413482 (SOL)NO.
13482
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
FIELD oST
:+ CON. I'/(I,�CTION,EST MATE
'1ST FL. `,
2ND. FL. U,
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POR. :/ /V`7)
GAR.
CAR P. p F's
WALL SO. FT
NO. ELECTRICAL FEES
UNITS
MOBILEHOME SVC.
POWER OUTLET
NO. PLUMBING FEES
CL
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
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7z
SO. FT. @
CommunityValuation
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URINAL
Dote
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Imo11MH
ESTIMATED CONSTRUCTION VALUATION $
Off.
I,�
WATER PIPING
Permit Fee b
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
Use/Cosa No.
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
Set Bock,
VENT SYSTEM-- — FAN EVAP. COOL HOOD
SIGN
WASHER (AUTO)(DISH)
F S 5
APPLIANCE DRYER
Electrical Fee Dbl $tr
GARBAGE DISPOSAL
Group
FURNACE UNIT WALL FLOOR SUSPENDED
SMI Fee S
LAUNDRY TRAY
Bond Amt.
S
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
Inspector
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
Const. Lender Branch
r
, .e
COMPRESSOR HP
POLE, TEMP/PERM
LAVATORY
Address % j,.•� `: �Giiy.Zip
/ 7
%� J
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
,
BOILER B.T.U.
SO. FT. @ a
BATH TUB
City Zip
Received by -
SO. FT. @ a
WATER HEATER
Licenser '
Trees required
SO. FT. RESID @ 1 t/aa
SEWAGE DISPOSAL
City Zip
r; .
S0. FT. GAR @ 1/44
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
'7 j
•
DBL.
TOTAL FEESmOB.
HM, FEE
MICRO'FEE
MECH. FEE PL. CK. FEE
I CONST. FEE ELECT. FEE
SMI FEE
FEE
PL B. FEE
PERMIT NO.
413482
lob Address 5 ace
1- �" V �'C-1?N/ t120
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Owner
CommunityValuation
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Dote
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Dist.
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F.C.C.
Permit Fee b
Micro Film Fee Cop S
Use of Permit
4
�, � i c� leo o� t.t±.; � �7�; ��
Parcel No.
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.: l .,
Use/Cosa No.
Ck. By
Mach. Fee Dbl S
Pl. Ck. Fee E
Set Bock,
Lot Size
Construction Fee Dbl $
Legal Description
�r —, /"• j j - /
S•�y'T L.r 1�
F S 5
R
Electrical Fee Dbl $tr
Zone Restrictions
Group
Type
SMI Fee S
Plumbing Fee Dbl S
Bond Amt.
S
Plan No.
Plan Checker
Final Dote
1-5-41
Inspector
Unit
Sp. Insp. Fee $
Dental. Fee S
Const. Lender Branch
r
, .e
Supplimenta Permit Numbers
IVA
j
Registr. Fee S
Mileage Fee S
Address % j,.•� `: �Giiy.Zip
/ 7
%� J
Witness Fee $
Reinsp. Fee S
Owner/Agent
i
Tel. Zip
Ot, Al FA
Total Fees S
I] [DM.O. N.C. Cash ❑ Check
Adddrress
4. i-1 (�
A 9� 4. .t
City Zip
Received by -
Contractor
p
Tel.
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`T Ca
Licenser '
Trees required
Sewage System 1' r yj
dress
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City Zip
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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' r
.1 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.
LHERL&Y'•ClERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
Form 284-208 (Rev. 1/80) --'Wf5eORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA
verified by:i
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE
INSPEC�OR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs & Frms
3A
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.
43
Final
JOA
Fireplace T. 0.
°o
ADDITIONAL INFORMATION
-
R
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
25
Final
Tank Pit L. Line
REAR OF PROPERTY LINE
,
'
P/L
P/
ELECTRICAL APPROVALS
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
DEPARTMENT OF BUILDING AND SAFETY APPLICATION CERTIFICATE
COUNTY OF RIVERSIDE' PERMIT N
Effective July 1, 1980, Chapter 1301 Section 19825'of the HEealth 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:
[_.•,J 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. 3q��7d
Q OWNER -BUILDER DECLARATION r
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.).
Q I am exempt under Section
Date Owner
B.&P.C. for this reason:
0 WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a Certificate -of
jWorkers'
Compensation Insurance, or a certified copy'thereof'(Sec. 3800, Lab. Code).-
Policy
ode). Policy No. Insurance %'—�.� i :��-> >, . -r
0 Certified copy is hereby furnished. '
!Certified copy is filed with the County of Riverside, Department of Building and Safety.
Date - ' _ > �-: �� Applicant r�A�-� •i �r ' _-��.�" y%
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 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.)
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.
[� 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 �ffoorWhi, h�fhav�`a`pplliieed for"'this permit for the purpose of making inspections.
rgnat�ofpp icant ' ge'�� % � 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
Permit No
/,/ . / _ ../
284 199 9/74 CANARY—FILE, PINK—APPLICANT
Owner fAr hitect Contract ��� �
Address' des Addre /
s_
y�
City-7City City_
Phone Phone Phone
01W
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 e n ithin 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 proper t be cupied t' I e) have
complied with all laws of the County of Riverside and the State of California governing said property.
`�y
DATE SIGNATURE OF OWNER AND/OR AGEN
Approval by Signature from the Following Departments Listed Below
Must Be Obtained Prior to the Issuing of a Construction Permit.
