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00021865 (SFD)d/1'4fY N�I�J Sv��' MI) YURs 1638 PWWWROWT GA 922600000 I,OB.)S[T,E gYRESSISPACE AVE DIAZ CIT] /r COWIB1HSTJILEIZIP CA 922530000 7?3 312 99;5 166 TWN� no v0 S INTO 000 Kb s A l4511 Q�4O SB 17 14L Y �9yy�y�.5'VCMAQ,#, pig r yK�•-1 tp'®1n"S1�6p..,4.pEJ¢I/�ryE odAE,.�1R-1', DEV C CO PHONE# hit N p r BURS 16, 38 PTAi2f7'NW9WT CA 922600000 tlT4' C L. 8— d 0 4 B 7T4'-568-104B:[ A V 'V W BLDG. INSPECTOR FINAL DATE ARCIENG FIRM NAME LICNC N ADDRESS CITYICOM M UNITYISTATEIZI P PLAN # PLANS EXAMINER APPROVE DATE Ml.� ATT CAR LU gUS,B.OFRERMITi lWi Rlt1N Wt ngg iJ VVb� S�gy AlT q�gy QAV. yy SM0 ZONE ORD # LOT SZ o oNs o o 1 sn APPLICATION FOR STRUCTURAL PERMIT T H I u s I S A N A P PL is C A T I 0 N O N L. Y FORM 284.208 (11.81) 1I `SPE :TOR . TOTAL . FEE CA CK I NO I COUNTER B.I. COUNTER LL..'U.T.F APPLICATION FOR STRUCTURAL PERMIT T H I u s I S A N A P PL is C A T I 0 N O N L. Y FORM 284.208 (11.81) 1I `SPE :TOR . NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Ftgs & Frms 34 Plenums 8 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, 43 Final 10A Fireplace T.O. OP'N NO. ADDITIONAL INFORMATION SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath 12 Internal Loth 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Walls (Batts) 12B Ceiling (Botts) 12C Ceiling (Blown) 14 1 Final PLUMBING APPROVALS _ 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 Tank Pit L.Line REAR OF PROPERTY LINE PSL P/ ELECTRICAL APPROVALS 26 Power Pole 27r Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final STREET NAME I( County of Riverside Department of Building and Safety 4080 Lemon Sr 2nd Floor 135 N Alessandro Rd Rm 203 880 N Slate Street 227 North ''0" Street 46.209 Oasis St Rm 310 160 N Broadway Riverside. CA 92501 Banning. CA 92220 Hemet, CA 92343 Perris. CA 92370 Indw. CA 92201 Who, CA 92225 Ph. 787.6146 Ph 8497312 Ph 658-4464 Ph 657.3698 Ph 342.8271 Ph 9222670 This permit becomes void it work not commenced within 180 days from date of issuance. OR, it work las beer suspended or abandoned lot a period of lad days ❑ a CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE- This section need not be com-. DECLARATION: I hereby affirm that I under provisions of Chapter 9 ( comment. Coon LICC4ith poled it the permit 1s for one hundred ($100) or less. I certify that in the performance of the work for which this 7000) of 3 of the io s Code, �wilh Section 7000) of Division 3 of the Business and Professions Code, and my license is in lull force and effect. S permit is issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensa- tion Laws of California. EJDate -- ---- -- - - - --- --Applicant - - - --- - ------ s' NOTICE TO APPLICANT If, after making this Certificate of Exemption. you should become subject to the Workers' 0 R -BUILDER DECLARATION. I hereby alfum that I am exempt from the Contraclor's License Law for the Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be f Ing reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to con- deemed revoked. - , aIle,, improve, demolish. Or repat, any Structure. prior to its issuance, also requues the applicant for such NEWS 1638 l0 lite a signed statement Ihat he is licensed pursuant to the provisions of the Contractor's License Law DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION ( er 9 (commencing with Section 7000) of Division 3 of the Business and Prolessibns Code) or Thal he is ex- Of hereby certify that no excavation five (5) or more feet in depth Into which a person is required to descend. will e,,V Jherelrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any apphcanl for a per- be made in connection with work authorized by this permit. and that no building structure. scaffolding, falsework, mil subjects the applicant to a civil penally of not more than five hunderd dollars (5500).): or demolition or dismantling thereof. will be more than Ihirly-six (36) feel high. (Chap. 3.2. Grp 2. Art 2. Sec 341, ❑ 1. as owner of the properly, or my employees with wages as their sole compensation, will do the work, and the Title 8. C.A.C. ). structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License OAS owner -builder. I will not employ anyone to do work which would require a permit from the Division of In - Law does not apply to an owner of properly who builds or improves