427448 (PLBG)PERMIT NO. DEPARTMENT OF BUILDING & SAFETY DS
427448COUNTY OF RIVERSIDE FIELD
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL.
2ND. FL.
FOR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @ $
UNITS
Zip �,
f
YARD SPKLR SYSTEM
SQ. FT. @
Com nity
MOBILEHOME SVC. BAR SINK
SQ. FT. @
SQ. FT. @ POWER OUTLET ROOF DRAINS
DRAINAGE PIPING
SQ. FT. @
Dist.
l /
DRINKING FOUNTAIN
SQ. FT. @
F.C.C.
SQ. FT. @ URINAL
Micro Film Fee
VALUATION $ WATER PIPING
Use of Permit /'� (
/ �'�� q�
�+ (
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
No.
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
Set Backs
VENT SYSTEM FAN EVAP. COOL HOOD
SIGN
WASHER (AUTO)(DISH)
Legal Descriptiot.
f" �rG ( -J �.. (�
APPLIANCE DRYER
GARBAGE DISPOSAL
Zone Restrictions
FURNACE UNIT WALL FLOOR SUSPENDED
Type
LAUNDRY TRAY
SMI Fee E
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
Plan No.
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE,TEMP/PERM
LAVATORY
Sp. Insp. Fee $
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. @ c
BATH TUB
Registr. Fee $
SQ. FT. @ c
WATER HEATER
Witness Fee $
Reinsp. Fee -
S0. FT. RESID @ 1114 c
I SEWAGE DISPOSAL
A0 501
S0. FT. GAR @ '/ c
HOUSE SEWER
Zip
Total Fees
$
GAS PIPING
(
14,
PERMIT FEE
PERMIT FEE
PERMIT FEE
Received by
DBL.
TOTAL FEES
MOB. HM. FEE
MICRO FEE
MECH. FEE PL. CK. FEE
I CONST. FEE ELECT. FEE
SMI FEE
FEE
PLUMB. FE
PERMIT NO.
1427448
1
Job Address _ -
- -
e
• Space
Zip �,
Owner
-
Com nity
t
v P9
Valuation
is
Date j
/` ` C!
C� ..�
Dist.
l /
Ofd,•
/-
F.C.C.
MH.Permit Fee E
Micro Film Fee
Cop $
Use of Permit /'� (
/ �'�� q�
�+ (
`.; /•yam ��/+-' ,j� ,Q.
v� ` (,l' I /(/ f(J,�
7 0. r
.. / -/ / ^ ` q
Use/Case
No.
Ckl4y
Mech. Fee Dbl $
Pl. Ck. Fee $
Set Backs
Lot Size
Construction Fee Dbl E
Legal Descriptiot.
f" �rG ( -J �.. (�
F S S R
Electrical Fee Dbl E
Zone Restrictions
Group
Type
SMI Fee E
Plumbing Fee
Dbl $
Bond Amt.
E
Plan No.
Plan Checker
Final DoteInspector
Unit
Sp. Insp. Fee $
Demol. Fee
$
Const. Lender
Branch
Suppliment Permit Numbers
al -4i
Registr. Fee $
Mileage Fee $
Address City Zip
Witness Fee $
Reinsp. Fee -
$
Owner/Agent
Tel.
Zip
Total Fees
$
Address
_a JA
(
14,
City
Zip
M.O. 0 .C. Cosh Check
Received by
1, -
Contractor
y .`'�) t •• IL
.. ILL
Tel.
/ j
License#
YYA
Trees required f
Sewage System
S_
Address
i
City Zip
T LL P
'i Sewer District
I Form 284-208 (Rev.8/78) @s
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by:
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
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA.
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. pry`
�'fru.^�sw.tr-�--+-•�:�+�=awn._aid.-�re4�:+.e,�i-r�i..r-rem—....c.-..,a.-.-:a..--:a.w..-.,.�...,.�.www-,..,..Y..a....i�..e.:+w.�..l...:i.
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System "
2
Ftgs & Frms
34
Plenums & Ducts
2A
Slab Grade
35
Furnace Comport.
3
Steel
36
Inlets & 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. C]
43
Final
10A
Fireplace T.O.
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 z
20 Sewer
21 Water Heater
22 Watei Softener
23 Water Service
24 Gas Test
25
Final
Tank Pit L.Line
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
ry
J �
C h
7
P/L �(' P/
6'
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
DEPARTMENT OF BUILDING AND SAFETY . COUNTY OF RIVERSIDE
OFFICE DATE TIME PERMIT NUMBER
2.-a6 a3
INSPECTION
ADDRESS
5I-$35 lA��
OWNER
BUILDING PLUMBING
REMARKS
OWNER/CONTRACTOR TEL.NO
COMMUNITY
ELECTRICAL
SPACE NO.