P 04,5
!/\ �GCTURE
i / ,�� ` ��t* r , e�/l/�/F//.� �: t USE OF S
JOB ADDRESS 1
I FAMILY [� DUPLEX
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L GAL DE RIP -T10 OF OPERTY 6�_ ,G�'SGJ�NGLE
/ Ct1 �/ �f— APARTMENTS AGRIC.
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/�� ( COMMERCIAL INDUSTRIAL rL
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COMMU ITY p ALTERATIONS n
N0. OF SUBMITTED PLANS — _ USE OF IT
CASE NO.
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NO. OF PA,"rNG SP ES REQUIRED NO. OF BUILDINGS NOW EXISTING
Q
ZONE v /SETBACKS: FRONT SIDE REAR
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m
GRADING PERMIT REQUIRED? YES 0 NO ❑ LOT SIZE
�
SETBACK ORD I NCE �OF FEET REQUIRED ON
DATEr SIGNATURE OF LAND USE OFFICIAL
F
DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET --
CURB AND GUTTER REQUIRED: YES ❑ NO ❑ STREET
H
s
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 ❑ NO ❑
49
DATE __ SIGNATURE OF ROAD DEPT. OFFICIAL
I
SWIMMING POOLS PUBLIC
WSEWAGE
DISPOSAL _
FOOD ESTABLISHMENT
_
WATER POLLUTION _ REMARKS
�n FLOOD CONTROL
AIR POLLUTION
W z
DIV OF HWY
o < — YOUR PROPERTY MAY BE SUBJECT TO
0
o FLOOD. RIVERSIDE COUNTY ASSUMES
NO RESPONSIBILITY IN EVENT OF FLOOD.
284 199 9/74 CANARY—FILE, PINK—APPLICANT
BUILDING PERMIT
PERMIT NO.
413482
DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE 1
COUNTY OF RIVERSIDE t
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINP
FEES
7 Nrvr S
1ST FL.
2ND. FL.
FOR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SO. FT. .@ $
UNITS
eS 74 LFO
Off. F.C.C.
MH Permit Fee S
SQ. FT. @ YARD SPKLR SYSTEM
Use of Permit
PPermit F] -q� �t / '+�" f /
If i to [ o POOL j -4t5 A f 4./ 1?,.
"`�
SO. FT., @ MOBILEHOME SVC. BAR SINK
Ck. By
SQ. FT. @ POWER OUTLET ROOF DRAINS
PI. Ck. Fee $
DRAINAGE PIPING.
SQ. FT. @
Construction Fee Obi S
DRINKING FOUNTAIN
SQ. FT. @
Electrical FeeDbl S
SO. FT. @ URINAL
Plumbing Fee Dbl S
VALUATION $ WATER PIPING
Plan No.
NOTE: Not to be used as property tax voluation
SWIM POOL, PVT
FLOOR DRAIN
Unit
Sp. Insp. Fee S
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
Registr. Fee S
Mileage Fee S
VENT SYSTEM FAN EVAP. COOL HOOD
SIGN
WASHER (AUTO)(DISH)
Owner/Agent �'
M k r LEN N 1 S
Tel. Zip
LA Oc1/&! 7
APPLIANCE DRYER
Total Fees S A KO
GARBAGE DISPOSAL
City Zip
M.O. 0 N.C. E] Cash Check
FURNACE UNIT WALL FLOOR SUSPENDED
Contractor ti rtr
C �1c,t �(�L co
LAUNDRY TRAY
Licensell
Trees required
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
BATH TUB
SO. FT. @ c
WATER HEATER
~
SO. FT. RESID @ 1 �'/4c
SEWAGE DISPOSAL
SO. FT. GAR @ t/44
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
do
DBL.
TOTAL3ES
MOB. HM. FEE
MICRO FEE
MECH. FEE PL. CK. FEE
CONST. FEE ELECT. FEE
SMI FEE
FEE
PLUMB. FEE
NO.
4134 8 2
Job Address (/. '' ({�' j�Jj � J / / �/� Spo<R
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%PERMIT
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7 Nrvr S
Community
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yaluotion
S
Date tY^!n1
� „� • o u
Dist.
Off. F.C.C.
MH Permit Fee S
Micro Film Fee Cop S
Use of Permit
PPermit F] -q� �t / '+�" f /
If i to [ o POOL j -4t5 A f 4./ 1?,.
"`�
Parcel No. ( % Use/Case No.
� `7 ,/ —�„% � — �!
Ck. By
Mech. Fee Obl 5
PI. Ck. Fee $
Set Socks Lot Size
F S S R
Zone Restrictions Group Type
1i—
Construction Fee Obi S
Legal Description
Electrical FeeDbl S
SMI Fee S
Plumbing Fee Dbl S
Bond Amt.
S
Plan No.
Plan Checker
Final Dote
a/ —5^&—
Inspector
Unit
Sp. Insp. Fee S
Dental. Fee S
Const. lender Branch
-
Suppiimental Permit Numbers
Registr. Fee S
Mileage Fee S
Address ! , - ity Zip
'^
+
Witness Fee S
Reinsp. Fee S
Owner/Agent �'
M k r LEN N 1 S
Tel. Zip
LA Oc1/&! 7
o (A 0
Total Fees S A KO
Address/
4' "�fi A Vr— I—
City Zip
M.O. 0 N.C. E] Cash Check
Received by _
Contractor ti rtr
C �1c,t �(�L co
Tel.
7�4-cl�S6
Licensell
Trees required
Sewage System
ddress
7D ( /V � �
City Zip
�rci�� M 111 1) UC
T LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by:,
Sower 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
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA.
H) CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
Form 284.208 (Rev. 1/80) RDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.