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376563 (SFD)BUILDING -PERMIT — PERMIT NO. - DEPARTMENT OF BUILDING & SAFETY 3765 6.3,,�� COUNTY OF RIVERSIDE FIELD MIT I' M. 0.. Received by 'Trees requir Sewage Syse T _ U. _ .. P District Form 284-208 (Rev.8/78).,©s' Job Address 53100 Y Community "" Valuation GA Qui NTA $ Use of Permit , )WELL NG 'AND -''ATT. a'G'ARA6N. Legal Description _ L .6, sca;�' iia oi- 1 n. Bond Amt. Plan No.'Plan Checker $ 1 05239 Const. Lender - Branch 42 Address if Cilx.,,/) .Zip space Zip T�Gjjli ner �, + 2253A?i 1,4114 -& P I C2 +Dote Dist. - Off. F.C.C. Parcel No. Use/Case No.' • - • Ck. By ' ' Set Backs ' r' Lot Size Zone RestrictionsGroup Type ' VN Final Dat- Its ector Unit. .i Supplimentol Permit Numbers 8�3?6 63. Owner/Agan _ Tel. • - Zip 5.47-28.90 Address City Zip a \ Contractor - ' ' Tel. License# .. Address'City Zip f• I THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK 4*0?ied by: FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. . I HEREBY AGREE THAT ALL WORK IN C!?uNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OFRIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS"HAS DONE.SO IN t.,� .ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS d1%OF THtSTATE OF CALIFORNIA. CONSTRUCTION ESTIMATE- NO. •' ',ELECTRICAL FEES NO. PLUMBING'FEES IST FL. 2ND. FL. POR. _ GAR. CAR P. WALL 1222 409-^ SQ. FT. @ .6.81.4 $ $ UNITS Micro Film Fee: Cop $ SQ. FT. @ - YARD SPKLR SYSTEM Dbl $ MOBILEHOME SVC. BAR SINK SQ. FT. @ �• �_ T SQ�FT. @ 6 `5' 2600,00 POWER OUTLET ROOF DRAINS ' DRAINAGE PIPING SQ.,FT. @, Dbl $ SQ. FT. @ ;:� t DRINKING FOUNTAIN • '_, Electrical Fee. SQ. FT. @ ESTIMATED_ CONSTRUCTION VALUATION' $ r� yyy}�� 25084080 < $ URINAL 1 WATER PIPING 1 } J NOTE: Not'to be used as property tax valuation -4S SWIM POOL, PVT $ FLOOR DRAIN 'Demol. Fee $ MECHANICAL'FEES Registr. Fee SWIM POOL, COMM WATER SOFTENER $ . VENT SYSTEM FAN EVAP. COOL 3 HOOD $ SIGN Reinsp. Fee 2 WASHER (AUTO)(DISH) - APPLIANCE DRYER. 1 300 .Total Fees 1 GARBAGE DISPOSAL' t 2,50 FURNACE UNIT WALL FLOOR SUSPENDED ' ..-. LAUNDRY TRAY,'%:.�' AIR HANDLING UNIT CFM '. IDLE METER KITCHEN S(NKS. ABSORPTION SYSTEM B.T.U. ' TEMP USE PERMIT SVC 2 WATER CLOSET --.500, COMPRESSOR . 350 HP "750- - ' . POLE,TEMP/PERM 2 LAVATORY 500 HEATING SYSTEM 1 FORCED GRAVITY 1k' �. 4:4 00 a 00AMPERES SERV ENT'•00 SHOWER BOILER '_ B.T.U. SQ. FT: @ C '"2 BATHTUB., 500 i .. SQ: FT. '@` rt 2, WATER HEATER , '500 i <1222 Q. FT. RESID @I1AC �'S�� 1 SEWAGE DISPOSAL' S0. FT. GAR @ s/ c 300 HOUSE SEWER . 'GAS PIPING PERMIT FEE 4 00. PERMIT FEE 00 PERMIT FEE 4/a ns WFE!EGi DBL. 1t. TOTAL' FEES- •:�' O W4 MOB.HM.FEE • MICRO FEE a +x- - MECH. FEE - fes, YT s-��YJ PL. CK. FEE., �'._ t'•'.J CONST FEE O�✓i/U'� ELECT. FEE ' $MI FEE • 2v ,� .