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413111 (ELEC)PERMIT NO. DEPARTMENT OF BUILDING & SAFETY 13111 COUNTY OF RIVERSIDE FIELD [it I Dsr CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES Job Address NO. PLUMBING FEES 1ST Fl. 2ND. FL. POR. GAR. CAR P. WALL ESTIMATED CONSTRUCTION SQ. FT. @ $ UNITS SQ. FT. @ YARD SPKLR SYSTEM SQ. FT. @ MOBILEHOME SVC. BAR SINK r SQ. FT. @ POWER OUTLET ROOF DRAINS SQ. FT. @ DRAINAGE PIPING SO. FT. @ DRINKING FOUNTAIN r SO. FT. @ URINAL VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation SWIM POOL, PVT Set 15cks FLOOR DRAIN MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER VENT SYSTEM FAN EVAP. COOL HOOD SIGN Electrical Fee Dbl SAZone WASHER (AUTO)(DISH) APPLIANCE DRYER i SMI Fee $ GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED ei �,I6> O LAUNDRY TRAY A'R HANDLING UNIT CFM IDLE METER Inspector A&6z4— KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC S WATER CLOSET COMPRESSOR HP POLE, TEMP/PERM Supplimental Permit Nunbers � - LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT Witness Fee S SHOWER BOILER B.T.U. SQ. FT. @ a BATH TUB Tel. Zip SQ. FT. @ a Total Fees WATER HEATER Address r' SO. FT. RESID @ 1 t/4a SEWAGE DISPOSAL M N.0 sh Check S0. FT. GAR @ 3/4a HOUSE SEWER vi L Tel. r Licensee GAS PIPING PERMIT FEE PERMIT FEE /n t� A -L PERMIT FEE D8L. TOTAL FEESj MOB. HM. FEEMICRO FEE MECH. FEE PL. CK. FEE CONST. FEE EL CT. FEE, . SMI FEE FEE PLUMB. FEE . PERMIT NO. 413111 Job Address ,���� .� J Community Valuation Date Dist Off.,,.. F.C.C. MH Permit Fee S Micro Film Fee Cop S Use of Permit v k Q% C J Parcel No. / , 5 Oe W Usa/Cole No. Ck 8 Mech. Fee Dbl E Pl. Ck. Fee S Set 15cks I Lot Size Construction Fee Dbl $ legal Descriptionr to --,z \'%/— F S S R Electrical Fee Dbl SAZone Restri s Group Type SMI Fee $ Plumbing Fee Dbl S Bond Amt. $ Plan No. Plan Checker Final Date /a z*8'9 Inspector A&6z4— Unit Sp. Insp. Fee S Demol. Fee S Const. Lender Branch Supplimental Permit Nunbers � - r. Fee $ e Mil Mileage Fee 5 a Address r City Zip Witness Fee S Reinsp. Fee S Owner/Agent Tel. Zip Total Fees S Address r' City Zip M N.0 sh Check Received b Co ror vi L Tel. r Licensee Trees requiredaff Sewage System Address /n t� A -L Ciry Zip �. 'r � l V.�'r.-•..r.+`I G. \ l'S �--� I K Sewer District I. Form 284-208 (Rev, 1/80) THIS PERMIT SHALL BEC04 VOICJ IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK veryied by: FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. r I HERE6Y 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. CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN CE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System + 2 Ftgs & Frms 34 r Plenums & Ducts 2A Slab Grade 35 Furnace Comport. 3 Steel 36 Inlets & 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. OW 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) 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 ELECTRICAL APPROVALS + P/L i P/L t STREET NAME 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire G� 29B Bonding 30 Fixtures 31 Service 32 Final DEPARTMENT OF BUILDING AND SAFETY . COUN OFFICE DATE TIME D PERMIT NUMBER OF RIVERSIDE AtfRESS v ( —tFQ— SPACE NO. I OWNER COMMUNITY a BUILDING PLUMBING ELECTRICAL ANICAt REMARKS: OWNER/CONTRACTOR TEL.NO. INSPECTION REQUESTED FOR: A.M. P.M. MON TU>ES 3S a WED rITOUR FRI 28446 11/15 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 Contractor_'O� Owner Architect— —. __—_ . Address-'neddress--- Address_G: -9 E-16 �q CityCE,/yEity-- city_ r4zC� Phone / Phone _. _ Phone --St int!c_4if_ I (we) the undersigned, hereby certify and acknowledge that I (we) have read the application and agree that if Curb and Gutter, and C 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 laws of the Countv of Riverside and the State of California governing said property. DATEy ___-d — SIGNATURE OF OWNER AND/OR A G E N Approval by Signature from the Following Departments Listed Below Must Be Obtained Prior to the Issuing of a Construction Permit. I SPACE N0. USE OF STRUCTURE JOB ADDRESS j-7/=9V�JeSINGLE FAMILY DUPLEX z F LE AL DESCRIPTION OF PROPERTY Z_7/ —f—��- - APARTMENTS AGRIC. E] 0 L6 H Q COMMERCIAL INDUSTRIAL L] j '^ C COMMUNITY ALTERATIONS n NO. OF SUBMITTED PLANS — US OF PERMIT W Q �+ r w CASE