPT. OFFICIAL _ SWIMMING POOLS PUBLIC H W W SEWAGE DISPOSAL FOOD ESTABLISHMENT _ WATER POLLUTION REMARKS �n FLOOD CONTROL— z AIR POLLUTION W DIV OF HWY 0 a — YOUR PROPERTY MAY BE SUBJECT TO d c FLOOD. RIVERSIDE COUNTY ASSUMES NO RESPONSIBILITY IN EVENT OF FLOOD. 284 199 9/74 CANARY—FILE, PINK—APPLICANT PERMIT NO. 418020 DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE M;)j COUNTY OF RIVERSIDE CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. 2ND. FL. SQ. FT. @ $ UNITS (� V F.G.C. SQ. FT. @ YARD SPKLR SYSTEM POR. GAR. SQ. FT. @ MOBILEHOME SVC. BAR SINK SQ. FT. @ POWER OUTLET ROOF DRAINS CAR P. SQ. FL @ 'WALL SQ. FT. @ SQ. FT. @ ESTIMATED CONSTRUCTION VALUATION $ No. DRAINAGE PIPING DRINKING FOUNTAIN URINAL 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 S GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED Electrical Fee Dbl $ 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. SQ. FT. @ t BATH TUB Demol. Fee. SQ. FT. @ c WATER HEATER Branch SQ. FT. RESID @ 1'/. c SEWAGE DISPOSAL SQ. FT. GAR @ %c HOUSE SEWER Registr. Fee $ Mileage Fee $ GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE _ DBL. TOT L FEES �, MOB. HM. FEE MICRO FEE MECH. FEE PL. CK. FEE CONST. FEE -ELECT. FEE SMI FEE FEE PL MB.. FEE 67V w PERMIT NO. 418020 Job Address . Communityy Space Zip Valuation Dote $ r e� Owner Dis.00 Z. O (� V F.G.C. IMH.Permit Fee $ Micro Film Fee Cop $ se df P mil �. Parcel No. Use/Case No. Ck. By Mech. Fee Dbl $� PI. Ck. Fee $ Set Backs Lot Size Cons ruilon Fed Dbl $ Legal Description -0 J' '• /��Y_ F S S R , Electrical Fee Dbl $ Zone Restr' ns . Group Type .1*0, SMI Fee $ Plumbing Fee Sp. Insp. Fee Dbi $ $ Bondr. Am $ Pan No.. Plan Chec r Final Date - s /_ Inspec r Unit 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 M.O. Received by Trees requiredJ. Is N.C. Cash Check Addre /V JW, on rot r 71�5� . YP City .-Zip Tel. Licensed Sewage System e Address - X /- 7, a � 4, eg'a, tz 212 Zip T LL P THIS PERMIT SHALL BECOMMID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSXTION OF WORK verified by: Sewer District 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 LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. I HER CERTIFY THAT THE INDIVIDUAL•WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE 50 IN Form 284-208 (Rev.B/78) ©s ACCORDANCE WITH SECTION SSGI OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.