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399514 (SFD)BUILDING PERMIT i PERMIT NO. DEPARTMENT OF BUILDING 8c SAFETY _ •• �. FIELD DST 99514 .T COUNTY OF RIVERSIDE ` CONSTRUCTION ESTIMATE Job Address t �- - �>i/.Co. NO. ELECTRICAL FEES Zip NO. PLUMBING FEES 1ST FL. `• 2ND. FL. POR.-' GAR. CAR P. WALL ESTIMATED CONSTRUC ON SO. FT.. ° $ Valuation $- UNITS - Dcae' Diit. , SO. FT. @ YARD SPKLR SYSTEM F.C.C. SO. FT. @ MOBILEHOME SVC. BAR SINK MH Permit Fee $ SO. FT. @ POWER OUTLET ROOF DRAINS Us•of ermii e , s^� 1 X .� SO. FT. @ DRAINAGE PIPING ai4l No. /—" SO. FT. @ DRINKING FOUNTAIN ? URINAL Ck. By '" VALUATION $ F, ,. WATER PIPING PI. Ck. Fee ' �$ / NOTE: Not to be used as property tax valuation Lot Siza SWIM POOL, PVT Construction Fee Dbl $ loe— FLOOR DRAIN ' MECHANICAL FEES R SWIM POOL, COMM t i� �•�•,,Cs,�( G ).11 WATER SOFTENER VENT SYSTEM FAN EVAP. COOL HOOD , SIGN WASHER (AUTO)(DISH) Electrical Fee Dbl S T APPLIANCE DRYER Group Type GARBAGE DISPOSAL G °~ FURNACE UNIT WALL FLOOR SUSPENDED ;r�,: LAUNDRY TRAY AIR HANDLAG UNIT CFM r IDLE METER a `o.�" KITCHEN SINK _ ABSORPTION SYSTEM B.T.U. f TEMP USE PERMIT SVC Unit WATER CLOSET >! _ COMPRESSOR HP Const. Lender Branch "' POLE, TEMP/PERM Supp" limental '04 LAVATORY '� J HEATING SYSTEM FORCED GRAVITY Registr, Fee $ AMPERES SERV ENT Address _ ity Zip s+ I SHOWER Reinsp: Fee $ BOILER B.T.U. SO. FT. @ a Cr BATH TUB Zip SO. FT. @ a v WATER HEATER 19 50. FT. RESID @ 1114a Address •'�'� SEWAGE DISPOSAL City '" ,� Zip S0. FT. GAR @ V4a Received br, `j .�; HOUSE SEWER Tel. - ' Li<enseR GAS PIPING o n PERMIT FEE Address PERMIT FEE City Z PERMIT FEE Zip DBL TOTAL FEES,— MOB. HM. FEE i MICRO FEE FEE PL. CK. FEE CONST. FEE E L neE SMI FEE FEE PERMIT NO. 3 9 9 514 Job Address t �- - �>i/.Co. Space, Zip Owner .ty - Valuation $- - - Dcae' Diit. , Off. F.C.C. MH Permit Fee $ Micro Film Fee Cop S Us•of ermii e , s^� 1 X .� ai4l No. /—" ''`/ ^• 'Use/Ca A. Ck. By '" Mech. Fee - Db1 $'7� PI. Ck. Fee ' �$ / A �r �Se]� s 'Z-.'�j Lot Siza Construction Fee Dbl $ loe— Legal Description F S t S R t i� �•�•,,Cs,�( G ).11 Electrical Fee Dbl S T Zone Restrictions Group Type SMI Fee S , ,r ,U Plumbing Fee Dbl $ :and Am, ,g a `o.�" 016n Checker Final —11,L' f Inspector Unit t Sp. Insp. Fee S Demol. Fee S Const. Lender Branch "' ''• Supp" limental '04 ermit Numbers / . Registr, Fee $ Mileage Fee S Address _ ity Zip s+ I Witness Fee - g Reinsp: Fee $ O+.ner/Agent. •'� .t .. � L Tel. Cr �• i Zip I Total Fees 5 Address •'�'� .r' City '" ,� Zip M.O. ❑ N.C. ❑ Cash C eck ❑ Received br, `j .�; Controcto` Tel. - ' Li<enseR Trees refjui6J./r.�� r Sewage y!t •� jv'ry•.rt „ , Address City Zip - % e T LL "`-1 `P"- THIS PERMIT SHALL BECOME -VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION,61F WORK .eribcd by: FOR 120 DAYS SHALL ALSO CA Sewer .Di�4iU USE PERMIT TO BECOME VOID: ' e .I HEREBY AGREE THAT -ALL WORK IN CONNECTION_WITH THIS PERMIT'WILL BE CONE IN ACCORDANCE WITH THE LAWS OF RIVERSIDE; COUNTY. AND THE STATE OF CALIFORNIA.