NO. p Z Q 0 NO. OXKIN G SPACES REQUIRED _— N0. OF BUILDINGS NOW EXI ING ZONE cETBACKS: FRONT SIDE REAR J m GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE SETBACK ORDINANCE N OF FEET REQUIRED ON -- _ STREET DATE SIGNATURE OF LAND USE OFFICIAL t DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET_ 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 D C IMPROVEMENT? YES ❑ NO F-1 °C DATE SIGNATURE OF ROAD DEPT. OFFICIAI S SWIMMING POOLS PUBLIC Q W SEWAGE DISPOSAL FOOD ESTABLISHMENT _ WATER POLLUTION REMARKS rn FLOOD CONTROL t- z AIR POLLUTION W DIV OF HWY o a — YOUR PROPERTY MAY BE SUBJECT TO a 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 Heilth 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: - 0 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 G / U License No. ,,,�S' s 2 / /g r Date ss -r, Contractor is IZ, - . _ -ee- 7"/ 45.1 Q OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reasons: [� 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 comple-ion, I understand I will have the burden of proving I did not build.or improve for.the purpose of sale (Sec. 7031.5;'8.&P.C.). [� I, as owner of the property, am exclusively contracting with licensed contractors to construct the Froject (Sec. 7044, B.&P.C.). I am exempt uncer Section B.&P.C. for this reason: Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I haw_ 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. Insurance 71 Certified copy is hereby furnished. M Certified copy is filed with the County of Riverside, Department of Building and Safety. Date Applicant CERTI=ICATE 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 *f 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 /,?P <_ — � - R V Appl s cant CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issuec (Sec. 3097, Civ. Code). Lender's Name Lender's Address DIVISION OF INDUSTRIAL'SAFETY PERMIT CERTIFICATION 0 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, faisework, 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 %ill 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 pernit to do such work from that division. M 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 pp scant/ gene Date Print Applicant/Agent Name 284-2000 7/80 BUILDING PERMIT PERMITsNO. 413111 DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE DST COUNTY OF RIVERSIDE I � IN I ' CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. 2ND. FL. FOR. GAR. CAR P. WALL ESTIMATED CONSTRUCTION SO. FT. @ $ UNITS Community s s SO. 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 F GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED X)d JL Q 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 Demol. Fee SO. FT. @ a WATER HEATER Branch S0. FT. RESID @ 1'44 SEWAGE DISPOSAL Registr. Fee $ S0. FT. GAR @ t/a HOUSE SEWER Witness Fee $ Reinsp. Fee GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL. TOTAL F 13�' MOB. HM. FEE MICRO FEE MECH. FEE Pl. CK. FEE CONST. FEE ELECT. F�EJ SMI FEE FEE PL -MB. FEE - PERMIT NO. 413111 Job Address / " �P,3 , v o� z i� Space Zip Cswner 9 A)s Community s s Valuotion S Dote ^ V 4D Dist Off F.C.C. MH Permit Fee S Micro Film Fee Cop S Use of Permit `' tz �.ER. C &-e �I - �+ V Parcel No. rc / , " ,� b ,-2vl Use/Case No. I Ck. B Mech. Fee Dbl $ PI. Ck. Fee $ Set Backs Lot Size Construction Fee Dbl $ Legal Description (� r^�J� ��i'^ Cf� _01a F S S R Electrical Fee Dbl S��(((\^''(((��, Zone Reori s l Group Type SMI Fee S Plumbing Fee Dbl $ Bond Amt. S Plan No.P Ion Checker Fin I Dote / F ! "� In p ctor Unit Sp. Insp. Fee $ Demol. Fee $ Const. Lender Branch Supplimentol Permit Numbers Registr. Fee $ Mileage Fee $ Address ! City Zip Witness Fee $ Reinsp. Fee $ Owner/Agent Tel. Zip Total Fees $ Address. City Zip M C] N. h Q Check Received by Coj r ctor L Tel. // ! IQ License« Trees required,. Sewage System Address kA -- a � City��t•••J// A Zip `T C y L' 1;,)- )4 3 T LL THIS PERMIT SHALL BECOM VOld IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK Sewer District FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. L) 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. I HE Y CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN Form 284-208 (Rev. 1/801 RDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. verllied by: