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418211 (PLBG)PERMIT No. DEPARTMENT OF BUILDING & •SAFETY FT 418 211 COUNTY OF RIVERSIDE FIELD CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. 2ND. FL. SQ. FT. @ $ UNITS nit /ly/�� Comm� t/ (,.�' SQ. FT. @ YARD SPKLR SYSTEM POR. GAR. SQ. FT. @ MOBILEHOME SVC. BAR SINK MH.Permit Fee E SQ, FT, @ POWER OUTLET ROOF DRAINS Micro Film Fee Micro CAR P. SQ. FT. @ WALL SQ. FT. @ SQ. FT. @ ESTIMATED CONSTRUCTION VALUATION $ Use of Permit I ♦ �� 1 A DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING Parcel No. Use/Case No. 'j NOTE: Not to be used as property tax valuation SWIM POOL, PVT FLOOR DRAIN Set Backs MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER F 5 VENT SYSTEM FAN EVAP. COOL HOOD SIGN WASHER (AUTO)(DISH) Type APPLIANCE DRYER Plumbing Fee GARBAGE DISPOSAL r Bond Amt. E FURNACE UNIT WALL FLOOR SUSPENDED Plan LAUNDRY TRAY Final Date — Z I O AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK Dental. Fee ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET Supp l imental Permit Numbers ' COMPRESSOR HP POLE,TEMP/PERM LAVATORY Witness Fee E HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. @ c BATH TUB E Addre 1 � `7 ...�i7✓ SQ. FT. @ c WATER HEATER Received b Trees required – SQ. FT. RESID @11/4c SEWAGE DISPOSAL Tel.O License N/'r Sewage System SQ. FT. GAR @ s/. c HOUSE SEWER ��r' r � Zip GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBI. T AD �i MOB.HM.FEE MICRO FEE MECH. FEE PL. CK. FEE CONST. FEE ELECT. FEE SMI FEE FEE PLIJMB� PERMIT NO. 4182 11 Job Add ss yl� «/r/�S Space �`,s Owner ���•/�/�/� �} / �y nit /ly/�� Comm� t/ (,.�' Valuation E Date -02 14 (J�� 02 D'st. / F.C.C. MH.Permit Fee E Micro Film Fee Micro Cop E Use of Permit I ♦ �� 1 A // Ao .' Parcel No. Use/Case No. 'j C y ,�� Mech. Fee Dbl E PI. Ck. Fee E Set Backs Lot Size Construction Fee Dbl S Legal Descriptio �� //L,/A �r •y17� , r`/7 v�. �� I7"" / F 5 S R Electrical Fee Dbl E ZoneJ(RReest/rryctions Group ' �,/ Type SMI Fee E Plumbing Fee Dbl E 54 r Bond Amt. E Plan No. Plan Checker Final Date — Z I O Inspe or Unit Sp. Insp. Fee E Dental. Fee E Const. Lender Branch Supp l imental Permit Numbers ' Registr. Fee E Mileage Fee E Address City Zip Witness Fee E Reinsp. Fee E Owner/Agent Tel. Zip Total Fees E Addre 1 � `7 ...�i7✓ City Zip M.O. .C. ash Check Received b Trees required – Contra ,� –�+� Tel.O License N/'r Sewage System Address .` � v ��r' r � 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 PERMIT WILL BE DONE IN ACCORDANCE WITH T LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. r RTIFY THAT THE INDIVIDUAL 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. verified bW, NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS I Set Back 33 Ventilation System t 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 IDA Fireplace T. 0. 0 FI ADDITIONAL INFORMATION 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 20 Sewer 21 Water Heater 22 Water Softener 23 Water Service 24 Gas Test — Zl 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 STREET NAME PERMIT O. 418211 DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE mil COUNTY OF RIVERSIDE CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES , , IST FL. 2ND. FL. POR. GAR. CAR P. WALL ESTIMATED CONSTRUCTION SQ, FT. @ $ UNITS ' D st SQ. FT. @ YARD SPKLR SYSTEM MH.Permit Fee $ SQ. FT. @ MOBILEHOME SVC. BAR SINK Use of Permit �y / /` _ t (/ /!,� / .��' �` ) , SQ. FT. @ POWER OUTLET ROOF DRAINS Mech. Fee E FDb SQ. FT. @ DRAINAGE PIPING Set Backs SQ. FT. @ DRINKING FOUNTAIN Construction Fee Dbt $ SQ. FT. @ URINAL F S VALUATION $ 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 Plan No. VENT SYSTEM FAN EVAP. COOL HOOD SIGN WASHER (AUTO)(DISH) Unit APPLIANCE DRYER Demo 1. 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 M.O. .C. ash F1 Check. COMPRESSOR HP POLE,TEMP/PERM LAVATORY Sewage System ' T LL P HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER ¢ BOILER B.T.U. SQ. FT. @ c BATH TUB SQ. FT. @ c WATER HEATER SQ. FT. RESID @ 11/. c SEWAGE DISPOSAL SQ. FT. GAR @ 'G c HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBI. TQTAL FFFC MOB.HM.FEE MICRO FEE MECH. FEE PL. CK. FEE CONST. FEE ELECT. FEE SMI FEE FEE PIL g. PERMIT NO. 41 211 Job Add r ss / ./,/��P1R`.,,,�w, Space w � � � ✓ � / 7'f ��! �� Comm oily act Valuation Date D st F.C.C. MH.Permit Fee $ Micro Film Fee $ Use of Permit �y / /` _ t (/ /!,� / .