399480 (ELEC)BUILDING PERMIT
PERMIT NO.
99480
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
FIELD 7'ST
I
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST Fl.
2ND. FL.
POR:
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SO. FT. .@ $
UNITS
Dist.
SQ. FT. @
YARD SPKLR SYSTEM
SO. FT. @ MOBILEHOME SVC.
BAR SINK
SO. FT. @ POWER OUTLET
ROOF DRAINS
SQ. FT. @
DRAINAGE PIPING
SO. FT. @
DRINKING FOUNTAIN
SO. FT. @
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_
Final Date
GARBAGE DISPOSAL
FURNACE UNIT WALL . FLOOR SUSPENDED
:57uv 4w, e_
LAUNDRY TRAY
AIR HANDLING UNIT CFM
rDLE METER 1 t
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
Tel.
SO. FT. @ a
WATER HEATER
Sew ^ ste
SO. FT. RESID @ 1 I/aa
SEWAGE DISPOSAL
S0. FT. GAR @ s/4a
HOUSE SEWER
'
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL.
TOTAL FEESMOB.
HM. FEE
MICRO FEE
MECH. FEE PL. CK. FEE
CONST. FEE EiJTL. FEE'
SMI FEE
FEE PLUMB. FEE
t
PERMIT NO.
399480
Job Address V Space Zip
r
— — — �-
Owner
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C u ty cr Int..
(� R fry
Valuation
S
[Criefer' �
1719 s:%h-
Dist.
Off.
I F.C.C.
MH Permit Fee $
Micro Film Fee Cop $
se of erdff
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l- c c r ii � - � LAG
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Parcel No.
r !% �% r,� �. 7
Use/Cas No.
Ck. By -
•'
OSQ
Mech. Fee Dbl $aiall-,�
PL Ck. Fee $
Set BacksLot
Size
Construction Fee Dbl S
Legal Description
siElectrical
� e x
/'-•�~ �� ,� i 7 /��
F
5 SEP
Fee Dbl $
Zone Restrictions
Type
SMI Fee $ L)
Plumbing Fee Dbl S
Bond Amt. Plo o.
$
Plan Checker "'
Final Date
InsyM,ectnor' /
Unit
Sp. Insp. Fee $
NDemol. Fee $
t
Const. lender Branch
Suglitcil Permit Numbers t
Tel. Zip
Zip
M.O. N.C. Q ' Cash &— E)
Received y � t
Contrac or
Tel.
licensell
Trees
Sew ^ ste
Address
City Zip
T LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by:
Sewer District t FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
a s
•1 HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH
THE WS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO -IN"'
Form 284-208 (Rev. 1/80) ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALLFORNIA.,-
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System'
'2f
Ftgs 8 Frms
34
Plenums 8 Ducts t !'•
2A
Slab Grade
.35
Furnace Comports '
3 y
Steel
36
Inlets 8 Outlets
4
Grout Blocks
37
Combustion.Air y
_'
5
Bond Beams -
..38
Compressor
r
1
6
Roof Deck -
39
Appl. Clearonce t
7
Framing
-
40
Fire Damper q
j
8
Vents
41
Smoke Detection Device
i
9
Garage Fire Wall
..
d2.'!' 'Commercial
Hood
10
Fiieploce P. L.
43, final.:::': -
-
10A
Fireplace T.O.
[`}
OW
`
ADDITIONAL INFORMATION
-
-
-
r
'
y
-
1
"
e
i
a '
s
1
t
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
-.13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts)
'12B Ceiling (Batts) 1
12C Ceiling (Blown)
14 Final
PLUMBING APPROVALS
15 Ground Plumb _
16 Water Piping
17 Rough Plumb
16 Vents,
19 Sewage Disposal
20 Sewer
21 Water Heater
22 Water Softener
23 Water Service
24 Gas Test
Tank
- Pit L. Line
r
REAR OF PROPERTY LINE
,
1 ,
ELECTRICAL APPROVALS
P/L
ly P/
f
=`r
26 Power Pole
27 Conduit
28 Service Entrance -
29 Wiring
.29A Grounding Wire (�—� — — -
298 'Bonding
_
30 Fixtures -
31 Ser,,ice
32 Final
STREET NAME
i
i DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF.RIVERSIDE
OWNER -BUILDER VERIFICATION
ner
Address4LeZVeM
g/ < �� v
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)
20 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: - —�-- --- -
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
Address City
Contractors License 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
Xigpat2ugrf Property Owner Date.
Social Security Number
284-2002 7/80
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 bean 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
nemployment compensation contributions.
There maybe 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" bui.lding 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 are 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. l
Director
284-2001 7/80
DEPARTMENT OF BUILDING AND SAFETY APPLICATION CERTIFICATE
COUNTY OF RIVERSIDE PERMIT N
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.
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
I hereby affirm that I am exempt from the Contractor's License Law for the following reasons:
Q 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, B.&P.C.).
0 I, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec. 7044, B.&P.C.).
M I am exempt under Section , B.&P.C. for this reason:
Date Owner
0 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
n CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE
/JC (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
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 in 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.)
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
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
repres tative of the County of Ri i, ent of Building and Safety to enter upon the pro -
pert r which I have app 'ed f is dep it par r the purpose of making inspction---J.) cnd
i ture o ica Date
Print Applicant
284-2000 7/80
COUNTY OF RIVERSIDE
DEPARTMENT OF
BUILDING & SAFETY
APPROVED
BY DATE
Approval of these plans sha,-,1no-t bviolat t uof any Of
v 3 permit for, or an approval of, anys.
