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40301813UILOINU PERMIT PERMIT NO, DEPARTMENT OF BUILDING & SAFETY FIELD °', . 0 3 018 COUNTY OF RIVERSIDE CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 77 IST Fl. SO. FT. .@ $ 2ND. FL. SO. FT. @ FOR. SO. FT. @ GAR. SO. FT. @ CAR P. SO. FT. @ WALL SO. FT. @ )fL._.—. s' SO. FT. @ T _ �! - tESTIA6,CTj ' " 1ifu TION VALUATION $ '4r— �'"'"�"' n• UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used:as property tax voluation SWIM POOL, PVT FLOOR DRAIN 'MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER .3 VENT SYSTEM FAN EVAP. COOL HOOD SIGN WASHER (AUTO)(DISH) APPLIANCE DRYER lot Size GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED ZR - /I" 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. SO. FT. @ a BATH TUB 1” viot g'7 SO. FT. @ a WATER HEATER p, Sp. Imp. Fee S SO. FT. RESID @ 1 t/aa SEWAGE DISPOSAL Const. lender Bran It S0. FT. GAR @ Y44 HOUSE SEWER Supplimental Permit Numbers Registr. Fee $ Mileage Fee $ GAS PIPING PERMIT FEE Witness Fee S PERMIT FEE PERMIT FEE DBL. TOTAL FEESMOB. HM. FEE MICRO FEE MECH. FEE PL CK. FEE I CONST. FEE ELECT. FEE SMI FEE FEE PLU FEf- e PER NO. 403018 I Job Address M �- � unit f • 4.. zC • .. War— Space Zi Owner , .. r� Ddt-,. J / /�+- ¢_'Dist. Otv : ,.FPC.C. .� MH Permit Fee $ Micro Film Fee Cop S U -.f ctvpbtm'TL, rL-4 /„v+l� j} ,y f /"•4. C.�� �: i'°�....wrt( °"i✓'/.:. a (Sr/tt <�i Ja'�'c• '% s• rn "4 1„: r C. Pia No. �a' j se/Case _ Ck. By Mach. Fee Dbl $ PI. Ck. Fee $ G✓ tSa lot Size Construction Fee Dbl S Lego Descn"phon - �, A^--/..rP> d i / , 4 ,e,,,r�,,, r /;i� ZR - /I" i S S R Electrical Fee Obi $ Zone Restrictions Group Type SMI Fee S Plumbing Fee Dbl $ Bond Amt. S Plan No. Plo s. Checker 1” viot g'7 InspectUnit Sp. Imp. Fee S Dismal. Fee $ Const. lender Bran It Supplimental Permit Numbers Registr. Fee $ Mileage Fee $ Address City Zip Witness Fee S Reinsp. Fee $ Owner/Agent Tel. Zip Total Fees $ M.O. N.C. Q Cash Q Check' ❑' Address City - i Zip Received by "'R %1 1 N Cohtroctor rls I'%—.. Tel. Licensee e Trees required 04- Sewage System.. r* Aildreh r✓ . / X ieP"/�, ��;�. iY'. �= ,{ ,/ Ci�'y 1 � � �" Zip yr T LL p � U THIS`Pf±RM'T'SHX[L/B2E3ME VOID`rIF WORK IS NOT COMMENCE VOIT1414r12(T DAYS. CESSATtSN t3ftdkKfwe<itied by: Sewer District FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. - 1 HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN,ACCORDANCE WITH ' THE LAWS OF RIVERSIDE COUNTY AND THEtST47E OF CALIFORNIA. R.EBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN Farm 284-208 (Rev. 1/80) 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 8 Frms 34 Plenums d Ducts 2A Slab Grade 35 Furnoce,Comport. 3 Steel 36 Inlets 8 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. [] °o __ ___ ADDITIONAL INFORMATION _______ SEWAGE SYSTEM SIZE 8r. LOCATION 11 Exterior Loth 12 Internal Lath 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Walls (Batts) 12B Ceiling (Batts) 12C Ceiling (Blown) 14 Final .PLUMBIN.G.APP.ROVALS __________. __ 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 Z7—So 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 298 Bonding 30 Fixtures 31 Service 32 Final STREET NAME NOTICE: THIS IS NOT A BUILDING PERMIT DISTRICT APPLICATION TO CONSTRUCT Permit No DEPARTMENT OF BUILDING AND SAFETY COUNT" OF RIVERSIDE 284 199A 9/74 f CANARY—'FILE, PINK—APPLICANT r, Owner Y00 '12 Architect Contractor -i LipL _) b Lw P(bq_ — —: 1' r S0 Awe I<J Add , �-_ Address__' Address----%Y-3`J--_- _ z 7- City_— City_ t o 0R_ _ -L _ Cit .y Phone �7` �/ Phone3 c?41 -Phone _ _� _--_ cc W I (we) the undersigned, hereby certify and acknowlege 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 is agreed that I (we) will not occLQy said property and will not causo*said property to be occupied til I (we) ve complied with all of the County of Riverside and the State of California governing said prope gqlaws r��. `h v-- SIG4ATURE OF OWNER AND/OR AG �C���! DATE -- Approval by Signature from the Following Departments Listed Below Must Be Obtained Peior to the Issuing of a Construction Permit. ISPACE NO 1951: OF STRUCTURE` JOB ADDRESS - -- INGLE FAMILY DUPLEX Ej LEGAL DESCRIPTION OF PRO,AERTYz�7-- Z F 0 LL_ _Q'A64 ,���"� - APARTMENTS AGRIC, El —_._,5^ _ -- N Q COMMERCIAL INDUSTRIAL ❑ 0 COMMUNITY . Tl� . ALTERA..I�NS LJ 0 Z UA NO. OF SUBMITTED PLANS USE F.PERAIT _S , c rolr CASE NO. C'L� - 0 Z NO. OF PA KING SPACES,REQUIRED _- N0. OF BUILDINGS NOW EXISTING - Q ZONE SETBACKS: FRONT—__ SIDE REAR J Co ' GRADING PERMIT REQUIRED? YES:❑ NO ❑ LOT SIZE SETBACK ORDINANCE I$ OF. FEET REQUIRED ON ozSTREET - DATE—G--�—V, SIGNATLRE OF LAND USE OFFICIA _ --- DEDICATION REQUIRED: YES ❑ NO ❑ NC_ OF FEET_ _ H uZi CURB AND GUTTER REQUIRED: YES ❑ NO ❑ —STREET H oc Q d CAN CURB AND GUTTER FEASIBLY BE INST^LLED? YES ❑ NO ❑ W• 0 HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET" Q IMPROVEMENT? -YES ❑ NO ❑ O °L DATE — _ SIGN4,TURE OF ROAD DEPT. OFFICIAL Z SWIMMING POOLS PUBLIC QW SEWAGE DISPOSAL S 0 FOOD ESTABLISHMENT WATER POLLUTION REMARKS %A FLOOD CONTROL h W AIR POLLUTION W DIV OF HWY 0 a YOUR PROPERTY MAY BE SUBJECT TO _ 'Q •``� FLOOD. RIVERSIDE COUNTY ASSUMES NO RESPONSIBILITY IN EVENT OF FLOOD. 284 199A 9/74 f CANARY—'FILE, PINK—APPLICANT r, 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 exec..• tion of the following applicable declarati m s prior to the issuance of a building permit.- Please print or type and sign below. a [] 'LICENSEES 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 r License No. Date fContractor - Q _ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for'the following reasons: > Q 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. 70.31 .5, B.&P.C:). t ' Q I, as owner of the property, am t?xclusively contracting with licensed contractors to construct the project (Sec..7044. B.&P.C.). 7ElI am exempt under Section B.&P.C. for this reason: Date Owner f Q r 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 t ,_ ' 0 Certified'copy is hereby furnished. Certified copy is'filed with.the •'_ounty of Riverside, Department of Building and Safety. Date i, Applicant �. 