426879 (ELEC)BUILDING PERMIT
PERMIT NO.
426879
CONSTRUCTION ESTIMATE
I ST FL. SQ. FT. @ $
2ND. FL. SQ. FT. @
POR. SQ. FT. @
GAR. SQ. FT. @
CAR P. SQ. FT. @
WALL SQ. FT. @
SO. FT. @ Q@ $
ESTIMATED CONSTRUCTION VALUATION
NOTE: Not to be used as property tax valuation
MECHANICAL FEES
VENT SYSTEM FAN EVAP. COOL HOOD
APPLIANCE DRYER
FURNACE UNIT WALL FLOOR SUSPENDEE
AIR.HANDLING UNIT CFM
ABSORPTION SYSTEM B.T.U.
COMPRESSOR HP'
HEATING'SYSTEM FORCED GRAVITY
BOILER B. T. U.
PERMIT FEE
DBL. TOTAL FEES
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
NO, I ELECTRICAL FEES
UNITS -
MOBILEHOME SVC..
POWER OUTLET
SWIM POOL, PVT
SWIM POOL, COMM
SIGN
IDLE METER
TEMP USE PERMIT SVC
POLE,TEMP/PERM
AMPERES SERV ENT
SQ. FT. @ C
SQ. FT. @ C
SQ. FT. RE SID @1 1AC
SQ. FT. GAR @ 31A t
PERMIT FEE
HM. FEE MICRO FEE MECH. FEE PL. CK. FEE I CONST. FEE
FEE
V
FIELD
PLUMBING FEES
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER (AUTO)(DISH)
GARBAGE DISPOSAL'
LAUNDRY TRAY
KITCHEN SINK
WATER CLOSET
LAVATORY
SHOWER
BATH TUB
WATER HEATER
SEWAGE DISPOSAL
HOUSE SEWER
GAS PIPING
PERMIT FEE
SMI FEE I 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 C7reQ
ELECTRICAL APPROVALS
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
SEWAGE SYSTEM SIZE & LOCATION
Tank Pit L. Line
REAR OF PROPERTY LINE
�a
P/L P/L
s
STREET NAME
PERMIT NO.
I42-6
Job Address •- v Space
Zip
Owner
10 P PIC,
Community
Valuation
Dote,
V
Qisi.
Off.
F.C.C.
MH.Permit Fee' $
Micro Film Fee Cop $
Use of Permit -
a., `� rJ � �
Parcel No.
r"' /S
Use/Case No.
Ck. By
Mech. Fee Dbi $
PI. Ck. Fee $
Set Backs
Lot Size
'
Construction Fee Dbl $ "
Legal Description •' `
.. f �•.., I, /�!j ;,,_fit•
fi ,.1 -f� "1 v V llir 4.."' fl`...
F
aj
S
��
S "sr�
R ,.,
Electrical Fee Dbl$ .�i:�
Zone Restrictions
-�`
Group
Type
SMI Fee $ -
Plumbing...Fee Dbl $ Al/ i ,r�
Bond Amt.'
$
Plan No.
Plan Checker
`�
FFii(�I Date,/
`s�
In-�^e-ctorr _
``�'�✓
Unit.
Sp. Insp. Fee " $
Demol. Fee* $
Const. Lender -. Branch
Supplimentol Permit Numbers
-
Registr. Fee $
Mileage Fee $ ,
Address City - Zip
Witness Fee $
Reinsp. Fee $
Owner/ en( ..
�
Tel. Zip
Total Fees $ �; !"7
r
Ad�%ss S •�L
! -
Ciry Tp Y,•
M.O.-] N.C. Cash Check
Received by �.�
Contracior
��;�, / � � , .(��.-•�j. A„/ •�.�...
Tel. - '
License#
'
Trees required
Sewage System -
T LL P`
Address" + a
City
THIS PERMIT SHALL BECOME'VOID IF WORK IS NOT COMMENCED WITH IN'120 DAYS. CESSATION OF, WORK verifiQl by:
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. COUNTN�-AND,TH€i STATE OF. CALIFORNIA.,,: t;
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
ACCORDANCE WITH SECTION 5541 OF THE BUSINESS 'AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
Sewer District
NO.
OPERATION
DATE INSPECTOR
NO.
OPERATION
DATE INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
1
Set Back
,��
33
Ventilation System
i
2
Ftgs 8. Frms
34
Plenums & Ducts
2A
Slab Grade
35
Furnace Comport.
3
Steel
36
Inlets & Outlets '
4
Grout Blocks
37
Combustion Air
00-1
5
Bond Beams
�// ��l J
38
Compressor
6
Roof Deck
39
Appl. Clearance
7
Framing
40
Fire Damper
8
Vents
41
Smoke Detection DBvice
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace
P. L. C
43
Final
1 1-
10A
Fireplace
T. 0.
ADDITIONAL INFORMATION
11
Exterior Lath
NO.
