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399421 (BLCK)BUILDING PERMIT. — PERMIT NO. DEPARTMENT OF BUILDING & SAFETY FIELD 13-994,21 COUNTY OF RIVERSIDE CONSTRUCTION ESTIMATE t - NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. ' 2ND. FL. POR. GAR. _ CAR P. WALL rSQ. ' ESTIMATED CONSTRUCTION SQ. FT. @ $ Valuation S /C/;✓ •:/ UNITS Dist. -/ SQ. FT. @ ' ' • YARD SPKLR SYSTEM - SO. FT. @ MOBILEHOME SVC. BAR SINK SQ. FT': @ POWER OUTLET ROOF DRAINS so. FT. _ DRAINAGE PIPING i � FT. @J DRINKING FOUNTAIN c SQ. FT. @ URINAL VALUATION $ WATER PIPING _ NOTE: Not to be used as property tax valuation S S SWIM, POOL, PVT ��� FLOOR DRAIN MECHANICAL FEES Zone Restrris s 'A SWIM POOL, COMM WATER SOFTENER VENT SYSTEM FAN EVAP. COOL HOOD Plumbing Fee D61 S / SIGN WASHER (AUTO)(DISH) APPLIANCE DRYER Final Dote (/ �% t GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED Demol. Fee S Const. Lender Branch LAUNDRY TRAY AIR HANDLING UNIT CFM Mileage Fee $ IDLE METER KITCHEN SINK ABSORPTION SYSTEM B.T.U. Owner/Agent TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP Address y 'r J POLE, TEMP/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY Contr ro l 1� .40J_ AMPERES SERV ENT SHOWER BOILER B.T.U. Sewage System Sewage SQ. FT. @ a BATH TUB t SO. FT. @ a WATER HEATER 50. FT. RESID @ 1 t/4a SEWAGE DISPOSAL SO. FT. GAR @ s/a ' ( HOUSE SEWER - L GAS PIPING PERMIT FEE , PERMIT FEE s PERMIT FEE DBL . TOTAI tF S) MOB. HM. FEE MICRO' FEE MECH. FEE • PL. CK. FEE „, CONST. FEE ELECT. FEE SMI FEE •4E1s' PLUMB. FEE - PERMIT NO. - 3994 2,.1• t - lob Address � / i -� ----_� _ Space //rn p� - -.`,,., Zip �/ ^} r Owne v �� (/y, e• `-F.C.C. Community; �j F. 1,I j •r✓ Valuation S /C/;✓ •:/ Date _ G' � G2 Dist. -/ Off. MH Permit Fee S Micro Film Fee Cop S �/ X, �,/��•- Use of Permit �'� �i C. / G'`.7 16- :�,!r 'f{_ (f 1�646(e�� ,)' Parcell NNNo. �, ��>> - / / �� (/.�- Use/Case No. C,k(.��y/n/ /! /b/ ' . Mech. Fee Dbl S PI. Ck. Fee 5 Set Backs Lot Size Construction Fee Dial S Leg al escriPtion , r ? , /y ,L ..�j ,r7 !/ G CK /7 c+ F S S R Electrical Fee Dal 5r2/ Zone Restrris s 'A Group Typo SMI Fee t $ Plumbing Fee D61 S / Bond Amt. $ Pion No. Plan Checker Final Dote (/ �% Inspe for 1c—_ Unit , Sp. Insp. Fee S Demol. Fee S Const. Lender Branch Sipplinfental Permit Numbers - I 10 , Registr. Fee $ Mileage Fee $ Address City Zip Witness Fee ' 'S Reinsp. Fee S Owner/Agent Tel. ` '- Zip �J Total Fees $ Address y 'r J City Zip M.O. N.C. Gosh Check Received , by! -'�' Contr ro l 1� .40J_ Tel.' / yj• "� t� .% 'LL7 / s licenseR . Trees r_ aved�� Sewage System Sewage Address _ _ City ' ' ' W7 ,' Zip t 'T LLTHIS7PERMIT SHALL BECOME VOID IF,WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK ,v a by: Sewer District FOR'120 DAYS SHAII'A150`CAUSE PERMIT TO BECOME VOID,r .,4 r` I HEREBY AGREE THAT ALL WORK IN CONNECTION WITHJHI5'PERMIT'WILL BE DONE IN ACCORDANCE_ WITH ` THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF.CALIFORNIA.01 1 EBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED-THE:PLANS AND SPECIFICATIONS HAS DONE SO.1N, ;�' -+• Form 284.208 (Rei. 1/80) � ORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS'CO_DE OF THE STATE OF CALIFORNIA 1/d i 3Nn Alba OU 10 MV38 3WVN 143N1S sa,nsx!j Oe 6uipuo8 96Z anM 6wpunOAE) , V6Z., a3goitu3 a3waS 87, impuo) LZ alod iamOd 9Z S1VA0HddV 1VJ1817313 1; d isal so0 6Z sa,nsx!j Oe 6uipuo8 96Z anM 6wpunOAE) , V6Z., a3goitu3 a3waS 87, impuo) LZ alod iamOd 9Z S1VA0HddV 1VJ1817313 l f isal so0 6Z 93!niaS JaloM i £L �h r is j1a19ak'SeicM' IZ'. aa. as OZ losods!Q a6omaS 61 t " stuaA 81 t i qwnld y6nod Ll - 6wdid JatoM 91 F gwnld punojo "St bYswnia_ ~sinn��dd�Ni (umol8) 6uil!a) Wl Rzi li` li i) (sito8) suoM VL • {{ - ( anloq N p41 NOIlVI(1SNI .. ?I ap-o ys!u!j - Cl 4 lioMR)a VZl p I tit�� �r•/Y G� ytol louiatul LI ;. ��� ytol joualx3 1l NOIIVW?JOdNI WNO11140b °O C] •0.1 aDoldaa!j Vol 14 loud eu 'Td a=jdanj o1 POOH lon awwOD ep i IIoM anj a6omO, 6 03inat7 uO!tDa48(], aslowS lj-- e ' stuaA 8 . _ ' r •. i jadwu(1 an j op 6u!woi j L aDuojoal� •IddV 6e po(] {oo8 9 ' 10ssaj8uio] gf - - ' k swoag puo8 g t nV _ _ _ ? spo18 tno„J uog' qwo:) LE �- 4 staltn0 J sialul 9E QQOB/g�j/'G/� O17�� G ^(� IaatS E i� 'podwo:) aoouinj cc apoi0 golS VL sionp g T nuald I't Xn !