391934 (AR)BUILDING PERMIT
PERMIT No. DEPARTMENT OF BUILDING & SAFETY
3 91934 COUNTY OF RIVERSIDE FIELD
CONSTRUCTION
ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. @ `P
UNITS
Valuation �"1
$
DI
2ND. FL. SQ. FT. @
OV f(,.
YARD SPKLR SYSTEM
MH.Permit Fee $
FOR. SQ. FT. @
MOBILEHOME SVC.
BAR SINK
Use/Case No.
3 + / �'
GAR. SQ. FT. @
POWER OUTLET
ROOF DRAINS
Set Backs
CAR P. SQ. FT. @
Construction Fee Dbl $
DRAINAGE PIPING
f S S R
WALL SQ. FT. @
Zone Rest icti s
��. ...
DRINKING FOUNTAIN
Type
SQ. FT. @
Plumbing Fee Dbl $ /
URINAL
Plan No.
ESTIMATED CONSTRUCTION VALUATION $
Final Date
WATER PIPING
Unit
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
SuppliefolrmitNumbers
/
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
Witness Fee $
VENT SYSTEM FAN EVAP. COOL HOOD
SIGN
WASHER (AUTO)(DISH)
APPLIANCE DRYER
/ 1
I fJJ///f
c { `-•C_''.,�-^`--.+-�......,.,
GARBAGE DISPOSAL
M.V.N. Ej Cash Check
FURNACE UNIT WALL FLOOR SUSPENDED
Contract\ (� ^t
LAUNDRY TRAY
Licensed
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
CIry Zip
A.AL.t (A.i L '7 � 7:""2
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. @ c
BATH TUB
SQ. FT. @ c
WATER HEATER
SQ. FT. RESID @I'Ac
SEWAGE DISPOSAL
0
SQ. FT. GAR @ 3/, c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
`7
DBL.
T T),AfL�FEESfiu/
�
MOB. HM. FEE
MICRO FEE
MECH. FEE ,- PL. CK. FEE
I CONST. FEE ELECT. FEE
SMI FEE
FEE
/�jLUC�yyt�B�•
/
PERMIT NO.
3 919 3 4
Job Address, y,� �' SpaceV;zPr3
� � `l �fl v 5 0 ;u
Owner
e -,i-, 1,
Co ity
mun��
1"' Vi" c't'✓
Valuation �"1
$
DI
ist.
OV f(,.
F.C.C.
MH.Permit Fee $
Micro Film Fee Cop $
Use of Permit
j�\ (\ p� ,..>/�
ir-' V J •tom- 1 itr... O!"'i'"r.�i i�, t
Par/$'e�I N (�qy�l /� /L
I ! `�" 9 - !J� 7/ i
Use/Case No.
3 + / �'
Ck. B
*?...i
Mech. Fee Dbl $
Pl. Ck. Fee $
Set Backs
Lot Size
Construction Fee Dbl $
Legal Description /`/^ Y/ "( ,,,,,J
[�- r.+r..
�y/' 3g C 1 t
"+ �, i 1 �. ...J a �' �.c:
f S S R
Electrical Fee Dbl $
Zone Rest icti s
��. ...
Group
Type
SMI Fee $
Plumbing Fee Dbl $ /
Bond Amt.
$
Plan No.
Plan Checker
Final Date
Inspe o P
Unit
Sp. Insp. Fee $
Demol. Fee E
Const. Lender Branch
SuppliefolrmitNumbers
/
RegMileag Fee $
Mileage Fee $
Address -- -City ,. . Zi
.. .. tY � P ,
Witness Fee $
Reinsp. Fee $
Owner/Agent
Tel. Zip
>
Total Fees $Address'\,
/ 1
I fJJ///f
c { `-•C_''.,�-^`--.+-�......,.,
City Zip
M.V.N. Ej Cash Check
Received b ^t<i
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR.
BUILDING APPROVALS
MECHANICAL APPROVALS
I
Set Back
33
Ventilation System j
2
Ftgs 8 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. E]
43
Final
IDA
Fireplace T. 0.