( BY CERTIFY THAT THE INDIVIDUAL_ WHO PREPARED THE PLANS AND SPECFICATIONS HAS DONE SO IN +' AC RDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE O' THE STATE F CALIFORNIA. sh, Form ZBd-208 (Rei. 1/B0) Q r 3WVN 133815 I/d _ r 1/d i 3N11 AlMdoad 10 HV38 au!l .l U Juol N011VJ01 T 3ZIS W31SAS 30VM3S 4 ! t l , i 801)3dSNl JOIiVWH ANC 1VN011maV; _ •ON NAC -o!MaS POOH 10!»aww0) Zv t. OE'. a3!n90 uogP310(3 01OwS lC aj!M 6ulpunojo jadwo(I an j O9 6Z a3u0,001) •IddV 6£ 4!npuo) jossaidwo) 8£ 9Z j!v uo!tsngwo) LE losods!p a6omaS staltn0 8 stalul 9E 'ljodwo) mown j SE spn0 g swnuald 7C Ll wats/S uo!101!tua6 ££ S1VAObddV 1V:)INVH:)3W 91 31V0 NOI1V83dO ON 801)3dSNl 0 1; l S1VA02lddv 1VD180313 IDU! j Z£ -o!MaS f (E saanix! j t. OE'. 60lpu09 96Z 'i aj!M 6ulpunojo V6Z 6uU!M 6Z aauoa4u3 a0!NaS 8Z 4!npuo) LZ i alod Jamod 9Z %J`rV—�� / IDUH SZ ��—C✓/ 4501 so`J . GZ a�!. JOS Ja1DM £Z iaualloS Ja46M Ja40aH J010M ZZ tZ jamas OZ losods!p a6omaS 61 J s4uQA 81 9wnld 46no8 Ll 6utdid A040M 91 �p 9wnld PunouJ SI SIVAO?JddV ON18wn1d lou! j 4l (um019) 6ail!a) )Zl (slto9) 6uip) 9Zl (su09) slloM VL anloA 8 1.41 NOI1V1f15N1 apo.0 4s!u!d llomAjd ylol lowatul Ei VZI Zl 4401 joualx3 I l . .. n •0•1 a=lda,!d Vol L 'I'd a-mldaald Ol IIoM anj 060jo`J 6 }, �7 G / Oppjj s1U8A 6uiwoJj 8 L VV O D— t— -z pa(] 1008 9 sw029-puog S s)po19 tnoi'j 9 IaalS £ apolO 9olS VZ sw�d 8 s6lj 1p09 taS L t SIVAOMddV fWalln8 31V0 NOI1V83dO On DEPARTMENT OF BUILD)NG AND SAFETY APPLICATION CERTIFICATE COUNTY OF RIVERSIDE PERMIT # 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 print or type and sign below. i0 LICENSED CONTRACTORS DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with `ection 7000) of Division 3 of the Business and >Professions Code and my license is in full force anc. effect. License Class ^� ��`��� License No. � 7/ Date /� Contractor ti r Q OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the followiig reasons: Q I, as owner of the property, or my employees with wages as their sole c)mpensation, 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 dij not build or improve for the purpose of sale (Sec. 7031.5, B.&P.C.). Q I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, B.&P.C.). [:J I am exempt under Section Date Owner , B.&P.C. for oris reason: Q 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. Certified copy is filed with the County of Riverside, Department of Bu-lding and Safety. Date Applicant t� CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE P (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 ;hall not employ any person in any manner so as to become subject to the Workers' Compensation law; 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�-p7ermit shall be deemed revoked. Date / /t�� /��� Applicant 