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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 i P/L P/1 ,i 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 •/^s� M.O. O N.C. Cash Ch ck 7(3 Received by Use/Case No. Trees Ck. By .7 Sewage System �j+Y a..W✓"fir, T LL P ess Space Zip Owner • 'a y g - - - alien - Dote 1 r mit Parcel No. Use/Case No. - - ` Ck. By .7 Lot Size •�h cription F S I R - y ' Zone Restrictions Group Type " len N Final re - Inspector Unit ti -rX rlan-Checker r ,der Branch Suppliimennttol Permit Numbers 9 • city zip , f '""`•fit / s gent ss16 F Tel. Zip • W :C/`•" �/ Ciry. �.� Zip u�- Tel.' ••J"' - Llcensest + - • r City .. Zip 4. 'v 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— W I (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. 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 Z LEGAL D ' CRI TIONnj P OPERTY— APARTMENTS AGRIC.El Zi � 0 U. � Q L - -Z_7 �:� =fJ !� COMMERCIAL INDUSTRIAL I '^ COMMUNITYJ -L ERA ' C Z 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 J m .'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 ❑ Lu HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET Q IMPROVEMENT? YES ❑ NO ❑ O 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 _,� ;1.4r:; �.�;,,, T .�.•'..{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 'UG7t 9 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- D 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 �•„t_-;�! e.+r: `" : . Vob;Ad-dress.r. - �- -_.. .'... �,:. •.: _' _ ,.r _ - -•" - _-...Space ,f 1 '3ip --"`_ .. z.z � Owner .- .. - :. - o� Community , 01 g o // // Dist. F.C.*C�. . ,y r MH Permit'Fee . Micro Film Fee Cap S ,Use of P &mit IParcel No. w ,Use/Gose .No. Ck. By Mech. Fee Dbl Pl. Ck.Fee' S et Backs Lo Size ' " Construction Fee Dbl g Legal Description < •` - y _1'� < +1T oSGvL�•L F - S S R 'Electrical Fee'- Dbl S ` Zone Restrictions _ Group Typa t SMI Fee r S Plumbing Fee Dbl $ 13ond Amt. g ort No. IanChecker Final Dote �� _//•- `/ Insp - 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 - - '. Zip M.O. C3 N.C.0 Cosh 5KCheck Ej Received bye " �^^ � f Con actor ' - Tel. '. - - + Licisns.9 •. -1 Trees red?r Sewage System qAA ` i Address • Ci<y , .�. Z'P. i{ � < - • -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.