No
ADDITIONAL INFORMATION
_
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Loth
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 _ V
20 Sewer
21 Water Heater
22 Water Softener
23 Water Service
24 Gas Test
25
Final _l f 8v
Tank Pit Line
REAR OF PROPERTY LINE
�Y
PSL a P/I
`
Q
Q
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 //-) U/ L 1E 6 0 61
1
You will need approvals from the following agencies:
COUNTY AND STATE OFFICES
([► Riverside Offices j
Z County of Riverside
Administrative Center
4080 Lemon Street `
Planning Commission
Road Department
Building and Safety
land Use Division '
Health Service Building
q 357511thStreet 92501 '
Environmental Health
^ Flood Control District }
1995 Market SL 92501 ^
Weights and Measures w
2950 Washington 92504
State of California
Regional Water Quality Control Board„
6809 Indiana, Suite 200, Riverside 92506
Transportation Dept. of Calif.CALTRANS Dist 8
247 W. 3rd Si. , San Bernardino, CA 92401
State Fire Marshal
303 W. 3rd St.
San Bernardino, CA 92401 ,
South Coast Air Management Dist. -` '
t • 22850 Cooley Drive '
# Colton, CA.
1 IndioOffices -
-- ='Administrative Center
46.209 Oasis 92201 r
I Planning Commission
Road Department +
_ Environmental Health
Air Pollution Control
Building and Safety & Land Use Div.
Coachella Valley Water District _
85-820 Coachella His. Q O. Box 1058
Coachella,CA 92236
Water Quality Control Board (State)
t 73.271 Hwy 111, Palm Desert 92260
Calif. Division of Forestry
46-2090asis, Indio, CA92201'
Hemeto fficas
. .4
Administrative Center
' 880 N. State St., Hemet, CA 92343
Building and Safety
Health Department
Perris
California Division of Forestry
T 210 San Jacinto St.,
P.O. Boz 248, Perris 82370
San Diego
Transportation Dept. of Calif-CALTRANS, Dist 11
4b75 Taylor, P.O. Box 390 92212
Regional Water Quality Control Bd. 09
(State) 6154 Mission Gorge Rd. '
Sacramento '• ' ,
Dept. of Aeronautics . r.
cSacramento Executive Airport
Sacramento, CA 95822
Room M
Phone
,�.
Land Use
Requirement
Bldg Div
Requirement
+
9th Floor
787.6181
8th Floor
787.6111.
9th Floor•
787-6146
9th Floor .
787-20111.
Basement
787-6543•
r
787.2015 _
-
_ _ •.
•
787.2820 '
'
684.9330
n
L
383.4536.
282
888-9255
L
824.2660
304'
342.8277
313-
342-8267
'
203
342.8287
205
342-8402
310
342.8271
r
398-2651
~
346.7491
308
347-1929.
j
•.
658.4464
}
`
658.5102
•.
a
657.3183
-
297-4501
286.5114
-
NOTICE: THIS IS NOT A BUILDING PERMIT DISTRICT J
APPLICATION TO CONSTRUCT Permit
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
284 199 9/74 CANARY -FILE, PINK -APPLICANT
/ii l�
Owner f .1 Architect Contractor_
Address ` t' /'1' JAddres5 Address_
6 / (r �.'r 7 : f
City city city__�—
Phone %" U �Phone Phone
C
W
1 (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. 1 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 occypjed until fwe) have
complied with all laws of the County of Riverside and the State of California governing said property. % )
C C�
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.
i I SPACE NO.
/ 1✓ %1� ' • 1
c.
USE OF STRUCTURE
A, /
JOB ADDRESS ar- .' __ -
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- SINGLE FAMILY Q DUPLEX
Z H
LEGAL DESCRIPT7ION ,��yy�� PR ERTY . ./ i" '_
< f . , 71Js, %P
�(� APARTMENTS AGRIC.
H Q
�� I ' ~y.� /,,
COMMERCIAL INDUSTRIAL �J
COMMUNITY 1!.-�
'^
�j LTERATIONS ❑
USE OF PERMIT
ZNO.
OF SUBMITTED PLANS —�—
CASE N0.
Y
Z
NO. OF PARKING SPACES REQUIRED NO. OF BUILDINGS NOW EXISTING
Q
ZONEL_SETBACKS: FRONT SIDE REAR
J
m
GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE
SETBACK ORDINANCE N _— OF FEET REQUIRED ON '� STREET
DATE "_ _" lT�a SIGNATURE OF LAND USE OFFICIAL -
DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET ---
z
CURB AND GUTTER REQUIRED: YES ❑ NO ❑ STREET
H
d
CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑
W
HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET
OIMPROVEMENT?
