404140 (BLCK)RUILIDING PERMIT
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PERMIT NO,
0 414 0
Job Address
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
FIELD
DST
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
r 1ST Fl.
2ND. Fl.
POR.
t GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. .@ $
UNITS
7
SQ. FT. @
YARD SPKLR SYSTEM
SQ. FT. @ MOBILEHOME SVC.
BAR SINK
SQ. FT. @ POWER OUTLET
ROOF DRAINS
SQ. FT. @
DRAINAGE PIPING
SO. FT. @ c �
DRINKING FOUNTAIN 4
SQ. 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
SMI Fee E
GARBAGE DISPOSAL
FURNACE UNIT WAIL FLOOR SUSPENDED
Flon No.
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 f
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER 1
BOILER B.T.U.
SO. FT. @ ¢
BATH TUB
Witness Fee E
SQ. FT. @ ¢
WATER HEATER
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SO. FT. RESID @ 1 V44
SEWAGE DISPOSAL
Zip .
SO. FT. GAR @ s/ a
HOUSE SEWER
Address • �•• 1- •�
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!City
GAS PIPING
PERMIT FEE
M.O. Q N.C.E) Cash O Checlj 2
PERMIT FEE
PERMIT FEE
DBL.TOTAL
FEES
®0j
MOB. HM. FEE
MICRO FEE
MECH. FEE PL. CK. FEE
CONST. FEE ELECT. FEE
SMI FEE
FEE PLUMB. FEE
PERMIT NO.
404140
Job Address
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Space
Zip
Owner
Cam ity
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Micro Film Fee Cop E
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Legal Descript
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Paticel No.
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Mech. Fee Dbl E
PI.,Ck. Fee S
'Construction Fee Dbl E
-SIA' Bac s
lot Size -
-
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Electrical Fee Dbl S /
Zone Restrictions
Group
Type
SMI Fee E
Plumbing Fee Dbl E
Bond Amt.
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Flon No.
I Plon^fhec
Final Do
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Inspector
Unit
Sp. Insp. Fee S
Demol. Fee E
Const. Lender
Branch
Supplimental Permit
Numbers
Regist, Fee E
Mileage Fee $
Address / City Zip
f
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Witness Fee E
Reinsp. Fee E
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Total Fees S
Address • �•• 1- •�
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Receive by
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Sewage System �_
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Address
City
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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.
e 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
,e.GJt!'�'j�ROANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
Form 284208 (Rev. 1/80)
verified, by:
4 �
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE h
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Bock
l �— (� .
33
Ventilation System .°
2
Ftgs 8 Frms
—
34
Plenums & Ducts
2A
Slab Grade
35
Furnace Comport.
3
Steel
36
Inlets & Outlets
4
Grout Blocks
q�
L '�.3 0 1
37
Combustion Air
5
Bond Beams
=/ –
V
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.
°o
ADDITIONAL INFORMATION
-
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick
R
Value
7A Walls (Batts)
12B Ceiling (Botts)
12C Ceiling (Blown)
14 Final Z 3 1
- - - - . _ 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
25
Final
Tank Pit L. Line
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
P/L
P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
OWNER -BUILDER VERIFICATION
Owner V�
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) __
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 i ty
Contractors License No. Y
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 Ci ty�
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
_ r
gnature Property Owner Date
284-2002 7/80
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 builde
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 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.
Director
284-2001 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
Owner - dA hitect—_ —_ Contractor—_------- _.
Address5lAddress-------- ----
City City__—_—
Phone _ Phone— —.--- _ . _.—_- _
W
I (we) the undersigned, hereby certify and acknowledge that I (we) have read the application and agree that if Curb and Gutter, and
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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
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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 //#j00 --- SIGNATURE OF OWNER AND/OR AGENT
Approval by Signature from the Following Departments Listed Below
Must Be Obtained Prior to the Issuing of a Construction Permit.
I SPACE NO.
1 USE OF STRUCTURE
JOB ADDRESS��y��N�i��� — SINGLE FAMILYDUPLEX
LEGAL DE$C IPT ON PER Y/+Ju
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APARTMENTS / LJ AGRIC.
