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00021902 (SATT)1 rr LILM IIVA County of Riverside Department of Building and Safety • 4080 Lemon St. 2nd Floor 135 N. Alessandro Rd. Rm. 203 880 N. State Street Riverside, CA 92501 Banning, CA 92220 Hemel. CA 92343 227 North -D- Street 46.209 Oasis St. Rm. 310 160 N. Broadway ♦ Ph: 787.6146 Ph: 849.7312 Ph: 658.446'�� Perris. CA 92370 Indio. CA 92201 Blythe. CA 92225 ( Ph: 657.3898 Ph. 342.8271 Ph: 922.2670 This permit becomes void it work not commenced within 180 days from date of issuance. OR, it work has beer suspended or abandoned for a period of 180 days. ` ❑ 1294`�f EP24 i3 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be com- LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (comment- pleled it the permit is for one hundred ($100) or less. I certify that in the performance of the work for which this ing with Section 7000) of Division 3 0l the Business and Professions Code, and my license is in full force and effect. permit is issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensa- S tion Laws of California. ❑ Date __ Applicant OWNER -BUILDER DECLARATION: I hereby affirm That I am exempt Irom the Contractor's license Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a to NOTICE TO APPLICANT: II, atter makingthis Certificate of Exemption, you should become subject to the Workers' Compensation provisions al the Labor Code, you must forthwith comply with such provisions or this permit shall be permit con- strucl. alter, improve, demolish, or repair any structure. prior to its issuance, also requires the applicant for such deemed revoked. permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or [hat he is ex- DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: empl therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a per- Of hereby certify that no excavation live (5) or more feet in de plh into which a person is required to descend. will mit subjects the applicant to a civil penalty of not more than five hunderd dollars ($500).): be made in connection with work authorized by this permit. and that no building structure, scaffolding, lalsework. ❑ I. as owner of the properly, or my employees with wages as their sole compensation, will do the work, and the 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.). structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to []As owner -builder, I will not employ anyone to do work which would require from an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If. however. a permit the Division of In - dustrial Safety, as noted above. unless such person has a permit to do such work from the division. the building or improvement is sold within one year of completion, the owner -builder will have the burden of prov- ❑Division of Industrial Safety Permit No. ing [hal he did not build or improve for the purpose of sale ) _ ❑I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044. Business and Professions Code: The Contractor's License Law does not apply to an owner of properly who builds or improves thereon, and who contracts lot such projects with a contractor(s) licensed pursuant to the Con- tractor's License Law.) ❑I am exempt under Sec. . B.8 P.C. (Attach Certificate). Date Owner WORKERS' COMPENSATION DECLARATION: I hereby affirm [hat I have a certificate of consent to self - insure, or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800. Lab. C.). ❑Certified copy is hereby furnished. ❑Certified copy is filed with the County Building Inspection Department or County Department. II T'M1'3 N P7{M(#h�' MI) plugs "TaG p4 t," `PT CA 922600000 YAQ7Ait RESSISPACE VEL AVEV1IGG.. V'6. I��.t1 �r9 ASCO iCITV..7COQMTffTr E/ZIP {�q�q 4, WM7 {lO Q 1sl�f/'S 1294`�f EP24 i3 TWN fig V WI o 6�0 S 0 0 0 1 v 7u UO� i SB �UUTO q� Ar.Ey►V� �p1 pyFy7yk�/�gVLyAp y���l'M fF'pr'I T , DEV CO PHONE N pW�.1p"glpM�LJyEN1��gE6�1� VJgRAV0 Nli©RN �re�,�' y� A ry` 4 LOLe, �,J^' 36 MRS 1631 11°t"'r1�tP'l CA 922600000 VINEi IL-15 8— 1 040 FOG. INSPECTOR FINAL DATE ARCIENG FIRM NAME LICNC N ADDRESS CITYICOMMUNITYISTATEIZIP , PLAN NP EX 1 R APP(g�pVE DATE Q Z ,YJ,W WmlQATT GARAGE CA iDN Q�i U � ��� a� ��GR.