413805 (PAT)BUILDING PERMIT —
PERRMMIT NO. DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
DST
11413 O 0 5 COUNTY OF RIVERSIDE /
CONSTRUCTION ESTIMATE
NO. ; ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL.
2ND. FL.
POR.
GAR.
CAR P.
WALK A
S—C,
ESTIMATED CONSTRUCTION
SO. FT. @ $
UNITS
Date //��
/ ; ✓/
SO. FT. @
YARD SPKLR SYSTEM
SO'. FT. @ MOBILEHOME SVC.
BAR SINK
SO. FT. @ POWER OUTLET
ROOF DRAINS
SO. FT. @
DRAINAGE PIPING
SO: 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
WASHER (AUTO)(DISH)
APPLIANCE DRYER
Plumbing Fee Dbl $
_GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
Pion Checker
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. @ 4
BATH TUB
SO. FT. @ a
WATER HEATER
City Zip
S0. FT. RESID @ 1 t%c
SEWAGE DISPOSAL
/(7ofr%
�f G+ . V-•�!/,f/! •'J
S0. FT. GAR @, 3/44
HOUSE SEWER t
Trees re
Se a System
�J
'Address
GAS PIPING
f
PERMIT FEE
PERMIT FEE
PERMIT FEE +
DBL.
L4�
MOB. HM. FEE
MICRO'FEE
MECH. FEE PL. CK. FEE
-
CON$At E ELECT. FEE
�7 -I-,
SMI FEE
'Osl
FEE PLUMB. FEE
PERMIT NO.
4138 0 5
lob Add, Spac Zip
2,7 /" O / ��
17 Pr 4rr(/ (.i �� ,�c� 'S
Owner
SCo�rT
Communitny
�7/ ��(�•' �"
alua ion QG
$
Date //��
/ ; ✓/
/D''�tt
/ /
Off.
F.C.C.
01/
MH Permit Fee $
Micro Film Fee Cop $
Use o Permit
j/
Parcel No.
Use Cose No.
/
Ck. B
Mech. Fee Dbl $
Pi. Ck. Fee S
Set Backs
Lot Size
Construction Fee Dbl S
Legal Description /
J % �G� / X,2
F
S SIR
(/
Electrical Fee Dbl $
Zone Reesyyytrict' s
Group
Type
SMI Fee $
Plumbing Fee Dbl $
Bond Amt.
S
Plan No.
r13
Pion Checker
Final Date
—2
Inspector
Unit
Sp. Insp. Fee 5
Demol. Fee $
Const. Lender Branch
Supplemental Permit Numbers
,
Registr- Fee $
Mileage Fee
Address � �
City � t Zip .
I
Witness Fee . - 4 �
Reinsp. Fee $ (
,Owner gent
f
Tel. Zip
Total Fees $
Addre �
r
City Zip
M.O. Q N.C. Q Cash Q Check
Received bContr
y
/(7ofr%
�f G+ . V-•�!/,f/! •'J
Tel.
7 � �.
LL''��cJan y//�
✓ g7
Trees re
Se a System
�J
'Address
City � - Zip
T LL. '�7 p THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS, CESSATION OF WORK verified by:
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
�7 THEE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA.
G/C/f_�/•f�'y'^SE CE"HAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
Form 284-208 (Rev. 1/80) A A CE WITH SECTION 5541 OF TFE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
DUILUIrAv rcxmii ,
PERMIT No. DEPARTMENT OF BUILDING & SAFETY FIELD DST
4 13 8 05 COUNTY OF RIVERSIDE ,I
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEE5 i
1ST Fl.
2ND. FL.
POR.
GAR.
CAR P. -
WALL + s
:JG s' /� Ab
ESTIMATED CONSTRUCTION
SQ. FT. @ $
UNITS
�t
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. @ 1! si:
URINAL
VALUATION $ —•
WATER PIPING
NOTE: Not to be used as propetty tax valuation
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
,VENT SYSTEM FAN EVAP. COOL HOOD
SIGN
WASHER (AUTO)(DISH)
h
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
Gro/up
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. @ a
BATH TUB
'
SQ. FT. @ a
WATER HEATER
'Address ? City Zip
50. FT. RESID @ 1 t%a
SEWAGE DISPOSAL }
$
S0. FT. GAR @ Y44
HOUSE SEWER y
Zip
GAS PIPING
PERMIT FEE
PERMIT .FEE
PERMIT FEE J
DBL
pTQTV3
MOB. HM. FEE
MICRO'FEE
MECH. FEE PL. CK. FEE
C�ONyF, E ELECT. FEE
SMIFEEE`
FEE PLUMB. FEE
T LL r 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 ACCORD'ANCE.WITH
P THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. �'
_ C�Ejj6i1«T'HAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS,HAS d E SLO IN
Form 284208 (Rev. 1/80) �A�j WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THEiSTATE'OFICA1IFORNIA.
verified by:
��A
�,
"
Job Addre - -- ,, Spec Zip
� �-'��� �-��- kr/
-Owner
PERMIT NO.
413 8 0'51*..
Communiitty
�V / �`
oluotion
$
Dote
/DD''st.,
.I /
Off.
r ,N,:d4'[
F.C.C.
1
MH Permit Fee S
Micro Film Fee
Cap S
Use o Permit j�
Parcel No. Or
1 f
Use/Case
No.
Mech. Fee Dbl $
Pl. Ck. Fee $
Set Becks
Lot Size
Construction Fee Dbl S / r..
Legal Description r
��✓��1�'�•'. !(> �` / 4
000JJJ
F S /'�'7 S^7
/_`
(y �
ye�
Electrical Fee Dbl S
Zone Rgggstricti s
/,
Gro/up
Type
SMI Fee S ,�
Plumbing Fee
Dbl $
Bond Amt.
$
Pion No.
Plan Checker
Final/D.2!G!� � Spector
v
,_
leg
Unit O
-
Sp. Insp. Fee $
Dental. Fee
$
Const. Lender Branch
Supplimentol Permit Numbers
'
Registr. Fee ? $
Mileage Fee 'i $ ,` /'Address
'Address ? City Zip
Witness Fee $
Reinsp. Fee
$
Owner/ gbenr. ( ,r f R
--2'\/)!% PAIJL+J S7 �„
Tel.
Zip
t.
Total Fees
S !
Address �^'
r
City
Zip
M.O. E] N.C. ❑ Cosh Check
Received by
Contr or
Tel. �'n
L' In
Trees rem
Se e 5y stem
rn�
• ° t,l V
'Address
//
�� '..• eft` �1.�7f �(9 "oZzllf7
City
Zip
T LL r 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 ACCORD'ANCE.WITH
P THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. �'
_ C�Ejj6i1«T'HAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS,HAS d E SLO IN
Form 284208 (Rev. 1/80) �A�j WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THEiSTATE'OFICA1IFORNIA.
verified by:
��A
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE s�
''INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
Z �^
33
Ventilation System
2
Ftgs & Frms
jr2 -7- ^ V
a
34
Plenums & Ducts
2A
Slob Grade
_ 7 7
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 n
10A
Fireplace T. 0.
°o
_______��.a_.
ADDITIONAL INFORMATION
__._._.__-__._.�,_.__._
t
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
T PLUMBING APPROVALS
15 Ground Plumb
16 Water Piping
17 Rough Plumb
18 Vents
IF 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
P/L
P/
r `
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
n
r
14a-- LCG
m 151. F-socso
e
r'
F; LNJ
7,3- 3:30..:-rAK4r7l(,V., Lel :.il�.l .�'"`�•'`
OME REAR YARD
--------SOT AREA ---PARKING
a ------DATE RECORDED — rd OAG
-- _FRONT YARD �dzpT BLDG.
% a?_SIDE YARD OF LOT COV'D. 1
1--=a6.UKTE
—SES'
A, 1 10VED BY:-
LAND
Y:LAND USE DIVISION
14a-- LCG
m 151. F-socso
e
r'
F; LNJ
7,3- 3:30..:-rAK4r7l(,V., Lel :.il�.l .�'"`�•'`
OME REAR YARD
--------SOT AREA ---PARKING
a ------DATE RECORDED — rd OAG
-- _FRONT YARD �dzpT BLDG.
% a?_SIDE YARD OF LOT COV'D. 1
1--=a6.UKTE
—SES'
A, 1 10VED BY:-
LAND
Y:LAND USE DIVISION
f�J '
I
13 zi-Av
i .3 to 10
i m i m x dpi
ta, 01
}A� 6
—1
' J1 j � � f. lig m ... . _.... �. •
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.