/�,(, Cll/ ���` 7-101v k —�
(�
12
Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts)
12B Ceiling (Batts)
12C Ceiling (Blown)
14 I Final
,rY� p'tt
PLUMBING APPR"'
NOT:CE: THIS IS NOT A BUILDING PERMIT
APPLICATION TO CONSTRUCT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY dF RIVERSIDE
b
DISTRICT + /
J
Permit No
284 199A� 9/74 CANARY—FILE, PINK—APPLICANT
G p.C/ f�L� u�i� Gi/F�'�✓ .
Owner C f/r Architect Contractor
�7 yG ���UAddressj�%���/y �� Address����d
Add —
City_ ��/ City_
Phone S':;2 -1s1 17/-�fPhone 3 ^ -2, 2-e)
_ PhoneD
cc
I (we) the undersigned, hereby certify and acknowledge that I (we) have read the application and agree that if Curb and Gutter, and^
W
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 R/
O
zthCounty
without an encroachment permit.
NOW, therefore, it is agreed that 1 (we) will not occupy said property and will not cause said propert o.be occupied I have
complied with all laws of the Countv of Riverside and the State of California governing said property. ,
O /
DATE SIGNATURE OF OWNER AND/OR AGEN
Approval by Signature from the Following. Departments Listed Below
Must Be Obtained Prior to the Is of a Construction Permit.
-suing
V� C. C..G.- V SPACE N O.
Ts(�
p�j�f �.IJ ���• ��� USE OFZUCTURE
JOB ADDRESS --_.—_ I -
--'-�� v� y SINGLE FAMILY DUPLEX
Z
LEGAL DESCRIPTION 8 ROPERT �� v _
!�%/ ��Oek � tr— APARTMENTS � AGRIC.
O LL
in a
--'— COMMERCIAL INDUSTRIAL n
V 1
>_
C
COMMUNITY ` �--1
/) ALTERATIONS LJ
Z
USE OF PERMIT NO. OF SUBMITTED PLANS -
,^
CASE NO.
Z
NO. OF�ARKING SPACES REQUIRED -- _ -- N0. OF BUILDIN SNOW EXISTING
f s
SETBACKS:
Q �
ZONE FRONT s SIDE — REAR
J m
GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE
SETBA/C_K ORDINANCE # OF FEET REQUIRED ON STREET'
V 36 _,/
DATE SIGNATURE OF LAND USE OFFICIAL _ --
DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET-_
W
CURB AND GUTTER REQUIRED: YES ❑ NO ❑ STREET
ccH
a
CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑
W
HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET
'
Q
IMPROVEMENT? YES ❑ NO ❑
O
o�
DATE SIGNATURE OF ROAD DEPT. OFFICIAL
S
SWIMMING POOLS PUBLIC
F
JW
SEWAGE DISPOSAL
_
FOOD ESTABLISHMENT
WATER POLLUTION REMARKS
s
rn FLOOD CONTROL
t—
W AIR POLLUTION
V° DIV OF HWY
YOUR PROPERTY MAY BE SUBJECT TO
n"` FLOOD. RIVERSIDE COUNTY ASSUMES
NO RESPONSIBILITY IN EVENT OF FLOOD.
284 199A� 9/74 CANARY—FILE, PINK—APPLICANT
,' a:rv..swwtwsrST+r'•�. ..:C.,e°'n,�_.-w"'..y!3.Y w'" ,t�..Frw++��-s. '(::""Y7 7do�va..:9 "'9r *. �'fWHd•3"r "{x4{.;i:
DEPARTMENT OF BUILDING AND SAFETY, APPLICATION CERTIFICATE
COUNTY 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•' s
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 Class C_Gj_.W1 SSC 4C1.•L4 I License No. a.9
Date' 2,(-, ontractor .
[� y 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. 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.).
[� 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.
Certified copy is filed with the County of Riverside, Department of Building and Safety.
Date Applicant
CERTIFICATE OF.EXEMPTION FROM WORKERS' COMPENSATION INSURANCE
r (This section need not'be completed if permit valuation..is for $100+'00 or less.) j
I certify that',in 'the performance of the work for which this permit is issued, I shall not employ
any person in any manner so as to;become subject to the Workers" Compensation laws of California.
I further -understand that if after making this Certificate of�txemption,I should -become subject to
the Workers' Compensation provisions of the code, I must forthwith comply with such provisions
or this permit shall be deemed .revoked.
Date'/— —.30 — ?'/ 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.)
0 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 certify I have read this application and state that the information given is correct. I agree to
comply with all stated awsjand county ordinances relating to building construction, and authorize a
ta
representive of th'e County of Riverside, Department of Building and Safety to enter upon the pro-
perty or which I�haveiapplied for this permit for the purpose of making inspections.
33;dnSture oflADoiica"nt' gent Date /
284-2000 7/80 1
PERMIT NO. DEPARTMENT OF BUILDING 6 5AFETY r 'l. +' DST
' COUNTY OF RIVERSIDE •FIELD'OFFICE'
42&879
- CONSTRUCTION ESTIMATE
NO.. ELECTRICAL FEES,
NO. ,4 PLUMBING FEES .
r IST FL.
