403565 (BLCK)BUILDING PERMIT
PERMIT NO. DEPARTMENT OF BUILDING 8t: SAFETY
403 5 6 5 11
COUNTY OF RIVERSIDE FIELD fDs%r
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING -SEES
1ST FL. SO. FT. @ $
UNITS
Owner -
rr i
2ND. FL. SO. FT. @
Community
YARD SPKLR SYSTEM
POR. SO. FT. @
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. @
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT. @
Micro Film Fee Cop $
DRAINAGE PIPING
WALL i SO. FT. @
\
�.� ` — ICS• ✓1\
DRINKING FOUNTAIN
SO. FT. @
Use/Case
URINAL f
ESTIMATED CONSTRUCTION VALUATION $
Mach. Fee Dbl $
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
Electrical Fee Dist $
GARBAGE DISPOSAL
FURNACE UNIT WAIL 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.
SO. FT. @ a
BATH TUB
SO. FT. @ a
WATER HEATER
Suppliesimmmeend/taalll Permit Numbers
S0. FT. RESID @ 11/44
SEWAGE DISPOSAL
Mileage Fee $
SO. FT. GAR @ 3/44
HOUSE SEWER
Reinsp. Fee $
Own/•Agent r,
;. ;;/ T f �,%
J _
GAS PIPING
PERMIT FEE
Tel.
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
l ..�
--
Tel.
License#
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PERMIT NO.
403565-
-.
JobAddi:ess �- - - - -� - Space
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Zip
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Owner -
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Community
i<i
Valuation
$ 4`!`, G • �,. . V
Date
O —7 • t} �
Dist.
I . �
Off.
i-
F.C.C.
,
MH Permit Fee $
Micro Film Fee Cop $
Use of Permit
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Parcel No.
1
~/ ll [ '- U 0
Use/Case
No.
Ck. By
i
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Mach. Fee Dbl $
Pl. Ck. Fee S
Set Backs
Lot Size ;
i
j
Construction Fee Dbl $
Legal Description
1 9
l) (Cta
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1 •d �. �� d_l �� Z/-. {,y
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Pl/
f
F
S S
R
Electrical Fee Dist $
Zone Restrictions
f"t
Group
Type
,
SMI Fee $
Plumbing Fee Dbl $
Bond Amt.
$
Plan No.
Plan Checker
Final Dote
Inspect
Unit J-
Sp. Insp. Fee S
Demol. Fee $
Const. Lender
Branch
Suppliesimmmeend/taalll Permit Numbers
i.
Registr. Fee
Mileage Fee $
Address -�City 9r'Zip
Witness Fee $
Reinsp. Fee $
Own/•Agent r,
;. ;;/ T f �,%
J _
.✓'r rwf1�.
'
Tel.
Zip
Total Fees S
Address ,.. '" .
.... f �.,C" •j v %i- 4A / :
.. �.
City
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Zip P
tl L G.� -5 4 !<
M.O. ❑ N.C. ❑ Cash ❑Check
Received by
Contractor
--
Tel.
License#
..
Trees required
Sewage System
Address
City Zip
T LL Is 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.
. � x
1I HEREBY AGREE THAT ALL. WORWIN CONNECTION. WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA.
EBY CERTIFY THAT,THE -INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
,,Form 284-208 (Rev. 1/80) CCC..✓/��7 ORDANCE'.WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
verified by:
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
o -13-96
33
Ventilation System
2
Ftgs & Frms
�y�
t�
34
Plenums 8 Ducts
2A
Slab Grade
35
Furnace Comport.
3
Steel
jO�
`
36
Inlets 8 Outlets
4
Grout Blocks
37
Combustion Air
5
6
Bond Beams
Roof Deck
38
39
Compressor
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 Loth
12 Internal Loth
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts)
12B Ceiling (Batts)
12C Ceiling (Blown)
14 Final e ( 3
-.---------PLUMB[NG-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
ELECTRICAL APPROVALS
P/L
+
+
P/
I
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
i
30 Fixtures
31 Service
32 Final
• STREET NAME
PERMIT NO^••" DEPARTMENT OF BUILDING & SAFETY , FIELD OFFICE 0/1
4 0 3 5.6 5 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
Zip
� z
SQ. FT. @
YARD SPKLR SYSTEM
SO. FT. @ MOBILEHOME SVC.
BAR SINK
SO. FT. @ POWER OUTLET
ROOF DRAINS
SO. FT. @ "
DRAINAGE PIPING
SO. FT. @
DRINKING FOUNTAIN
SO. 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
Set Backs
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 HIP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. @ a
BATH TUB
Plan Checker
SQ. FT. @ a
WATER HEATER
Inspect
S0. FT. RESID @ 1 t/<a
SEWAGE DISPOSAL
S0: FT. GAR @ 3/aa
HOUSE SEWER
Const. lender
• GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBI.TOTAL
FEES
0
—
M08. HM. FEE
MICRO -FEE
MECH. FEE PL. CK. FEE
CONST. FEE ELECT. FEE
�!j es
�..
SMI FEE
-
FEE PLUMB. FEE
PERMIT NO.
403565
Job Address
—
-T_Space
Zip
� z
Owner .
F
-
Community
Valuation
$
on
Date
I,r
Dist.
Ott.
F.C.C.
MH Permit Fee $
Micro Film Fee Cop S
Use o err i
Parcel No.
