403762 (BLCK)BUILDING PERMIT rt
PERMIT NO. DEPARTMENT OF BUILDING & SAFETY FIELD DST Z
03762
COUNTY OF RIVERSIDE .
CONSTRUCTION ESTIMATE '
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL.
2ND. FL.
• 'POR.
GAR.,
CAR P.
WALL
✓ -
ESTIMATED CONSTRUCTION
SO. FT. .@ $
UNITS
50. FT. @
YARD SPKLR SYSTEM
SO. FT. @ MOBILEHOME SVC.
BAR SINK
SO. FT. @ POWER OUTLET
ROOF DRAINS
SO. FT. @
DRAINAGE PIPING ,
50. FT. •@ .'7 �,r -•'".i"v
DRINKING FOUNTAIN �
SO. FT. @ f
URINAL L
VALUATION $ e a r
WATER PIPING k
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
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY i
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
ti
AMPERES SERV ENT
SHOWER i.
BOILER B.T.U.
SO. FT. @ a
BATH TUB
r SO. FT. @ a
WATER HEATER
•
S0. FT. RESID @ I V<a -
SEWAGE DISPOSAL _ s
t
S0. FT. GAR @ s/aa
HOUSE SEWER
GAS PIPING ` I
PERMIT FEE `
? c
PERMIT FEE '.
PERMIT FEE
DBL.
TOTAL FEES
MOB. HM. FEE
,MICRO'FEE
t, MECH. FEE
PL. CK. FEE.
CONST. FEE ELECT. FEE
SMI FEE -
•FEE PLUMB. FEE
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
26
27
28
29
29A
29B
30
31
32
Power Pole
Conduit
Service Entrance
Wiring
Grounding Wire
Bonding
Fixtures
Service
Final
ELECTRICAL APPROVALS
SEWAGE SYSTEM SIZE & LOCATION
Pit L. Line
REAR OF PROPERTY LINE
d n
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P/L
P/1
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STREET NAME
PERMIT NO.
./403762
.
Space
MH Permit Fee S
Owner
Micro Film Fee Cop S
Mach. Fee Dbl $
PI. Ck. Fee $
'a
Construction Fee Dbl S
Electrical Fee Dbl $
SMI Fee $
Plumbing Fee Dbl $
- - -
Sp. Insp. Fee S
-
Demol. Fee S
Registr. Fee $
Mileage Fee $
1
Witness Fee S
-
Reinsp. Fee $
Total Fees S
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M.O. O N.C. Cash
Ch ck 7(3
Received by
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Zone Restrictions
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Suppliimennttol Permit Numbers
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THE LAWS OF RIVERSIDE COUNTY- AND THE STATE OF CALIFORNIA. • •• V • ^ .. , S
I • RE - RTIFY THAT TFIEINDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN ^
\�
C ANCE ;WITH SECTION 5541 OF THE BUSINESS• AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. �x
Form 284-208 (Rev. 1/80) � '
NO. I OPERATION I DATE INSPECTOR I NO. I OPERATION I DATE I INSPECTOR
BUILDING APPROVALS MECHANICAL APPROVALS
I I Set Back
Q
33
Ventilation System
2 Ftgs 8 Frms
O.�/J �Q
34
Plenums 8 Ducts
2A Slab Grade
Fire Damper
35
Furnace Comport.
3 Steel
%'(Z " &Li
36
Inlets & Outlets
4 Grout Blocks
�
' 37
Combustion Air
5 Bond Beams
0��3
( 38
Compressor
Final
10A
Fireplace T.O.
,
7
Framing
40
Fire Damper
8
Vents
t
41
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L.
43
Final
10A
Fireplace T.O.
,
°o
ADDITIONAL INFORMATION
r r
11 Exterior Loth !
12 Internal Lath
12A Drywall
13 ! Finish Grade
' INSULATION Thick
R
Value
7A Walls (Batts)
128 Ceiling (Batts)
12C Ceiling (Blown)
14 Final Cyt'
DIIIMRIAIf_ ADDDAVAIt If
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
Owner G�LArchitect -- _ Contractor q�±VQ/— —
Addres 0LA ___ Address--- Address — ---
a' �Jf
City— City--- — City----- — —
Phone Phone _ Phone—
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I (we) the undersigned, hereby certify and acknowledge that I (we) have read the application and agree that if Curb and Gutter, and
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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. 1 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 be occ ied ntil I ) ve
complied with all laws of the County of Riverside and the State of California governing said property.
t
DATE —I rI SIGNATURE OF OWNER AND/OR AGENT
Approval by Signature from the Following Departments Lis B w
Must Be Obtained Prior to the Issuing of a Constructio er t.