1 ye i :henlans must be keptson the job until) completia�
d i
�ot
0
1 ��� �„p VU6 br.Naod►7v� b1NInM
�a�i� a� �r� an x08 vd3dd3H LL9"
Imodo '1 'a MIX
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 t, CANARY—FILE, PINK—APPLICANT
Owner�T; iG-/`� 4fi4e' rchitect Contractor
190, ax
5'SIFAddress_'5�K"'412 3-E°d.�2FR Address Address—
City l' ) -J '00, T�iiI4 City City_
Phone _ t �_!5�3 Phone Phone
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. 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 o be occupied until ( have
complied with all laws of the County of Riverside and the State of California governing said property.
DATESIGNATURE OF OWNER AND/OR A
Approval by Signature from the Following Departments ist Below
Must Be Obtained Prior to the Issuing of a Const ction Permit.
(� I SPACE N0.
G�/ 1 USE OF STRUCTURE
JOB ADDRESS -� erg^ ;Vlony'RQ � lI
SIAGLE FAMILY DUPLEX
Z
�/�/y—
LE AL DESCRIPTION OF PROPERTY �% '�� -APARTMENTS AGRIC.
70;e��—�
`tt MMERCIAL INDUSTRIAL n
j '^
COMMUNITY ALTEIONS n
G
Z
USE OF PERMIT NO. OF SUBMITTED PLANS — _ —
CASE NO.
Z
NO. OF PARKING SPACES REQUIRED NO. OF BUILDINGS NOW EXISTING ---
Q �ZONE
..,, SETBACKS: FRONT SIDE REAR
J m
GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE
SETBACK ORDINANCE # __ OF i FEET REQUIRED ON T EFT
7--
DATE . SIGNATURE OF LAND USE OFFICIAL
DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET ---
t-
CURB AND GUTTER REQUIRED: YES ❑ NO ❑ - STREET
t-
d
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 ❑
DATE J SIGNATURE OF ROAD DEPT. OFFICIAL
=
s
SWIMMING POOLS PUBLIC
WSEWAGE
DISPOSAL
_
FOOD ESTABLISHMENT
WATER POLLUTION REMARKS
�n FLOOD CONTROL—
ONTROLW
Z_AIR POLLUTION
Y '
• _ DIV OF HWY
YOUR PROPEFtTY•MAY BE SUBJECT TO
c FLOOD. RIVERSIDE COUNTY ASSUMES
NO RESPONSIBILITY IN EVENT OF FLOOD.
284 199 9/74 t, CANARY—FILE, PINK—APPLICANT
BUILDING PERMIT
PERMIT NO.
399480
DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE D/
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL.
2ND. Fl.
FOR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SO. FT. .La� $
UNITS
Zip
SO. FT. @
YARD SPKLR SYSTEM,-
MOBILEHOME SVC.
SQ. FT. @
BAR SINK L
SQ. FT. @ POWER OUTLET
ROOF DRAINS
SQ. FT. @
DRAINAGE PIP{NG
SQ. FT. @
DRINKING FOWL TAl
SO. FT. @
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
Lot Size
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDEDLAUNDRY
Legal )Description
1 0„�• _ 9 ,�C�- .
—^�
TRAY
AIR HANDLING UNIT CFM
M ER
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
SO. FT. @ a
WATER HEATER
Unit
SO. FT. RESID @ 1 t/aa
SEWAGE DISPOSAL
Demol. Fee $
SO. FT. GAR @ t/4a
HOUSE SEWER
Branch
Supplimentol
Permit Numb
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL.
TOTAL FEES
'V
MOB. HM. FEEMICRO
FEE
MECH. FEE PL. CK. FEE
CONST. FEE E.
00
SMI FEE
FEE PLUMB. FEE
PERMIT NO.
3 9 9 4 8 0
Job Address ,fG
Y �i
—
00
Space
Zip
Owner
G
/0��
C u ,ty
24 a, ,
i'
Voluotion
S
t
•
Dist.
Off.
F.C.C.
-
MH Permit Fee S
Micro Film Fee Cop S
se o erm �i
Parcel No.
Use/Case
No.
Ck. By
Mech. Fee Dist S
PI. Ck. Fee S
Set Backs
Lot Size
Construction Fee Dbl S
Legal )Description
1 0„�• _ 9 ,�C�- .
—^�
F S S
R
Electrical Fee Dbl S
Zone Restrictions
Group
Type
SMI Fee S
Plumbing Fee Dbl $
Bond Amt.
S
Plan o.
Plan Checker
Final Date
—
Inspector
Unit
Sp. Insp. Fee S
Demol. Fee $
Const. Lander
Branch
Supplimentol
Permit Numb
s
s
Regior. Fee $
Mileage Fee $
Address City
_
Witness Fee $
Reinsp. Fee $
er/
/
Tel.
Zip
Total Fees S
O
Address
City
Zip
'
M.O. ❑ N.C. ❑ Cash C ec4;2�,r-1
Received
Contrac or
Tel.
Licensell
Treo re
Sew yste
Address
City
Zip
T LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION 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
THELAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
Form 284-208 (Rev. 1/80) ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND,PROFESSIONS CODE OF THE STATE OF CALIFORNIA.