thereon, and who does such work himself or dusirial Safety. as noted above, unless such person has a permit to do such work from the division. through his own employees, provided that such improvements are not intended or offered for sale. 11, however, ❑Division Industrial Safely Permit No the building or improvement is sold within one year of completion. the owner- builder will have the burden of prov- of Ing that he did not build or improve for the purpose of sale.) ❑I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec 7044, Business and Professions Code. The Contractor's License Law does not apply to an owner of property who builds or improves thereon. and who contracts for such projects with a contractor(s) licensed pursuant to the Con- tractor's License Law.) ❑I am exempt under Sec. . B 8 P.C. (Attach Certdicale). Date Owner WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell - insure, or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800. Lab. C.). ❑Certified copy is hereby furnished. ❑Certified copy is filed with the County Building Inspection Department or County _Department. DANNI MN!" MI). _ - RS 1638 FAMMIEWT CA 922600000 " MOId 'tRESSISPACE AVE DIAZ Or"'t EJJWOO CA 922530000 iia 1112 913 9 n"" n 0 11t0 5 JJAdTQ000 D014 1 "i s' BLKK-170 �yy,NgV�'�.h1FiQf17, 1 ff_"- DE8ERT, DEV CO PHONE# V1414AIINMR N L' 5436 NEWS 1638 P1412 "UT"Off CA 422600000 V P! J *— J LVOma„ 0 48 1 BLDG. INSPECTOR FINAL DATE A/RCIIENG FIRMNAMEi LICNC N ADDRESS CITYICOM MUNITYISTATEIZI P PLAN N P N EX M APPROVE DATE OWL`S: IL ATT GAR to RfN 070 1 ows OTV JOTO I IrRD ZONE ORD N LOT SZ A 1001 O 1 9'IDS r CONSTRUCTION LENDING AGENCY. I hereby affirm that there is a construction lending agency for the perfor- mance of the work for which this permit is issued (Sec. 3097. Civ. C ). Lender's Name Lender's Address 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 stale laws and county ordinances relating to building cogS1rucbon. and authorize a representative of the County of Riverside. Department of Building and Safety to enter upon�frlq pp which I have applied for this permit for thhJ�J]urpose of making inns/pections i L�M gnature of Applicant or Agent Date Print Applicant/Agent Name C 865 1 ESTIMATED PLAN REV FEE 111115 1 Mr.7 i i I I TOTAL J l FEE' $1577 CA CIX NCWWll�+J'T R B.I. COUNTER L.U.T. PERMIT FOR STRUCTURAL PLAN REVIEW TOTAL PERMI"T COST IS $151.77 CONSTRUCTION ESTIMATE Description PRIMARY DWLG SECNDRY AIRCON $E�NDRY PRIFAR Est Ian Rey ee based 284:208(11.81) INSPECTOR (NOTEi N t to be used as property FCC roup Type Sq tit 101 R-3 V_W 1211 900 R-3 R 1221 , on3Total Estimated Val'tn J valuation) Rate Valuation $27.60 $33423 $92.1200 $2664 $33%44 is s $4f1191 .77 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 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, 0 43 Final 10A Fireplace T.O. No ADDITIONAL INFORMATION i SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Loth 12 Internal Lath 12A Drywall 13 Finish Grade ' INSULATION Thick R Value 7A Walls (Batts) 12B Ceiling (Botts) 12C Ceiling (Blown) 14 Final PLUMBING APPROVALS 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 Tank Pit L.Line PSL REAR OF PROPERTY LINE ELECTRICAL APPROVALS P/ 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service' . . 32 Final STREET NAME RIVERSIDE COUNTY DEPARTMENT OF HEALTH APPLICATION FOR PERMIT TO INSTALL A RESIDENTIAL SUBSURFACE DISPOSAL SYSTEM Applicant: Submit this form with three copies of a scaled plot plan drawn to the specifications required on the attached check list. A non refundable filing fee of $15 is required when the application is submitted. Check must be made payable to County of Riverside. Name Mailing Address Q City State Zip Code Phone Z O ~ V 'Property Address 'City or Community ' Legal Description of Property W N "Assessors Parcel No. Water Serving Property From Signature of Applicant Date 'The above information must be verified from Building Application Staff Use -- Do Not Write Below This Line Initial Date Soils feasibility report required Yes ❑ No 0 Detailed boring report required Yes ❑ No ❑ Detailed contour plot required Yes ❑ No ❑ Z Soils or boring report by Date O V Approved by Date _ W N Soils Map Page .. Soil Type Tract File No. Other _ Number of Bedrooms Septic Tank Size (gallons) Rate Required (sq. ft./100 gal or gal. sq. ft./day) Leach line sq. ft. of bottom area trench Leach bed (sq. ft. of bottom area bed) Seepage Pit Diameter Seepage Pit Vertical Feet Number of Seepage Pits Maximum Depth of Pit Location of System Additional Requirements V A permit is approved/denied for the installation of a subsurface disposal system as indicated on the accompanied Z plot plan using the requirements set forth in Section C above. O H U W y Signature of Health Official Date Receipt No. Issued By District: Riverside ❑ DISTRIBUTION: WHITE - Office File Indio ❑ Hemet ❑ YELLOW - Applicant Date PINK - Building Dept. GOLDENROD - Attached to Plans Ix w Z O 0 r - O LU IX (3).