��' �` ) , Po�r�cyl/�N/yoy •� ,,,��j Use/Case No. C y �LA 1 �,✓D V/ I� Mech. Fee E FDb PI. Ck. Fee $ Set Backs Lot Size Construction Fee Dbt $ Legal Description • F S S R Electrical Fee Dbl E ZoneJRy��/, coons " �,/ �.. Group Type SMI Fee $/,/�;• Plumbing Fee Dbl $ Bond Amt. $ Plan No. Plan `Checker Final Date y�/--(�/ Inspe Unit Sp. Insp. Fee $ Demo 1. Fee $ Const. Lender Branch Supplimental Permit Numbers Regisir. Fee $ Mileage Fee $ Address City Zip Witness Fee $ Reinsp. Fee $ Owner/Agent Tel. Zip Total Fees $ Addre City - Zip M.O. .C. ash F1 Check. Received b - Trees required Contr Addresyw.y Tel. LicenseM- Zip Sewage System ' T LL P 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 THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. Sewer District r. Form 284-208 (Rev.8/78) @s IFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN �'-A O ANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF -THE STATE OF CALIFORNIA. DEPARTMENT OF BUILDING`AND SAFETY APPLICATION CERTIFICATE COUNTY''OF RIVERSIDE PERMIT # Effective July1, 1980, Chapter 1301 Section 19825*of the Nealth 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: x.:11 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 pf�orce and effect. License Class rL'cense No. ,o2 jdo 0 Date 4/20/X/ Contractor !/s��i�s %'��'si Q OWNER-BUILDER'DECLARATION I hereby affirm that I am.exempt from the Contractor's License Law for the following reasons: Q 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.). [:] I am exempt under Section , B.&P.C. for this reason: Date Owner ID 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 Policy No. ,S c %,e Z%— 0CQ Insurance 0 Certified copy is hereby furnished. Certified copy is` filed with the Cou�/J��nty of Riverside,Department of Building and Safety. Date ���/ Applicant A� �,ti�j 0 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATIONINSURANCE (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 EJ 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.) Q 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 representative of the County of Riverside, Department of Building and Safety to enter upon the pro- perty for which d have applied for this permit for the purpose of making inspections. Signature of Applicant/Agent Date Print Applicant/Agent Name 284-2000 7/80 NOTICE: THIS IS NOT A BUILDING PERMIT APPLICATION TO CONSTRUCT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE DISTRICT ' e Permit No 284 199A 9/74 + CANARY—FILE, PINK—APPLICANT Ow er G Architect —. --_ Conr r Address, _ /Address___ Address——liJ /57'___ City_ a City_- City- - Phone Phone _ Phone —3� _3C@,—_.._ cc I (we) the undersigned, hereby certify and acknowledge that I (we) have read the application and agree that if Curb and Gutter, and W 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 la s 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 ed Below Must Be Obtained Prior to the Issuing of a Constru ton Permit. I SPACE NO. USE OFRUCTURE JOB ADDRESS C _`6-U SINGLE FAMILY DUPLEX Z W LEGAL QESCRIPTION OF PROP TY 1 APARTMENTS AGRIC. h. Q� <-.� B. Q -—� - r COMMERCIAL INDUSTRIAL ❑ `^ G COMMUNITY ALTERATIONS Z NO. OF SUBMITTED PLANS USE OF PERMIT 6 Q CASE NO. NO. OF tKINJ SPACES REQUIRED — NO. OF BUILDINGS(N+ EXISTING G Z Q 0 ZONE SETBACKS: FRONT SIDE REAR J m GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE SETBACK ORDINANC # OF • FEET REQUIRE �N� STREET / DATE ~' ` SIGNATURE OF LAND USE OFFICIAL\ ) — DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET— F- z CURB AND GUTTER REQUIRED: YES ❑ NO ❑ STREET oc , a 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. OFFICIAI I SWIMMING POOLS PUBLIC H SEWAGE DISPOSAL Q W _ FOOD ESTABLISHMENT WATER POLLUTION t REMARKS to FLOOD CONTROL— z AIR POLLUTION WDIV OF HWY ce" r" YOUR PROPERTY MAY BE SUBJECT TO O .4 — FLOOD. RIVERSIDE COUNTY ASSUMES NO RESPONSIBILITY IN EVENT OF FLOOD. 284 199A 9/74 + CANARY—FILE, PINK—APPLICANT