in
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II -Tai,
I t - rc-i Fac, T�xn of 1c)1
y I • ' -
COUNTY OF�-RIVERSID®
•
DEPARTMENT OF
BUILDING & SAFETY
` APPRO
Approval of these plans shall of be cans}rtr' r
e permit for, or an approval of, any violation `fy�to b°
fhe rovisions of the state or county laws. TPPigt of
f �oPans must be kept on the: iob until. Somoilm" S
X
NOTICE: THIS IS NOT A BUILDING PERMIT
APPLICATION TO CONSTRUCT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
DISTRICT
Permit No
284 199 9/70
CANARY—FILE, PINK—APPLICANT
.vera
Owners rh _ '7 .Architect Contractor'- �- t a +✓.?'! 1
Addressl; " 7, -' S'tJt AAddress Address
CityL,1 �,�y ){ i -(ti\. (.-4 City— City -
Phone Phone Phone - - —
W
1 (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 is agreed that I (we) will not occupy said property and will not cause said property to be occupied until 1 (we) have
complied with all laws of the County of Riverside and the State of California governing said property.
DATE SIGNATURE OF OWNER AND/OR AGENT
Approval by Signature from the Following Departments Listed Below
Must Be Obtained Prior to the Issuing of a Construction Permit.
U ISPACE NO.
1 USE OF STRUCTURE
JOB ADDRESS �- �' �
1� N IG FAMILY\] DUPLEX
>-
Z t-
0
LEGAL DESCRIPTION OF PROPERTY"r `
/ �+ /�� APARTMENTS AGRIC. El
H ul:'^
42z !' COMMERCIAL INDUSTRIAL n
U %
Z
COMMUNITY �V / r ��
NO. OF SUBMITTED PLANS --_ USE OF PERMIT Si�iC� l� %�EC-./lJ pTC ALTERATIONS []
CASE NO. PI) e.4 4=- X
C Z
NO. OF P KING SPACES REQUIRED NO. OF BUILDINGS NOW EXISTING ---
J
ZONE SETBACKS: FRCP T SIDE REAR ��e-
m
GRADING PERMIT REQUIRED? Y;ffES ❑ NO ❑ LOT SIZE '
G
SETBACK ORDINANCE II ! OF FEET REQUIRED ON REET
DATE SIGNATURE OF LAND USE OFFICIALrj 042 0 _
t—
DEDICATION, REQUIRED: YES ❑ NO ❑ NO. OF FEET__—.
CURB AND'tGUTTER REQUIRED: YES ❑ NO ❑ STREET
W
CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑
HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET
IMPROVEMENT? YES ❑ • NO ❑
at
DATE _ SIGNATURE OF ROAD DEPT. OFFICIA1
_
SWIMMING POOLS PUBLIC
QW
SEWAGE DISPOSAL _
FOOD ESTABLISHMENT
•
_
0.
~
/�
WATER POLLUTION R K S
,FLOOD CONTROL
AIR POLLUTION
.
W V '
DIV OF HWY r
YOUR PROPERTY MAY BE SUBJECT TO
FLOOD. RIVERSIDE COUNTY ASSUMES
NO RESPONSIBILITY IN EVENT OF FLOOD.
284 199 9/70
CANARY—FILE, PINK—APPLICANT
DEPARTMENT OF BUILDING AND SAFETY APPLICATION CERTIFICATE
COUNT, OF RIVERSIDE PERMIT N
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:
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 lass S I _�� Licen.e No. 3 ��/ ��
Datek-[�4A)-� `/ Contracto e7 -h^ 1e / / �S� e- itrJVX� _ Y4
1UWNtK-8U1LULR UELLAKA11UN
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.).
[�
I. as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec. 7044, B.&P.C.).
Q 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).
Policy No. Insurance
0 Certified copy is hereby furnished.
EJ 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 wox_k�or which this permit is issued, I shall not employ
any person in any manner so as to become/subject to a Worr!prs' CompepsationAws of California.
I further understand that if after ma 'ing this rti it t�e//Of Exempt/ion, I �shoul become subject to
the Workers' Compensation provisions of the labgr c1de I m st f rthwith c mply 9th such rovisions
or this ,p�rmit shall
be deemed .revok d.
Dated uA� ) 2499 tW 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.
[] Division of Industrial Safety Permit No.
Date Applicant
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY
I certif I havp_,read tpis•application and/state that the information given is correct. I agree to
comply w 'th all stateaws and county ordinances relating to building construction, and authorize a
representative of, the County of�Rj4ersi e, Department o Building and Safety to enter upon the pro-
perty,ofor which I. hav applired for thi permit forlthe purpose of making inspections. ,,
�_V9 .
/ A � l 4a/
• _ignature of ADDl scan gent j Date i..'
•' � � T l_ �`fQc3400 \ n4
r nt pplicant/Agent Name -
284-2000 7/80