� 'FEE PLUMB. •A• �� M. 0.. Received by 'Trees requir Sewage Syse T _ U. _ .. P District Form 284-208 (Rev.8/78).,©s' Job Address 53100 Y Community "" Valuation GA Qui NTA $ Use of Permit , )WELL NG 'AND -''ATT. a'G'ARA6N. Legal Description _ L .6, sca;�' iia oi- 1 n. Bond Amt. Plan No.'Plan Checker $ 1 05239 Const. Lender - Branch 42 Address if Cilx.,,/) .Zip space Zip T�Gjjli ner �, + 2253A?i 1,4114 -& P I C2 +Dote Dist. - Off. F.C.C. Parcel No. Use/Case No.' • - • Ck. By ' ' Set Backs ' r' Lot Size Zone RestrictionsGroup Type ' VN Final Dat- Its ector Unit. .i Supplimentol Permit Numbers 8�3?6 63. Owner/Agan _ Tel. • - Zip 5.47-28.90 Address City Zip a \ Contractor - ' ' Tel. License# .. Address'City Zip f• I THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK 4*0?ied by: FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. . I HEREBY AGREE THAT ALL WORK IN C!?uNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OFRIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS"HAS DONE.SO IN t.,� .ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS d1%OF THtSTATE OF CALIFORNIA. PERMIT NO. x.3:"76 56 3. . MH.Permit Fee $ " Micro Film Fee: Cop $ Meth. Fee Dbl $ ':N P.I. Ck. Fee , ' $ Construction Fee Dbl $ Electrical Fee. Dbl $�q SMI Fee $ 9 .Plumbing -Fee Dbl $ -4S Sp: Insp. Fee $ 'Demol. Fee $ Registr. Fee $ 'Mileage Fee' $ . Withers Fee $ Reinsp. Fee $ - .Total Fees yy M. 0.. Received by 'Trees requir Sewage Syse T _ U. _ .. P District Form 284-208 (Rev.8/78).,©s' Job Address 53100 Y Community "" Valuation GA Qui NTA $ Use of Permit , )WELL NG 'AND -''ATT. a'G'ARA6N. Legal Description _ L .6, sca;�' iia oi- 1 n. Bond Amt. Plan No.'Plan Checker $ 1 05239 Const. Lender - Branch 42 Address if Cilx.,,/) .Zip space Zip T�Gjjli ner �, + 2253A?i 1,4114 -& P I C2 +Dote Dist. - Off. F.C.C. Parcel No. Use/Case No.' • - • Ck. By ' ' Set Backs ' r' Lot Size Zone RestrictionsGroup Type ' VN Final Dat- Its ector Unit. .i Supplimentol Permit Numbers 8�3?6 63. Owner/Agan _ Tel. • - Zip 5.47-28.90 Address City Zip a \ Contractor - ' ' Tel. License# .. Address'City Zip f• I THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK 4*0?ied by: FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. . I HEREBY AGREE THAT ALL WORK IN C!?uNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OFRIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS"HAS DONE.SO IN t.,� .ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS d1%OF THtSTATE OF CALIFORNIA. NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS_ 1 Set Back _ 7 9 33 Ventilation System 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 �t �1.,2 (- % / 39 Appl. Clearance 7 Framing40 Fire Damper 8 Vents 41 Smoke Detection Device 9 Garage Fire Wall 42 Commercial Hood 10 Fireplace P. L. 43 Final 10A Fireplace T. 0. P' ADDITIONAL INFORMATION ? G P, T A-0C!A_ -A-f�/��'� .6', � /� O ,(/G LC.S.S)s 0 /_ ' SEWAGE SYSTEM SIZE & LOCATION 11 Exterior lFtLa.:5L41 Q 12 -Internal Lath 12A Drywall 13 ,Finish Grade o� INSULATION Thick R Value 7A Walls (Batts) -3-17-90 12B Ceiling (Batts) / _ 12C Ceiling (Blown) 14 Final `J- PLUMBING APPROVALS 15 Ground Plumb 16 Water Piping 17 Rough Plumb 18 Vents 19 Sewage Disposal 20 Sewer 21 Water Fjeater 22 Water Softener 23 Water Service c 24 Gas Test 2s Final � �, i� Tank 000 Pit ( L.Line REAR OF PROPERTY LINE k W C PSL IP/ 6 ELECTRICAL APPROVALS 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring _ — O 29A Grounding Wire Ov �t 29B Bonding 30 Fixtures 31 Service 32 Final ' STREET NAME _3—too DEPARTMENT OF BUILDING AND SAFETY . COUNTY OF RIVERSIDE OFFICE DATE TIME PERMIT NUMBER INSPECTION REQUESTED FOR: ADDRESS I SPACE NO. I I F A.M. OWNER t0 UNITY P14X BUILDING PLUMBING ELECTRICAL MECHANICAL X /� �� 3� i'roTUES - I yet WE l TMUR REMARKS: f (�Q f �F aFRI C OWNER/CONTRACTOR TEL.NO. 264 ry;.,+t..:(t•-Fsri.- a+... a:i1 rst•Tr^s,.s-�'sY`y 'h'' t* e.. a- 1 _:fit �'""---�:- NOTICE: THIS IS. NOT. A, BUILDING PERMIT DISTRICT £� APPLICATION TO`CONSTRUCT^: a DEPARTMENT OFBUILDING AND SAFETY Perm(t,No e 'COUNTY- OF RIVERSIDE p. . , .. .. '_-�, '... +- /i C; :• `• _ :.� ..�.. - r -i: .. ` eLlA✓C. X5...4 0 !/': /, GY" 1 Contractor Owner Architect - r r I �t d _w 1' Hi~ , r1aJ- C C . i?J/�07 tetQ<:% 9�. ' Address— Addres� Address � a I✓ t4�1'S d rte`: err_ City ! CitCit,'' 3 Oat 34'7_ 34'7_ binPhone " Phone Phone - R/ 1 (we) the undeisigned,.hereby certify and acknowledge that%'f (we) have read the .application" and agree that if. Curb and Gutter, and. W Z 'Paving,%nd/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 requirement's have been met. I am also aware•that no work is to be done within the County R/W • O without an eri.roachmenf permit., - NOW, therefore, it is agreed;'that I (we) will>not occupy said. property and will not cause_ said .property to be occupied unt' 1 (we) have -' complied with all laws of the'County of Rrverside: and they State of�California governing said. property. y SIGNATURE OF 'OWNER AND/OR AGENT DATE au i Approval by Signature..froni the'"Following Departments Listed'Below Must Bc"Obtained Prior to the Issuing:;of :a- Const�uction'Permit. ;- ISPACE NO. � 1 USE OF STRUCTURE 7 TRUCTUREJOB f.'hl r {p _ e JOBADDRESS s: J 0A1 SINGLE FAMILY i.�}�*DUPLEX > Z •f. LEGA .