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40223 GradingPERMIT �^ t, Count of Riverside of Riverside "✓ ✓. De artment o p Buildingand Safety ' 4080 Lemon SL 2nd Flo r 135 N. Alessandro Rd. Rm. 203 880 N. Slate Street 227 North "D" Street 46.209 Oa is St. Rm. 310 160 N. Broadway . Riverside. CA 92501 Banning, CA 92220 Hemet. CA 92343 Perris. CA 92370 Indio. CA 4201 Blythe. CA 92225 . Ph: 787.6146 Ph: 849.7312 Ph: 6584464 Ph: 6573898 Ph: 342-E71 Ph: 9222670 This permit becomes void it work not commenced within 180 days Irom date of issuance. OR, it work has beer suspended'or abandoned for a period of 180 days. ❑ ` CERTIFICATE OF EXEMPTION FROM WORKERS' COMDENSATION. INSURANCE: This section need not be com-, LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (comment pleted it the permit is for one hundred ($100) or less. '1 certify that in the performance of the work for which this ing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensa- MOD tion Laws of California. ❑ • . Date _ Applicant OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law for the NOTICE TO APPLICANT: If, after makingthis Certificate of Exemption, you should become subject to the Workers' . Compensation provisions of the Labor Code. you must f alhwith,comply with such provisions or this permit shall be following reason (Sec. 7031.5. Business and Professions Code: Any city or county which requires a permit to con- - deemed revoked. - ' struct. alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such CITY/COMMUNITY/STATEIZIP permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFIC.TION: (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is ex- ❑I hereby certify that excavation live (5) or more tee depth into which person is required to descend, will empt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a per- mit subjects the applicant to a civil penalty of not more than live hunderd dollars ($500).): with ln be made in connection wth work authorized by this pernit, and That no building structure, scafloltling, falsework. ❑ I, or demolition or dismantling thereof. will be more than It irly-six (36) feet high. (Chap. 3.2. Grp 2. Art 2: Sec 341, Title 8, C.A.C.). ' 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 lot sale (Sec. 7044, Business and Professions Code: The Contractor's Licerise ❑ As owner -builder, I will not employ anyone to do work Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees. provided that such improvements are not intended or offered for sale. II, however. which would require a,permil from the Division of In - duslrial Salety. as noted above, unless such person has a permit to do such work from the division. the building or improvement is sold within one year of completion, the owner -builder will have the burden of prov- ❑Division of Industrial Safety Permit No. ing that he did not build or improve for the purpose of sale.) SSB 01, as ownerof the property. am exclusively contracting with licensed contractors to construct the project (Sec. CONSTRUCTION LENDING AGENCY: I hereby affirm nal there is a construction lending agency for the perlor-' 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who mance of The work for which this permit is issued (See. 3097. Civ. C.). builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Con- Lender's Name tractor's License Law.) Lender's Address 01 am exempt under Sec. B.& P.C. (Attach Cerlilicale). END Date Owner - CERTIFICATE OF COMPLIANCE AND AUTHORIZATION EF ENTRY: I certify I have read this application and state - That the information given is%correct. I agree to comply with all slate laws and county ordinances relating to aulborize 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. C.). building construction, and a representative of 91e County of Riverside, Department of Buildingrand Safety to enter+upon the propefly & which"I hate applied for this permit for the purpose o making Apbons. Yy o X-''f�`�- n �`4"` `�R^y+�`� 2 ❑Certified copy is hereby lurnishetl. — ❑Certified copy is filed with the County Building Inspection Department or County Department. Signature of Applicant or Agent Date APPLICAN�•T,NA'M�EL, F M) dY:7tA�iA ADDRESS��yYA,]Y,a.Y,1. P000 F, ox CITYyIIC'O,,,,�MM(pU��Na!II�Tp�YYI.STTATt^E�I'�ZIP ,�pQ S� . !llci uIat w$ c4u 4 1►iy/ JOB SITE ADDREESSSISPP�ACE =r Bonita s pa CITYICOMMUNITYISTATEIZIP **� ' * �_ * 9 .✓ BOK PAG JPRC I -C TWN RN' SE S TRACT LOT MOD SB TRACT NAME OWNER N71ME�L F MID dAW ry / P� CONTRACTOR -FIRM NAME LICNC If ADDRESS CITY/COMMUNITY/STATEIZIP PHONE# - BLDG. INSPECTOR FINAL DATE ARC/ENG FIRM NAME LICNC If ADDRESS CITYICOM MUNITYISTATEIZIP PLAN # PLANS EXAMINER APPROVE DATE USE OF PERMIT . W�55 cu*Ydfi *cot/ «y M BL - ZON FSB I SSB SSB RSB O ZONEORD# LOT SZ END SIDE Print Applicant/Agent Name APPUPRMT p PS jDATE 40223 "T TAL FEE ' CA CK NC I CODUN`TER B.I. COUNTER L.U.T. , ZI Al yo ;y FORM 284.208(11.81) INSPECTOR NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Figs 13 Frms 34 Plenums 8 Ducts 2A Slab Grade 35 Furnace Comport. 3 Steel 36 Inlets 8 Outlets 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 loA Fireplace T. 0. No 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 (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 25 Final Tank Pit L.Line REAR OF PROPERTY LINE PSL P/ ELECTRICAL APPROVALS 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final STREET NAME m NOTICE: THIS IS NOT A BUILDING PERMIT DISTRICT �J APPLICATION TO CONSTRUCT Permit No DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE 284 199A 9/74 CANARY—FILE, PINK—APPLICANT OwneZft W "06b Architect _ -___ Contractor— .- ddress Addresse� /Doa -___ Address_-_ Address— CityQt!!N 7-4 city-- City------ - City Phone_" Z6 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 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 untilII (we) have complied with all laws oftheCounty of Riverside and the State of California governing said property. ` V DATE *—/4-/—d_2___ SIGNATURE OF OWNER AND/OR AGENT — -- fff 11, Approval by Signature from the Following Departme sted Be ow Must Be Obtained Prior to the Issuing of a Con ction Permit. 0 _ I SPACE NO. USE OF STRUCTURE `lief. JOB ADDRESS �ei_ �t SINGLE FAAAILY � DUPLEX LEGAL D CRIPTION OF PROPERTY Z F _ 2 APARTMENTS AGRIC. � � �eC—`/ —S11COMMERCIAL Q i INDUSTRIAL COMMUNITY ❑ � ALTERATIONS C C Z NO. OF SUBMITTED PLANS USE OF PERMIT MA ' Q CASE NO. - ---- C Z NO. OF PA KING SPACES REQUIRED - NO. OF BUILDINGS NOW EXISTING - OF Z ZONE FRONT SIDE REAR J Co GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE SETBAC OR NANO OF FEET REQUIRED ON ST EET DATE SIGNATURE OF LAND USE OFFICI -- DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET__ F- ,= CURB AND GUTTER REQUIRED: YES ❑ NO ❑ -STREET 1 ot: a CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑ W HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET Q IMPROVEMENT? YES ❑ NO ❑ O °C DATE SIGNATURE OF ROAD DEPT. OFFICIAL_ Z SWIMMING POOLS PUBLIC QW SEWAGE DISPOSAL _ FOOD ESTABLISHMENT WATER POLLUTION REMARKS rA FLOOD CONTROL H Z AIR POLLUTION � W _DIV OF HWY t - c a — YOUR PROPERTY MAY BE SUBJECT TO o. c FLOOD. RIVERSIDE COUNTY ASSUMES NO RESPONSIBILITY IN EVENT OF FLOOD. 284 199A 9/74 CANARY—FILE, PINK—APPLICANT PERMIT APPLICATION County of Riverside Department of Building and Safety . 40804@mon St. 2ndf Floor '135 N. Alessandro Rd. Rm. 203 880 N. Slate Street vw .. o •. 227 North "0"Street 46-209 Oasis St. Rm. 310 •160 N:, Broadway Riverside. CA 92501. Banning. CA 92220. - Hemet. CA 92343 Perris. CA 92370 ` Indio. C4 92201 Blythe. CA 92225 Ph: 787.6146. Ph: 849.7312 ' t Ph: 658.4464 Ph:, 657.3898 Ph: 342-8271 Ph: 922.2670 This permit becomes void it work not commenced within 180 days from date of issuance, OR, if work has beer suspended or abandoned -for. a period of 180 days. - Q CERTIFICATE OF EXEMPTION FROM WORKERS" COMPENSATION INSURANCE: This section need not be com- _ LICENSED CONTRACTORS DECLARATION: I hereby aflirm that I am licensed under provisions.of Chapter 9 (comment- pleted if the permit is for one hundred ($100) or less. , I certify.that in the performance of the work for which this , permit issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensa- ing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full force and effect. tion Laws of California: - •,.+ .,Date... Applicant - - ' .NOTICE TO APPLICANT: It. after making this Cerlifi:ateof Exemption, you should become subject to the Workers' i .' OWNER -BUILDER DECLARATION: I hereby affirm [hat I am exempt from the Contractor's License Law for. the Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be - following reason (Sec. 7031.5, Business and Professions Code' Any city or county which requires'a permit to con- deemed revoked. - , strucl, after, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such • CONTRACTOR -FIRM NAME permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law_ DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is ex-. 