�R ZONE ORD N LOT SZ 0 (E,50 0 15% CONSTRUCTION LENDING AGENCY: I hereby allirm that there is a construction lending agency for the perfor- mance of the work for which this permit is issued (Sec. 3097. Civ. C.). Lender's Name Lender's Address CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certily I have read this application and stale that the information given is correct. I agree to comply with all slate 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 properly fpr which I have applied for this permit for tl e, purpose of making inspections. "'Signature of Applicant or Agent Date Print AoDlicant/Anent Name WU ETS 90 CD 07l 1 ZPAT62 ESTIMATED PLAIN REV FEE -39587 TOTAL ,FEE $151 77 CA CI� NC COUNTERS I. ++ COUNTER L.U.T. PERMIT FOR STRUCTURAL PLAN REVIEW TOTAL PERMIT COST IS $151.77 You must se* the following Departments (if Listed)• for conc:urreencee BEFORE ' peprt�.i t can be issued. Peesc r ition -------- .,.. — Dept to Bess .; HOLD -ROAD) H ALTH �_�_~ LAND USE ....� _.. CUN$TRUCTION ESTXMATE (NOTEt Not to be u%ed as prop r�ty valuation) Description FCC croup Type � . t Rate Valuation -. PTt MARY DW LG 14401 R-3 V_ Ell $27.60 *33423 CM1�RY P I AR 4:0 M--3 RWiD 13 0 $9.10 $2912 E#t Plan Rev Fee based on fot�al Estimated Val,'tn of. $38999 is: $151.77 , F`1RMi284-208 (11,81) INSPECTOR i• NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Ftgs & Frms 34 Plenums 8 Ducts 2A Slab Grade 35 Furnace Compol. 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. 0 43 Final 10A Fireplace T.O. 0 PADDITIONAL INFORMATION SEWAGE SYSTEM SIZE 8 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) 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 P/L REAR OF PROPERTY LINE ELECTRICAL APPROVALS % PI 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service, 32 Final STREET NAME L■ Vf4j t N /l'{.J q(q jF' MI) z 3'00MEJAWRESSISPACEME112M TWN u 3 %�� SB j$4j;VAI4&AQ 3FJDy - `71 Q ,!i' M w, • -qEv Cu PHONE N _WAIRMAIIJAM NNW K W 5,10 pJ 40 -'10 4 • S � p i� BLDG. INSPECTOR FINAL DATE ARCIENG FIRM NAME '• • LICNC 4 ADDRESS. " 91TYICOMMUN ITYISTATEIZI P PLAN # PLANS EXAMINER APPROVE DATE 700C MWI N ES USW i35FSJ A) FW ZONE ORD # LOT SZ . + " . — - w-"V-�.✓•�- ��. - - -.•...a�.���"�C•'1-�+✓++..•......-..ter-.rr — -�, w.�.. �.. ._.i _.... -. •� � w-_.�.ri .l�".�-- s,•' �� ` ApPl.xC;A110hi .bC3: '.STRUCtURAL F'iMi` You Must seer .the fool wing DeparttaenTs .(i4'. listed) for concurrence BEFORE . a Permit can he ifasued: a w... Descri ti )et to See�.�..�o S TOTAL . FEE CA. CK NC COUNTER B.I. COUNTER L..0 ,/ . — - w-"V-�.✓•�- ��. - - -.•...a�.���"�C•'1-�+✓++..•......-..ter-.rr — -�, w.�.. �.. ._.i _.... -. •� � w-_.�.ri .l�".�-- s,•' �� ` ApPl.xC;A110hi .bC3: '.STRUCtURAL F'iMi` You Must seer .the fool wing DeparttaenTs .(i4'. listed) for concurrence BEFORE . a Permit can he ifasued: a w... Descri ti )et to See�.�..�o NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Ftgs 8 Frms 34 Plenums 8 Ducts 2A Slab Grade 35 Furnace Comport. 3 Steel 36 Irlets 8 Outlets 4 Grout Blocks 37 Combustion Air 5 Bond Beams 38 Compressor 6 Roof Deck 39 A.ppl. 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 IDA Fireplace T.O. No ADDITIONAL INFORMATION SEWAGE SYSTEM SIZE & 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) 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 P/L REAR OF PROPERTY LINE ELECTRICAL APPROVALS" P/ 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final STREET NAME VAR -AW, "I vURS 1638 PrAM"WIaEVT CA��r922600000 j��(��*«+ 4 JATy.$ITE.A9RjESS�SIISJP�7A�C�E AV4+. VELAAw/CO 1UTOty}ty1yN �lS(S'MAZIP CA ?22530000 B�' U24 6 " ono v o S294 yQVTV 000 TOl 1 1W.41 SB �p 1Jyf��pi�"I "I� I&# BL.tK -p1 5 1 y�eht 3 �iy T�p�9 �{EEg[` T{ DEV {+{.7 PHONE # �Wp,(4MMgE�Ip(1�, A!t'1!`t ►'1'Y {.�� N 1'11:J.RN p�,,r "y �e Ll�l� 154 G,7 VOW 1638 PrA`L°4sT"f113'L' MAPT CA 922600000 P/ r -W-568-1 0 8 J �"f Gf BLDG. INSPECTOR FINAL DATE AROIE�Nf G FIRM NAME LICNC H ADDRESS CITYICOM MUNITYISTATEIZI P - PLAN# PLANS EXAMINER APPROVE DATE �7 U$E OEP�RMIL ATT GARAGE$g O RZ N� 0211j ASBg V 1 {� gSg� QVIS (� (fig NIC O ,�ly� J.FND ZONE ORD # LOT SZ Own n 0 y va vqJT X190 2 JXPA 0'71137232 39569 TOTAL . FEE i CA CK NC I COUNTER B.I. COUNTER L•:,U..T. 1 APPLICATION FOR STRUCTURAL. PLAN REVIEW T H I S 1 8 A N A P P L. I C A T I 0 N O N L. Y You must see the following Dep4riments (if listed) for concurrence BE -FORE a `Permit can be issued s Dps cr tion Dep t to Sea .._...�.,. Hi3L.D-ROAR? a HEALTH LPAND USE FORM 284.208 (11.81) INSPECTOR ' NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Ftgs & Frms 34 Plenums & Ducts 2A Slab Grade 35 Furnace Compert. 