'F �CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance c -f 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 wh-ch a person is re- quired to descend, will be made in connection with work authorized by this permit, and that no building, structure, scaffolding, falsework, or demolition or dismantling .hereof, 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 •1 permit from the Division of Industrial Safety, as noted above, unless such person has a pe -mit 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. � Signature`of App]ican' /Agent Date `� Print Applicant/Agent'Name ot ` 284-2000 7/80 NOTICE: THIS IS NOT Ar BUILDING PERMIT DISTRICT APPLICATION TO CONSTRUCT Permit No DEPARTMENT OF BUILDING-AN..DSAFETY k. COUNTY OF RIVERSIDE 284 199 9/74 s CANARY—FILE, PINK,—APPLICANT Owner//' T / �— Architect Contractor Address_ 200lL Address_ Address_ City Os4 i t` W(2 - ��%9�,� City- Phone — �6 Phone` Phone — -- of W I (we) the undersigned;, hereby certify and acknowledgethatI (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 We County'R/W O without an encroachment permit. - - - NOW, therefore, it is. agreed that I Iwe) will not occupy said property and. will not cause said property t3 be occupied until'.1 (we) have' ' 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 N0. IJ�eL USE OF STRUCTURE JOB ADDRESS r SINGLE FAMILf DUPLEX >_- Z LEGAL DESCRIPTION OF PROPERTY :A'PARTMENTS AGRIC. ..rp_Q. CJ`L AMMERCIAL 'Q -INDUSTRIAL LJ . 'nCOMMUNITY 77-7;4- ALTERATIONS C, O.- Z NO. OF SUBMITTEWPLANS ---_ USE 0 PER T - N Q - CASE.NO. --r Z NO.rOF P KING SPACES REQUIRED — NO. OF BUILDINGS NOW EXISTING Q ZONE ETBACKS: FRONT SIDE REAR `NO Co ,GRADING PERMIT REQUIRED? YES ❑ ❑ LOT SIZE SETBACK ORDINANCE N __ OF FEETREQUIRED ON. — STREET- ' D`ATE' `� r'_ d SIGNATURE O.F.LAND USE OFFICIA DEDICATION REQUIRED: 'YES ❑ NO p _ NO. OF FEET__—.. _ W ''_ CURB AND GUTTER REQUIRED: YES E3NO C1 -STREET W . CAN CURB AND _GUTTER FEASIBLY BE INSTALLED? YES ,❑ NO ❑ . HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT F02 'DRIVEWAY, AND STREET IMPROVEMENsT? YES- ❑`_ NO ❑ O �" °L DATE "" �' ' SIGNATURE OF ROAD- DEPT. OFFICIAL SWIMMING•POOLS-9PUBLIC 2 WSEWAGE"DISPOSAL' i_ FOOD E51ABLISHMENT = C ' WATER POLLUTIONREMARKS �n FLOOD,CONTROL ' Z AIR:POLLUTION' - . DIV OF HWY}- a YOUR PROPERTY MAY BE SUBJECT TO K o FLOOD. RIVERSIDE COUNTY ASSUMES' NO RESPONSIBILITY IN EVENT OF FLOOD. 284 199 9/74 s CANARY—FILE, PINK,—APPLICANT ovswuw rcrtnu + i, . cpERM1T NO,-,' DEPARTMENT, OF .BUILDING. &.. S.AFETY_ s - 136 n C' COUNT*.OF RIVERSIDE_' FIELDOFFICE 9 J ESTIMATE NO. ELECTRICALFEES ': NO ' PLUMBING FEES .:CONSTRUCTION _ .3 -9.9, rs, ,s. t Cam• ity- - Valuation _S 1ST' FL SQ. FT. .@ $ ' UNITS .«r•. 