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417161 (PLBG)
PERMIT No. DEPARTMENT OF BUILDING t& SAFETY DST I 417161 COUNTY OF RIVERSIDE FIELD CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. 2ND. FL. POR. GAR. CAR P. WALL ESTIMATED CONSTRUCTION SQ. FT. @ UNITS Dote Dist. Off. YARD SPKLR SYSTEM SQ. FT. @ MH.Permit Fee $ MOBILEHOME SVC. BAR SINK t SQ. FT. @ Use of Permit < _ b �/�� POWER OUTLET ROOF DRAINS SQ. FT. @ Use/Cosa No. DRAINAGE PIPING SQ. FT. @ Mach. Fee Dbl $ DRINKING FOUNTAIN SQ. FT. @ Set Backs SQ. FT. @ URINAL I Construction Fee Dbl $ VALUATION $ WATER PIPING F S S R NOTE: Not to be used as property tax valuation SWIM POOL, PVT FLOOR DRAIN YP e MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER Plan No. VENT SYSTEM FAN EVAP. COOL HOOD SIGN WASHER (AUTO)(DISH) Unit APPLIANCE DRYER Demol. Fee $ GARBAGE DISPOSAL Supplimer ermit Numbers .10 Ole FURNACE UNIT WALL FLOOR SUSPENDED Mileage Fee $ LAUNDRY TRAY Witness Fee $ AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET M. 0. n N.C. CO& Check COMPRESSOR HP POLE, TEMP/PERM LAVATORY License# HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER Ci Zip BOILER B.T.U. SQ. FT. @ c BATH TUB SQ. FT. @ c WATER HEATER SQ. FT. RESID @1'/.c SEWAGE DISPOSAL SQ. FT. GAR @ % c HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL. TOTAL FPS MOB.HM.FEE MICRO FEE MECH. FEE PL. CK. FEE CONST. FEE ELECT. FEE SMI FEE FEE T PLUMB PERMIT NO. 417161-1 Job Address kr /ry Space .� f 'r] a122-_11 Zip Owner Community %Valuation ' $ Dote Dist. Off. F.C.C. MH.Permit Fee $ Micro Film Fee Cop $ Use of Permit < _ b �/�� Parcel No. / ,�+� "� 6 V X/? �(.J / Use/Cosa No. Ck. By ` Mach. Fee Dbl $ PI. Ck. Fee $ Set Backs Lot Size Construction Fee Dbl $ Legal Description F S S R Electrical Fee Dbl $ Zone Restrictions �. 4 "- 'roupT YP e SMI Fee $ Plumbing Fee Dbl $ Y Bond Amt. $ Plan No. Plan Checker Final Date /1 Z ' / �^ 8 Inspector Unit Sp. Insp. Fee $ Demol. Fee $ Const. Lender Branch Supplimer ermit Numbers .10 Ole Registr. Fee s Mileage Fee $ Address City Zip Witness Fee $ Reinsp. Fee $ Owner/Agent Tel. Zip Total Fees $ Address .a ^''a_�✓)` City Zip M. 0. n N.C. CO& Check Received b w I actor 4,. %/y/ Tel. +� p a License# Trees Sewage System- rl�.� Address Ci Zip T LL __WP THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK 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 THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. EBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN Form 284-208 (Rev.8/78) ©s CORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. Jverified by: NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System n 2 Ftgs 8 Frms 34 Plenums 8 Ducts 2A Slab Grade 35 Furnace Comport. 3 Steel 36 Inlets 8 Outlets L 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 16A Fireplace T. 0. NON � 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 (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 Z i ,� 25 Final 47- ifl Tank Pit L.Line REAR OF PROPERTY LINE ELECTRICAL APPROVALS PSL P/ t t 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final i STREET NAME DEPARTMENT OF BUILDING AND SAFETY . COUNTY OF RIVERSIDE OFFICE DATE TIME/^ PERMIT NUMBER p INSPECTION FORUESTED ADDRESS SPACE NO. I A.M. P.M. OWNER COMMUNIT ,AWUILDING PLUMBING ELECTRICAL MECHANICAt . mm a >ES X-T-lu WED QTHUR REMARKS: FR!!' OWNER/CONTRACTOR TEL.NO. 261-6 tl/ir5 NOTICE: THIS IS NOT A BUILDING PERMIT DISTRICT APPLICATION TO CONSTRUCT Permit No DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE 284 199 9/74 CANARY—FILE, PINK—APPLICANT Owner n�Arcbi ect Contract— �� y Addres Ad/�ss Addres 1j I l . 4 ,/ City r/ u City City_ Phone — Phone Phone J I (we) the undersigned, hereby ccrtify'and acknowledge that I (we) have read the application and agree that if Curb and Gutter, and W 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 withall laws of the County of Riverside and the State of California governing said property. �P 9j DATE SIGNATURE OF OWNER AND/OR AGENT Approval by Signature from the Following Departments Listed Below Must Be rained Prior to the Issuing of a Construction Permit. I SPACE NO. i USE OF STRUCTURE 'ADgejg � J / �1/p'-)O JOB ADDRESS // _ C �T SINGLE FAMILY DUPLEX �] Z W LEG L DESC IP N,cOF�PROPERTY J AGRIC. El r'/Gl J SGT `y/� j �f - APARTMENTS O H Q T—COMMERCIAL INDUSTRIAL LJ SJ� CG Z COMMUNITY NO. OF SUBMITTED PLANS ---_ USE OF PERMIT T��7 ALTERATIONS Cj N Q CASE NO. p Z NO. OF PARKING SPACES REQUIRED NO. OF BUILDINGS NOW EXISTING - ZONES ! SETBACKS: FRONT SIDE REAR J m GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE SET BACORDINANCE OF FEET REQUIRED ON ET ^ ^'� ' DATE SIGNATURE OF LAND USE OFFICIAL DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET___ _ zCURB AND GUTTER REQUIRED: YES ❑ NO ❑ —STREET H ' s CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑ W HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET CIMPROVEMENT? YES ❑ NO ❑ °L DATE __ SIGNATURE OF ROAD DEPT. OFFICIAL Z SWIMMING POOLS PUBLIC•- WSEWAGE DISPOSAL _ _ FOOD ESTABLISHMENT .NATER POLLUTION REMARKS F-L'OOD CONTROL W -AIR POLLUTION at _'�? DIV OF HWY YOUR PROPERTY MAY BE SUBJECT TO 6. o FLOOD. RIVERSIDE COUNTY ASSUMES NO RESPONSIBILITY IN EVENT OF FLOOD. 284 199 9/74 CANARY—FILE, PINK—APPLICANT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE PERMIT N Effective July 1, 1980., Chapter 1301 Section 19825 ,of the Nealth 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: 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 C — 3Co License No. O t/ � Date ��? / -A _ / Contractor Q ✓ OWNER -BUILDER I hereby affirm that I amexempt 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,llicensed contractors to construct the project (Sec. 7044,yB.&P.C.). [� I am exempt under Section B.&P.C. for this reason: . A Date ? 1.3 Owner J0 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 0 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. Date �—� �' �� Applicant -.5w t/ 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). r 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,te. descend, will be made i6 connection with work authorized by this permit, and that no buildi,ng, 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. [� Division of Industrial Safety Permit -No. /I Date 2 / Applicant L J/�l I./ 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 ,a 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 makinZg infections. % -7�-�3i Signature of pp Tcant gent Date Print Applicant/Agent Name 284-2000 7/80 BUILDING PERMIT PERMIT NO. 417161 PERMIT NO. 41 1 DEPARTMENT OF BUILDING & SAFETY COUNTY OF RIVERSIDE FIELD OFFICE Valuation $ DST F// CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. 2ND. FL. FOR. GAR. CAR P. WALL ESTIMATED CONSTRUCTION SQ. FT. @ UNITS Use/Cosa No. Ck. By YARD SPKLR SYSTEM SQ. FT. @ PL Ck. Fee $ MOBILEHOME SVC. BAR SINK SQ. FT. @ Lot Size POWER OUTLET ROOF DRAINS SQ. FT. @ Legal Description �}L - S�� "f" � a DRAINAGE PIPI SQ. FT. @ — S R DRINKING FOU TAIN SQ. FT. @ Zone Restrictions SQ. FT. @ URINAL Type VALUATION $ WATER PIPIN Plumbing Fee Dbl $ NOTE: Not to be used as property tax vol.iation SWIM POOL, PVT FLOOR DRAIN Final Date (�/ _ (� MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER Demol. Fee $ VENT SYSTEM FAN EVAP. COOL HOOD SIGN WASHER (AUTO)(DISH) Mileage Fee $ APPLIANCE DRYER Witness Fee $ GARBAGE DISPOSAL Owner/Agent FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY Address AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK -tactor /") (�, `(,� ` 7 ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET Sewage System �' COMPRESSOR HP POLE, TEMP/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. @ c BATH TUB SQ. FT. @ c WATER HEATER SQ. FT. RESID @1'/.c SEWAGE DISPOSAL SQ. FT. GAR @ 3/4 c HOUSE SEWER GAS PIPING Z PERMIT FEE PERMIT FEE PERMIT FEE dBL. Or_ L FQS15 w�IJ MOB. HM. FEE MICRO FEE MECH. FEE PL. CK. FEE CONST. FEE ELECT. FEE SMI FEE FEE PLUME. FES J� PERMIT NO. 417161 J b Address k ' Space Zip - u >,� � �k Owner At' Co munit • f , Valuation $ Date f / Dist. Off. / F.C.C. MH Permit Fee E Micro Film Fee Cop $ Use of P,errrmmit`, �D"" Y � �Q Parcel No. J/% r // � -OD Use/Cosa No. Ck. By Mech. Fee Dbl E PL Ck. Fee $ Set Backs Lot Size Construction Fee Dbl $ Legal Description �}L - S�� "f" � a F S S R Electrical Fee Dbl $ Zone Restrictions Group Type SMI Fee $ Plumbing Fee Dbl $ Bond Amt. $ Plan No. Plan Checker Final Date (�/ _ (� I ec or Unit Sp. Insp. Fee $ Demol. Fee $ Const. Lender Branch Supplimentol Permit Numbers Registr. Fee $ Mileage Fee $ Address City Zip Witness Fee $ Reinsp. Fee $ Owner/Agent Tel. Zip Total Fees $ Address City Zip M.O. F1 N.C. Cc& Check Received b -tactor /") (�, `(,� ` 7 Tel. �..// �� V License# Trees req r Sewage System �' AddressXr��y. v C' F �p , T LL "''P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK 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 THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. EBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN Form 284-208 (Rev.8/78) @s ORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. 'verified by: