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413921 (AR)CULLUINLP rtumll PERMIT NO.DEPARTMENT OF.BUILDING BUILDING & SAFETY FIELD 1. COUNTY'OF RIVERSIDE D5� 1413921 , . j L;F�` CONSTRUCTION ESTIMATE -: .• NO. ELECTRICAL FEES NO. PLUMBING FEES j 1V FL tO. FT. @ / ,.:} _,e ,1 UNITS $ S /200%, 'vr _ FL. t SO. FT. @ F.C.C. 4i MM Permit Fee $ YARD SPKLR SYSTEM ff 1 SO. FT. @ MOBILEHOME SVC. Ck. BAR SINK PI. Ck. Fee - $ ' O 0 GAR. SO. FT. @ - POWER OUTLET Construction Fee Dbl $ :/ 147 ROOF DRAINS F Z O S S C. L z 6 R I• Electrical Fee Dbl S , Zone Restrict/ioJJLs \, Group CAR P. SO. FT. @ SMI Fee � S ` Plumbing Fee Dbl $ DRAINAGE PIPING Plan No. WALL SO. FT. @ +. Final Dote �� Inspector DRINKING FOUNTAIN Sp. Insp. Fee $ 4. SO. FT. ;@ " •' Const. Lender - - Branch Supplimental Permit Numbers , URINAL V ESTIMATED CONSTRUCTION VALUATION -ti ` $ Witness Fee $ Reinsp. Fee $ WATER PIPING Tel. Zip NOTE: Not to be used as property tax valuotion •/ t SWIM POOL, PVT Address jy ) ( ! / C`/ ��( O FLOOR DRAIN M.O. ❑ N.0 Cash ED Check MECHANICAL FEES SWIM POOL, COMM Tel. , "' WATER SOFTENER ,Trees required F VENT SYSTEM t FAN EVAP. COOL HOOD SIGN - City Zip WASHER (AUTO)(DISH) APPLIANCE DRYER 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 HP POLE, TEMP/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER C BOILER-. SO. FT.—@- a BATH TUB ASO. FT. @ a WATER HEATER •'`t - ss ?'a ..S0. FT. RESID @ 1'/aa SEWAGE DISPOSAL • x,%'_r.,: � t;• --t, � � W. FT. GAR @ 3/aa HOUSE SEWER GAS PIPING PERMITTEE PERMIT FEE �+ �� PERMIT FEE DBL. .. TOTAL FEES MOB. HM. FEE MICRO'FEE r MECH.-FEE Pl. CK. FEE CONST. FEE, ELECT. FEE, SMI FEE -FEE' PLUMB. -FEE c Y PERMIT NO. - _ , - _- . --• 413 9. , lobAddress •� ./ }� - `nSpace �St �/ P-, � Zippy Ownaerj+. M Community tValuation $ Dote C IDist Off. r F.C.C. 4i MM Permit Fee $ Micro Film Fee Cap S Use of Permit -1 .Parcel t 14 J0 r� _ �( 1.� .fi. C7 s ( h G Y • •_ T 1 •�Sf,. L(7 /vim , '+J LU �"• I? e�.y� No. 1 I .3 ' 7 ��a1 `.(... Z.. Use/Case No. " Ck. Mech. Fee Dbl $ PI. Ck. Fee - $ ' O 0 Set Backs ~Lot Size { O` (°'� K v Construction Fee Dbl $ :/ 147 Legal Description g p + �c (y�•,j',�)t ,,••�� '1{' ^+' •`�.\ � F Z O S S C. L z 6 R I• Electrical Fee Dbl S , Zone Restrict/ioJJLs \, Group Type; ' SMI Fee � S ` Plumbing Fee Dbl $ Bond Amt. $ Plan No. Plan Checker !!( Final Dote �� Inspector Unit Sp. Insp. Fee $ Demol. Fee $ Const. Lender - - Branch Supplimental Permit Numbers , r. Fee S e Mileage Mileage Fee g Address ,.' ' City Zip .,,X f-• y ., •,-...r'.• �, ,�� ll�'�'%/r w-7 Witness Fee $ Reinsp. Fee $ Own gent-•.• s -. ) Tel. Zip , Total Fees$ ! ! Address jy ) ( ! / C`/ ��( O .City Zip ` \.X 1i: s r� 1" `•�' M.O. ❑ N.0 Cash ED Check Recei.ed by Contractor '+. r• Tel. , License# ,Trees required F Sewage System r p Address - City Zip T LL A, P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by: i Sewer District FOR 120 DAYS SHALL ALSO CAUSE PERMIT -TO BECOME VOID. y 1* I HEREBY'AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH r //^"THE LAWS OF' RIVERSIDE COUNTY AND THE STATE OF,CALIFORNIA. ,� 4 iu T BY CERTIFY THAT THE'INDIVIDUAL-NKHO PREPARED THE PLANS !AND SPECIFICATIONS HAS DONE SO IN Form 284-208 (Res•.,1/80) ACCORDANCE WITH SECTION 5Wi, OF THErBUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. nti , PLUMBING APPROVALS 15 Ground Plumb -16 Water Piping 17 Rough Plumb 18 Vents ZZIAL - 19 Sewage Disposal PIT 00W Z.