0 CERTIFICATE,OF EXEMPTIOU 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 wort for which this permit is issued, I shall not employ any person in any manner so as to become sub,-ect 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. -,ode). Lender's Name Lender's Address DIVISION OF INDUSTRIA_ SAFETY PERMIT CERTIFICATION ®-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, falsevork, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Qhap 3.2, Grp 2, Art 2, Sec 341, Title 8, C.A.C.) [� As owner -builder, I will not employ anycne 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. f� ' Date fIl�;0 pplicant 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- perrty for which I have applied for this permit for the purpose of makiin inspections. or Signature, of Applicant/Agent Date f Print Applicant/Agent Name 284-2000 7/80 1. • F „ L d Ci ' 1 R � • � r • 1 W ♦ } �1 s, eRMir NoRr�rrr DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE MIS: 1463�018- COUNTY OF RIVERSIDE " ` CONSTRUCTION ESTIMATE NO. ` ELECTRICAL FEES NO. ' PLUMBING FEES .1ST FL' '2ND. FL. l POR:• GAR: _ • CAR P. - LL • j ,(22 �%/ /STIM;AT D TRU TION SQ. FT. .@ $ •UNITS, SQ..FT. @ YARD SPKLR SYSTEM SO: FT. @ MOBILEHOME •SVC. BAR SINK POWER OUTLET SQ. FT. ,�@ ROOF DRAINS SO. 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 r WASHER (AUTO)(DISH) APPLIANCE DRYER SMI Fee S.. F' , GARBAGE DISPOSAL FURNACE, ,'UNIT WALL FLOOR SUSPENDED Plan No.. 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.' SO. FT. @' c BATH TUB • SQ.. FT.. @ a WATER HEATER Owner/Agent S0. 'FT. RESID @'1 /aa SEWAGE DISPOSAL Total Fees $ •''\ S0. FT: GAR. @ 3/<a' HOUSE SEWER ' ,,; �.,,. /•_ i,� - �''� 'foniriictor=- • -, GAS PIPING' PERMIT FEE Tel. - PERMIT FEE ` PERMIT FEE DBL: - TOTAL - FEE MOB. HM. FEE n MICROFEE MECH. FEE PL. CK. FEE CONST. FEE t ELECT. FEE SMI FEE FEE PLUM . F E PERMIT NO. 403,0 • Job Address .. t Space Zip Owner - - - - - gq a. . -Ofp.. 'F .C. , IsZ MH Permit Fee S $ �„•,'.. :2 Micro Film Fee - Cop'g U of Ymi - '- " '' ; �.i. cd /S�'G /" 'rg4.• %f �/ l . P e No. _ Use/Case Pfalf -*f- Ck. By Mach. Fee Dbl 5 PI. Ck. Fee - gJ Set ck - Lot Size Construction Fee DbI S ay - Legal Description, ---��yii� ��� a 4. )—, fa' 1 Y, �+ F S S R Electrical fee Dbl g: Zane Restrictions Group Type SMI Fee S.. F' , Plumbing Fee • Dbl $ s and Amt. - Plan No.. Plan• Chei:ker Final f Ins for Unit Sp.'lnsp. Fee g. $ _�// l (Numbers- •' Demol. Fee. $ Const: Lender Branch Supplimental Permit , -• "` Reglstr. Fee g Mileage Fee $ Address + City Zip Witness Fee g Reinsp. Fee- g Owner/Agent Tel.: - Zip Total Fees $ •''\ Address -' Cify - Zip M.O. ❑ N.C. Cosh' heck ❑ ,,; �.,,. /•_ i,� - �''� 'foniriictor=- .. Received by, '"""•'� "� .'J Tel. - License# Trees required Sewage System dd s • Ci - Zip - cz T LL P' ~ THIS PERAKIT SHALL BECOME VOID IF WORK IS NOT COMMENLTE[T WITHIN 120 DAYS. CESSATION OF WORK verified by: Sower District FOR 120 DAYS SHALL ALSO CAUSE PERMIT. TO BECOME VOID. e .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. - `yAZkEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN For. 284.208 (Rev. 1/80) ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.