', 2ND. FL.
SQ. FT. @ t' $
UNITS-
Owner
ro �
-
PERMIT NO.
426979 t
�
SQ. FT. @ t YARD SPKLR. SYSTEM
J r ...
POR
GAR.
_
SQ. FT. Q
MOBILEHOME SVC.
/p+st.
BAR SINK'
.,
SQ, FT. @ POWER OUTLET ROOF DRAINS
Micro Film -Fee
' }CAR. P. SQ. -FT. @
' " Jr
WALL'.-, SQ. FT. @
T..: SQ. FT. @I • t
ESTIMATED CONSTRUCTION VALUATION
{ '
Use of Permit' ' .0
F ! _
! j
DRAINAGE PIPING
-
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
Ck..By
d
FLOOR DRAIN
dJ o
'MECHANICAL FEES {
SWIM POOL, COMM.
WATER SOFTENER
£
�egol Description .
} //1
Q . \
VENT SYSTEM FAN EVAP. COOL HOOD
SIGN i!
Electrical Fee Dbl is
WASHER (AUTO)(DISH)
Group
APPLIANCE DRYER
SMI fee $
GARBAGE DISPOSAL
Dbl $
FURNACE UNIT WALL FLOOR SUSPENDED
'Bond Amt. '
$
Plan No.
LAUNDRY TRAY ..
Plan Checker ;
AIR HANDLING UNIT CFM
IDLE METER t,
Inspec r .} .
KITCHEN SINK •s
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT. SVC
$
WATER CLOSET
Const. Lender r -
COMPRESSOR HP,
POLE,TEMP/PERM - !
Supplimental Permit Numbers +
- -.. - • '
- r
i
LAVATORY _
Registr. Fee $
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
Witness Fee . $
SHOWER
< r
BOILER B.T.U. •
SQ. FT. @ c, .
BATH TUB
>.
I Zip
.'''.Zip
SQ. FT. @ -c
Total Fees $
WATER HEATER
d
Received by
SQ. FT. RESID @ I th c.
SEWAGE DISPOSAL t
- Tel.
�� ..
T
License#
SQ. FT.. GAR @ '% c.
Trees required -
HOUSE SEWER
.+
Address r
v. _+
GAS PIPING
ei, SSU
PERMIT FEE
PERMIT FEE00
PERMIT FEE
i' a
DBL.
TOTAL FEES
MOB. HM. FEE
MICRO FEE
MECH.'FEE PL. CK. FEE
CONST. FEE ELECT. FEE
SMI FEE
FEE
PLUMB. FEE -
LL - P `''` .THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION -OF WORK verified by: L..
Sewer District FOR IM DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
c
t ! + 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.'
r I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED SHE PIANS AND SPECIFICATIONS HAS DONE SO IN
ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE, OF CALIFORNIA.
Form 284-208 (Rev.8/78) r i
Job Address
� �� f
•.
,Space
Zip
Owner
ro �
PERMIT NO.
426979 t
Community t
•. / A :
J r ...
Valuation
$
- f .
Date yy��
j_. 90
+j?
/p+st.
Off.
F.C.C.
MH.Permit Fee E • -
Micro Film -Fee
Cop $
Use of Permit' ' .0
F ! _
! j
- jr'
+
Parcel No. -
`' �l /tJ G. .4/
Use/Case No.
Ck..By
d
Mech. fee Dbl $ -
PI. Ck. Fee $
Set Backs
Lot Size
Construction fee Dbl E
£
�egol Description .
} //1
Q . \
, ,
111
~ V �•+i . 6•^••
.`
F S� . S ` ` R
J
Electrical Fee Dbl is
Zone Restrictions
( f
Group
Type r
SMI fee $
Plumbing Fee
Dbl $
!Aj 6P(i
'Bond Amt. '
$
Plan No.
Plan Checker ;
+
Final Date
a O l
Inspec r .} .
Unit' -.
Sp. Insp. Fee $ .
Demol. Fee
$
Const. Lender r -
Branch
-
Supplimental Permit Numbers +
- -.. - • '
- r
i
.•
�.
Registr. Fee $
•
Mileage Fee• $
Address Cit . Zi
Y P
Witness Fee . $
Reinsp. Fee
$
Owner/ ent,
`
Tel. _ '
City •, _
r -
I Zip
.'''.Zip
Total Fees $
ess "
+-.
M.O. N.C.' Cash Check
Received by
Contractor •• 1
C, t+
�i / Y J
+JJJ,`/
- Tel.
�� ..
T
License#
'• ,.
.
Trees required -
Sewage System f
.+
Address r
v. _+
Cit
LL - P `''` .THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION -OF WORK verified by: L..
Sewer District FOR IM DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
c
t ! + 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.'
r I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED SHE PIANS AND SPECIFICATIONS HAS DONE SO IN
ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE, OF CALIFORNIA.
Form 284-208 (Rev.8/78) r i