` 61 20 Sewer 21 Water Heater 22 Water Softener 23 Water Service 24 Gas Test 25 1 Final ELECTRICAL APPROVALS 26 Power Pole 27 Conduit t ` NO. - O?...RATION DATE l INSPECTOR NO. OPERATION DATE INSPECTOR 298 Bonding BUILDING APPROVALS 30 MECHANICAL APPROVALS 1 Set Back Service 2 /- - $ 33 Ventilation System 2 Figs & Frms Z `�_ 34 t Plenums & Ducts Z -Z4 1 2A Slob Grade , Z ,+/� 35 Furnace Comport. 3 Steel 36 Inlets & Outlets 4 Grout Blocks 37 Combustion Air 5 Bond Beams 38 Compressor 6 Roof Deck Z - `4 . 39 Appl. Clearance 7 Framing _ ) Z- z,4 Q( 40 Fire Damper ' 8 Vents Z-Q-$(�� 41 Smoke Detection Deice 9 Garage Fire Wall 42 Commercial Hood 10 Fireplace P.L. n 43 Final 10A Fireplace T. 0. [] °o ADDITIONAL IN ORMATION 11 Exterior '�7 6 12 Internal Lath 12A Drywall y . / 13 Finish Grade INSULATION Thick R Value 7A Walls (Batts) 31(Z - 128 Ceiling (Batts) G�� ^� �� Qwt U i 12C Ceiling (Blown) T14' Final i PLUMBING APPROVALS 15 Ground Plumb -16 Water Piping 17 Rough Plumb 18 Vents ZZIAL - 19 Sewage Disposal PIT 00W Z.` 61 20 Sewer 21 Water Heater 22 Water Softener 23 Water Service 24 Gas Test 25 1 Final ELECTRICAL APPROVALS 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring z 29A Grounding Wire 298 Bonding 30 Fixtures �y 31 Service 32 Final / f2- SEWAGE SYSTEM SIZE & LOCATION Tank Pit 16-, L. line REAR OF PROPERTY LINE c .. P/L h P/L • �Cn t, 4 STREET NAME AVE M&A5iG0 DEPARTMENT OF BUILDING AND SAFETY APPLICATION CERTIFICATE COUNTY OF RIVERSWE• PERMIT q 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. M 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 .,,L ci ense"No. Date Contractor . _.- >< < 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 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.). M I am exempt under Section , B.&P.C. for this reason: Date -U-_ Owner 'fi Q 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. Insurance [� Certified copy is hereby furnished. 0 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 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 thisepermit shall be deemed revoked. ( J Dale r��ir. � / 41APPIicant v 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. 3091; Civ. Code). Lender's Name Lender's Address DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION Q 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. (Chap 3.2, Grp 2, Art 2, Sec 341, Title 8, C.A.C.) [] 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 for which I hawe.applied for this permit for the purpose of making inspections. r'Signature of Applicant/Agent Date \ ,.y I* I& 284-2000 7/80 .,, . .-s. , .