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402746 (BLCK)BUILDING PERMIT PERMIT NO. DEPARTMENT OF BUILDING & SAFETY FIELD Mon 0 2746 COUNTY OF RIVERSIDE CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO: PLUMBING FEES 1ST FL. 2ND. FL. POR. GAR. CAR P. WALL <., ESTIMATED CONSTRUCTION SO. FT. .@ $ UNITS SQ. FT. @ YARD SPKLR SYSTEM s SQ. FT. @ MOBILEHOME SVC. BAR SINK SO. FT. @ POWER OUTLET ROOF DRAINS SQ. FT. @ DRAINAGE PIPING SQ. FT. @ Tii DRINKING FOUNTAIN SQ. 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 No. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED Inspector 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. @ a BATH TUB ' SQ. FT. @ a WATER HEATER Tel. " f SO. FT. RESID @ 1 t%a SEWAGE DISPOSAL Sewage System SO. FT. GAR @ V4a 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. 402746 lab Address --. - — -space �" - - zip _ Owner C m nity t' (p/ ' Off. F.C.C. MH Permit Fee $ Micro Film Fee Cop $ Use ol'Pe mit /(,./ / - a el o. �` se/Case WV ,,.rte .. Ck. By Mach. Fee Dist S PI. Ck. Fee $ Set / Lot Size Construction Fee Dbl $ Legal Description `f [, / F s S R Electrical Fee Dbl $ f Zane Restrictions Group Type SMI Fee $ Plumbing Fee Dbl $ Bond Amt. $ Plan No. Plan Checker Finovbto /gam $^ 24nr Cl O Inspector Unit ' Sp. Insp. Fee $ Dismal. Fee $ Const. Lender Branch Supplimee�ntal Permit Numbers Registr. fee $ Mileage Fee $ Address City Zip Witness Fee $ Reinsp. Fee $ Owner/Agent Tel. Zip Total Fees $ Address 1 l I 1• ' Pty Zip . M.O. ❑ N.C. ❑ Cash ❑ e Received by 7 Contractor Tel. " f LicenseR • Trees required Sewage System isj / i•� v City Zip • "' T LL iJ(! ,qu1/1­1I 'PERMIT SFiAtr IfE&AE VO D IF WORK IS NOT COMMENCED WITHIN 12O'6A S. >C ATIO O OR - t v riWad by: !Ower 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"3^��' ' L THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. •, z-` - (0 g �RDAN YCERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO U�"eii, S '"CE*WITH SECTION 5.541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA: F+4. -r �' Farm 284.108 (Res•. 1/80) NO. OPERATION DATE INSPECTOR NO. OPERATION DATE %NSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Bock x i �J -11 33 Ventilation System 2 Ftgs 8� Frms — i 2� �j-� V� 34 Plenums & Ducts 2A Slab Grade 35 Furnace Comport. 3 Steel _/ 36 Inlets & Outlets 4 Grout Blocks ,�'L2 .. 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.O. °o ADDITIONAL INFORMATION r ' ' SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath 12 Internal Lath 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Walls (Botts) 12B Ceiling (Botts) 12C Ceiling (Blown) 14 Final — ZZ 1 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 REAR OF PROPERTY LINE P/L P/ c! 1. ELECTRICAL APPROVALS 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 298 Bonding 30 Fixtures 31 Service 32 Final STREET NAME NOTICE: THIS IS NOT A BUILDING PERMIT APPLICATION TO CONSTRUCT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE DISTRICT ' Permit 284 199A 9/74 CANARY—FILE, PINK—APPLICANT Owner J Archite� —. _ Contractor_ - A1 Address- ZCC)`/SLI o R Aclaiesss Address -- City _r4// �? City--- _ City. -j -24-66,"z Phone Phone _ Phone; -z3 � O Z 'Zi 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 ntil I (we) have complied with all laws of the County of Riverside and the State of California governing said property. DATE(-�O -- SIGNATURE OF OWNER AND/OR AGENT — —. Approval by Signature from the Following Departments Listed Belo Must Be Obtained Prior to the Issuing of a Construction Permit. �� / 1 SPACE NO. USE OF STRUCTURE 9a } S d%C' JOB ADDRESS —/_� (/� �nSINGLE FAMILY DUPLEX IJ�I LEGAL DESCRIPTION OF PROPERTY % ❑ ��'—_¢- Z FF O LL!O'/—� APARTMENTS AGRIC. E] N Q COMMERCIAL INDUSTRIAL [j j '^ COMMUNITY. ALT IONS ❑ C G Z USE OF PERMIT NO. OF SUBMITTED PLANS — - H Q CASE NO. — Z ,.NO. OF PARKING SPACES REQUIRED — — NO. OF BUILDINGS NOW EXISTING - Q o ZONEe SETBA(fKS: FRONT SIDE REAR J m - GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE