Loading...
47252 (PLBG)PtHMII APYLIU-ATION County of Riverside h• Department of Building and Safety !ar Aw ;. - 4080 Lemon -S}. 2nd Floor 135 N. Alessandro Ptl. Rm. 203 860 N. Slate Street 227 North "0" Street 46.209 Oasis SL Rm. 310 160 M.Bro�IwaY Riverside. CA92501 Banning. CA 92220 Hemet. CA 92343 Perris. CA 92370 Indio. CA 92201 : .91)7he SA; 92225'- Ph: 787.6146' Ph: 8497312 Ph: 658.4464 Ph- 657-3898 Ph: 342.8271 "RPh: 922.2670 1 k This permit becomes void if work not commenced within 180 days Irom date of issuance. OR. il,work has been suspended or abandoned for a period of 180 days. t - ❑ CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be corn -;- LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commenc- pleted if the permit is for one hundred ($100) or less. I certify that in the performance of the work for who -h this.. ing with Section 7000) of Division 3 of 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' Corla3ensa-'9 1 tion Laws of California. " Date Applicant 4, ' OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law for the NOTICE TO APPLICANT: If, after makingthis Certificate of Exemption. you should become subject to the W rrkers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or This permit shall be A. following reason (Sec. 7031.5. Business and Professions Cade: Any city or county which requires a permit to con- deemed revoked. 1f strucl, alter, improve. demolish, or repair any structure, prior to its Issuance, also requires the applicant lot such 1) JPHONE# . permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is ex- -� 01 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descer d. will empt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a per- 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, fall;work, " or demolition dr.dismantling thereof. will be more than thirty-six (36)feet high. (Chap. 3.2. Grp 2. Art 2. Sec 341. ❑ 1, as owner. of the property, or my employees with wages as their sole compensation, will do the work, and the Title 8. C.A.C.). structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License []As owner -builder, I will not employ anyone to do work which would require a from the Division of In - Law does not apply to an owner of properly who builds or improves thereon, and who does such work himself or permit dustrial Salety. as noted above. unless such person has a permit to do such work from the division. through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of piov- C] Division of Industrial Safety Permit No. ing that he did not build or improve for the purpose of sale.) I NC Of, as owner of the property, am exclusively contracting with licensed contractors to construct the project(Sec. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the aerfor- 7044. Business and Professions Code: The Contractor's License Law does not apply to an owner of property who mance of the work for which this permit is issued (Sec. 3097. Civ. C.). builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Con- Lender's Name I tractor's License Law.) Lender's Address ❑I am exempt under Sec. BA P.C. (Attach Certificate). LOT SZ - Date Owner CERTIFICATE OF COMPLIANCE AND AUTHOR "ATI �ENTRY:' I certify I have read this application and state -} that 1h¢ information given is Correct. I "Q'E to Omply with all stale laws and county ordinances relaing t0 •; WORKERS' COMPENSAT16N DECLARATION: I hereby affirm that I have a certificate of consent to sell•insure. ora building construction, and authorize a re FBsenl Ive of the County of Riverside. Department of Building ant Safety tooeenter up he fo c ave ap If for this lot the inspe +certificate of Workers' Compensation Insurance. or a certified copy thereof (Sec. 3800. Lab. C.). property permit purpose of making liorc. ` ifII I QCertified copy is hereby furnished. /�� `���` ,A " I v 7 ""'�--�_ ' ❑Certified copy is filed with the County Building Inspection Department or County Department. Signature of Applicant. Age 1 Date �r -� 1 a." APPLICANT NAME (L, F. MI) F L'La) ' C,a' I, SANDBAR M180 CALLS TAMPICO L: fF7coryg4}fy(pATprE/ZIP CA 922530000 ;49U JE4QQIRESSISPACE CALLS AMP ICO i UU i'i' :gITKr�cor,�gt1'ul AITAIZIP CA 922530000 �l.Q9uullWVS. �g P14c,. `0 'fib ft 116 bi T"goN7,4-,NW �� r�Qg �j d SB ##��,,..++ q /LOT TRACT) / i 1`W .