✓ swj j V 04d Z e wats6S uo!jol!tuaA L'E ''po8 $as 1 S1VAOiJddV 1VJINVHJ3W i{ S1VAOHddV Wining N01D3dSNl 31VO NOI1VN3d0 �� ON 801:)3dSNl 31Va NOI1VN3d0^ ON SAF ®� ;� plans shall of s an aPProval anY Of' the stat the job n � f<eot on Un FA1m. of 0� mw• -- �rClG DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE GARDEN WALL SECTIONS (THIS DESIGN IS NOT TO BE USED TO RETAIN EARTH) 1/2-1 cp BAR CONTrNVOOS THRCJ EXD�'N'SfON JO�NTs 6" MINI 349 �� BARS t� GfZADE ' I . j. uI GONG. BLOCK 2-O R CONT. U CONSTRUCTION: � � All cells containin steel shall be filled solid with grout. All reinforcing steel to 'lap a minimum 2 -0". 284-196 Rev. 5/79 NOTICE: THIS IS NOT A BUILDING PERMIT APPLICATION TO CONSTRUCT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE DISTRICT Permit No 284 199A 9/74 CANARY—FILE, PINK—APPLICANT G /;r7— Owne Architect_---. —_—_ Contractor—_ , 2_ Addres 3 G PL__ Address___ Address -- /— -- e City/,!_L[G City-- City_—_.— — Phone S6 Of 333/ � 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 i agreed that I (we) will not occupy said property and will not cause said property to be occupied until I (we) have complied ith all laws f the Counn of Riverside and the State of California governing said property. DATY— —Q- - SIGNATURE OF OWNER AND/OR-'���=N,r I - Approval by Signature from the Following Departments Listed Below Must Be Obtained Prior to the Issuing of a Construction Permit. '(2z -S"3 (SPACE NO. USE OF STRUCTUREJOB V VG ADDRESS SINGLE FAMILY �" DUPLEX 00 Z F 0 / /� 1° APARTMENTS AGRIC. LEGAL DESPT NOF ROPERZT� _�� 2-Q K7 �' N j _— — COMMERCIAL INDUSTRIAL �Q v ��a > c COMMUNITY `� ALTERATIONS ❑ Z NO. OF SUBMITTED PLANS USE OF PERM T Lu 4 6 CASE NO. --- - G Z NO. OF PARKING SPACES REQUIRED _ NO. OF BUILDINGS NOW EXISTING - Q ZONE —r sETBAC�KS: FRONT SIDE REAR J m GRADING PERMIT REQUIRED? YES-;] ;NO ❑ LOT SIZE SETBACK ORDINA�E # OF FEET REQUIRED ON S EET DATE T �.Z �d SIGNATURE OF LAND USE OFFICIAL DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET—. F- z CURB AND GUTTER REQUIRED: YES ❑ NO ❑ STREET oe e d CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑ W HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET Q IMPROVEMENT? YES ❑ NO ❑ O Ce DATE SIGNATURE OF ROAD DEPT. OFFICIAL S SWIMMING POOLS PUBLIC QW SEWAGE DISPOSAL _ FOOD ESTABLISHMENT WATER POLLUTION REMARKS vt FLOOD CONTROL H W AIR POLLUTION _ I DIV OF HWY c — YOUR PROPERTY MAY BE SUBJECT TO 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 # 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. [-1 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 /-? / License No. _? TeF % 3 9 Date '7 -� a rt - 0 Contractor ,,W,,-, X,. 0 OWNER -BUILDER DECLARATION f I hereby affirm that I am exempt from the Contractor's License Law for the following reasons: 0 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.). Q I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, B.&P.C.). [ ] 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). T Policy No. Insurancevol 1',' '0 r• , /*., 0 Certified copy is hereby furnished. Certified copy is filed with the County of Riverside, Department of Building and Safety. Date Applicant [-1 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 this permit shall be deemed revoked. Date Applicant 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. 3097, Civ. Code). Lender's Name -0,1,, 'e Lender's Address DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION 421 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 inconnection 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.) Q 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. Q 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- i7� ` r perty for which I ha've.app.l'ied for this permit for the purpose of making inspections. Signature of Appli.cant/Agent Date Print Applicant/Agent Name C . 284-2000 7/80 PERMIT NO. F3994 21 PERMIT NO. [� 9 4 2 J Job Address V s Space Zip - DEPARTMENT OF BUILDING 8r. SAFETY . COUNTY OF RIVERSIDE •. FIELD OFFICE DST �� - CONSTRUCTION -ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES F.C.C. 1ST FL. 2ND. Fl. POR. GAR. CAR P. WALL ESTIMATED CONSTRUCTION SQ. FT. @ $ UNITS Parcel No. /� �i / ,2 / al Use/Case No." SQ. FT. @ YARD SPKLR'SYSTEM Mech. Fee Dbl g r SQ. FT. @ MOBILEHOME SVC. ` BAR SINK" Set Backs SO. FT. @ POWER OUTLET - ROOF DRAINS - Construction Fee Dbl S SO. FL DRAINAGE<PIPING. F �yFT1 DRINKING FOUNTAIN ' SQ. FT. @ URINAL •, _ Electrical Fee - Dist S ' VALUATION $ WATER PIPING Group NOTE: Not to be used os property tax voluotion SWIM POOL, PVT. FLOOR DRAIN Bond 'Amt.Plan S MECHANICAL FEES SWIM POOL, 'COMM WATER,SOFTENER Ins ector VENT SYSTEM FAN EVAP. COOL HOOD.* SIGN , WASHER;(AUTO)(DISH) , Const. Lender - Branch APPLIANCE DRYER Regrstr. Fee S. -GARBAGE DISPOSAL Address City Zip .. FURNACE UNIT WALL FLOOR SUSPENDED Reinsp. Fee S LAUNDRY -TRAY Tel. Zip AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK City - Zip `�• ' ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET, Tel. ( COMPRESSOR HP POLE, TEMP/PERM 'LAVATORY - Address •�. - HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER ' BOILER - B.T.U. SQ. FT. @ a .' BATH TUB ' SO. FT. @ a WATER HEATER • S0. FT. RESID. @ 1 t/a SEWAGE.+DISPOSAL ' SO. FT.. GAR @ 3/<a HOUSE SEWER'. - - GAS PIPING ' PERMIT FEE PERMIT FEE PERMIT FEE' DBL. TOTAL FEF�SJsM08. //9 HM. FEE i - MICRO:FEE MECH. FEE Pl. CK. FEE CONST. FEE r'� ELECT. FEE SMI FEE �W PLUMB. FEE PERMIT NO. F3994 21 Job Address V s Space Zip - Owne'r Chi�titis- Communiy/,(//)�',J •�-fJ L:N (.J"^" voluotion Dote /Dist. Off., .••GGG+++ F.C.C. MH Permit Fee S Micro Film Fee Cop S Use of. Permit - (y U� G✓ i� /�✓ �. q' ,,� //� !"'•' Low /C- yG ✓ •,wi ` •J (/ b V Parcel No. /� �i / ,2 / al Use/Case No." Ck. By Mech. Fee Dbl g r PI. 6. Fee 5 Set Backs Lot Size Construction Fee Dbl S Legool Description/��//�/ v �7i ,(!�/ �y "'LG, c' e is (,r U f:7 F S- S R Electrical Fee - Dist S ' Zone Restrictions Group Type - SMI Fee S Plumbing Fee Dbl S Bond 'Amt.Plan S No. - Plan Checker Final Dote /9 �V — V V Ins ector Unit ' Sp.' Insp. Fee S Demol. Fee S Const. Lender - Branch Supplimentol Permit Numbers , = •' - - - Regrstr. Fee S. Mileage Fee S, Address City Zip .. Witness Fee $, Reinsp. Fee S Owner/Agent Tel. Zip Total Fees S Address - �� ! City - Zip `�• ' " M.O. I] N.C. Cash.Check - Ra`ea. cf ntro or�G/., �.-w Tel. ( License�# r �- Trees Sewage System Address •�. - City Zip t - T LL P THIS PERMIT SHALL BECOME VOID IF WORK 15 NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by: Sewer District FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. ,t, I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDAN�E WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFQRNIA. 1 H REBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS•AND SPECIFICATIONS HAS DONE SO IN ' Form 284.208 (Rev. 1/80)A RDANCE WITH SECTION 5541.OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.