SETBACK ORDINANCE# OF FEET REQUIRED ON STREET DATE" LJ'� SIGNATURE OF LAND USE OFFICIAL - DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET -- — F z CURB AND GUTTER REQUIRED: YES ❑ NO ❑ —STREET cc 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 cc DATE SIGNATURE OF ROAD DEPT. OFFICIAL = SWIMMING POOLS PUBLIC F W , SEWAGE DISPOSAL Q _ FOOD ESTABLISHMENT WATER POLLUTION — REMARKS to FLOOD CONTROL W AIR POLLUTION W DIV OF HWY c cc YOUR PROPERTY MAY BE SUBJECT TO — c 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 N 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. i [7 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 e" - 1�-3 License No. % Sr / S Z - Date r _ 7"r. 1°i., Contractor I n 1444.e2 f I . _ f r . . � -, s /c f` - _ ,4-n.5, Kr -i F-1 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.). Q 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 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. Sf�/uG 715'5 rlt cL I n s u r a n c e 0 ,If- IJ -15 - -.%i's (F � , _T__. /t,G - �7f.'XAk4 F11Ad 0 Certified copy is hereby furnished. 0 E'r Certified copy is filed with the County of Riverside, Department of Building and Safety. / Date ,6? 7-Z /- B / Applicant_—J#4---,- (4 R df -,-e , P rn 0 rtjA,7oirrr,/C'/L [� 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 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.) 0 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. [7 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. Signature'of Appl,ican't/Agent %( Date � U Print Applicant/Agent Name 284-2000 7/80 {' , . NO. 461 PERMIT NO. 02746 DEPARTMENT OF 'BUILDING, &. SAFETY COUNTY OF RIVERSIDE FIELD OFFICE DST CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. 2ND. FL. ; POR. GAR. 'CAR P. WALL 7 ESTIMATED CONSTRUCTION SO. FT. .@ $ UNITS SQ. FT. @ YARD.,SPKLR SYSTEM s ' • SQ. FT. @ MOIBILEHOME SVC. ' - BAR SINK' SO. FT. @ POWER OUTLET• ROOF DRAINS SQ. FT. .@ DRAINAGE' PIPING SO., FT. @ DRINKING FOUNTAIN /`9•�///' y +:-^�2 �i.Y J 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 t WASHER (AUTO)(DISH) - APPLIANCE DRYER Const. Lender Branch ., 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 1' WATER CLOSET i COMPRESSOR HP POLE, TEMP%PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. @ a BATH TUB SQ. FT. @ - a' WATER HEATER ' SO. FT.' RESID @ 1 1/<a SEWAGE DISPOSAL ` SO. FT. GAR @ 1/ a - HOUSE. SEWER • - City Zip - GAS•PIPING ^ PERMIT FEE -PERMIT FEE - PERMIT -FEE ^SMI DBL. TOTAL FEES MOB. HM. FEE • MICRO FEE MECH. FEE PL. CK. FEE CONST. FEE ELECT. FEE FEE FEE PLUMB.•FEE {' , . NO. 461 yr 1 lob Address A.,PERMIT C m nity Space 'Zip Owner — -' - • .. - ot. Off. _ , [altatiFn MH Permit Fee $ Micro Film Fee Cop S Use of 'Permit - ^' ' i "�1v'� , Leg/al Description e _ a el No. se/Casa No. T Z77- 71,2 _ Set Bocks. ;Lot Size ------------- F - 5 S R Ck. By - ; Mach. Fee Dbl S PI. Ck. Fee S Construction Fee Dbl $ - Electrical Fee Dbl S /`9•�///' y +:-^�2 �i.Y J Zone RestrictionsGroup Type ' SMI Fee S Plumbing Fee Dbl $ Bond Amt.. - $ Plan No. Plan Checker Final tey_ "fDd ^ou Inspector 0A Unit Sp. In Fee $ Demol. Fee S Const. Lender Branch ., Supplimentol Permit Numbers _ •, ` • , Registr. Fee $ Mileage Fee S Address City Zip Witness Fee $ Reinsp. Fee $ Owner/Agent Tel.. Zip - Total Fees S Address •' e < City - Zip i^ r M.O. ❑ N.C. Q Cash C]Check Received. by -•Contractor ` '.s' Tel. .Licensett ` Trees required Sewage System - ss, City Zip , f n n �r- T LL 1/51?I [HIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WIIHIN 1{U DAYS. CtJSAIION OF WUKK verified by: -Sewer District f WN FORt12O;DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. " .1 HEREBY'AGREEtTHAT ALL WORK IN CONNECTION 'WITH THIS PERMIT WILL BE DONE IN ACCORDANCEWITH f /J THE LAWS, OF RIVERSIDE -COUNTY AND THE STATE OF CALIFORNIA., Y CERTIFY THAT_TFIE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO -IN Form 284.208 (Rev. 1/80) G�� A CORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OFJHE STATE OF CALIFORNIA.' .