418270 (RC)✓ W • sd %d A • %041 . rJ AV tv G7 a OV to ♦ V w/ ..rxx ♦ j i!
NO.
T
PERMIT NO.
DEPARTMENT OF BUILDING & SAFETY
ip Owner
� Space Loll
DST
"PERMIT
418270
COUNTY OF RIVERSIDE
FIELD A
CONSTRUCTION I
" NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. @ $
UNITS
Off. F.C.C.
2ND. FL. SQ. FT. @
Micro Film Fee
YARD SPKLR SYSTEM
POR. SQ. FT. @
MOBILEHOME SVC. `"
BAR SINK
GAR. SQ. FT. @'
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT. @
PI. Ck. Fee $
DRAINAGE PIPING
WALL SQ. FT. @
Construction fee
DRINKING FOUNTAIN +�
SQ. FT. @
-
URINAL
a
ESTIMATED CONSTRUCTION VALUATION - $
`na
WATER PIPING
NOTE: Not to be used as property tax valuation
" SWIM POOL, PVT
r FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER Diu
VENT SYSTEM FAN EVAP. COOL HOOD
SIGN
WASHER (AUTO)(DISH)
APPLIANCE DRYER
Plumbing Fee
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
Bond Amt.
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
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER f"
BOILER B.T.U.
SQ. FT. @ t
BATH TUB
SQ. FT. @ c
WATER HEATER
SQ. FT. RESID @1'/.c f
SEWAGE DISPOSAL
Address
S0. FT. GAR @ s/. c
HOUSE SEWER
City Zip
GAS PIPING
PERMIT FEE
Reinsp. Fee
PERMIT FEE
PERMIT FEE
DBL.
TOTAL FEESMOB.
HM. FEE
MICRO FEE
MECH. FEE PL. CK. FEE
CONST. FEE ELE . VE
SMI FEE
FEE PLUM1. E
✓ W • sd %d A • %041 . rJ AV tv G7 a OV to ♦ V w/ ..rxx ♦ j i!
NO.
T
Job Address
?B��:-
ip Owner
� Space Loll
"PERMIT
ate s nONDWA
J1
Community Valuation
V. t $
.. s.r Date Dist.
^
Off. F.C.C.
MH3ermit Fee $
Micro Film Fee
Cop $
a0 of - 4' t a `Par
I -S [? V +L7f It
L.LMM REMODEL
t r
a � d
9,�
•' a/Case
Ck.�6�"K+
Mech. Fee Dbl $
PI. Ck. Fee $
+� 'S cks Lot Size
Construction fee
Dbl $
50
Le trip on + i V
F S S R
Electrical Fee
Dbl $
v
L4 :iJ 1&2 DESERT CLUB TR Tl�
one estrictioris Group r -
rr wlu
ype
SMI Fee
$9
n
Plumbing Fee
Dbl $
Bond Amt.
Plan No.
Plan Checker
Final Date
Inspe t ry,
UnII
Sp. Insp. Fee
$
$
V /-2--
Demo!. Fee
$
Const. Lender Branch
Supplimental Permit Numbers
Registr. Fee $ H
Address
Mileage Fee
$
City Zip
Witness Fee $
Reinsp. Fee
$
Owner/Agent
7
Tel.
Zip
Tota! Fees
$
AtOress }' -
�,ty �"
Zip
M.O. N.F,
Cash Check
vy
Received by
'Con ract /M• i
to - r �'e:. y's
License#
Frees requve
Sewage System
Address
City Zip.
r
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by:
T LLP
Sewer District
FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
lr
11 +
1 HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS
PERMIT WILL BE DONE IN ACCORDANCF VVITN ,
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. V
BYTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
Form 284-208 (Rev.8/78) @s CE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. `
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
'1
Set Back
33
Ventilation System
2
Ftgs 8 Frms
34
Plenums 8 Ducts
2A
Slab Grade
35
Furnace Comport.
3
Steel
36
Inlets 6 Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beams
3B
Compressor
6
Roof Deck
39
Appl. Clearance
7
Framing
�� I
40
Fire Damper
8'
Vents
41
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace
P. L.
43
Final
IDA
Fireplace
T. 0. 0
No
I
ADDITIONAL INFORMATION
l
SEWAGE SYSTEM SIZE & LOCATION
it Exterior Loth
12 Internal Loth
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 `g-
22 Water Softener
23 Water Service
24 Gas Test
25
Final
f
Tank _Pit Q L.Line
REAR OF PROPERTY LINE
f p
PSL `O &,:�7'% P/
„ lr
IL
r -
ELECTRICAL APPROVALS
26 Power Pole
27 Conduit N,
28 Service Entrance
29 Wiring `
29A Grounding Wire
29B Bonding
30 Fixtures
P'
31 Service
32 Final V -2-01
STREET. NAME
a-
DEPARTMENT OF BUILDING AND SAFETY APPLICATION CERTIFICATE
COUNTY OF RIVERSIDE PERMIT N
Effective July 1, 1980, Chapter 1301, Section 19825•of the H"I th 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,beiow:
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 Z?— I License No. �-Z- 3 it, (!