YES ❑ NO ❑
°L
DATE — SIGNATURE OF ROAD DEPT. OFFICIAI
3 _ j atd'
=
SWIMMING POOLS PUBLIC 1
H H
_
SEWAGE DISPOSAL /��_ -:�-!"' -� '�•"'t- :? pct 6:-['•
_ W
c �^
FOOD ESTABLIS-HMENT d 4' (/Alf, % t; C42
3 �. / • Aa !n SPIQ5 `W 0 r r y., r � mac.... 1,
WATER POLLUTION EMARKS
�n FLOOD CONTROL—
zAIR POLLUTION
W DIV OF HWY
c a — YOUR PROPERTY MAY BE SUBJECT TO
v
c FLOOD. RIVERSIDE COUNTY ASSUMES.
NO RESPONSIBILITY IN EVENT OF FLOOD.
284 199 9/74 CANARY -FILE, PINK -APPLICANT
PERMIT NO.
1.391934
DEPARTMENT OF BUILDING"& SAFETY FIELD OFFICE DST
COUNTY OF RIVERSIDE `/ f/
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL.
2N0. FL.
.POR.
GAR.
CAR P.
SQ. FT. @
UNITS
D e
� ;I:r
.jD/ist.
t 4.
F YARD SPKLR SYSTEM
SQ. FT. @
F.C.C.
MOBILEHOME SVC. BAR SINK
SQ. FT. @
Micro Film Fee Cop $
POWER OUTLET ROOF DRAINS
SQ. FT. @
Par el No. ///'Jy(� Use/Case No.
-73 �_ V45 I
SQ. FT. @ DRAINAGE PIPING
Mech. Fee Dbl 5
WALL
SQ. FT. @
Lot Size
,
DRINKING FOUNTAIN
Legal Description �"!/' L/ f (i F
�%`�
��` Vf
�/ j `�' "� t�
SQ. FT. @ .
ESTIMATED CONSTRUCTION VALUATION $
S
URINAL
WATER PIPING
Electrical Fee Dbl
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
SMI Fee $
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
Plan Checker
VENT SYSTEM FAN EVAP. COOL HOOD
SIGN
WASHER (AUTO)(DISH)
Sp. Insp. Fee $
APPLIANCE DRYER
Const. Lender Branch
GARBAGE DISPOSAL
Registr. Fee $
FURNACE UNIT WALL FLOOR SUSPENDED
Address City Zip
LAUNDRY TRAY
Reinsp. Fee $
AIR HANDLING UNIT o CFM
IDLE METER
KITCHEN SINK
Total Fees $
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
Received br _
COMPRESSOR HP
POLE,TEMP/PERM
LAVATORY
Trees required
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. @ c
BATH TUB
SQ. FT. @ c
WATER HEATER
SO. FT. RESID @1'/.c
SEWAGE DISPOSAL
SQ. FT. GAR @ s/. c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL.
T TALFF
MOB.HM.FEE
MICRO FEE
MECH. FEE PL. CK. FEE
CONST. FEE. ELECT. FEE
SMI FEE
FEE
P,LU/J1B,rjbE'�
PERMIT NO. -
391934
Job Address Space ip
Own
Co munity �f[/(�
�"�, 't tii/ j t.i�
Valuation
$ „f.
D e
� ;I:r
.jD/ist.
t 4.
ff
Off„
_L_
F.C.C.
MH.Permit Fee $
Micro Film Fee Cop $
Use of Permit
• T'�✓� J� �:�. `'►9'y.jV�` "\ a
Par el No. ///'Jy(� Use/Case No.
-73 �_ V45 I
Ck. B
�
Mech. Fee Dbl 5
Pl. Ck. Fee $
Set Bocks
Lot Size
,
'
Construction Fee Dbl $
Legal Description �"!/' L/ f (i F
�%`�
��` Vf
�/ j `�' "� t�
S
S R
Electrical Fee Dbl
{l Zone Rest iclI s r t
Group
Type
.
SMI Fee $
Plumbing Fee Dbl. $
Bond Amt.
$
Plan No.
Plan Checker
Final ote M -
aJ(��''
I-M&L
Unit
Sp. Insp. Fee $
Demol. Fee $
Const. Lender Branch
Supplimentol.Permit Numbers
Registr. Fee $
Mileage Fee $
Address City Zip
Witness Fee $
Reinsp. Fee $
Owner/Agent '
Tel. - Zip
Total Fees $
Address
City Zip
M. N. Cosh%Check
Received br _
Contract
\\ .J" ` '�i•.�
Tel. �/"�i
J (•,�
License#
Trees required
Sewage S{y�st(/e�jm
Addre s yam} (�J i
CityI) Zi _
V T LL P )u
Sewer district
Form 284-208 (Rev.8/78) es
THIS PERMIT SHALL BECOME VOID IF WORMS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by: A
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.