01 hereby conn than no excavation five (5) or more feet in depth into which a person is required to descend, will - empt the basis for the alleged exemption. Any violation of Section by applicant for aper- be made in connection with work authorized by This permit and that no building structure, scalfolding, lalsework, 0)any mit subjects the applicant to a civil penally of not more than five hunderd dollars•($500).l: subjects the applicant dollars, ($500).): or demolition or dismantling thereof, will be more than thirty-six (36), feet high. (Chap. 3.2, Grp 2, Art 2. Sec 341, - ❑ I, as owner of the property, or my employees with wages as their sole Compensation, will do the work, and the. Title 8. C.A.C.). - structure is not intended or offered for sale (Sec:. 7044, Business and Professions Code: The Contractor's License ❑ As owner -builder, I. will not empioy.anyone.to do work which would require a permit from the Division of.ln- Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or dustrial Safety. as noted above. unless such person has a permit to do such work from the division. through his own employees,provided than such improvements are not intended -or offered for sale. If, however. - - of Industrial Safety Permit No. + the building or improvement is sold within one year of•completion, the owner -builder will have the burden of prov- .Ing that he did not build or improve for the purposeof sale.) .❑Division _ Of. as owner licensed' to the CONSTRUCTION LENDING AGENCY; ,I hereby affirm that there is a construction lending agency for the perfor- - ol'the property, am exclusively contracting with contractors construct project (Sec. -7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who mance of the work for which this permit is issued (Sec. 3097, Civ. C.)., s ... builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Con- Lender's Name .•tractor's License Law.} Lender's Address ❑I am exempt under Sec' • . B.& P.C. (Attach Certificate). Date - Owner - CERTIFICATE OF COMPLIANCE ANDAUTHORIZATION OF ENTRY: I. certify I have readthis application and state. - - • - that the information given is correct. I agree to comply: with all stale laws and county ordinances relating to WORKERS' COMPENSATION-DECLARATION:•I hereby affirm that I have a certificate of consent to sell -insure, or building consand autVresenlatic of the County of Riverside, Department of Building and Safety to enter upon operly f vappl�i ' for thispermit for the purpose of m ing inspections. certificale of Workers" Compensation Insurance. or a certified copy thereof (Sec. 3800, Lab. C.). 'V.�, ❑Cerlified copy is hereby furnished. ❑Cernifie0 copy is filed with the County Building Inspection Department or County '' " Department. gnalure of Applicant or Agent ^ ,l e � 1. s�1 ` V , � �• r�m� - .. . + - Print Apolicant/Aoenl Name APPLICANT NAME (L, F, MI) ,. ADDRESS 3 o- or o CITYICOMMUNI /STATEIZIP ) ' JOB SITE A RESSISPACE o Ale, CITY/COMMUNITY/STATI I � , viNT� B PAG vA PO/ C/ TWN R�� SE S RACTLOT MOD SB TRACT NAME OW ER NAME (L,F,MI) oil PHONE N CONTRACTOR -FIRM NAME LICNC p ADDRESS- ' t. CITYICOMMUNITYISTATEIZIP ' PHONE BLDG. INSPECTOR t FINAL DATE- ARC/ENG FIRM NAME' LICNC If ADDRESS CITYICOMMUNITYISTATE/ZIP PLAN k+ PLANS EXAMINER APPROVE DATE USE OF PERMIj/"> .SSB• BL ZO)))O FSB SSB RS OFC iV ZOP#tORD# LOTSZ - END SIDE PERMIT APPLICATION County of Riverside . ry j 4rr Department of Building and Safety • 14088 Len6itiS \ 1 2nd Floor 135 N Alessandro Rd. Rm. 203 880 N. Slate Street._ ••flrversll�•CA 92501 Banning. CA - 227 North "0" Street 46-209 Oasis SI. Rm. 310 160 N. Broadway 92220 Hemet. CA 92343 "•L. rPh: Perris. CA 92370 Indio. CA 92201 Blythe. CA 92225 787.6146 Ph: 849.7312 Ph: 658.4464 Ph: 657-3898 Ph: 342.8271 Ph: 922.2670 ' This permit becomes veto if work not commenced within 180 days from dale of issuance. OR. it work has beer r ' suspended or abandoned for a period of 180 days. �: ❑�% , CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be com-: •'' LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (comment- pleted it the permit is for one hundred ($100). or less. I certify that in the performance of the work for whichIhis - ing with Sectionpermit is issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensa-''7000) of Division 3 of the Business and Professions Code. and my license is in lull force and effect. tion Laws of California. ET Date Applicant '1 NOTICE TO APPLICANT: If, after makingthis Certificate of Exemption, you should become subject to the Workers' • :OWNER -.BUILDER DECLARATION: I hereby affirm Thal I