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427166 (BLCK)BUILDING PERMIT PERMIT NO. 427166 DEPARTMENT, OF BUILDING & SAFETY COUNTY.OF RIVERSIDE . FIELD CONSTRUCTION ESTIMATE ,PERMIT NO. _ 4 L 1 6 6 NO. ELECTRICAL FEES NO. PLUMBING FEES a IST `FL. 21ND. FL. POR. GAR. All�fi �J ,�. 11� $ SQ. FT. @_ Com unity UNITS Date SQ. FT. @ YARD SPKLR SYSTEM MOBILEHOME SVC. SQ. FT. @ BAR SINK SQ. FT. @ POWER OUTLET ROOF DRAINS Parcel No.I p �y J V 11R DRAINAGE PIPING FT. @ i 1 J �"' DRINKING FOUNTAIN SQ FT @ URINAL ESTIMATED CONSTRUCTION VALUATION $ i C f 1 .� Legal Description f1K..• t/ If Q JL+` , WATER PIPING NOTE: Not to'be used as property tax valuation ZfojJ�je Restricctiia," h.• -Z Ur 000 ,/—A SWIM POOL, PVT FLOOR.DRAIN MECHANICAL FEES Plumbing Fee Dbl S SWIM POOL, COMM WATER SOFTENER VENT SYSTEM FAN EVAP. COOL HOOD SIGN WASHER (AUTO)(DISH) APPLIANCE DRYER Const: Lender Branch Supplimental Permit Num rs , GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR' SUSPENDED Address City Zip Witness Fee LAUNDRY TRAY AIR HANDLING UNIT CFM Tel. Zip , IDLE METER KITCHEN SINK„ ABSORPTION�SYSTEM B.T.U. City ZIP TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP Tel. )� d .r -! iV `t ` -: POLE,TEMP/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AddressCi.N �`/� �/' /; � �(�•�+ � AMPERES SERV ENT SHOWER BOILER B.T.U.: •Sewer District Form•Ri34 208 (Rev.e/78) ©s SO. FT. @ C BATH TUB SQ. -FT. @ c WATER HEATER SQ. FT. RESID @1'V.c SEWAGE DISPOSAL SQ'. FT. GAR @ i. c HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL.FEE¢ MOB. HM.EEE MICRO FEE MECH. FEE PL. CK. FEE ELECT. FEE CONST: WS WS r C3 SMI FEE - FEE PLUMB. FEE • ,PERMIT NO. _ 4 L 1 6 6 Job Add re (( Space Zip Owne _ Com unity Valuati Date Dist. Off F.C.C. MH.Permit Fee S Micro Film.Fee Cop 6 Use ofPermit - Y t X I. (,,. 3 V A'-�i� •••� L•E� �!� • Parcel No.I p �y J V 11R e/Case No. VIA?Z 191 f C •-' Mech. Fee Dbl S _ PI. Ck. Fee Set Backs Lot Size Construction Fee Dbl E 7 Legal Description f1K..• t/ If Q JL+` , S S R Electrical Fee Dbl S ZfojJ�je Restricctiia," h.• -Z Ur 000 ,/—A Group Type SMI Fee j Plumbing Fee Dbl S Bond Amt. _ Plan No.. Plan Checker Unit . j Sp. Insp. Fee r Demo!. Fee i Const: Lender Branch Supplimental Permit Num rs , 1 �I Registr. Fee Mileage. Fee s Address City Zip Witness Fee Reinsp. Fee. $ OwnegAgent Tel. Zip , • Total Fees = + Address% �} City ZIP M:O. N.C. C..hn Chec �-Received by_ Con rct�t or - j1p� �•'f�` (L���, (": Il.� '.,,J44V Tel. )� d .r -! iV `t ` -: License# . Trees required 'Sewage System AddressCi.N �`/� �/' /; � �(�•�+ � /) � .Zip THIS PERMIT SHAW BECOME VOID'IVWORK IS NOT COMMENCED WITHIN 120 DAYS. rCESSATIONbFWORK. verified by: 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. I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN ACCORDANCE WITH SECTION SUI OF, ITHE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. •Sewer District Form•Ri34 208 (Rev.e/78) ©s NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUIL®ONG APPROVALS lt�i KHA VOCAL APPROVALS 1 Set Back �,! 33 Ventilation System 2 Figs 6 Firms 34 Plenums & Ducts 2A Slab Grade 35 Furnace Comport. 3 Steel ' 36 1 Inlets 8 Outlets ,Q4 Grout Blocks -.