- 1 ' 01 Il DEPARTMENT OF BUILDING AND SAFETY COUNTY-OF.RIVERSIDE OWNER-BUILDER„VERIFICATION Aaaress ; ' An "owner -builder” building permit has been applied for in your name and bearing " your signature. Please complete and returnithis 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 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 the' proposed wor ',./ 3. I have contracted;,with the following person (firm) to provide the pro- posed construction: Name A Phone Address - _ �. City ` Contractors License No. 4. I plan to provideLportions of the work, but I have hired the following person to,coordinate, supervise,'and provide the major work: Name IL ' Phone a Address.` City Contractors License No. 5: I will provide some of the work but I have contracted (hired) the-,fo17 4 lowing persons to 'provide the work indicated: ' Name/ Address Phone Type__of work ` Si natu.r_e Property, Date Pro / 9 P y. Owner (/ V So_ J al , S2cur.i ty,Number 284-2002 7/80' DEPARTMENT OF QUILOING 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 iaw 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 otherwise engage an 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 emp.loyees, 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 e o p o I do Rojo, r. V Director 284-2001 7/80 NOT:CE: THIS IS NOT A BUILDING PERMIT APPLICATION TO CONSTRUCT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE DISTRICT I Permit �4 199A 9/74 1 ��..' CANARY—FILE, PINK—APPLICANT Owner 1 Architect_ --_ --_ Contractor__ _ pelina4Address___ Address 5V Address ----- ddress_ _--Citye City ueo_City--_ City_—_ - Phoney.J�7 Phone _ Phone— -.._ I (we) the undersigned, hereby certify and acknowledge that I (we) have read the application and agree that if Curb and Gutter, and 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 County of Riverside and the State of California governing said property. DATE at -2K 7-9 / SIGNATURE OF OWNER AND/OR AGEN ed Approval by Signature from the Following Departments Lis� Must Be Obtained Prior to the Issuing of a Construction Permit. I SPACE NO. I USE OF STRUCTURE A /L _J�4�' JOB ADDRESS/_J�__. - SINGLE FAMILY All" DUPLEX f..-ILEGAL ELESCRIPTION OF PROPERTY —__L/— - APARTMENTS AGRIC. El Sa' ��---/9� COMM ERCIAL INDUSTRIALL '^ COMMUNITY 5 C ALTERATIONS ❑ i Bjorn 119QTI'F� NO. OF SUBMITTED PLANS USE OF PERMIT A�nto m - _ UA a CASE NO. / " �x,O T 2-00AM.'T7 2)WAV4 -1W6, G Z NO. OF PARKING SPACES REQUIRED _ NO. OF BUILDINGS NO EXISTING Q pJ / ZONE ` SETBACKS: FRONT C�L0 SIDE � � � REAR J m _r GRADING PERMIT REQUIRED? YES ] NO ❑ LOT SIZE SETBACK ORDINANCE N OF FEET REQUIRED ON STREET DATE SIGNATURE OF LAND USE OFFICIAL. - DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET_ - t- W CURB AND GUTTER REQUIRED: YES ❑ NO ❑ -STREET 1- ccn a CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑ ul 0` HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET G IMPROVEMENT? YES ❑ NO ❑ °C DATE SIGNATURE OF ROAD DEPT. OFFICIAL -44 `�,)��O SEWAGE DISPOSAL Sf6°�+c� i°�r Ex1fT, sYSr, T,c�/Lu IIE'J DireiB A. -4 ujW 6. .� T A&' _r AIS CONn/6Ci E � , l %�A&W�-6ok = S -b C.41 52F,4/ -7c_ F02_--X/ST, 2 A'_4•. DwAw. ! AaA a 4 WATER POLLUTION- REMARKS FLOOD CONTROL - z AIR POLLUTION W DIV OF HWY c cc YOUR PROPERTY MAY BE SUBJECT TO — o_ FLOOD. RIVERSIDE COUNTY ASSUMES NO RESPONSIBILITY IN EVENT OF FOOD. •-� .