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413836 (BLCK)v i PERMIT No. 13 8 3 6 PERMIT NO. DEPARTMENT OF BUILDING SL SAFETY COUNTY OF RIVERSIDE FIELD DST CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. 2ND. FL. FOR. GAR. CAR P. WALL ESTIMATED CONSTRLI ION SO. FT. .@ $ UNITS SO. FT. @ YARD SPKLR SYSTEM SO. FT. @ MOBILEHOME SVC. BAR SINK SO. FT. @ POWER OUTLET ROOF DRAINS SO. FT. @ DRAINAGE PIPING SO. FT. @ DRINKING FOUNTAIN URINAL VALUATION $ WATER PIPING NOTE: Not to be used os 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 SL.SPENDED Use o Permit / / - 2 /�` ' ��� '� 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. SQ. FT. @ a BATH TUB Electrical Fee Dbl $ SQ. FT. @ c WATER HEATER ype� ' SO. FT. RESID ea 11144 SEWAGE DISPOSAL Bond Ami^'' $ SO. FT. GAR @a s/ae HOUSE SEWER • Unit GAS PIPING PERMIT FEE -4-1 PERMIT FEE PERMIT FEE ' DBI. TOTAL FEESMOB. HM. FEE M CRO FEE MECH. FEE PL. CK. FEE CONST. FEE ELECT. FEE y{ SMI FEE FEE PLUMB. FEE v i PERMIT NO. Job Address - '- Space Zip - Owner - y d valuation Dd1. Dist. OIL F.C.C.4138 � G�MH Permit Fee s r� $ Z' r f ^ /^ / Micro Film Fee Cop $ Use o Permit / / - 2 /�` ' ��� '� orcel No. Use/Case No. Ck. By Mach. Fee Dbl s ;% / S Pl. Ck. Fee $ Sit Bckf Lot Size Construction Fee Dbl S Legal Description "' hJ r- 15- Fe k 201 . 11 �r F S S R Electrical Fee Dbl $ Zone Restrictions ;Group ype� ' ' SMI Fee $ Plumbing Fee Dbl $ Bond Ami^'' $ Plan We. rcs,(Ch-ker FincilfWte f Inspe Unit Sp. Insp.`Fee $ Demol. Fee $ Const. Lender Branch Supplimental Permit Number"— , Regisir. Fee S Mileage Fee $ Address City Zip Witness Fee $ Reinsp. Fee $ Owner/Agent Tel. Zip Total Fees $ Address r _ City Zip M.O. ❑ N.C. ❑ Cash ❑ C eck Received by rte' Contra or �i J / Tel. ♦� �7 Ucensep Trees ri �Z--"G� r 4— ^ Y' ( /� Sewage System Address v ' City �' O Zip C) j, /•09 V IfI -T`av 'j/ LL ':ref (p THIS PER/TfT StHALL BECOME VOID IF WORK IS NOT COMME E WITH 114 2 ` AYS. 'CESSkTION OF WORK verified by: Sewer District 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 c THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. a I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN t��1••;.�!y. DANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. Form 264-208 (Rev. 1/80) z r�Esl-- .: f"X. . NO. OPERATION DATE INSPECTOR NO. OPERATION D.TE - INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS <-1 I G." Back 33 Ventilation System ` 2 ` Ftgs 8 Frms j 34 Plenums 8 Ducts 2A Slab Grade 35 Furnace Comport. 3 Steel _ 2?— l 36 Inlets 8 Outlets 4 Grout Blocks 12-5 7 Combustion Air 5 Bond Beams i_ a., ! 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 IDA Fireplace T.O. E] No ______- ADDITIONAL INFORMATION S _. _ -_ _ r -_ . , _ ., _. ------- •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 (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/ A 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 APPLICATION CERTIFICATE COUNTY OF RIVERSIDE PERMIT N Effective July1, 1980, Chapter 1301 Section 19825'of the k"I th and Safety Code requires the execu- tion of the following applicable declarations prior to the issuance of a building permit. Please print'or type .and sign below:- W LICENSED CONTRACTORS DECLARATION I`hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Businessand Professions Code and my license is in full force and effect. License Class ;2, License No. Date /— '7 _x4 T Contractor /A-' P .0 JC�� 0 OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reasons: [� 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,.1 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 C] 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 Q Certified copy is hereby furnished. E3 Certified ccpy is filed with the County of Riverside, Department of Building and Safety. Date Applicant �r 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 1-2 3-,-P % ApplicantX 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 0 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.) [7 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- perty for which I have applied for this permit for the purpose of