am exempt from,lhe Contractor's License Law for the Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be following reason (Sec. 7031.5. Business and Professions Code: Any City Or County which requires a permit IO Con- deemed revoked.. - ' strucl. alter"• improve, demolish• or repair any structure, prior to its issuance, also requires the applicant for such ;:.permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: - (Chapter9 (commencing with Section 7000) bf Division 3 of the Business and Professions Code) or that he is ex- OI hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend. will ' empt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for aper- be made in connection with work authorized by this permit. and that no building structure, scaffolding, lalsework, . mit subjects the applicant to a civil penalty of not more than five hunderd dollars ($500).): . ior demolition or dismantling thereol. will be more than thirty-six_ (36) feet high. (Chap. 3.2. Grp 2, Art 2. Sec 341. O I, theproperty, Title 8. C.A.C.). as owner of or my employees with wages as (heir sole compensation, will do the work, and the "structure is not intended or offered'for safe (Sec. 7044, Business and Professions Code: The Contractor's License OAS owner -builder. I will not employ anyone to do work which would require from the Division In Law does not apply to an owner Of property who builds or improves thereon, and who does such work himsell.or a permit of - dustrial Safely. as noted above. unless such person has a permit to do such work from the division., • through his own employees• provided that such improvements are not intended or offered for sale. It, however. the building or improvement is sold within one year of completion, the owner -builder will have the burden of prov- ❑ Division of Industrial Safety Permit No. t .ing that he did not build or improve for the purpose of sale,) as owner of the property, am' exclusively contracting with licensed contractors to construct the project (Secmance of the work for which this permit is issued (Sec. 3097. Civ. C.).. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the perfor- - " 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of properly who ARC/ENG FIRM NAME r:.• builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Com Lender's Name -. •tractor's License Law.) ' Lender's Address OI am exempt under Sec. . B.& P.C. (Attach Certificate). .Date Owner 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, "WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell -insure, Ora - building construcljon2 and aulhortze a revresenlaliu 'oI the County of Riverside. Department of Building and Safety to 'c :., certificate o1.Warkers' Compensation Insurance, or a certified copy thereof (Sec. 3800. Lab. C.). ente� n Of 'Property In I fiav appli for his permit for the purpose of m ing.insp cti0ns. +� ~ �`'• �^"'` OCertified copy is hereby furnished. --- licant or 9gen}, DSte - ;jgnalure of PAI " OCertified copy is filed with the County Building Inspection Department or County Department. 1 } ��� M'I �� �4../ ) tl, /1 0 _ Print Applicant /Agent Name - APPLICANT NA l f 7) �� �• ��' -.. � �f� �,,,,v r - (j••.r APPLIPRMT p PS e DATE �• et /(moi_` 4 O 1 /'� A L/JJ- I Oct CITY/COMMUNIT/,Y/STATE/ZIP " JOB SIT ;ESS/SPACE CITY/COMMUNITY/STATEI - A/ JY/ "15) �� C y 31 P .IF � A1 IRCC .i.�'.C..., G /i9._3 TWN RN l� SE S TRACT ., I.LOT . I I MOD I S13 TRACT NAME' OW ER NAM E (L.F/, �,MI) 11411,4;) PHONE p y /"1 %tJ1;J 4At1"'A 3-Y,5 2�ilG" CONTRACTOR -FIRM NAME LICNC p ADDRESS CITY/COMMUNITY/STATE/ZIP - PHONE p _ BLDG. INSPECTOR FINAL DATE ARC/ENG FIRM NAME LICNC 0 ,'CITY/COMMUNITY/STATE/ZIP - 1+ PLAN p PLANS EX MINER AP ROVE DATE �i USE OF PERMIT/"'? BL ZON FSB SSB SSR RS OF - TOTAL flEE ,ZONE ORDp LOT.SZ END SIDE CA C .NC COUI��..�.✓.r••"� COUNTER L.U:T. ' • w �� F c1+ 'FORM 284.208(11.81) INSPECTOR NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Ftgs & Frms 34 Plenums & Ducts 2A Slob Grade 35 Furnace Comport. 3 Steel 36 Inlets & Outlets 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. C] 43 Final 10A Fireplace T.O. ❑ No ADDITIONAL INFORMATION t - - — - SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Loth 12 Internal Lath 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Walls (Botts) 12B Ceiling (Botts) 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 25 Final Tank Pit L.Line REAR OF PROPERTY LINE PSL P/ ELECTRICAL APPROVALS 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final STREET NAME