-, �4 199A 9/74 1 ��..' CANARY—FILE, PINK—APPLICANT BUILDING PERMIT PERMIT N 413921O. PERMIT No. 413921 Job Address d. (-x�(f�co DEPARTMENT ` OF BUILDING & SAFETY COUNTY OF RIVERSIDE Zip IZZ FIELD OFFICE Community r �.� Dsr / F+ "(CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1444 IST FL. .,.-.� Q. FT. @ d %%�� )ND. FL. y SO. FT. @ FOR. SQ. FT. @ GAR. SO. FT. @ (.�. UNITS MOBILEHOME SVC. POWER OUTLET MH Permit Fee $ f , S+•,� rft'jiJ,'Fi• YARD SP LR SYSTEM - BAR SINK ROOF DRAINS Cop SNO— CAR P. SQ. FT. @ WALL SO. FT. @ SO. FT. @ ESTIMATED CONSTRUCTION VALUATION $ Parcel No. '1 �s iii � Z Use/Cosa ' DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING- Ck. , NOTE: Not to be used as property tax valuation SWIM POOL; PVT gel Backs FLOOR DRAIN Construction Fee Dal $ 0 MECHANICAL FEES SWIM POOL, COMM eve S S 6 .(Z WATER SOFTENER Electrical Fee Dbl E VENT SYSTEM FAN EVAP. COOL HOOD SIGN. WASHER (AUTO)(DISH) SMI Fee S APPLIANCE DRYER Dial $ Bond Amt. $ GARBAGE DISPOSAL Plan Checker FURNACE UNIT WALL FLOOR SUSPENDED Inspec s LAUNDRY TRAY Sp. Insp. Fee S AIR HANDLING UNIT CFM IDLE METER Const. Lender , KITCHEN SINK n ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC ' Mileage Fee S WATER CLOSET a `� COMPRESSOR HP POLE, TEMP/PERM Own gent LAVATORY. a/ HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT Total Fees SHOWER Address (, -i' L/ j \ [� BOILER B.T.U. SO. FT. @ a Zip BATH TUB ' Received by SO. FT. @ 'a + WATER HEATER Licensell ' S0. FT. RESID @ 1 t/aa 614SEWAGE Sewage System DISPOSAL Address 50. FT. GAR @ t/a HOUSE SEWER " GAS PIPING PERMIT FEE PERMIT FEE Qy� PERMIT FEE DBL. TOTAL FEES 17 (�C, MOB. HM. FEE MICRO FEE MECH. FEE PL. CK. FEE 300 CONST. FEE ELECT. FEE �io. too �/. �� SMI FEE FEE PLUMB. FEE r elso PERMIT N 413921O. Job Address d. (-x�(f�co Space Zip IZZ Owner 4A - Community r �.� k s Valuation his S 111 . „ f +�'�J Dote o 9y 1 �" Q ! Dist Off. ,�► nF.C.C•� J/ ✓l/G+�J MH Permit Fee $ Micro Film Fee Cop SNO— Use of Permit �t>U ;%E.{�f�'oo I �� b' 40 k i Sr. Sit ,y ��'C s� lei L I t • s�:1 Parcel No. '1 �s iii � Z Use/Cosa ' No. Ck. Mach. Fee Dial $ PI. Ck. Fee g gel Backs Lot Size - s o x 00 Construction Fee Dal $ 0 legol Description ? i T'y �— j .Yr \ I `� ` w U s f Z eve S S 6 .(Z R 1 Electrical Fee Dbl E Zone Restrictio s - i Group Type SMI Fee S Plumbing Fee Dial $ Bond Amt. $ Plan No. Plan Checker Final Date / Inspec s Unit Sp. Insp. Fee S Darrel. Fee S Const. Lender , Branch Supplimental Permit Numbers - ' Ragistr. Fee E Mileage Fee S AddreYss ..�. City ` Zip : (JI(/ � r �Gi � -C. ,-'•^._✓,�.,+ '�('✓f_,•i%%! Witness Fee 5 Reinsp. Fee g Own gent Tel. i. o Zip Total Fees s ! Address (, -i' L/ j \ [� S o' City (/ v _ 1 Lil i .i Zip C M.O. N.Cash Check Received by Contractor + Tel, Licensell ' 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 verified by: 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 ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. .• 461f4 BY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN Form 284-208 (Rev. 1/80) ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.