> 37 1 Combustion Air Bond Beams 0 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 10A Fireplace T.O. 0 P' ADDITIONAL INFORMATION �1 V "(`► a (y� If I 1-__ / Of 47 ^ n r _ SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Loth 12 Internal Loth 12A Drywall 13 Finish Grade INSULATION Thick Value 7A Walls (Botts) 12B Ceiling (Botts) 12C Ceiling (Blown) 14 FinalOK PLUMBUNG A R VAA 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 LLine P/L REAR OF PROPERTY LINE ELECTRICAL APPROVALS P/ 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire - 29B Bonding 30 Fixtures 31 Service 32 Final STREET NAME NOT:CE: THIS IS NOT A BUILDING PERMIT APPLICATION TO CONSTRUCT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE DISTRICT NO Permit No 284 --f.0-9A 9/74 CANARY—FILE, PINK—APPLICANT Owner Architect— _ Contractor--- — n G' Address -IA .M`^^"` ess___ Address� 1rw rj ol-�°} City —— -"' City— City____lA�nN1� Phone�3J Phone_ �,. )3 Phone- - — _ I (wej the undersigned, hereby certify and acknowledge that I (we) have read the application and agree, that & 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 shall not .make a Final Inspection until said requirements have been met. I am also aware that no ,work is to be donewithin 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 prop ty to be occupied until I (we) have complied with all laws of the County of Riverside and the State of California governing said property: /j pl rte` JJ �� DATE SIGNATURE OF OWNER AND/OR AGENT Approval by Signature from the Following Departments Listed Below Most Be Obtained Prior to the Issuing of a Conskinc%oe Permit. SPACE` NO. ;2 3 1 USE OF STRUCTURE -JOB ADDRESS SINGLE FAMILY DUPLEX Z O " LEGAL DESCRIPTION OF PRO ERTY $ - APARTMENTS AGRIC. COMMERCIAL �' INDUSTRIAL Ej N N OMMUNITY . ALTERATIONS G c- m�� NO, OF SUBMITTED PLANS USE OF PERMIT h W a CASE NO. O p Z N.O. OF PARKING SPACES REQUIRED NO. OF BUILDINGS NOW EXISTING a ZONE � PFB CM: FRONT SIDE REAR J m GRADING PERMIT REQUIRED? YE -S- E:1 NO ❑ LOT SIZE. SETBACK ORDINANCE # — .OF FEET REQUIRED ON STREET DATE SIGNATURE OF LAND USE OFFICIAL - F, DEDICATION REQUIRED; YES ❑ NO ❑ NO.. OF FEET CURB AND GUTTER REQUIRED; YES ❑ NO ❑ ° —STREET. t- ee IL CAN CUR4 AND GUTTER FEASIBLY BE 'INSTALLED? YES C3NO F1 W HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET CIMPROVEMENT? YES ElNO ❑ O0 'DATE SIGNATURE OF ROAD DEPT. OFFICIAI S F f SWIMM:ING.POOLS PUBLIC r 0. -SEWAGE�D1SPOSAL . Z'= F'OQD;,ESJ'A 8 LI SH M'E N T WATER POLLUTION REMARKS �n FLOOD CONTROL W AIR POLLUTION- = I, - DIV OF HWY ~ °L YOUR PROPERTY MAY BE SUBJECT TO o,, d FLOOD. RIVERSIDE COUNTY ASSUMES NO RESPONSIBILITY IN EVENT OF FLOOD. 284 --f.0-9A 9/74 CANARY—FILE, PINK—APPLICANT DEPARTMENT OF BUILDING AND SAFETY APPLICATION CERTIFICATE COUNTY OF RIVERSIDE PERMIT p Effective July 1, 1980., Chapter 1301 Section 19825 of the Health and Safety Code requires the execu- tion of the following applicable declarati'ons.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 �,^ I license No ��C'f 4 /%,. Date -1 -7 — d f Contractor cARA5 F; I Ll Q OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License taw 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. 1031.5, B.&P.C.). [] I, as owner of the property., am exclusively contracting with licensed contractors to construct the project (Sec. 7044, B.&P.C.). [� I am exempt under Section B.&P.C. for this reason,: Date Owner WORKERS' COMPENSATION DECLARATION I hereby affi.rm 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. urance 0 Certified copy is hereby furnished. [. ] Certified cop is filed.with the County of Riverside, Department f BuI ding�and,S t�y.