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FORM. 2867208 (2/81).
' .A .• � `- .:,�j �^ .ten
s
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
T..D,YTE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs 8 Frms
�%
`
34
Plenums & Ducts
2A
Slob 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.
43
Final
10A
Fireplace T.O.
°o
ADDITIONAL INFORMATION
---------------- -- --------------- --
,
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Botts)
128 Ceiling (Batts)
12C Ceiling (Blown)
14 Final
----------- PLUMBING /IPP OVALS-----------------------
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
ELECTRICAL APPROVALS
PSL
r
P/
Y
i
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
i i i :j STREET NAME
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
OWNER -BUILDER INFORMATION
Dear Property Owner.: '..
An application for a building permit has been submitted in your name listing yourself as the builder
of the property improvements specified.
For your protection you should be aware that as owner -builder you are the responsible party of re-
cord on such a permit. Building permits are not required to be signed by -property owners unless
they are personally performing their own work. If your work is being performed -by someone -other
than yourself, you,may protect yourself from possible liability if that -person -applies -for the pro-
per permit in his or her name.
Contractors are required by law to.be licensed and bonded by the State -of California.and,_ where
required, to have -a business license from the city or county. They are -also required by law to put
their license number on -all permits for_which they apply. -
If you plan to do your own work, with the exception of various trades that you plan to subcontract,
you should be aware of the following information for your benefit and protection. -
If you employ_or oth'erwise:engage'any'persons other than your -immediate family, and the work
(including materials and other costs) is $200 or more for the entire project, and such persons are
not licensed as contractors or subcontractors,.then you may be an employer.
If you are an employer, -you must register with the state and federal government -as an employer and
you are subject to several obligations including state and federal income tax withholding, -federal
social security taxes, workers' compensation insurance, disability insurance costs, and unemploy-
ment compensation -contributions.
There may be`financi'al risks for you`if you do 'not carry out these'obligations,•and these risks are
especially serious with respect to workers' compensation insurance..
For more specific -information about your obligations under federal law, contact the Internal Revenue
Service (and, if 'you wish, the U.S. Small Business Administration). For more specific information
about your obligations under state law, contact the Department of Benefit Payments and the Division
of Industrial Accidents.,, '
If the structure is intended for sale, property owners who are not licensed contractors are allowed
to perform their work,personally,or through their own employees, without a licensed contractor or
subcontractor, only under limited conditions.
- - c. .
A frequent practice ofunlicensed persons professing to be contractors is to secure an " owner-
builder" building permit', -erroneously implying that the property owner is provi'ding his or her own
labor and material personally. Building permits are not required to be signed bysproperty owners
unless they are performing their own work personally.
Information about -licensed contractors may be,obtained.by contacting the-Contractors;,State.License
Board in -,your community or -at 1020 N,Street, Sacramento, California 9581,4._.3. ..
Please complete and return the enclosed owner -builder verification'form so that wecanconfirm that
you are.awar,_e of these matters. The building permit will not be issued until the verification is
returned.
Sincerely,
DEPARTMENT OF BUILDING AND SAFETY
Leopoldo Rojo, Jr.
Director
284-2001 7/80
."-
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
OWNER --BUILDER VERIFICATION
;.Owner
20
Address
An "owner -builder" building permit has been applied for in your name and bearing
your signature.
Please complete and return this information in the envelope provided at your
earliest opportunity to avoid unnecessary delay in processing and issuing your
building permit. No building permit will be issued unt.i.l this verification is
received.
1. I personally plan to provide the major labor and materials for con-
struction of the proposed property improvement (yes or no) Y
2. I (have/have not) signed an application for building permit
for`the proposed work.
3. I have contracted with the following person (firm) to provide the pro-
posed construction:
Name Phone
Address City.
Contractors License No.
4. I plan to provide portions of the work, but I have hired the following
person to coordinate, supervise, and provide the major work:
Name Phone
Address City
Contractors License No.
5. I will provide some of the work but I have contracted (hired)'the fol-
lowing persons to provide the work indicated:
Name Address Phone Type of work
A .. ..
Signature Property Owner C
Social Security Number
284-2d02 7/80
ate
NOTICE: THIS IS NOT A BUILDING PERMIT
APPLICATION TO CONSTRUCT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
DISTRICT
Permit No
284 199A 9/74 CANARY—FILE, PINK—APPLICANT
Owne W71C O.// Architect ___ —_—_ Contractor—_. — _
Add/6,152--A-10 tSf&e O_,A-� Address___ Address — —
Citya4&_D1eQ City-- City__._._- —
Phone�6 la3 / Phone _ Phone— ---_--_._
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 octt�py said property and will not cause said property to a oc upied until I (we) have
-complied with laws of the County of Riverside and the State of California governing said property.
/all
DATE -/--- SIGNATURE OF OWNER AND/OR AGENT _00,
Approval by Signature from the Following Departments Listed Below
Must Be Obtained Prior to the Issuing of a Construction Permit.
' `' 1 SPACE NO.
USE OF
7STR-TURE
C&C-c--c e13/S40
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JOB ADDRESS _— _._ SINGLE FAMILYPLEX ,
DESCRIPTION OF OPERTY – / ' OGS_
LEGAL P"_7J APARTMENTS � AGRIC. El
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u/L� 0"104 �2�C/ .$
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— COMMERCIAL INDUSTRIAL
v %
j `^
c
COMMUNITY ALTERATIONS
x �d
C
Z
NO. OF SUBMITTED PLANS — USE Of PERMIT
Lu Q
CASE NO.
Z
NO. OF P KING SPACES REQUIRED — NO. OF BUILDINGS NOW EXISTING
Q
ZONE SETBACKS: FRONT �� SIDE (t/ REAR. O
J m
GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE /2- E %LS
SETBACK ORD NANCE # OF FEET REQUIRED ON STREET
DATEr SIGNATURE OF LAND USE OFFICIAL _ -
DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET.—
W
CURB AND GUTTER REQUIRED: YES ❑ NO ❑ —STREET
1
d
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
°L
DATE SIGNATURE OF ROAD DEPT. OFFICIAL
Z
SWIMMING POOLS PUBLIC
aW
SEWAGE DISPOSAL
_
FOOD ESTABLISHMENT
WATER POLLUTION REMARKS
H FLOOD CONTROL
t-
W AIR POLLUTION
V° DIV OF HWY
F-
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
t-7 ..4 �r� - • - — .. . --- -- 3— �' — - �+
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• W
06
COUNTY OF RIVERSID!!
S ' T STRtiP l26p DEPARTMENT OF -All
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BU I IN &SAFETY "
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4! „ Appio se plans shall.;notbe. construed oto ba
-per tl-for;aorean,apProval';of;,any°vlolat,on of•'any5ot'�
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