4 i . _ 2ND: FL., SQ. FT: @ / Mc ro Flip Fee S YARD SPKLR SYSTEM of a Use mit - MOBILEHOME SVCS La '�•f. `.'BAR SINK FOR. SO. FT. @ s _ PI Ck Feet- g t- ' ,GAR. SQ. FT. @ _ POWER_ OUTLET - - - ,ROOF.DRAINS ' . ! t� CAR P'. SQ. -FT, @ F S -R ;,' - DRAINAGE PIPING .r WALL ; SO. FT. @ s ' - a - DRINKING FOUNTAIN Fee • S URINAL . '. ESTIMATEDCONSTRUCTIONVALUATION, $, 'G k. :, WATER PIPING ' an Checker 0.Final NOTE: ' Not to be used as property tow valuation Inspector • SWIM POOL% PVT FLOOR;DRAIN Sp..Insp., Fee g r MECHANICAL FEES r. ` SWIM-,POOL,'COMM WATER SOFTENER VENT SYSTEM FAN EVAP. COOL HOOD De6l. Fee i, c S SIGN'' WASHER (AUTO)(DISH Branch »• +s" r• APPLIANCE �'� - ':-DRYER y GARBAGE DISPOSAL .. •tY :FURNACE' UNIT r ' WALL' FLOOR SUSPENDED �i�, ! LAUNDRY TRAY AIR HANDL G'UNIT' CFM IDLE METER, ' - KITCHEN SINK Witness Fee ABSORPTION'.SYSTEM " w }` . s B.T.U: „ ' L i - TEMP USE PERMIT SVC' - WATER CLOSET Tel, "+: <% < s� r - ' Zip . •COMPRESSOR . •HP ., �'. POLE, TEMP/PERM LAVATORY, i _ HEATING SYSTEM FORCED, '-' GRAVITY -- r' Y:_ x ••`A'MPERES,"SERV 'ENT �, 'SHOWER `BOILER B.T.U. L �. SO.'FL` @ ; a BATHTUB -R -'' -hcke_ 0 •` SQ. FT. @ a WATER HEATER ^� . k ,,, Tel' ,,� • ; LfcenseN X., 50. FT.. RESID, @ 1 /4a SEWAGE, DISPOSAL 1 s ... y ... s/4a HOUSE SEWER Address . _ ''� A. •FEE GAS PIPING Or PERMIT FEE - ` " v,- i, . }° - PERMIT. PERMIT FEE �. DBL "TOTAL FEES MOB: HM .FEE MICRO�fEE M H. FEE `^ PUCK FEE z CONST. FEE Ee CL. E - SMI FEE -'FEE' PI MB. Pa ' -PERMIT NO:, .5'14 .�1o6- Add ess,... t ' - -. '✓ +__ - `Space Zip'.: Avo .3 -9.9, rs, ,s. t Cam• ity- - Valuation _S Date Dist. 'Off. F.C.C.. } ' MH Permf it ee ria S" _ / Mc ro Flip Fee S • of a Use mit a I No. Use/Ca o. Ck. e i . /J.�l '�i ;7j ']-'' / Q s Mech Fee t•1 $ ' PI Ck Feet- g t- `:� / _ e s - Lot Size ` ,• .. s `�S Const coon fee ?" S [Db Legal DesE prion + F S -R Elect caLFee S � 2one Rest cions Grou T e p YP$MI Fee • S X' • 'i ' Y Plumbing Fee 5. Bond AW.w,l r' •. L_an a. an Checker 0.Final Inspector • Unit - Sp..Insp., Fee g r .S '•• s, ` • a- De6l. Fee i, c S Const •' Branch »• +s" r• Suppl mentol Permit Numbers y 'Lender '- •tY 4 _ Regstr: Fee;.'. « g- '7 Mileoge Fee a'f` S Address `4 • Zips- Witness Fee Reinsp. Fee . g. „ .Owner/'Agent✓ Tel, "+: <% < s� r - ' Zip . Total Feer S Addess City - Zip �. ,' ' M.O. N.C. Cash• -hcke_ 0 a Received b Contractor ' i Tel' ,,� • ; LfcenseN X., Trees ur Sewa ' Address . _ City Or THIS PERMIT SHALL BECOME VOID IF WORK 15 NOT COMMENCED WITHIN 120 DAYS.= - CESSATION OF.WORK'r -"verified 6 T u` P FOR Ir20 DAYS SHALL ALSO CAUSE PERMIT'TO,BECOME VOID, +< " Y., Sewer District ....� .. ,I HEREBY AGREE THAT -ALL WORK IN`CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH' ` •�• _ • AL THE LAWS OF RIVERSIDE COUNTY AND JHE STATE•OF CALIFORNIA.. .., •. i . ,' - +- BY CERTIFY THAT.THE.INDIVIDUAL WHO PREPARED THE. PLANS AND'SP.ECIFICATIONS HAS DONE SQ'IN '- •' ' ` Form 284.208 (Rev. %801, • AC RDANCE•WITH SECTION 5541 OF,THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIAN . t i t y