Loading...
400199 (RER)BUILDING PERMIT PERMIT NO, 400199 DEPARTMENT OF BUILDING & SAFETY COUNTY OF RIVERSIDE FIELD = osT {I r� CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. 2ND. FL. FOR. GAR. CAR P. WALL ESTIMATED CONSTRUCTION SQ. FT. @ $ UNITS Space SQ. FT. @ YARD SPKLR SYSTEM SQ. FT. @ MOBILEHOME SVC. BAR SINK SO. FT. @ POWER OUTLET ROOF DRAINS SQ. FT. @ DRAINAGE PIPING SQ. 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 Lot Size F _ 5•,.,,..�"� S GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED Construction Fee Dbl S 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. SQ. FT. @ a BATH TUB SO. FT. @ a WATER HEATER Unit SO. FT. RESID @ 1 t/4a SEWAGE DISPOSAL Demol. Fee $ SO. FT. GAR @ 3/44 HOUSE SEWER Branch GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL. TOTAL FEESMOB. HM. FEE MICRO -FEE MECH. FEE PL. CK. FEE CONST. FEE ELECT. FEE SMI FEE FEE PLUMB. FEE 4 P N 9 9 JoAddress bAw©V V 6'IQ�f L} Space Zip Owner I f 1 r 1 5 Commucity s ' _1. \ ss ` , Valuation f ) �� Dote , ••r cJ Dist. '�' '' Off. S "`� F.C.C. MH Permit Fee 5 Micro Film Fee Cop $ Use of Permit ' ..,. � - �I - ,' r� Parcel No. / - Use/Case No. Ck. By Mesh. Fee Dbl $ PI. Ck. Fee S Set Backs Lot Size F _ 5•,.,,..�"� S Construction Fee Dbl S Legal Description _ . -•t ( 1 e _ ..''�f < �- Electrical Fee Dist s Zone Restrictions Group Type SMI Fee S Plumbing Fee Dbl $ Bond Amt. S Plan No. Plan Checker F' IDote VIns !� for Unit Sp. Insp. Fee S Demol. Fee $ Const. Lender Branch Supplimentol Permit Numbers ! IO „//�j� r .�• r. Fee S Mileage Mileage Fee S Address City Zip ...� Witness Fee $ Reinsp. Fee $ Owner/Agent)yi ��(' d .� / /`s Tel. Zip Total '!es $ l' , t �' Address City Zip„ M.O. ❑ N.C. ❑ Cash ❑ Check Received by 1 - I 0" �.. Contractor Tel. Licensee Trees required Sewage System Address City Zip T LL P Sewer Distllct v Form 284.208 (Rev. 1/80) THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by: 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 ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. 17( NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR f BUILDING APPROVALS MECHANICAL APPROVALS I Set, Back 33 Ventilation System 2 Ftgs & Frms 34 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 _V 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. 0. °o ADDITIONAL INFORMATION , - SEWAGE SYSTEM SIZEA LOCATION 11 Exterior Lath 12 Internal Lath 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Walls (Batts) 12B Ceiling (Batts) 12C Ceiling (Blown) 1•4 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 + P/ 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 CERTIFICATF, COUNTY OF RIVERSIDE • PERMIT # 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. 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 C1 ss Licen a No. Date �— Contractor 11 f, COAX o 01-INER-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 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 B.&P.C. for this reason: Date Owner 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. 5 ?T Insurance �177^GF U A) [] Certified copy is hereby furnished. Certified copy is filed with the County of Riverside, Department of Building and Safety. Date Applicant [� 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 Dermit is issued. I shall not.emnlov 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 1 CONSTRUCTION LENDING AGENCY 1 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. [� As owner -builder, I wi.11 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 - pert f r ich I hav lie for this permit for the purpose of making insp c i ns. S gnature of App i n %gen DatO Print Applicant/Agent Name 284=2000 7/80 NOTICE: THIS IS NOT A BUILDING PERMIT DISTRICT/�Q�C� APPLICATION TO CONSTRUCT Permit NoQd + J ' DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE 284 199 9/74 CANARY—FILE, PINK—APPLICANT OwneoL-r t'c�i� i'Srt�l?-.'S Xrr,� Architgct Contractor/{/� AddresE'-J �-:ter✓w:fv�'�ddress Address_{b-/�O/t'� City t� City City AA .'^'- Phone Phone cc W 1 (we) the undersigned, nereby 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 pe -mit. NOW, therefore, it is ag-eed that I (we) will not occupy said property and will not cause said property to be occupied until 1 (we) have complied with all laws of the County of Riverside and the State of California governing said property F ' ' DATE 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. SPACE NO. r 00A I USE OF STRUCTURE JOB 6� � >' ADDRESS�q r '� - SINGLE FAMILY] DUPLEX LL LEGAL DESCRIPTION OF PROPE TY 1 - APARTMENTS AGRIC. ❑ O H Q { -. COMMERCIAL INDUSTRIAL 0 '^ O O Ml COMMUNITY `_A ALTERATIONS NO. OF SUBMITTED PLANS USE OF PERMIT r Z Q _-___ -- CASE NO. - it �JQ k C "Ana; _ V p Z NO. OF PARKING SPACES REQUIRED NO. OF BUILDINGS NOW EXISTING Q ZONE SETBACKS: FRONT_ SIDE REAR J m _ GRAoING PERMIT REQ01'KED?:= - 'YES ❑ NO ❑ LOT SIZE SETBACK ORDINANCE __— OF FEET REQUIRED ON STREET vto DATE - s 1 SIGNATURE OF LAND USE OFFICIAL��I`t�� F DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET_- CURB AND GUTTER REQUIRED: YES ❑ NO ❑ -STREET t - tot i CAN CURB AND GUTTER FEASIBLY BE INSTALLED?XDEMPT.NTOFFIECINAL W HAS AN ACCEPTABLE APPLICATION BEEN MADE FIT FOR DRIVEWAY AND STREET O C IMPROVEMENT? YES ❑ NO ❑ °G DATE __ SIGNATURE = SWIMMING POOLS PUBLIC WSEWAGE DISPOSAL _ FOOD ESTABLISHMENT S WATER POLLUTION REMARKS 12 FLOOD CONTROL z AIR POLLUTION W DIV OF HWY 0 a — YOUR PROPERTY MAY BE SUBJECT TO IL o FLOOD. RIVERSIDE COUNTY ASSUMES NO RESPONSIBILITY IN EVENT OF FLOOD. 284 199 9/74 CANARY—FILE, PINK—APPLICANT