Date 4_2-:/ -ir/ Contractor e-444e?"c eJ
Q OWNER -BUILDER DECLARATION
I hereby affirm 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 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.).
[� 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
Q 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
0 Certified copy is hereby furnished.
Ea Certified copy is filed with the County of Riverside, Department of Building and Safety.
Date Applicant
0 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE
(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 is1ssued (Sec. 3097, Civ. Code).
Lender's Na6
Lender's Address
DIVISION OF INDUSTRIAL -SAFETY PERMIT CERTIFICATION
1?J 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 i6 connection with work authorized by this permit, and that nc
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.)
Q 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 worl.
from that division.
�] Division of Industrial Safety Permit No. / r
Date Z/_.L1_ ,Cl,.,/Applicant C_R-4. k_o_5, % ,lt Iii7-A of /--C
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
representative of the County of Riverside, Department of Building and Safety to enter upon the pro-
perty for which I h ve appl".ed for th's permit for the purpose of making inspections.
Signature.of Applicant/Agent Date
Print 'App icant/Agent Name
284-2007/80
NOTICE: THIS IS NOT A BUILDING PERMIT
APPLICATION TO CONSTRUCT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
1
�!
DISTRICT
Address57-1 P- 7 L, ID 37 Address Address 0 `—
Permit No
City 4./jU`--Cs' -City—City- 1r4 �'
,MT..
'199 9/74 - ?.::•.,er' CANARY—FIL::, PINK—APPLICANT
IA-,
rt ` AL l L I !d .� r .F
Owner090Architect Contractor
Address57-1 P- 7 L, ID 37 Address Address 0 `—
City 4./jU`--Cs' -City—City- 1r4 �'
Phone
Phone_�s2� 60% / Phone Phone01
W
I (we) the undersigned, hereby certify and acknowledge that I (we) have read the application and agree that if Cur:) and Gutter, and
Z
Paving, and/or Dedication of right of way is required by the County of Riverside, the Riverside County Department of B.-iilding 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 Omit t (wej will not occupy said property and will. not cause said property to be occupiec until t (we have
i complied withall laws, of the County of Riverside and the State of Cafrfornia governing said property.
DATE 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.
SPACE NO.
USE
r, R
OF STRUCT JRE
JOB ADDRESS
SINGLE FAMILY DUPLEX
t-
LEGAL DESCRIPTION OF PROPERTTY
ASICPARTMENTS AGRlC.
���
--QY` {
H•
COMMERCIAL r_ INDUSTRIAL ED
COMMUNITY
Z
ALTERATIONS
NO. OF SUBMITTED PLANS USE OF PERMIT .'r.01 a 42r
Q
.
CASE NO. ' 4 -'47 22
=
NO. OF PARKING SPACES REQUIRED NO. F BUILDINGS NOW EXISTING -.
I
ZONE . cETBACKS: • Fj2k71VT SIDE REAR
m
GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE
SETBACK ORDINANCE N __— OF FEET REQUIRED ON — — STREET
DATE ��r—_ SIGNATURE OF LAND USE OFFICIAL I Z
t
DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET.__.
CURB AND GUTTER REQUIRED: YES ❑ NO ❑ STREET
F
ac
d
CAN CURB. AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑
me
q
HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWA`r AND STREET
O
C
IMPROVEMENT? YES ElNO El
°L
DATE--- SIGNATURE OF ROAD DEPT. OFFICIAL
u onn a oi�nt tr { Xisr 2I Fa. �- IffMUt/i 7JCrV.AV6 AOA I/JF.N, = 2 V irk,AfA
SEWAGE DISPOSAL AQe1' %+, / k 40 W,664Gf_. iT /,/ 5,044-I CQAAI. E'4/75a 72
rs
Frtt�lrf CCT'A Gll�uu FUT
irsrr.r_s+��rww /•jr r a gii, V f- (lW ' r S r- % a 4C .4t 3l'017 G, % -111✓IC.
g
r-ASN`rc PO /�T A Cr) var 70J or A OIAIo A V
,2-7A, /
WATER POLLUTION
r i�� � r ! 1 / REMARKS
�n FLOOD CONTROL
z AIR POLLUTION
h DIV OF HWY
YOUR PROPERTY MAY BE SUBJECT TO
FLOOD. RIVERSIDE COUNTY ASSUMES
..f
NO RESPONSIBILITY IN EVENT OF FLOOD.
,MT..
'199 9/74 - ?.::•.,er' CANARY—FIL::, PINK—APPLICANT
IA-,