-77,4*-
0 l� ., O /
IIIGQQJ
use/Gose
No. 171
�
Mech. Fee Dbl $
Pl. Ck, Fee S
Set Backs
Lot Size
Construction Fee Dbl S ap
Legal Description
yI
1.. i 1
1 /
s .! 1 Q C. 1� r � iIA(�
F
S S R
Electrical Fee Dbl $j-��
Zone Restrictions
Group
Type
SMI Fee $
Plumbing Fee Dbl $
Bond Amt.
S
Plan No.
Plan Checker
-
Final Date`
el— —'CC // I
Inspect
�]
Unit
Sp. Insp. Fee S
Demol. Fee S
Const. lender
-Branch
Supplimental Permit Numbers
-
Regisir. Fee S
Mileage Fee $
Address - City Zip
Witness Fee
Reinsp. Fee $
Ower �enlj
re+" C"
t
/'
Tel.
-
Zip
Total Fees Is A
Address
.. tI
° t
City
2
Zip
M.O. N.C. ❑ Cash Q Check
Received by
Contractor
Tel.
Licensee
Trees required
Sewage System
Address
City -
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 ACCORDANq WITH
THE 'LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. `
I EBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
Form 284-208 (Rev. 1/80) -ORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
verified by:
J
NOTICE: THIS IS NOT A BUILDING PERMIT DISTRICT �<
APPLICATION TO CONSTRUCT Permit No
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
284 199A 9/74 CANARY—FILE, PINK—APPLICANT
Owner Zs Architect---.---- Contractor d��� _ del -1496e_
Address'✓�"/-�T�O/ IF -V44( y!ftt Address___ Address---_ �_ ---_-
City �/�f N%�r/� City_ _ City-
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 occupy said property and will not cause said propert to be occupied u iI I (we) have
complied with all laws of the County of Riverside and the State of California governing said property.
Mo
®('� /7C
DATE J------ SIGNATURE OF OWNER AND/OR AGENT -_
Approval by Signature from the Following Departments Listed Below
Must Be Obtained Prior to the Issuing of a Construction Permit.
I SPACE NO.
USE %S�TRUTURE
JOB ADDRESS _-_ -. -- SINGLE FAMILPLEX
>
Z !-
0
LEGAL DESCRIPTION OF PROPERTY - — APARTMENTS AGRIC.
14 srv�cs� x.18
COMMERCIAL INDUSTRIAL ❑
'^
C
COMMUNITY L rti>1�
ALTERATIONS
T NO. OF SUBMITTED PLANS - USE OF PERMIT
� Q
CASE N0. �
� 47
Z
NO. OF P IRKING SPACES REQUIRED ._ -_ NO. OF BUILDINGS NOW EXISTING -- -
Q
ZONE �r SETBACKS: FRONT SIDE REAR
J
m
GRADING,PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE
SETBACK ORDINANCE OF FEET REQUIRED ON STREET
/0-
DATE SIGNATURE OF LAND USE OFFICI _
DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET
H
W
CURB AND GUTTER REQUIRED: YES ❑ NO ❑ STREET
t -
a
CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑
W
HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT -PERMIT FOR DRIVEWAY AND STREET
IMPROVEMENT? YES ❑ NO ❑
°t
DATE __-.- SIGNATURE OF ROAD DEPT. OFFICIAL
=
SWIMMING POOLS PUBLIC
QW
SEWAGE DISPOSAL
FOOD ESTABLISHMENT
_
WATER POLLUTION REMARKS
FLOOD CONTROL -
F
z AIR POLLUTION
= DIV OF HWY
c a — YOUR PROPERTY MAY BE SUBJECT TO
o: -
c FLOOD. RIVERSIDE -COUNTY ASSUMES
NO RESPONSIBILITY IN EVENT OF FLOOD.
284 199A 9/74 CANARY—FILE, PINK—APPLICANT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
OWNER -BUILDER VERIFICATION
Address i
ti An."owner-builder" building permit has been applied for in your name and bearing
,,your.• s.i gnature,. It
Please complete and return this information in the envelope provided at your '
earl .iest,opportunity. to. -avoid ,unnecessary. delay in processing and issuing your
building permit. No building permit will be issued until 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)
2. I (have/have not) signed an application for building permit
for IWC 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 fol1 owing ' '
person to coordinate, supervise, and provide the major work:
Name t, Phone,
Address -City,
Contractors License No.
5. I will provide some of the work but I have contracted (hired) the fol- L
lowing persons to provide the work indicated:-":,"
Name Address .' " Phone Type of work
Y.�1 711.-, ... � � .v ._ i v,Jl. .. .. :y 4. i.t :1-:i y. :. i:_ !
1 1,
[vl. .,. •�: t. � ;'r i M. r �li/� F �./ - .. � . — ti..i ti .� .r, 'e .tj:.. •r' �;�.?
rla, ^,� _ r�r.,i:F.t yr(�M�;.••, � '. r�n � .:/.,� ji�iC/� J . ._r. ,� ,` r �, r -
�� L 'i S.ignaturel--Property Owner Date
`)"Social Security Number
284-2002 7/80
Lill Vr DVILU111U hUVU
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 la_w 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 otherwise 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 financial 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.
A frequent practice of unlicensed persons professing to be contractors is to secure an "owner -
builder" building permit, erroneously implying that the property -owner is providing his or her own
labor and material personally. Building permits are not required to be signed by property 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 95814...
Please'complete`and return the enclosed owner -builder verification form so that we can confirm that
you are aware 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