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--- —^� COMMERCIAL E] INDUSTRIAL C,
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COMMUNITY ALTERATIONS n
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NO. OF SUBMITTED PLANS — USE OF PERMIT OZ.6.2
CASE NO.
l7
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NO. OF PARKING SPACES REQUIRED .— —_— NO. OF BUILDINGS NOW EXISTING —
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ZONE SETBACKS: FRONT SIDE REAR
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GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE
SETBACK RDINANC # OF FEET REQUIRED ON STREET
DATE r SIGNATURE OF LAND USE OFFICIALt'1��� ----
I
DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET-—
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CURB AND GUTTER REQUIRED:. YES ❑ NO ❑ STREET
ce
a
CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑
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HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET
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IMPROVEMENT? YES ElNO ❑
o�
DATE SIGNATURE OF ROAD DEPT. OFFICIAL
S
SWIMMING POOLS PUBLIC
I,.:
Q
SEWAGE DISPOSAL
FOOD ESTABLISHMENT
_
WATER POLLUTION REMARKS
FLOOD CONTROL—
F
z AIR POLLUTION
W :* DIV OF HWY
I- t—
I-
Cc
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
BUILDING PERMIT
PERMIT NO,
04140
DEPARTMENT OF BUILDING 8L SAFETY FIELD OFFICE �� III
COUNTY OF RIVERSIDE Iql
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL.
2ND. FL.
POR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT..@ $
Parcel No.se/Case
UNITS
k. B
SQ. FT. @
YARD SPKLR SYSTEM
50. FT. @ MOBILEHOME SVC.
BAR SINK
SQ. FT. @ POWER OUTLET
•ROOF DRAINS
SQ. FT. @ -
DRAINAGE PIPING
SO. FT. @ 7.
DRINKING FOUNTAIN
SQ. FT. @
URINAL
VALUATION. $
WATER PIPING
NOTE: Not to be used os property tax voluation
Final Dot �.
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
Dental. Fee $
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM - FAN EVAP. COOL HOOD
Mileage Fee S
SIGN
WASHER (AUTO)(DISH)
APPLIANCE DRYER
Total Fees $
IQ
Address -
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i
�"�' . ,•�
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR - SUSPENDED
Receive y
Trees requb -
Contractor y
LAUNDRY TRAY
AIR HANDLING UNIT CFM
Sewage System
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. @ a
BATH TUB
SQ. FT. @ a
WATER HEATER
S0. FT. RESID @ 1 t/4a
SEWAGE DISPOSAL
S0. FT. GAR @ 3/4a
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERM R FEE
PERMIT FEE
DBL.
TOTAL FEES
60
MOB. HM. FEE
MICRO'FEE
MECH. FEE
PL. CK. FEE
CONST. FEE ELECT. FEE
Poo
SMI FEE
FEE PLUMB. FEE
PERMIT NO.
40414 0
Job Address Space Zip Owner
Cammenity - D., . I Off. .C.
1
MH Permit Fee S
Micro Film Fee Cop $
Use of Permit
Legal Descripti
Parcel No.se/Case
o.
tr/
,�,
k. B
Mech. Fee Dbl $
PI. Ck. Fee S
Construction Fee Dbl S
Electrical Fee Dbl $
5dFBtk,
Lot Sire
F
$
S
R
Zone Restrictions
Group
Type
SMI Fee - S
Plumbing Fee Dbl $
Bond Amt.
S
Fan No. [Plan'Checkff-
Final Dot �.
I Inspector
Unit
Sp. Insp. Fee $
Dental. Fee $
Const. Lender Branch
Supplimental Permit Numbers
Tel. - Zip
Registr. Fee S
Mileage Fee S
Address .City Zip
caner Agen
Witness Fee S
Reinsp. Fee $
Total Fees $
IQ
Address -
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i
�"�' . ,•�
City Zip
°M.O. N.C. Q Cosh Check
Receive y
Trees requb -
Contractor y
Tel.
'
License#
Sewage System
Address
City Zip
T LL v 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
t 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
Form 284.208 (Rev. 1/80) ANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.