I
I
MECHANICAL
REQUESTED
FOR:
A.M.
P.M.
F-1 MON
El TUE S
WED
THUR
FRI
284-6 tl/I5.
NOT:CE: THIS IS NOT A BUILDING PERMIT
APPLICATION TO CONSTRUCT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
DISTRICT f
Permit No
284 199A 9/74 CANARY—FILE, PINK—APPLICANT
Owner `} I a, t-- \%I Architect —_ Contractor4,E�
Address f -f e Zw—_ Address___— Addres4_13_0_,,__U_
City 1. r�t�1-I,;;,T 4 City_-- City�����1���
Phone + Phone
oC
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. 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 I (we) have
complied with all laws of the County of Riverside and the State of California governing said prop t .
DATE G��—---=� -- 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.
SPACE NO.
I
USE OF STRUCTURE
--�, I
rLEGAL
JOB ADDRESS /= �� ,-47/l/�
/T SINGLE FAMILY DUPLEX [l
1l� ���_
Z W
DESCRIPTION OF PROPERTY
' APARTMENTS AGRIC.
/a
O
.01 �--I
N .4
COMMERCIAL INDUSTRIAL LJ
j '^
o
Z
COMMUNITY ALTERATIONS [�
NO. OF SUBMITTED PLANS USE OF PERM��V� ��z�� ��/ �—�
uj a
G
�G 4, "y
CASE NO. , 4x,
t7
T
p Z
NO. OF P__A,R!�KKING SPACES REQUIRED NO. OF BUILDINGS NOW EXISTING _
Q0
ZOI ��SETBACKS: FRONT SIDE REAR
J
m
GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE
SETBACK OR NAJ" E # OF FEET REQUIRED ON TREET
DATE SIGNATURE OF LAND USE OFFI
DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET__
W
CURB AND GUTTER REQUIRED: YES ❑ NO ❑ —STREET
H
oc
a
CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑
W
HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET
D
IMPROVEMENT? YES ❑ NO ❑
°C
DATE SIGNATURE OF ROAD DEPT. OFFICIAL
=
SWIMMING POOL S PUBLIC
Q W
SEWAGE DISPOSAL I>\ ,�P� a \ S�sX� ��� a C C t l l �a JC
f'
FOOD ESTABI ISHMENT fY•R� �j .�—_�jY (Y�4.� �•C\C�' f y'fZ r���. �l � u_``�, "
= O
WATER POLLUTION REMARKS
FLOOD CONTROL
H
zAIR POLLUTION
_ DIV OF HWY
c a — YOUR PROPERTY MAY BE SUBJECT TO
a
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
Effective July 1, 1980, Chapter 1301 Section
tion of the following applicable declarations
print or type.and.sign below;.
APPLICATION CERTIFICATE
PERMIT N
19825'of the Heilth and Safety Code requires the execu-
prior to the issuance of a building permit. Please
[� LICENSED CONTRACTORS DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9
Division 3 of the Business and Professions Code and my license is
License—Class C.....
Date
I hereby affirm that
License No
OWNER -BUILDER DECLARATION
(commencing with Section 7000) of
in full force and effect.
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.).
Q I am exempt under Section
Date Owner
B:&P.C. for this reason:
a 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. Insurancef—/ T� /�I(r"r �() ).fA
[� Certified copy is hereby furnished.
Certified copy is filed with th -County,, of R,iiv/e+side, Department of Building and Safety.
Date"—'a�% ApplicantZl(d�
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE
(This section need not be completed if permit valuation is for $100.00 or less
I certify that ,in the performance of the work for which this permit is issued, I shall not employ
any person in any manner so as to become subject to the Workers' Compensation laws of California.
I further understand that if after making this Certificate of Exemption, I should become subject to
the Workers' Compensation provisions of the labor code, I must forthwith comply with such provisions
or this permit shall be deemed revoked.
Date Applicant
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the work for
which this permit is Issued (Sec. 3097, Civ. Code).