� Date 7 Z7-1 Applicant ,QdV il�( TGA 4��t�t// d !� "� [: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This sectionneed 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 Q 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.) 0 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 la s and county ordinances relating to building construction, and authorize a representative of the Cou ty of Riverside, Department.,of Building and Safety to enter upon the pro= pert forwhichI have ap ed^fop thi p i or the purpose of making inspecions. / t, _z /� Mna ure o pp c t: gent p,, ate 7jail; � -Rekod 0I OUACt— Print Applicant/Agent Name 284-2000 7/80 BUILDING PERMIT PERMIT NO. DEPARTMENT OF BUILDING & SAFETY D - S _ n c COUNTY OF RIVERSIDE FIELD OFFICE CONSTRUCTION ESTIMATE Job Addr Space NO. ELECTRICAL FEES NiO. PLUMBING FEES IST FL. 20D. FL. POR. GAR. CAR P. -WASO ESTIMATED CONSTRUCTION SQ, FT. @ Valuotl a 1 UNITS Dote '7 2"71 8 I SQ. FT. @ YARD SPKLR SYSTEM ' - MOBILEHOME SVC., SQ. FT, ({q BAR SINK SQ. FT, ® POWER OUTLET ROOF DRAINS FT 6 DRAINAGE PIPING 5(Q. FT. (� ' DRINKING FOUNTAIN SQ. FT. @URINAL PI. Ck. Fee S VALUATION $ 1 / WATER PIPING NOTE: Not to be used as-propery lox valuation aegal Description 0,1 1 1I 1i•�.� Z(/Q_�2-1,000 �� I � 3 � • SWIM POOL, PVT FLOOR DRAIN MECHANICAL FEES j SWIM POOL, COMM WATER SOFTENER VEKT SYSTEM _ FAN EVAP. COOL HOOD SIGN WASHER (AUTO)(D1SH) APPLIANCE' DRYER Obl s Bond Amt. S• GARBAGE DISPOSAL FURNACE UNIT WALL, FLOOR SUSPENDED final Date , &L, InSpettor LAUNDRY TRAY AIR ,HANDLING UNIT CFM Sp. Imp. Fee f IDLE METER KITCHEN SINK ABSORPTION SYSTEM B.T.U. Supplimental Permit Numbers TEMP LUSE PERMIT SVC WATER CLOSET COMPRESSOR HP Address city Zip 'POLE,TEMP/PERM LAVATORY HEATING SYSTEM FORCED' GRAVITY Own Agent. JAMPERES SERV ENT SHOWER BOILER B.T:U. Total Fees SQ. FT. ® " c ",BATH TUB City Zip SQ. FT. @ t WATER HEATER Contr #to TL_ � A L/�•e� _ SQ. FT. RESID ( 1-1/4 c SEWAGE DISPOSAL License# . Trees required S.Q. Ft GAR V. a HOUSE SEWER Adder Ci y ��'jJ zip GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBI. TOTAL FEES MOB:MM.FEEMItRO FEEMECH. FEE' ' PL.. CK. FEE- CONST. PEE ELECT. FEE SMI FEE FEE PLUMB, FEE PERMIT NO. 4271G6 Job Addr Space Zip 0755 Ow . Com/�nunlry �`�J uAn" �+` / w.: - Valuotl a 1 ell Dote '7 2"71 8 I Dist. 11 Off. r f. C: C. MH.Permit•Fee S Micro Film Fee Cop S Use of Permit I ,1 Z 5 Q �� Parcel No. _ UBe/Cose No. Ck-R Mech. Fee. Dbl $ PI. Ck. Fee S 5ei Backs lot Sim Cdnstruction'Fee� Dbl $ aegal Description 0,1 1 1I 1i•�.� Z(/Q_�2-1,000 �� I � 3 � • 5 S R Electrical Fee Dbl $ - iR�estrict¢ions - h.' i • , 0 Q 0 Group Type SMI. Fee, $ PI_umliing_ Fee Obl s Bond Amt. S• ,Plan No: Rtfin Checker final Date , &L, InSpettor Unit Sp. Imp. Fee f Demol. Fee $ :Const. Lender - Branch Supplimental Permit Numbers Reglstr.,Fee _ "Mllegge Fee s Address city Zip Witness Fee Reinsp: Fee =, Own Agent. Tel, Zip Total Fees s. Address VA, -JA, Z 0 City Zip M.O. 0 N.1ch Cash rl ChockM Received by Contr #to TL_ � A L/�•e� _ Tel a,� Sb 4' G 1 +� License# . Trees required Sewage System Adder Ci y ��'jJ zip T LL PTHIS PERMIT SHALL BECOME VOID IF WORK IS NOT COM( I CED 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 THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS. DONE -SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. r,Fbrm'48.4-208 (Rev.8r78) ©s