I SPACE N0. ,
USE OF STRUCTURE
o['26 O/
ADDRESS
JOB ✓� _l SINGLE FAMILY;KDUPLEX
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LEGAL D ' CRI TIONnj P OPERTY— APARTMENTS AGRIC.El
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L - -Z_7 �:� =fJ !� COMMERCIAL INDUSTRIAL I
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COMMUNITYJ
-L ERA '
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NO. OF SUBMITTED PLANS — USE OF PERMITAll
Q
CASE N 0
. -- ---
Z
NO. OF AP�ING SPACES REQUIRED NO. OF BUILDINGS NOW EXISTING
Z
ZONE_/ SETBACKS: FRONT SIDE REAR
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.'GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE
SETBACK ORDINANCE OF FEET REQUIRED ON STREET
DATE "0�� SIGNATURE OF LAND USE OFFICI
DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET --
W
CURB AND GUTTER REQUIRED: YES ❑ NO ❑ STREET
H
d
CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑
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HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET
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IMPROVEMENT? YES ❑ NO ❑
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Cr
DATE SIGNATURE OF ROAD DEPT. OFFICIAL
I
SWIMMING POOLS PUBLIC
QW
SEWAGE DISPOSAL
_
FOOD ESTABLISHMENT
WATER POLLUTION REMARKS
vt FLOOD CONTROL
H
W AIR POLLUTION
W IDIV
OF HWY
c cc YOUR PROPERTY MAY BE SUBJECT TO
—
Lu FLOOD. RIVERSIDE COUNTY ASSUMES
NO RESPONSIBILITY IN EVENT OF FLOOD.
284 199A 9/74 CANARY—FILE, PINK—APPLICANT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
n.i LISC l':(
OWNER -BUILDER VERIFICATION
y�N1`i9 C40 2 Z.f 3
_ • '
Ha.aress
?JUf GUS Jrn'
tF*.,s,,An."owner-builder"-building permit has been applied for in your name and bearing
�tit�n g1you;r,,,.,ignature..,1; .
_ �.�� tY �';-r' Lr�'• :'1'i ;l�z.'l).i�''1.; U4s: (ti; .1;.%;lr:� „�.r1 C�tE; ,:Cf,� :'sLli7i,i !�
jJ•'C,ci (;:1j(7':,.r;l fi;;Cly Tb' JC:jsG' 't!13 ,::ii i; M1j ''It i.^tJU�:?.'
Please complete'and return this information in the envelope provided at your
earl -i estxo • or.tun:i t ; cto-'awo d unneeessar .dela ,--,i:n , , rocess�,ng, -and issuing your
:.',')'.�f burl di ng .-perm-i t.:,-,_Nof bu.i,l ding permit fwi .1,ibe i ssued,,untiil this' ver, ,fi:cati ons is
received. '
1 . I personally plan to provide the major labor =and 'materfial s'Xfor con-, ^ria `L 1
struction of the proposed property, improvement ,('yes,or-no)'Jt,�V `
^",it arc,e .1'. r,. �� �:> •;
2. I (have/have not)4.141 t signed an application for building permit
for the proposed work. i.�;:;�:fez :zti :,: ; •s..c�, ^
' >'^'C4't'at
3. I have contracted with the following person (fi•rm)' to provide the pro-
posed construction:
Name >'Phou),- :�•t�c ,,:;.",r;c ,J,.rx_sY;<;
Address City
Contractors License No.
L •..
4. I plan to provide portions of the work, but'I!:'haveAired'if ie following'°'
person to coordinate, supervise, and provide the major work:
q:j 1txJs'l';;+iJ —
NamePhone•,,•
• .
Address Cfity, J•;;ra
Contractors License No.
5. I will provide some of the work but I have, con tractedt(htred),rthe`•foT-=a) r;_"
lowing persons to provide the work indicated `Q! '
T ; ' Name Address ' `'"t Ph' ne`Ur4"—Type of work
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.�.•'..{r+.Sc ,. !IC t. .'.ir i..,L - �� a-r3..i.;l }•'7. "Itis .! :i!r9'l ;fit. _% .•
l=%fi I ►,F:r C1 4J`.ht; v - r• ..;, w` r , - .r ar .n '
;• ►: j'.Sc iw ,c.'. _v.; .ig.i.l.; if'-. t• •1 J. .. •sl •,': 4L6 _a'..,1
f�711.rr_ri�.�,Cl.i: ':3�.Ei n....Si.'.11.•c•c ti _:..3L .,i , ,�'• ? ;•
{ p,: i� �. �:z. J.. •,� 1 is xr•.uy;•i ,:L';, ) E. ,k: 1.:ij...l_+.li.,l.i•. :•s:M, U
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coL• ou Znco s , ,-: ;iJ i';i `: J »y. <r..C' ;f!7 _ F i n "tt
s t c? ..r i U ,[, , i t
�-v'i, i1^flf. 13i,+ryi=c!"iiGi.��^•`•"ai:f• if i' 1'':�i :� QR;i.rL .f'i i'•.iir.. `'3.. ., ttr`�l�j`�r?��r'�;�i»,�A. :3t
Cq rpC, J}.. Dr I n Sig..na°tu_re! Prop.e,r..ty�Owner Date'
,•:`Y.'�ri:.l r) - (.+,'.:'"_�`a_i= i.::; '? �ik'k�}.t '!'..�!-ri.i.vr�� :U hr)i, t}•'.uE; 'c';il`.`� .',�7;.i'i�' raJfi i�l1.1 1tii.
