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404014 (RER)BUILDING PERMIT e PERMIT NO. DEPARTMENT OF BUILDING 8L SAFETY FIELD FSI 04014 COUNTY OF RIVERSIDE JJ CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. 2ND. Fl. POR. GAR. CAR P: WALL . t#O,tnv ESTIMATED CONSTRUCTION SQ. FT. .@ $ UNITS SQ. FT. @ YARD SPKLR SYSTEM ' SO. FT. @ MOBILEHOME SVC. BAR SINK SQ. FT. @ POWER OUTLET ROOF DRAINS SQ. FT. @ DRAINAGE PIPING SQ. FT. @ DRINKING FOUNTAIN URINAL VALUATION $ !ilr WATER PIPING i{ NOTE: Not to be used as property tax valuation SWIM POOL, PVT FLOOR DRAIN MECHANICAL FEES SWIM POOL, COMM v } WATER SOFTENER VENT SYSTEM FAN EVAP. COOL HOOD SIGN �,� WASHER (AUTO)(DISH) APPLIANCE . DRYER AA n / f N f-eL• % r/{.�A, �AG.G� r / GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED 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. SO. FT. @ a BATH TUB ` Zone Restrictions SQ. FT. @ a WATER HEATER SMI Fee SO. FT. RESID @ 1 /ae SEWAGE DISPOSAL S0. FT. GAR @ 1/4c HOUSE SEWER Plumbing Fee Dbl S GAS PIPING PERMIT FEE e- f �/ PERMIT FEE PERMIT FEE DBL. TOTAL FEES MOB. HM. FEE MICRO'FEE MECH. FEE PL. CK. FEE SCS CONST. FEE ELECT. FEE SMI FEE FEE PLUMB. FEE 404014 ' C munity '. Valuation isf. Off. F.C.C. + r 0C, ID6'fe k" ! ,MH Permit Fee S Micro Film Fee Cop $ Us'e-o PeriM Parcel No. J j'U,./Cd`se`N.. _ C "$i,•;y�, Mesh. Fee Dbl S AA n / f N f-eL• % r/{.�A, �AG.G� r / Q `- / , r'�SRt` PI. Ck. Fee $ C// ' V •� _ r'1 • Set Bd s Lot Size 'fir =re' +•' Cr. Construction Fee Dbl $ i Ld68I ` e32ripti . IS 11 Electrical Fee Dbl $ 'i l % %�%�U {y'�i Zone Restrictions Group Type ' SMI Fee S , Plumbing Fee Dbl S Pla dam• -Pion ecke'r e- f �/ In e, or Unit Sp. Insp. Fee $ $41 v 1 t Demol. Fee $ Const. Lender Branch Supplimental Permit Numbers Regist, Fee S Mileage Fee $ Address City Zip Witness Fee $ I Reinsp. Fee $ OwnerA en /�+ Tel. Zip ; l' Total Fees $ ddie'ss""^r %''s•'" %, ""•"r*s• _ �" City Zip M.O. ❑ N.C.Ej Cash Check I Received by,. f, i Contractor - Tel. Licenses) - Trees a it ' �j •_ r'l Address CTY Zip j00 /^ a T LL 1 J P THIS PERMIT SHALL BECOME VOID F GJORK IS NOT COMME CED''\ 1 0 DKYS. 'CESSATION OF WORK verified by: FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. Sewer District �. HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH I ,1 THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. .s, �jII REBB CERTIFY THAT THE INDP'IDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN u y S [Form 284 208 (Rev. I/801 --'R•�•d'cv�+NCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. 'j� NO. OPERATION DATE INSPECTOR NO. OPERATION DATEINSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS ' 1 Set Back 33 Ventilation System 2 Ftgs 8 Frms 34 Plenums 6 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 Comm erciol� Hood.. 10 Fireplace P. L. a 43 Final 10A Fireplace T. 0. E] °o _.a_._s_ ADDITIONAL INFORMATION ' SEWAGE SYSTEM SIZE & LOCATION 11 Exterior lath 12 Internal lath 12A Drywall y ,,_ ,/L 13 Finish Grade INSULATION Thick Value 7A Walls (Batts) f/ 12B Ceiling (Batts) /r 1 v 12C Ceiling (Blown) 14 Final / .-PLUMBING-.. PPROVALS___. _.._ .. 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 i T P/L P/ " 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service q 32 Final / .. ✓ _ _- STREET NAME DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE OWNER -BUILDER INFORMATION Dear Property Owner: ' An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as owner -builder you are the responsible party of re- cord on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that -person applies for the pro- per permit in his or her name. Contractors are required by law to.be licensed and bonded by the State.of California and, where