- Z �- CLL J_ Q 5y m a6 a6 F t, Z z~ za aw J � IL 0 >- Z F Uj O LL J Q m +8 r APPLICATION FOR TREE PLANTING I (we), the undersigned, hereby certify and acknowledge that I (we) have read the application and agree that if trees are required under River- side County Ordinance No. 457, the applicant agrees to install said trees prior to final inspection. It is understood that no final inspection will be given until said requirements have been met or exception has been granted by the County. Now, therefore, it is ogreed that the prop- erty owner shall cause the property lines to be surveyed in the event no survey stakes can be found. Further, it is agreed that the County of Riverside shall assume no responsibility should trees Ave to be removed due to lot line errors. Owner's Nam ItmMailing Address a ' Cit , Job Address Legal Description Assessor's Map, Book & Page — Type of Soi.Iwater available _/Rood Dept. Plot Plan No. Type of existing trees in road right—of—way- ,_ Trees preferred by applicant (1) ���L (2) Date i /�2 —i/ _Z_ Owner's Signature Planning Commission Case No. ilding Permit ate Community Type Structure (3) ROAD DEPARTMENT APPROVAL Approved species Number Spacing of trees Distance from lot lines: Front Side_ Additional requirements (Date Building and Safety notified Signature REQUEST FOR EXCEPTION Reason Request for hearing: YES ❑ Owner's Signature Planning Dept. Concur ❑ Date Road Dept. Zip!%a r. of trees (attach additional page if necessary) (Forward application to Planning Dept. if exception requested) NO REQUEST FOR HEARING Non -concur ❑ Explanation Signature Concur ❑ Non -Concur ❑ Date Signature REQUEST FOR HEARING AND COMMITTEE DECISION Date hearing established Date hearing notice mailed to owner Approved ❑ Disapproved ❑ Date Owner notified of decision Date Building & Safety notified • Signature Final Date Job Address Inspector Requirements for tree planting complied with Remarks 284-230, REV. 1/74 APPROVAL BY BUILDING INSPECTOR Building Permit No. Community (Detach and forward above information to Road Department Riverside) f `� � ��. � ��, �, J it ' +~ ..�,�. APPLICANT NAME (L, F, MI) DAN HORN MRS 16;38 PTAVY"` ROrT CA 922600000 � WNWWRESSISPACE ATED I AZ 71y1�{1(l7 V>W �A 7C�A ETWO F3'd(@T$T„E ZIP {�! A 1®rYw .l i. 1 Ph 9225S©O O O 3 j 3 6 TWN �j O n S (� o000 U014 U 1 A SB MVC AQ*17; BLK-170 i7 ��! rA F...i1MEi/Cr ER 1' ai DEV 100 PHONE# �PA?4?JQfjj4 NPADRN �(� q,�A rpt UMP3i 436 9w5 1638 P1&rUN9F.ffY CA922600000 "Y'r- —568— 1 h �/� tl 3 V "P G7 BLDG. INSPECTOR FINAL DATE ARCIENG FIRM NAME UCNC # ADDRESS CITYICOMMUNITYISTATEIZIP'- PLAA�NQ(# EXAMINER APPROVE DATE /��PyLANS 16 ATT CAR ' Qd/{7¢.1.P 4i0 If 0'2' n$g b GU6 $gam OJED n{�gy 0d{0 Q {� .LF�4D ZONE ORD# LOTSZfEN.30 01TIDO 0-1 APPLICATION FOR STRUCTURAL K.AN REVIEWDO Ic I S I S A.N A P w L, I C A T I O N U N L Y You must sect the following Departments (if listed) for concurrence BEFORE a permit can be is sued i �.,. - Description .� ,.� w.... �,_� �._�.ww4� �.. _.�..-�.....r.,.�,.,��.�.� ........... De T TO See .-...--- HOLD -90AD, HEALTH LA9D USE: FORM 284208(11.81) INSPECTOR NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Ftgs 8 Frms 34 Plenums 8 Ducts 2A Slab Grade 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. E] 43 Final 10A Fireplace T.O. 0 OFIN NO. ADDITIONAL INFORMATION SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath 12 Internal Lath 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Walls (Bans) 12B Ceiling (Batts) 12C Ceiling (Blown) 14 Final PLUMBING APPROVALS 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 Tank Pit L.Line REAR OF PROPERTY LINE ELECTRICAL APPROVALS PSL P/ 26 Power Pole ' 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtur6s 31 Service 32 Final STREET NAME