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 IDA Fireplace T. 0. No ADDITIONAL INFORMATION - SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Loth 12 Internal Lath 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Walls (Batts) 12B Ceiling (Botts) 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 PSL P/ 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final STREET NAME Receipt No" '��x- Issued By District: Riverside Q Indio ®. Hemet ❑ DISTRIBUTION: WHITE - Office'File YELLOW - Applicant DOH SAN 122 (New 10/81) Date ,�. PINK - Building Dept. GOLDENROD - Attached to Plans RIVERSIDE COUNTY DEPARTMENT OF HEALTH APPLICATION FOR PERMIT—TO -INSTALL A RESIDENTIAL SUBSURFACE DISPOSAL SYSTEM Applicant: Submit this form with three copies of a scaled plot plan drawn to the specifications required on the attached check list. A non refundable filing fee of $15 is required when the application is submitted. Check must be made payable to County of Riverside. Name Mailing Address Q City State Zip Code Phone U 'Property Address 'City or Community 'Legal Description of Property Uj � 2.7 : -� 00 .. A <,- n 0 'Assessors`Parcel No. Water Serving Property From Signature of Applicant 0" 1 Date 'The above information must be verified from Building Application Staff Use — Do Not Write Below This Line Initial Date Soils feasibility report required Yes ❑ No ❑t r�� < Detailed boring report required Yes ❑ No / Detailed contour plot required Yes ❑ No L m Z Soils or boring report by Date O V Approved by Date m Soils Map Page Soil Type Tract File No. Other4- Number of Bedrooms Septic Tank Size (gallons) Rate Required (sq. ft./100 gal or gal. sq. ft./day) ht r Leach line sq. ft. of bottom area trench Leach bed (sq. ft. of bottom area bed) Seepage Pit Diameter Seepage Pit Vertical Feet Number of Seepage Pits Maximum Depth of Pit Location of System Additional Requirements A permit is approved/denied for the installation of a subsurface disposal system as indicated on the accompanied Z plot plan using the requirements set forth in Section C above. r Signature of Health Official Date Receipt No" '��x- Issued By District: Riverside Q Indio ®. Hemet ❑ DISTRIBUTION: WHITE - Office'File YELLOW - Applicant DOH SAN 122 (New 10/81) Date ,�. PINK - Building Dept. GOLDENROD - Attached to Plans H W LL Q N a6 t - a W O 0 O 0 z z� za Q W J � IL O} Zt- sLL J Q m a6 t ' APPLICATION FOR TREE PLANTING I (we), the undersigned, hereby certify and acknowledge that. I (we) have read the application and agree that if trees are required under River- side County Ordinance No. 457, the applicant agrees to install said trees prior to final insyaction. It is understood that no final inspection will be given until said requirements have been met or exception has been granted by the County. Now, therefore, it is agreed that the prop- erty owner shall cause the property lines to be surveyed in the event no survey stakes can be found. Further, it is agreed that the County of Riverside shall assume no responsibility should trees have to be removed due to lot line errors. �pOwners Name ���� � �� W ' Building Permit No. Mailing Address - 8 City ` State G Zip Job Address CX ity r Legal Description l _ Assessor's Map, Book & Page Z c4lO2 Type Structure Type of Soil — Is water available Road Dept. Plot Plan No. Type of existing trees in road right-of-wa Trees preferred by applicant (1) C i �_e_. (2) ADL„" Q (3) Date [ —/ 2 Owner's Signature Planning Commission Case No. ROAD DEPARTMENT APPROVAL Approved species Number of trees Spacing of trees Distance from lot.lines: Front Side Additional requirements - Date Building and Safety notified Signature Reason Request for hearing: Owner's Signature Planning Dept. Concur n Date YES ❑ REQUEST FOR EXCEPTION (attach additional page if necessary) (Forward application to Planning Dept. if exception requested) NO REQUEST FOR HEARING Non -concur M Explanation Signature Road Dept. Concur r-1 Non -Concur n Date Signature REQUEST FOR HEARING AND COMMITTEE DECISION Date hearing established Date hearing notice mailed to owner Approved C3 Disapproved Dote Owner notified of decision Date Building & Safety notified, Signature APPROVAL BY BUILDING INSPECTOR Final Date Job Address Inspector Requirements for tree planting complied with Remarks Building Permit No. Community (Detach and forward above information to Road Deportment Riverside) 284-230, REV. 1/74 ^ ` r-� � �_ u / '