Social Security Number
284-2002 7/80 41"14- s'i! i �� 1: ;I:�K1a" { s)',•i
117 9-
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DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
OWNER -BUILDER INFORMATION
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder
of the property improvements specified.
For your protection you should be aware that as owner -builder you are the responsible party of re-
cord on such a permit. Building permits are not required to be signed by property owners unless
they are personally performing their own work. If your work is being performed by someone other
than yourself, you may protect yourself from possible liability if that person applies for the pro-
per permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and, where
required, to have a business license from the city or county. They are,also required by law to put
their license number on all permits for which they apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract,
you should be aware of the following information for your benefit and protection.
If you employ or otherwise engage any persons other than your immediate family, and the work
(including materials and other costs) is $200 or more for the entire project, and such persons are
not licensed as contractors or subcontractors, then you may be an employer.
If you are an employer, you must register with the state and federal government as an employer and
you are subject to several obligations including state and federal income tax withholding, federal
social security taxes, workers' compensation insurance, disability insurance costs, and unemploy-
ment compensation contributions.
There may be financial risks for you if you do not carry out these obligations, and these risks are
especially serious with respect to workers' compensation insurance.
For more specific information about your obligations under federal law, contact the Internal Revenue
Service (and, if you wish, the U.S. Small Business Administration). For more specific information
about your obligations under state law, contact the Department of Benefit Payments and the Division
of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed
to perform their work personally or through their own employees, without a licensed contractor or
subcontractor, only under limited conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "owner -
builder" building permit, erroneously implying that the property owner is providing his or her own
labor and material personally. Building permits are not required to be signed by property owners
unless they are performing their own work personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License
Board in your community,or at 1020 N Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification form so that we can confirm that
you are aware of,these matters. The building permit will not be issued until the verification is
returned.
Sincerely,
DEPARTMENT OF BUILDING AND SAFETY
Leopoldo Rojo, Jr.
Director
284-2001 7/80
PERMIT NO.. t DEPARTMENT OF"BUILDING & " SAFETY ' .FIELD OFFICE Dsr
403762' �COUNT,Y OF RIVERSIDE
/.
CONSTRUCTION ESTIMATE',',. ,:.:
NO, ELECTRICAL FEES '' "
NO. PLUMBING FEESZ',
IST FL.
' 2N6. FL.
POR.
GAR.
CAR P: �
' WALL •
,ESTIMATED CONSTRUCTION
SO. FT. @ $
UNITS
.. - :.
-
o�
SO. FT, @ • -
YARD SPKLR SYSTEM �, _s •.
SO.'FT: •@ MOBILEHOME SVC.
BAR SINK -
SO. FT. @ • POWER .OUTLET
ROOF DRAINS
SO.' FT. @ �
DRAINAGE PIPING '
SO. FT. @ , 75—DRINKING 42—
FOUNTAIN
SO. FT. •@ " `•" '' -
URINAL.
VALUATION $ Q' i
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
F -
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR.," SUSPENDED -
R
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
BATHTUB
Sp. Insp. Fee $
SO: FT. @ a
WATER HEATER'
<
SO. =FT. •RESID @ 11/4a
SEWAGE DISPOSAL
} `
S0. FT.,GAR @ 3/4a
HOUSE SEWER
Address City Zip
Witness Fee g
Reinsp. _Fee g
GAS PIPING
PERMIT FEE
Tel. -
44
PERMIT FEE
PERMIT FEE
DBL. -
TOTAL FEES
MOB. HM. FEE
MICRO FEE MECH. FEE
PL. CK. FEE
CONST. FEE ELECT. FEE
SMI. FEE
•FEE ` PLUMB. FEE �.
- _..
- PERMIT NO. -
403762
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et Backs
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Construction Fee Dbl g
Legal Description
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'Electrical Fee'- Dbl S `
Zone Restrictions
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Group
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SMI Fee r S
Plumbing Fee Dbl $
13ond Amt.
g
ort No.
IanChecker
Final Dote
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Unit ,
Sp. Insp. Fee $
Demol. Fee S
Const. Lender
Branch r --
'
Supplimental Permit Number,.
Reglstr. Fee g
Mileage Fee S
Address City Zip
Witness Fee g
Reinsp. _Fee g
Owner Agent
-
Tel. -
44
Zip
Total Fees. S
Address '
City -
-
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M.O. C3 N.C.0 Cosh 5KCheck Ej
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-7 LL P Inta rCKMt1 bNALL Ntt-UMI: VUIU IF WUKK R, NUI CUMMENCED. WITHIN 120 DAYS. ,CESSATION OF WORK, vers@ed by:
Sewer District FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. ;.r• }t
•1 HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH 11
• THE LAWS OF RIVERSIDE COUNTY AND THE'STATE OF CALIFORNIA: • - " .< "
- ERTIFY THAT THE INDIVIDUAL WHO PREPARED +THE„ PLANS AND SPECIFICATIONS HAS DONE SO IN�
Form 284.208 (Rev. 1/80) ACCORDANCE WITH SECTION.5541 OF THE BUSINESS'AND PROFESSIONS CODE OFeTHE STATE OF CALIFORNIA.