required, to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do,your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection. - ` If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. If you are an employer, you must register with the state and federal government as an employer and you are subject to.several obligations including state and federal,,income tax withholding, federal social security taxes, workers' compensation insurance, disability insurance costs, and unemploy- ment compensation contributions. There may be financial risks for you if you do not carry out these 'obligations,•and these -risks are especially serious.with respect to workers' compensation insurance. _ For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration).. For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner - builder" building permit, erroneously implying that the property owner is`providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information"about licensed contractors may be obtained by contacting the Contractors' State License Board in,your community.or.at 1020 N.Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification form so that we can confirm that you arer.aware of.;these matters. The building permit will not be issued until the verification is returned. Sincerely, DEPARTMENT OF BUILDING AND SAFETY Leopoldo Rojo, Jr. Director 284-2001 7/80 DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE OWNER -BUILDER VERIFICATION Owner Address An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for con- struction of the proposed property improvement (yes or no)` T 2. I (have/have not) signed an application for building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the pro- posed construction: Name Phone Address City Contractors License No. J 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work: Name - _ Phone T - Address City .-- Contractors Cicense No. 5. I will provide some of the work but I have contracted (hired) the fol" lowing persons to provide the work indicated: Name Address Phone Type of work Signature Property Owner^ — ^ Date 284-2002 7/80 DEPARTMENT OF BUILDING AND SAFETY APPLICATION CERTIFICATE COUNTY OF RIVERSIDE PERMIT N Effective July 1, 1980, Chapter 1301 Section 19825 -of the Neilth 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: 0 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 License No. Date Contractor ! OWNER -BUILDER DECLARATION YI he-e�ffirm 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, I understand I will have the burden of proving I did not build or improve for.the purpose of sale (Sec. 7031.5;•6.&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 , B.&P.C. for this reason: v �] 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 Building and Safety. Date Applicant Q 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. !f y _ le- Z A n Date eLgl?�/w Applicant N W 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 (366)�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. M Division of Industrial Safety Permit No. Date — - — -Applicant u+ — -- — - 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 �o ente, upon the pro- perty?for which I have appl% ed or this permit for the purpose of making ins ections e. 'rgna' ure of Applicant/Agent Date PrintApplicant/Agent Name 284-2000 7/80 NOTICE: THIS IS NOT A BUILDING PERMIT APPLICATION TO CONSTRUCT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE DISTRICT Permit No 284 199A 9/74 CANARY—FILE, PINK—APPLICANT Architect __ —_—_ Contractor_. _ Owner -01�j �—� Addres/O7a.s C�+�Ftfllr�YEless___— Address_—_—_— City 1A &Z City--_ _ City___--_ Phone— Phone Phone _ Phone— WI (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 property. DATE ----- SIGNATURE OF OWNER AND/OR AGENT_%�/�kiZ' Approval by Signature from the Following Departments Listed' Below Must Be Obtained Prior to the Issuing of a Construction Permit. I SPACE NO. I USE OF STRUCTURE JOB ADDRESS u I�A I SINGLE FAMILY DUPLEX Z F O LL LEGAL -DESCRIPTION '�x�r L� �jOFFPPROPERTY �y%F_� /1i�F/p—%� pARTMENTS AGRIC. N `q���J—1 ——��� — COMA�(ERCIAL INDUSTRIAL n COMMUNITY ..17 ALTER S ❑ C C Z NO. OF SUBMITTED PLANS USE OF PER T H CASE NO. p Z NO. OF PARKING SPACES REQUIRED — -- NO. OF BUILDINGS NOW EXISTI Q ZONE y—�.--z SETBACKS: FRONT SIDE REAR J m GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE SETBACK.ORDINA CE -- OF FEET REQUIRED ON STREET DATEZOO SIGNATURE OF LAND USE OFFICIAL F DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET -- z CURB AND GUTTER REQUIRED: YES ❑ NO ❑ _ —STREET i - • H a W CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑ HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET D IMPROVEMENT? YES ❑ NO ❑ °L DATE SIGNATURE OF ROAD DEPT. OFFICIAL— S SWIMMING POOLS PUBLIC Q W SEWAGE DISPOSAL FOOD ESTABLISHMENT _ WATER POLLUTION — REMARKS FLOOD CONTROL f H W AIR POLLUTION W DIV OF HWY a � _ a — YOUR PROPERTY MAY BE SUBJECT TO a ' c FLOOD. RIVERSIDE COUNTY ASSUMES NO RESPONSIBILITY IN EVENT OF FLOOD. 284 199A 9/74 CANARY—FILE, PINK—APPLICANT GlI .46Ad44 1,10e6 -44P12 , � , a el& rx fe COUNTY OF RIVERSIDE DEPARTMENT OF BUILDING & SAFETY APIP ROV Approval of these plans shall no ATE o• permit for, or an approval of, anybv of tion o, f revisions of the state or eoun must kept lob laws. I wail opmpk j-- BUILDING PERMIT PERMIT NO. 04014 DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE 7/1 COUNTY OF RIVERSIDE CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. 2ND. FL. POR. • GAR. CAR P. WALL ESTIMATED CONSTRUCTION SQ. FT. .@ I$ UNITS Zip- SQ. FT. @ YARD SPKLR SYSTEM MOBILEHOME SVC. SQ. FT. @ BAR SINK SQ. FT. @ POWER OUTLET ROOF DRAINS SQ. FT. @ DRAINAGE PIPING SQ. FT. @ DRINKING FOUNTAIN MH Permit Fee S URINAL VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation SWIM POOL, PVT 4 FLOOR DRAIN MECHANICAL FEES SWIM POOL, COMM ` WATER SOFTENER VENT SYSTEM FAN EVAP. COOL HOOD SIGN •� WASHER (AUTO)(DISH) APPLIANCE DRYER B A f. �+ $ GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED MKer 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. @ c BATH TUB Owner/A nt SQ. FT. @ c WATER HEATER ' S0. FT. RESID @ 1 t/<c SEWAGE DISPOSAL heck E] S0. FT. GAR @ 3/<c HOUSE SEWER City Zip Received b GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL. TOTAL FEESMOB. S� HM. FEE MICRO FEE MECH. FEE PL. CK. FEE s -o CONST. FEE ELECT. FEE ,a SMI FEE - FEE PLUMB. FEE V PERMIT NO. 404014 Job Address -Ta V4 Space Zip- Owner ,Co .unity Voluotion S Dote AJA '. W. Off. F.C.C. MH Permit Fee S Micro Film Fee Cop S wM—o .'mit / Legol Descripti /�7- ` / /1G /C' Af' V ��4..+++����/// - S' O7�J Porcel No. Use/Case No. Ck. y - Set Bac s Lot Size F S $ R Mech. Fee Dbl S9 PI. Ck. FeeS Construction Fee Dbl S Electrical Fee Dbl $ Zone Restrictions Group Type SMI Fee $ Plumbing Fee Dbl g B A f. �+ $ rIcm o. Pan MKer Dole j'�---'� /' Inspector Unit Sp. Insp. Fee S Demol. Fee $ Const. Lender 8ronch Supplimentol Permit Numbers Regisir. Fee $ Mileage Fee S Address City Zip Witness Fee $ Reinsp. Fee g Owner/A nt Tel. Zip Total Fees s M.O. N.C.0 Cash heck E] ddress City Zip Received b Contractor Tel. �../ License# Tre$K=14, ys Address City T LL 7u P THIS PERMIT SHALL BECOME VOIDIF WORK IS NOT COMMENCED WAN 120 DAYS. CESSATION OF WORK Sewer District , FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. ,1 HEREBY AGREE THAT ALLWORKIN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. IRE ERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN Form 284.208 (Rev. 1/80( ANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. verified by: 7