{ / ".i 1) JPHONE# CONTRACTOR -FIRM NAME LICNC If ADDRESS CITY/COMMUNITY/STATE/ZIP PHONE i BLD PECT i o�7_ FINAL DATE d -z ARCIENG FIRM NAME LICNC i ADDRESS CITYICOM MUNITYISTATEIZIP PLAN It PLANS EXAMINER APPROVE DATE {i3Af/FITn1li ViHaW I NC FSB n �b L%Styo 0`6b . YND ZONE ORD r1 LOT SZ END 0 01"h A„PPUPhRMT 0 q IPP 0002681 PP .y O DyATE 47252 b l/� I / 8 PLUMBING FEE $14.50 S TOTAL FEE « CA I CKXt I NC COUNTER B.I. 1.,�.f ��// COUNTER L.U.T. �7 P L U M B) N C P C R M I T TOTAL PERMIT COST IS $14.50 PLOMPINC FEE COMPUTATIONS * Permit Fee (if applicable) raze Sewage Disposal -Newt 1 Old 0 f .FORM 284.208 (11.81) INSPECTOR 47252 F'E'E: t $4.00 FEE f $10.50 NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Figs & Frms 34 Plenums 8 Ducts 2A Slab Grade 35 Furnace 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 10A Fireplace T.O. 0 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 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 D Tank Pit ` L.Line REAR OF PROPERTY LINE P/L P/ ELECTRICAL APPROVALS 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final STREET NAME Z O U W N IVIS U Z O H U W N RIVERSIDE COUNTY DEPARTMENT OF HEALTH APPLICATION FOR PERMIT TO INSTALL A RESIDENTIAL SUBSURFACE DISPOSAL SYSTEM Applicant: Submit this form with three copies of a scalec plot plan drawn to the specifications required on the attached check list. A non refundable filing fee of $15 is required wl en the application is submitted. Check must be made payable.to County of Riverside. Name d ���>fti��. Mailing Address City State Zip Code Phone ,q I v P - '-6 t/ 'Property Address 'City or Community a 'Legal Description of Property � 'Assessors Parcel No. Water Serving Property, From �� �l�r, �, �� . A �n Signature of,/Applicant `�" 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 ❑ PJo ❑� ��' y� ��� Detailed boring report required Yes Q No ❑' '� �� Detailed contour plot required Yes ❑ No-ml- o-0lSoils Soilsor boring report by Date Approved by Date Soils Map Page Soil Type Tract File No. Other ems, Number of-Bedroorms l�Vitn �dn d�c, �r�e'ra�y Septil Tank Size (gallons) �`r�6 X25/ y ,s'd Rate Required (sq. ft./100 gal or gal. sq. ft./day) ` :,? , ) E f 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 `",Ci" �i•y� �� mfr;-,i,w,.gs�2 ' � A permit is,a proved/den.iedfor the installation of a subsurface disposal system as indicated on the accompanied plot plan using fh equirements set forth in Section C above. v , Signature of Health Official Date Y qr Receipt No. 2 Issued By / A,� District: Riverside ❑ Indio ❑ Hemet ❑ Date !i -?A �/ �� DISTRIBUTION: WHITE - Office File YELLOW - Applicart PINK - Building Dept. GOLDENROD - Attached to Plans DOH SAN 122 (New 10/81) ' ni Z O H U W N m Z O H U W rA fvjF.j Receipt No. A .3� a 7 Issued By District: Riverside ❑ Indio 0", Heme; ❑ Date � r DISTRIBUTION: WHITE - Office File YELLOW - Applicant PINK - Building Dept. GOLDENROD - Attached to Plans DOH SAN 122 (New 10/81) 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 :o County of Riverside. Name «1.79,0Y iS (f vc �%L,,. Iro SAA/o 64A Mailing Address Pd. 6Y Glz I,A ,�; S City J State Zip Code Phone 'Property Address iF3 12c, OA i �� —r,nu, 'City or Community C f 'Legal Description of Property S�ti, /t/&A Yu r. 6 S, 2. 7-15-- - p� � ...� .6 'Assessors Parcel No. 5 C3d-G/7- Water Serving Property Frorn'7 .... /? Signature of Applicant "'\ Date 'The above information must be verified from Building Application - Staff Use — Do Nat Write Below This Line Initial Date Soils feasibility report required Yes ❑ ho ❑� (fin. off !6/1 c/r, d � Detailed boring report required Yes ❑, ho ❑' Detailed contour plot required Yes ❑ No .� Soils or boring report by Date Approved by Date Soils Map Page Soil Type Tract File No. Other `Nurribereof-Bedrooms X� r V-1,1.vr /4 Mt�O.,li A001 rl <Se tie*aK Size (gallons) p (9 ) (j /L,r:'st T E Trt n � Rate Required s ft./100 al or al. s ft./da ) q (q• 9 9 q• Y (385rn V14001`41111 -'j 7s'L C�1c , 2 , o •� a le's Leach line sq. ft. of bottom area trench Leach bed (sq. ft. of'bottom area bed) Seepage Pit/Diameter l� �i Seepage Pitt Vertical Feet ac� r� •/ 61 " r� Number of Seepage Pits - Maximum Depth of Pit Location of System to Additional Requirements %'.P.c.i�.�`q �.�D }RB.LJ tiu C�X�•. t/QAaC iL�t�-=c.'Ysy��J.cz�lc�crn A permit is approved/`denied•for the installation of a subsurface disposal system as indicated on the accompanied plot plan using the requirements set forth in Section G above.' All 4 - Signature of Health Official Date, C Receipt No. A .3� a 7 Issued By District: Riverside ❑ Indio 0", Heme; ❑ Date � r DISTRIBUTION: WHITE - Office File YELLOW - Applicant PINK - Building Dept. GOLDENROD - Attached to Plans DOH SAN 122 (New 10/81)