`D SCR PTION OF-P.R OPE TY � i - APARTMENTS' 'Q AGRIC. H Q y - COMMERCIAL'' �. INDUSTRIAI�y r. L,. 'a,.,:. �2K of _ COMMUNITY %�. `-,,' 1y: O C Z NO. OF SUBMITTED'PLANS — _ U,SE OF PERMIT ffTERATIOOJS! as-.... CASE N0. .. .. • C•. .' t r u. Z NO. OF PAA SPACES REQUIRE , NO. OF BUILDI G$ 0)!I EXISTING+" - �L fP . .��� ,Qr)ZONE R_ p.``" - .' SETBACKS, FRONT SIDE g G$AOING PERMIT REQUIRED? ;•YES NO ❑ LOT SIZE b'`! /71 , SETBACK =RD NC E _- OF FEET REQUIRED ON - ° A STREET . DATE — �'' " SIGNATURE OF LAND USE OFFICIAL ..r DEDICATION -REQU.IRED: YES ❑ NO- p ; NO.. OF FEET__— ?. " W / CURB AND GUTTER REQUIRED. YES ❑ NO ❑ STREET Y CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES (:1NO ❑ C HAS AN ACCEPTABLE APPLICATION( BEEN MADE FOR ENCROACHMENT' PERMIT FOR DRIVEWAY AND STREET Q L ,t, IMPROVEMENT? YES : L�- NO ❑ J d �• r/ �' - ~ ' • , � DATE "' SIGNATURE ,OF ROAD DEPT. OFFICIAL tI4-,i c_- ' Q W W' C SEWAGE DISPOSAL r T®M� �. ✓` i 1• WATER POLLUTION r REMARKS z .. FLOOD CONTROL � ' 4 L Z -AIR POLLUTION.•.: S.. `DIV OF HWY es Wo a ;� _ �� YOUR PROPERTY MAY BE SUBJECT TO ': o FLOOD. RIVERSIDE. COUNTY ASSUMES ik kr R h N0,RESPONsiBiLITY-IN EVENT OF FLOOD. f '284+.CANARY—FILE, PINKi—APPLICANT +f .. •,.,,._ ..........tea-,_ - _. -..,s. .s ::�s.�.i�..d. _. L....._. ,. _. .... f - ,. �.-.v- •_ .__..... .. .. .._ .. .....�... .., .. - ...,.. 1 'r. ... .. a LU Z 3 O DH O yaj �D a >- Z t - LU D LL J Q � N ca O Z Z~ za 4 L J D a 0 >- Z t - LU D LL J Q m ad 1 APPLICATION FOR. TREE PLANTING , I (we), the undersigned, hereby certify and acknowledge that I (we) have read the application and agree that if trees are required under River- side County Ordinance Nho. 457; the'applicant agrees to install said trees prioi to final inspection. It is understood that no final n'sp�ction will be given until said requirements ave been met or exception has been granted by the County. Now; therefore, it is agreed that the prop- erty owner shall cause' the property lines to be surveyed in the event no survey stakes can be found\Further; it is agreed that thc;kCounty of Riverside shall assume no responsibility should trees have to be removed due to lot line errors. -37,65 Owner s Name "� ~ n�F ee t' Building Permit No. Mailing Address C� �' City, St to C ter' AZ�p Job Address1 Community Legal Description 44 v `(' C, ' Assessor 0s Ma ookk5 Page Type Structure Type of Soil Is water available Road.Btipt. Plot Plan No. Type of existing trees in road right-of-way QAS&_ Trees preferred by applicant (1) f%� Fit' PIAL' (2) BGI-elc _ (3) Date ��--79 Owner's Signature Planning Commission Case No. e ' ROAD DEPARTMENT APPROVAL Approved species Washingtonia robusta (Mexican fan palm) Number Spacing of trees Distance from lot lines: Front 2' in R/W. Side .. Additional requirements Per plot plan on reverse. No street.trees wi of trees 1 within 10 of driveways. —'`• Date Building and Safety notified 1/80 Signature REQUEST FOR EXCEPTION Reason C (attach additional page if necessary) Request for hearing: YES ❑ .Owner's Signature f (Forward application to Planning Dept. if exception requested) NO REQUEST FOR HEARING Planning Dept. f A Concur ❑ Date Non -concur ❑ Explanation Signature' Road, Dept. Concur ❑ Non -Concur ❑ Date Signature, REQUEST FOR HEARING AND COMMITTEE DECISION Date hearing established Date hearing notice mailed to owner Approved ❑ Disapproved ❑ Date Owner notified of decision Date Building & Safety notified, Signature APPROVAL BY BUILDING INSPECTOR Final Date Inspector _ Job Address Requirements for tree planting complied with Remarks y Building Permit No. Community _ (Detach and forward above information to Road Department Riverside) 284-230, REV. 1174 *� 0,4 1 DEPARTMENT OF BUILDING AND,$ , FETY . COUNTY .0'F RfVERSIDE OFFICE DATE_ TIME- PERMIT NUMBER INSPECTION v REQUESTED ,ADDRESS I SPACE NO. FOR: ;�- a- �, o A.M. OWNER COMM ITY P.m. BUILDING PLUMBING ELECTRICAL MECHANICAL. O,'IVI'ON U>FS a o(En REMARKS: aTHA �• • �gFRI OWNER/CONTRACTOR TEL.NO. ' 281-M tIL75 DEPARTMENT OF BUILDINGAND'SAF€TY e COUNTY'OF RIVERSIDE OFFICE DATE TIME PERMIT NUMBER INSPECTIOK REUUESTED ADDRESS I SPACE N0. FOR:, I OWNER COMMUNITY BUILDING PLUMBING ELECTRICAL MECHANICAL) ;. -WO TOES REMARKS: .aTHUR Q' FRI 4 OWNER/CON TRACTOR:TEL.NO: . , DEPARTMENT OF $UILDING AND SAFETY . COUNTY OF RFVERSl OFFICE - DATE TIME P•ERMIT,NUMBER e [ � INSPECTION. I{ ADDRESS PAREQUESTED- is CE N0. 1 FOR: I . OWNER ;COM.M NITY a A'M' f x ' E14 m. BUILDING PLUMBING ELECTRICAL MECHANICAL aM TUES I REMARKS: a WED THUR QFRI OWNER/CONTRACTOR TEL:NO.' DEPARTMENT OF BUIL.D.ING AND SAFETY" COUNTY OF OFFICE DATE TIME PERMIT NUMBER INSPECTION - REGIUESTED FOR. ADDRESS -T -SPACE N0. I S73 Ido o �, 0,b r z a A.M. OWNER OMMUNITY 99 1.7 P:At: BUILDING PLUMBING ELECTRICAL MECHANICAt . 1. KION . REMARKS: ' "Q r TPeUR ,,• F,RI �a. OWNER/CONTRACTOR TEL.NO. BUILDING PERMIT+ PERMIT NO. 37F;.gR_q DEPARTMENT -0i BUILDING & SAFETY FIELD OFFICE DST COUNTY OF RIVERSIDE PERMIT NO. 376563 CONSTRUCTION ESTESTIMATEp Job Address 5J100 Space IDA GBREGON NO. ELECTRICAL FEES NO. PLUMBING FEES Comm.AtVEN LA QUINTA 12, 2 SQ. FT. @ 18.40s 2248-1.80 UNITS F.C.C. 001 MH.Permit Fee $ Micro Film Fee Cop $ 1ST FL. Parcel No. 774045006-1 SQ. FT. @ Ck. By ' Mech. Fee ._• Dbl $ ­21411DWELUNG PI.,Ck. Fee $ YARD SPKLR.SYSTEM, Lot Size 100 0501 000 2ND. FL. FOR. SQ. FT. @ 90.34 MOBILEHOME SVC. - Zone