making inspections. Nt Iignature of pp icartJ gent JUMe Print Applicant/ gent Name t ,284-2000 7/80 NOTICE: THIS IS NOTA BUILDING PERMIT DISTRICT i (/ APPLICATION TO CONSTRUCT Permit No ` DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE 1 284•'199 9/74 CANARY—FILE, PINK—APPLICANT Owne oa Sf% a Architect Contractor- tZ( J ISI A 1 Addres�00 Ave. Z Address Addre (— i��L�/�PP_� ,, �6 City 1� q�, L city City_ ���%��/—� 5 =�-!7�_ 1 3 3 Phone Phone Phone u i of 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 to be occupi until 1 (we) ve complied with all laws of the County of Riverside and the State of California governing said property. DATE 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. I SPACE NO. 1 USE OF STRUCTURE Qv JOB ADDRESS ' �G`�" I SINGLE FAMILY DUPLEX ❑ ESC(3JPTION OF ERTY x Z � W �^6E.GAL /RfRO APARTMENTS AGRIC. G Q > Q ��n1�— 'TI �r F r— // COMMERCIAL INDUSTRIAL t '^ C COMMUNITY F. ALTERATIONS n Z NO. OF SUBMITTED PLANS ---_ USE OF PERMIT --- N Q CASE NO. iii.._ �� i��,(� in Z NO. OF P/A�jQKING SPACES REQUIRED NO. OF BUILDINGS NOW EXISTING --- Q ZONE e� SETBACKS: FRONT SIDE REAR J m GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE SETBAC_KpRD'IjNACCEfa -- OF FEET REQUIRED ON STREET r //�1�`-�7� GATE SIGNATURE OF LAND USE OFFICIAL ---- DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET___ t- rzt q CURB AND GUTTER REQUIRED: YES ❑ NO ❑ —STREET i H d CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑ W HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET OIMPROVEMENT? YES ❑ NO ❑ at DATE _ SIGNATURE OF ROAD DEPT. OFFICIAL = SWIMMING POOLS PUBLIC WSEWAGE DISPOSAL _ FOOD ESTABLISHMENT _ WATER POLLUTION REMARKS �n FLOOD CONTROL W AIR POLLUTION _ DIV OF HWY I.- 0 e _ YOUR PROPERTY MAY BE SUBJECT TO c FLOOD. RIVERSIDE COUNTY ASSUMES NO RESPONSIBILITY IN EVENT OF FLOOD. 284•'199 9/74 CANARY—FILE, PINK—APPLICANT PERMIT NO. 13836 DEPARTMENT OF BUILDING & SAFETY COUNTY OF RIVERSIDE FIELD OFFICE ;DS I CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. 2ND. FL. FOR. GAR. CAR P. WALL vwta-/;@- ESTIMATED CONSTRUCTION SQ. FT. .@ $ UNITS Valuation S "�) f / SQ. FT. @ YARD SPKLR SYSTEM SQ. FT. @ MOBILEHOME SVC. BAR SINK SQ. FT. @ POWER OUTLET ROOF DRAINS SQ. FT. @ DRAINAGE PIPING SO. FT. @ DRINKING FOUNTAIN Mech. Fee Dbl $ URINAL VALUATION $ = 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 Plumbing Fee Dbl S GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED Plan` Checker 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. SQ. FT. @ a BATH TUB Address s SQ. FT. @ a WATER HEATER Received by S0. FT. RESID @ 1 t/a SEWAGE DISPOSAL Lfcensall / L SO. FT. GAR @ 3/aa • HOUSE SEWER Address City Zip Ida T r GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBI.TOTAL FEES OG MOB. HM. FEE `MICRO FEE MECH. FEE Pl. CK. FEE CONST. FEE ELECT. FEE Ol/ SMI FEE FEE PLUMB. FEE " PERMIT NO. 413 8f Job Address Spore G Zip Owner m munity' % //) a ,A - Valuation S "�) f / Dote J7 Dist. Off. F.C.C. MH Permit Fee b Micro Film Fee Cop S Use of Permit , ' m' p� g y/ G 6&00 /& , Parcel No. /7 Use/ Case No. Ck. By Mech. Fee Dbl $ PI. Ck. Fee S Set Backs Lot Size �. �dQ Construction Fee Dbl S i ti Legal Description 1... Uf �'^" `"^ A7 f F S S R Electrical Fee Dbl S v Zone Restrictions Group Type SMI Fee S Plumbing Fee Dbl S Bon Amt. S Plan No. Plan` Checker Fina Date p- 7 7 % (� O G Inspector Unit Sp. Insp. Fee S Demol. Fee $ Const. Lander Branch Suppliimmentol Permit Numbers - Registr. Fee 5 Mileage Fee S Address City Zip Witness Fee $ Reinsp. Fee S Owner/Agent / Tal. Zip Total Fees S L / Address s Ply Zip " M.O. O N.C. ❑ Cash Check Received by Contra or Tel. / �yi ,,,, Lfcensall / L Trees Sewage System �I7 T tt Address City Zip Ida T r THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMME CED W HIA 12 AK ESSAMION (IF WORK ,,.rAi.d t.,. FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME.VOID. Sewer District ,t— .1 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.00, .�. 1 HERE CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN Form 284208 (Rev. 1/80( ANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.