Lender's Name
Lender's Address
DIVISION OF INDUSTRIAL'SAFETY PERMIT CERTIFICATION
[� I hereby certify that no excavation five (5) or more feet in depth into which a person is re-
quired to descend, will be made i6 connection with work authorized by this permit, and that no
building, structure, scaffolding, falsework, or demolition or dismantling thereof, will be
more than thirty-six (36) feet high. (Chap 3.2, Grp 2, Art 2, Sec 341, Title 8, C.A.C.)
As owner -builder, I will not employ anyone to do work which would require a permit from the
Division of Industrial Safety, as noted above, unless such person has a permit to do such work
from that division.
0 Division of Industrial Safety Permit No.
Date Applicant
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY
I certify I have read this application and state that the information given is correct. I agree to
comply with all state laws and county ordinances relating to building construction, and authorize a
representative of the County of Riverside, Department of Building and Safety to enter upon the pro-
pert�y for whit I have ap�p1J�/e�dwfo—r this permit for the purpose of makif g,inspections.
.. r�/~
ignatu?e of pp scant/ gent Date
00; mac- CtJ ��
Print Applicant/Agent Name
284-2000 7/80/(!
., a k�. sa -IaTi+ _. .Ili �.. - _..�_.. .....�... - w �4�•: .i' ... .i1 . . S.s_ ., �.$s... _: �':. ..ih .. r.. ..'L.i. .. .. ... .,.
BUILDING PERI
PERMIT NO.
42744
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING
FEES
IST FL. SQ. FT. @
2ND. FL. SQ. FT. @
POR. SQ. FT. @
GAR. SQ. FT. @
CAR P. SQ. FT. @
WALL SQ. FT. @
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
PERMIT NO.
427448
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
_
05-�/
,2
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
MH.Permit Fee $
VENT SYSTEM FAN EVAP. COOL HOOD
SIGN
WASHER (AUTO)(DISH)
Use of Permit t f f C..
� /
tt
/'�•4G F,✓e �. I Cit"
APPLIANCE DRYER
Use/Case No.
GARBAGE DISPOSAL
Mech. Fee Dbl E
FURNACE UNIT WALL FLOOR SUSPENDED
Set BacksLot
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
S
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE,TEMP/PERM
LAVATORY
Dbl E
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
Plan Checker
BOILER B.T.U.
SQ. FT. @ C
BATH TUB
Sp. Insp. Fee E
Dental. Fee
SQ. FT. @ C
WATER HEATER
Const. lender Branch
Supplimental Permit Numbers
SQ. FT. RESID @1'/.0
SEWAGE DISPOSAL
Mileage Fee y
Address City Zip
S0. FT. GAR @ s/. C
HOUSE SEWER
$
Owner/Agent
Tel.
GAS PIPING
PERMIT FEE
y
PERMIT FEE
PERMIT FEE
DBL.
TOTALFEES
MOB.HM.FEE
MICRO FEE
MECH. FEE PL. CK. FEE
I CONST. FEE ELECT. FEE
SMI FEE
FEE
PLUMB. FES_
4 5(a
T LL P
Sewer District
Form 284-208 (Rev.8/78) as
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by:
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
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA.
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.
Job Addrpss
`/_
Space
'P
1�w_5�
11
Q ner
PERMIT NO.
427448
Comm nityj /�J+ f j
r ` ��� i �� 1
Valuation
$
_
05-�/
,2
Dist.
///
f_014,F.C.C.
4
MH.Permit Fee $
Micro Film Fee
Cop $
Use of Permit t f f C..
� /
tt
/'�•4G F,✓e �. I Cit"
A%, No.
t �
Use/Case No.
Ck, y
Mech. Fee Dbl E
PI. Ck. Fee $
Set BacksLot
Size
Construction Fee Dbl S
Legal Description
F
S
S P110-p
Electrical Fee Dbl SZone
Restrictions
Type
SMI Fee $
Plumbing Fee
Dbl E
Bond Amt.
E
Plan No.
Plan Checker
Final Date
Inspector
Unit
Sp. Insp. Fee E
Dental. Fee
$
Const. lender Branch
Supplimental Permit Numbers
Regist, Fee $
Mileage Fee y
Address City Zip
Witness Fee E
Reinsp. Fee
$
Owner/Agent
Tel.
Zip
Total Fees
y
Addres
/
City _ R
Zip
M.O. C3 42b Cashn Check
Received by
Contractor ,{ �t/ ,` (/'`
, A)J r I <- f � CJi`01.� 4.— 11�J�
Telma ^� J
i 17 �1. /
License#
Trees required
Sewage System
Address
City Z
T LL P
Sewer District
Form 284-208 (Rev.8/78) as
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by:
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
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA.
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.