Restrictions 1 • BAR SINK + GAR. 4 SQ: FT. @ ! POWER OUTLET Plan Checker ROOF DRAINS Inspector CAR P. SQ. FT. @ ' Demol. Fee $ Const. Lender Branch S]]uu�pjDplli/m}�e-nytolll Permit Numbers , R.B03 ` 6563 ' - DRAINAGE'PIPING ' WALL SQ. FT. @ Reinsp. Fee $- Owner/Age . • . ON Tel. -'- Zip 347-0890 DRINKING FOUNTAIN Total Fees $ t AAddress{,� j�E" - + O• DR A ST EE City (�•� Zip I N D I O M.O. N.C. Cash Chec - -° Contractor URINAL Licensee Frees requir d SQ. FT. @ Address t > City Zip/ ESTIMATED. CONSTRUCTIONNALUATION 2 YJ�. Q� 1 1 WATER PIPING NOTE: Not to be used as property tax valuation SWIM POOL, PVT FLOOR DRAIN MECHANICAL FEES . ••" -� " ` J r" SWIM POOL, COMM WATER SOFTENER VENT SYSTEM - 2 FAN EVAP. COOL 1HOOD l/7��s 00 • SIGN 2E WASHER (AUTO)(DISH) 500 APPLIANCE DRYER .1 00 1 GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED-— LAUNDRY TRAY" AIR HANDLING UNIT CFM IDLE METER I KITCHEN SINK 250 ABSORPTION SYSTEM B.T.U. x."' TEMP USE PERMIT SVC 2 WATER CLOSET 500 COMPRESSOR 350HP 750 POLE,TEMP/PERM LAVATORY � 0 HEATING SYSTEM . FORCED GRAVITY 4013 20 AMPERES SERV ENT 700 SHOWER BOILER " B.T.U. SQ. FT. @ t 2 BATH TUB Q} SQ. FT. @ t 2WATER HEATER 5F 2 SQ. FT. RESID @ 1 /, c 1528 1 SEWAGE DISPOSAL 10150 00 SQ. FT. GAR @ 'N c 3W HOUSE SEWER ,. GAS PIPING PERMIT FEE 300 PERMIT FEE PERMIT FEE 4 DBL. TOTAL FEES MOB. HM. FEE MICRO FEE MECH. FEE PL. CK. FEE CONST. FEE• ELECT. FEE SMI -FEE FEE PLUMB. FEE 219.0 24.50 11.5.010. 28.22 .7 49.50 PERMIT NO. 376563 Job Address 5J100 Space IDA GBREGON Zip 192253 Owner CHAPMAN Comm.AtVEN LA QUINTA Valuation $ 25064.8 ole 10-12-79 Dist.RICE . 1.1 Off. 5 F.C.C. 001 MH.Permit Fee $ Micro Film Fee Cop $ Use of Permit AND ATT. GARAGE Parcel No. 774045006-1 Use/Cose No. JBS Ck. By ' Mech. Fee ._• Dbl $ ­21411DWELUNG PI.,Ck. Fee $ Set Backs J Lot Size 100 0501 000 Construction Fee Dbl $ 7Leggaall Dlescriptionc Irl #18 p '02 t+v+ r J X74 Q .i.f7 S00 �05 90.34 Electrical Fee Dbl $ Zone Restrictions 1 • Group A-3 Type t U Ty1V SMI fee - $ Plumbing Fee Dbl $ ✓ _Bond Amt. $ Plan No. 1 05239 Plan Checker Final Date Inspector Unit Sp. Insp. Fee $ Demol. Fee $ Const. Lender Branch S]]uu�pjDplli/m}�e-nytolll Permit Numbers , R.B03 ` 6563 ' - Registr. Fee $ Mileage Fee $ Address _ Zip Witness Fee $ Reinsp. Fee $- Owner/Age . • . ON Tel. -'- Zip 347-0890 Total Fees $ t AAddress{,� j�E" - + O• DR A ST EE City (�•� Zip I N D I O M.O. N.C. Cash Chec Received by Contractor Tel. Licensee Frees requir d Sewage System . - Address t > City Zip/ T LL P >Sewer District n Form 284-208 (Rev.8/78) ©s THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK 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. verified by: