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426918 (ELEC)MWILYII1L1 ►CKMI1 •--.- PERMIT NO. 4 2 6 918 PERMIT NO. p � 4269181 4 2 6 918 Job Addres �S ace �(/ DEPARTMENT OF BUILDING & SAFETY COUNTY OF RIVERSIDE FIELD DST Fl/ CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. 2ND. FL. POR. GAR. CAR P. WALL ESTIMATED CONSTRUCTION SQ. FT. @ $ UNITS' Use of Permit �!it� ( l/ SQ. FT. @ YARD SPKLR SYSTEM SQ. FT. @ MOBILEHOME SVC.. BAR SINK SQ. FT. @ POWER OUTLET ROOF DRAINS SQ. FT. @ DRAINAGE PIPING SQ. FT. @ DRINKING FOUNTAIN SQ. 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 Unit GARBAGE DISPOSAL FURNACE 1UNIT WALL FLOOR SUSPENDED f,, ir, J c 04.) 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. @ c BATH TUB LicenseX SQ. FT. @ c WATER HEATER Address SQ. FT. RESID @11hc SEWAGE DISPOSAL S0. FT. GAR @ 314 c HOUSE SEWER GAS PIPING PERMIT FEE w PERMIT FEE ? PERMIT FEE DBL. TOTAL FEES MOB.HM.FEE MICRO FEE MECH. FEE PL. CK. FEE I CONST. FEE ELECT. JE SMI FEE FEE PLUMB. FEE •--.- PERMIT NO. 4 2 6 918 Job Addres �S ace �(/ �r Owner LM , Community ? f 1'LZ e ; �{ t� Valuation E Date Dist. Off(,,- F.C.C. MH.Permit FeeE Micro Film Fee Cop E Use of Permit �!it� ( l/ Parcel No. % r �^� ..al .• :y Com. j i Use/Case No. - Ck. By j'� Mech. Fee Dbl E PI. Ck. Fee E Set Backs � lot Size Construction Fee Dbl E Legal Description �' j ( E J fes. Lf .-t �� -..' !� E S S R Electrical Fee Dbl E /• • Zone Restrictions Group Type` SMI fee E Plumbing Fee Dbl E Bond Amt. E Plan No. Plan Checker Final Dat' ✓ peo, I tr Unit Sp. Insp. Fee E Demol. Fee E Const. Lender Branch Supplimental Permit Numbers a / /741 /,rye �, ww••�• / ""' Registr. Fee � E Mileage Fee E Address Ci Zi city P Witness Fee E Reinsp. Fee E Owner/Agent f t ; �l ft; !'�i �: 1. 11,.E Tel. Zip `� �- � i r� �•� .S Total Fees E 1 Address City Zip e T M.O. 1J.C: Cash Check Receivedvb Contrac or Tel. LicenseX Trees q red Sewoge yste� . '41 Address City Zip T LL P Sewer District Form 2:8>1 (Rev?8/78 Pg! THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by:f 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. 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 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 Commercio. Hood 10 Fireplace. P. L. C] 43 Final 10A Fireplace T.O. P' 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 Plumli 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 PSL 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 DEPARTMENT OF BUILDING AND SAFETY APPLICATION CERTIFICATE COUNTY OF RIVERSIDE PERMIT H 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: i hereby affirm that Division 3 of the Bu License Class Date 0 I hereby affirm that LICENSED CONTRACTORS DECLARATION am licensed under provisions of Chapter 9 (commencing with Section 7000) of ess and Professions Code and my license is innfull /force and effect. License No._.? 3 J ^'- T" 3<," OWNER -BUILDER DECLARATION 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.). [:J I am exempt under Section Date Owner B.&P.C. for this reason: . [I 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.¢¢ 338-800, Lab..Code). Policy No. %� Szi — ���elnsurance Q Certified copy is hereby furnished. w [� 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 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 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 i6 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. 0 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. =rgna re"ofpp scant gent Date 41 r nt;Applicant/Agent Name 284-2000 7/80 284-141 Rev. 6/77 BUILDING PERMIT PERMITNO. -� 426918 I DEPARTMENT OF BUILDING & SAfETY DST COUNTY OF RIVERSIDE FIELD OFFICE `! . I CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. 2ND. FL. FOR. GAR. CAR P. WALL SQ. FT. @ $ UNITS Zip Owner SQ. FT. @ YARD SPKLR SYSTEM _ SQ. FT. @ MOBILEHOME SVC. BAR SINK SQ. FT. @ POWER OUTLET ROOF DRAINS SQ. FT. @ DRAINAGE PIPING SQ. FT. @ DRINKING FOUNTAIN Cop $ SQ. FT. @ �"'� I•'t,� C- I< Parcel No. � " C�' :7 .� URINAL ESTIMATED CONSTRUCTION VALUATION $ Mech. Fee Dbl E Pl. Ck. Fee $ WATER PIPING NOTE: Not to be used as property tax valuation SWIM POOL, PVT Construction fee Dbl E FLOOR DRAIN MECHANICAL FEES SWIM POOL, COMM S S R WATER SOFTENER VENT SYSTEM FAN EVAP. COOL HOOD SIGN Type %A WASHER (AUTO)(DISH) APPLIANCE DRYER Dbl $ Bond Amt. E GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED JTi;�. j, 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 Witness Fee E LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. @ c Total Fees BATHTUB Address L✓ ' SQ. FT. @ c City j j� ,t ' ` t � � L.f '� s is ta* WATER HEATER M.O. Cash Check SQ. FT. RESID @1'hc SEWAGE DISPOSAL SQ. FT. GAR @ I/. c licensed HOUSE SEWER Sewage ystem Addfess GAS PIPING PERMIT FEE ` PERMIT FEE QGi PERMIT FEE DBL.TOTAL.F.EES —J 21 MOB.HM.FEE MICRO FEE MECH. FEE PL. CK. FEE CONST. FEE ELECT. FEE 3 SMI FEE FEE PLUMB. FEE PERMIT NO. Job Addres�4.4 •. t` -T? V "{"' !� fit Space Zip Owner Community .(/. (�,,.d-A. � U. ( &)'4 j'�•' Valuation E Date �•. `Dist. Off. F.C.C. MH.Permit Fee '." E Micro Film Fee Cop $ Use of Permit d .+. (� �"'� I•'t,� C- I< Parcel No. � " C�' :7 .� Use/Case No. ` ✓ Ck. By �••.� Mech. Fee Dbl E Pl. Ck. Fee $ Set 8066 Lot Size Construction fee Dbl E Legal Description c F S S R Electrical Fee Dbl $ Zone Restrictions 2ti _9 Type %A SMI fee $ Plumbing Fee Dbl $ Bond Amt. E Plan No. Plan Checker Final DateInspe -1? -& Unit ' Sp. Insp. Fee E Demol. Fee $ Const. Lender Branch Supplimentol Permit Nimbers Z % / c 0 ( e Registr. Fee $ Mileage Fee E Address City Zip Witness Fee E ,Reinsp. Fee $ Owner/Agent Tel. - Zip Total Fees PC Address L✓ ' t� 1� ' (V '�3 City j j� ,t ' ` t � � L.f '� s is ta* Zip M.O. Cash Check Receive Contractor Tel. licensed Trees q re Sewage ystem Addfess City Zip ' T LL, P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK 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. I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN f ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF Tf-.E STATE OF CALIFORNIA. Form 284.208 (Rev.8/78) ©s verifie4 by: