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403065 (RPL)03065 DEPARTMENT OF BUILDING & SAFETY COUNTY OF RIVERSIDE FIELD FDTTJ PERMIT NO. 403065 CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. 2ND. FL. FOR. GAR. CAR P. WALL ESTIMATED CONSTRUCTION SQ. FT. @ $ UNITS Dist / Off. SQ. FT. @ YARD SPKLR SYSTEM SO. FT. '@ MOBILEHOME SVC. BAR SINK SQ. FT. @ POWER OUTLET ROOF DRAINS SO. FT. @ DRAINAGE PIPING SO. FT. @ DRINKING FOUNTAIN SQ. FT. @ URINAL VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation SWIM POOL, PVT Zone Restrictions FLOOR DRAIN Typa MECHANICAL FEES SWIM POOL, COMM Bond Amt. WATER SOFTENER VENT,SYSTEM FAN EVAP. COOL HOOD SIGN Unit ,. WASHER (AUTO)(DISH) APPLIANCE DRYER Supplimental Permit Numbers — �/���/,'[\ f Registr. Fee f GARBAGE DISPOSAL FUR"rACE• UNIT WALL FLOOR SUSPENDED Reinsp. fee f Owner/Agent e LAUNDRY TRAY AIR HANDLING UNIT CFM IDLE METER Gty Zip KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC License#. ) •� ,�; 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 SO. FT. @ ¢ WATER HEATER S0. FT. RESID @ 1 tAa SEWAGE DISPOSAL S0, FT: GAR @ 344 HOUSE SEWER GAS PIPING PERMIT FE PERMIT FEV ^CONST. J PERMIT FEE i DBL. TOTAL FE - M08. HM, FEE MICRO'FEE MECH, FEE PL. CK. . EEE ^'MHLECT_Ufr, SMI'FEE FEE FLUMB,,F,E2'� PERMIT NO. 403065 Space Zip Community Valuation S r Dist / Off. F.C.C. MM Permit Fee f Micro Film Fee Cap f Use of �Perm/it.L,rl. /a•` -/• ./ (/% F /e (Y� V�(/•%N///%Use/Case. No. Ck. By �'• Misch. Fee Dbl $ PI.. Ck. Fee S' �^- Set Socks Lot Size Construction Fee D S � Electrical Fee Db i lope!Description / �/"), % `fi Jr `-• iy% F Zone Restrictions Croup Typa SMI Fee S Plumbing Fee Dbl f. Bond Amt. Plan No. Plan Checker FinalData or Inspector Unit ,. Sp. Insp. 'Fee j1 $ Denial. Fee f Const. Lander Branch Supplimental Permit Numbers — �/���/,'[\ f Registr. Fee f Mileage Fee S Address - City - Zip Witness Fee f Reinsp. fee f Owner/Agent e Tel. Zip. Too! FeesI47.7S '-� Address. �'+wm," '' Nrtiy Gty Zip M.O. ❑ N.C. ❑ Cosh Check Q Contractor ry✓IJ °x .��'!'~_ 'Tet. s.�/• r,�� License#. ) •� ,�; T i °q9'f !.1 wage System .. _ •! Ad renp . City/` Zip. • T LL THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. Sewer District - . I HEREBY AGREE THAT ALL. WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH Z q THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. I,REBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS. HAS DONE SO IN Form 284'208 (Itev.' 1/80) RDANCE WITH .SECTION 5541 OF THE BUSINESS, AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. verified by: NO- OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Bock 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 Bdnd 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. F-1 43 Final 10A Fireplace T.O. [j °o ------------------------------------- ADDITIONAL INFORMATION n % --15 SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Loth 12 Internal Lash 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Walls (Batts) 12B Ceiling (Batts) 12C Ceiling (Blown) 14 Final -- --P-WmlatNG-APPROVALS. ------ ---------------------------------------------- 15Ground 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 P/L 4 P/ 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 298 Bonding. 30 Fixtures 31 Service 32 Final 1 2 STREET NAME DEPARTMENT OF BUILDING AND SAFETY .,:COUNTY OF RIVERSIDE OFFICE DATE TIME, PER Mlye 'INSPECTION FOR: -'REQUESTED ADDRESS 'SPACENO. AA - . IT COMMUN a_ BUILDING _ PLUMBING E .. LECTR - 1%1- MECHANICAL:_ ITN t TUIES- THUR -REMARKS:: nol OWNER/CONTRACTOR TELI.N.10. w. C. Fk . . . . . . . . .... .......... 71 TT LATEST*I'NSPECTIO.N INITIALIZED ON FINALIZED' ON EXPIRED ON 01/02/80 01/02/80 INSPECTION DATES nG fi Yt 5r PROCESSING COMPLETE 4 MIN3 DEPARTMENT OF BUILDING 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 follow.fng'applicable declarations prior to, the issuance of a building perm,it.` Please print or type and sign below. �-i LICENSED CONTRACTORS DECLARATION �I hereby affirm that I am, licensed under proxisions of Chapter 9 (commencing with Section 700.0) of Division 3 of the Business and Professions Code and my license is i'n fu€11 force and effect. License lass License Date —3 Contractors Q OWNER -BUILDER DECLARATION �- Me a 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 isnot 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 7037.5, B &P C'). e I, as ,owner of the property, am exclusive:l'y contractingwi`.th licensed contractors to construct the project (Sec. 7044, 6.&P.t j . [:I I am exempt under Section , B,.`&P.C. for this reason:: I hereby affirm that I'have a certificate of consent to•sel,.f-insure, ori -Certificate of'Workers' Compensation Insurance, or a certified copy, thereof (Sec.. 3800, Lab.. Code'). Policy No. Insurance [] Certified copy is hereby furnished. 0 Certified copy is filed with the County of River-si:de, Department of'Bui`lding and Safety.. Date Applicant CERTIFICATE OF EXEMPTION. FROM WORKERS' COMPENSATION INSURANCE (This section need not 6e completed if ipermit valuation is for $100.00 or less.,) I certify that in the performance of the work for which this permit is issued, I sha`11 not employ any person in any manner so as to become subject to the Workers' Compensation l.aws of California. I further understand that i' after making this Certificate of Exemption,, I should become subject:�to the Workers' Compensation proyisi'ons of the labor codej'I must forthwith 'comply with such provisions or this permit shall be deemed revoked. Da) � i�� �� � ADPI'i,cant �- ON LENDING AGENCY y affirm that there is a construction lending agency for the performance of the work for 'his permit is issued (Sec, 3097, Civ.. Code). s Name. DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION [� I hereby certify that no-excavatiton five ('5) or more feet in depth into which a person is re- quired to descend, will be made in connection with,work authorized by this permit,, and that no building, structure, scaffolding, fals'ework, a 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. Date Applicant CERTI!,FICATE OF COMPLIANCE AND.AUTHORIZATION OF ENTRY' F1. I certify I. have read this application and state that thedinformation g,i;ven fs :correct. I agree to com,'ply 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- erty fQr w)7h I`ffia'we applied for this permit for the purpose of making inspections. Si.gnat o App scar%A9 - - Date ( C rrnt AonlicanV&ent Name BUILDING . PERMIT PERMIT NQ: �'• ;. DEPARTMENT- OF BUILDING A SAFETY 14-03,0-6 C . ;CO.UNTY &JRIVERSIDE' FIELD OFFICEJ P CONSTRUCTION ESTIMATE NO. ' .. y .. ELECTRICAL; FEES - „NO. -PLUMBING. FEES 1ST FL 2ND FC. POR. GAR CAR.P., :• WALL _ - -. ESTIMATED. CONSTFU,CT.ION'• SQ:,,Fi. ' Owner ,[//� '• .'. , PERMIT' NO: S,Q:'FT: -@ YARD:SPKLR SYSTEM ' SCQ'.:FT.@-- _ AA081LEHOME SYC BAR'SINK ' SQ. -FT- @ FOVJER.OUTLET ROOF DRAINS, " S,Q:'FT.- •@ DRAINAGE PIPING SQ. SFT.G�'-. - - - DRINKING FOUNTAIN VoI gfien' - ISI r UR1NA} -I VALUATION, $., WATER; PTINfa' -CHI. NOTE:• Not to be used, cs', property tcxs valuation SV✓IM. POOL, Pv ; FLOOR DRAIN.: ' MH.Pertnil .Fee. MECHANICAL :F.EES ::._ " , :. _ - SWIM POOL,, coMM WArEA�soF.iENER Use of'Paimif- _ VENT'SYSIEM FAN E,"P,- CQ QL -HOOD - ' SIGN -, WASHER (AUTO)(DISH) APPLIANCE, ._ DRYER. lDbI GARBAGE- DISPOSAL 5,: 'FURNA_CN ._ s UNIT _, -WALL :. FLOOR. SUSPENDED ' / !T .! :p.. /f` f!' - YYY���"' -' • .DescriplionR LAUNDRY TRAY. ,�, • r• AIR: HANDLING UNIT, IDLE': METER KITCHEN SINK q ;Pl. Q. Feey ,ABSORPTION ;SYSTEM. ; �, B;T:U. TEMP UWPERMIT SVC WATER CLOSET - COMPRESSOR HP' I'POLE-; TEMP/ PERM LAVATORY . HEATINGSYSTEM FORCED GRAVITY' AMPERES SERV" ENT SHOWER' �•+• BOILER, - i B:T v SQ: FT. @' a. BATHTUB Zone1RedricMm:• 'Type _. SQ.. FT:'!@ a ,'WATER HEATERS +, a/ - .. rSMl.Fde _�• Sy- $0', FT,- RFSID -@ 1;Vi47 • !S EWAGE';DISPOSAL 'rood AmL. • Plan 'No.. S0, FT: GAR @ ?ba HOUSE .SEWER Do„- (1� . Inspeetor, _ CiA'S,PIPING' ' PERMIT FE _ f._ PERMR ;FE� ., RERMIT FEE Const lende-r Brbmch •.Address ,City, f DBL. - "TOTAL ,FEE - • MOB: HM FEE'. MICRO. FEE' MECH. FEE CK.. RFF�., C11�C�� CONST. FFi •�t6LECT_:jry SMIFEE- 'FE . PIUAAB, . ?_ _ LL _ _ IHib�F1:RMII SHALL BEEUME VUID•IF WORK 15 NO] EUMMENLED-WIIHIN-11U UATb. LtS,-,Al,lUN Ut WVRK • verified by( Sew FOR 120 DAYS,-5HALl A'LSOICAUSE PERMIT TO BECOME VOID.. Sr 'District . n - - -1'.HEREBj” AGREE THAT' ALL WORK IN CONNECTION WITH THIS PERMIT WIM BE DONE IN ACCORDANCE -WITH - THE `PAW, OF•.RIVERSIDE'€OUNTY'•AND THE, STATE OF CALIFORNIAS' /� f HEREBY CERTIFY7TiAT THE INDIVIDUAL WHO PREPARED THE PLAA5 AND-fSPECIFIC'ATIONS .JAS DONE SORIN t Form 28A 206 "(Rev. dy80) - Gam!/� - RDANCE WITH SECTION 3541 OF THE BUSINESS AND PROFESSIONS CDDE 06 THEBTATE OF ,C_:ALIFORNIA': -- - .. .. lob, Addreis - • - - .: y/ -, - r -:Spore li'p - n ' Owner ,[//� '• .'. , PERMIT' NO: 03 ,o. CA—unify - s ' - VoI gfien' - ISI Da . -I D!sl -CHI. ' T MH.Pertnil .Fee. Mt o filrrm Fee �. Cop'S:' - - Use of'Paimif- _ ,. Porcel%;N,cy:/� - �/ �S UTe/Case Ne:. Ck~ By �. lDbI Mech..Fee 5,: / !T .! :p.. /f` f!' - YYY���"' -' • .DescriplionR ,�, • r• - ;Pl. Q. Feey Set 'BprJis Lot :Size, Conrrudieri Fee Legol �Q �•+• 19 Zone1RedricMm:• 'Type _. Electrical --Fee DB +, a/ - .. rSMl.Fde _�• Sy- 'Plbmbing„Fee _ Ob( S-: " • 'rood AmL. • Plan 'No.. , Plon•Checkpc •"- f:Flnoi' Do„- (1� . Inspeetor, _ unit. Remol. Fee - ' "S, Const lende-r Brbmch •.Address ,City, Supplimeiitol Permit Nsfmben•', w��'• / �/ t• !% - Mileage• Fee S ', ''t 7 Zip ' - -.i1- WYnesr Fee ,. S� - t R r- - - -'-. art -761fi` -. • .. �' r .. Total;Feei E' Addr- - i .. "='' - City hL:O: a No -C ❑, .Cgsb• heck-row a ' z_ o_ c r: "_n -/ ' _ e_ F,7-1•+ - .lf�ensaR+�7 . wage System - ✓ 'Ad rens ' - / t - , Cit /J'l'sI : • :Yip. ' ?_ _ LL _ _ IHib�F1:RMII SHALL BEEUME VUID•IF WORK 15 NO] EUMMENLED-WIIHIN-11U UATb. LtS,-,Al,lUN Ut WVRK • verified by( Sew FOR 120 DAYS,-5HALl A'LSOICAUSE PERMIT TO BECOME VOID.. Sr 'District . n - - -1'.HEREBj” AGREE THAT' ALL WORK IN CONNECTION WITH THIS PERMIT WIM BE DONE IN ACCORDANCE -WITH - THE `PAW, OF•.RIVERSIDE'€OUNTY'•AND THE, STATE OF CALIFORNIAS' /� f HEREBY CERTIFY7TiAT THE INDIVIDUAL WHO PREPARED THE PLAA5 AND-fSPECIFIC'ATIONS .JAS DONE SORIN t Form 28A 206 "(Rev. dy80) - Gam!/� - RDANCE WITH SECTION 3541 OF THE BUSINESS AND PROFESSIONS CDDE 06 THEBTATE OF ,C_:ALIFORNIA': --