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366881 (SFD)BUILDING PERMIT ` PERMIT NO. DEPARTMENT OF BUILDING 8 SAFETY 36688 COUNTY OF RIVERSIDE • r _ FIELD r DST CONSTRUCTION ESTIMATE - NO. ELECTRICAL FEES 4 NO. PLUMBING FEES F IST FL. 2',_72 . 2ND. FL. POR. rZ `7 _ GAR. 4 CAR P. WALL $.r ^. SQ. FT. @ 'A t127 ' /� aluation, ( -, ..,("` . 8 y4'r NITS a Dote • �� Dist. 1 wOff. .71 L YARD SPKLR SYSTEM ` SQ. FT. @ j; MH.Permit Fee 8 SQ. FT. @� rf MOBILEHOME SVC. ` t ' BAR SINK t • —� r f ;- POWER OUTLET 4 ROOF DRAINS SQ. FT. @ DRAINAGE PIPING SQ. FT. - @ Parcel No. -.: • a • • t % - (j Gt•�. T'": (: `i"�- DRINKING FOUNTAIN SQ. FT. @ C,k-.y-By 4� L. �4' e SQ. FT. @ ESTIMATED CONSTRUCTION VALUATION $ ; C ��! (' lot Size e•'t•y f L Construction Fee Dbl 8.'•" URINALS .a .r r ✓ WATER PIPING F y` S 5` R _ / NOTE: Not to be used as property tax valuation Zone Re'I I. Ins Group •I/• SWIM POOL, PVT _,a,• y FLOOR•DRAIN Plumbing Fee Dbl 8 / MECHANICAL FEES Bond Amt. 8 SWIM POOL, COMM WATER SOFTENER " Fin Dot �� p r , / •�� O Unit VERT SYSTEMAN„f EVAP. COOL yFroft. •'t ' t� '( r� b SIGN WASHER (AUTO)(DISH) Const. .Lender (i.a APPLIANCE ' T DRYER^•N - •" .j a Regisir. Fee• 8 Mileage Fee 8 GARBAGE DISPOSAL Witness Fee E Reinsp. Fee FURNACE UNIT WALL FLOOR SUSPENDED Owner/Agent LAUNDRY TRAY Tel. ; , `City Zip AIR HANDLING UNIT CFM Total. Fees 8 IDLE METER KITCHEN SINK Address // b() FI -3 ABSORPTION SYSTEM B.T.U. - - Zip s �' �'? i''F3C 4�� C4 % L M. 0. N.C. Cash Check TEMP USE PERMIT SVC -t WATER CLOSET o "OC) COMPRESSOR .4 e HP 1 f.\, i �i i\�e Y•\ �'•'w` POLE,TEMP/PERM LAVATORY- Sewage System ,S V.�� } ,,.c•""•• �� I� HEATING SYSTEM !FORCED'-) GRAVITY Address 5 rb ��. '`..y J.'� �ii�r]".4 l) �L��' -TC> AMPERES SERV ENT ;>' SHOWER rte. BOILER B.T.U. SQ. FT. @ •t BATH TUB '1y SQ. FT. @ t / WATER HEATER -� t SQ. FT. REBID @I!/:c' `}x: 'rR SEWAGE DISPOSAL" r? • "V' ` r t t �. '• j SQ. FT. GAR @ '/. c '•? nr ' HOUSE SEWER , L r GAS PIPING - PERMIT FEE PERMIT FEE j' _ t r PERMIT FEE -4 r9r;,,> DBL. TOTAL FEES MOB. HM. FEE MICRO FEE MECH. FEE PL. CK. FEE CONST. FEE ELECT.FEE S SMI FEE FEE PLUMB- FEE 1119 PERMIT NO. 366881 Job Address r SpaceZip {;� Owner Community J /� aluation, ( -, ..,("` . 8 y4'r "} Dote • �� Dist. 1 wOff. .71 F,C.C. MH.Permit Fee 8 Micro Film Fee Cop 8 Use of Permit - 4 - - J t/✓" •. ' ,. L. ` ;%") .ice C- T 9 t NC_ +.' a Z Parcel No. -.: • a • • t % - (j Gt•�. T'": (: `i"�- Use/Case No. C,k-.y-By 4� L. �4' e Mech. Fee Dbl b U Ck. Fee 8 Set Backs . - lot Size e•'t•y f L Construction Fee Dbl 8.'•" Legal Description a K�r� V r/,, i 7 v ' •'� F i••; ` t a. F y` S 5` R _ Fee Dbl 8 ''� • "' Zone Re'I I. Ins Group •I/• Type • , f{ 'Electrical SMI Fee 8 i'' r�C Plumbing Fee Dbl 8 Bond Amt. 8 Pla No. / j 5 t 7 Plan ck/er `i-••. I I �.%Sr� ` Fin Dot �� p r , / •�� O Unit Sp. Insp. Foe 8 Demol. Fee b Const. .Lender t Branch - +, Supplimental Permit Numbers - •" .j a Regisir. Fee• 8 Mileage Fee 8 Address City �••+ Zip F `.. -.. Witness Fee E Reinsp. Fee 8 Owner/Agent '„ " / ` Tel. ; , `City Zip Total. Fees 8 r'7 y J Address // b() FI -3 � - tj R-, t.w\L i �w. ( - - Zip s �' �'? i''F3C 4�� C4 % L M. 0. N.C. Cash Check Received by e ; o ContractorJ� / i 1 f.\, i �i i\�e Y•\ �'•'w` Tel. ,/ • •:+' .:,�!'l7 ¢...r rY.'rt:..11.� - r •4 _ qs .v. ,.{:�� ! r License#- ._ �S,.� J� C.1 Trees required ; ti,,..r.�.. Sewage System ,S V.�� } ,,.c•""•• �� I� Address 5 rb ��. '`..y J.'� �ii�r]".4 l) �L��' City . 4 'Zip ...Y h.^ �e r 1_Z,•.` 4 ! ' T % LL P % THIS PERMIT SHALL BECOME VOID IF WORK ISNOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by: Sewer District- "' - 1 FOR 120 DAYS SHALL ALSO CAUS ERMIT TO BECOME VOID 14 �`� �'' •'" ` '%"` -�� '''"'" '`'-'"' •°'^ "i`"�4•� •, L 4 I HEREBY AGREE THAT ALL N SIJ PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVERSIDE COU TY AND Tr STATE O CQitIFORNIA;» a )YI IHEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN S RDANCE WITH SECTION 5441 OF THE'WSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. B Form 284-208 (Rev.8) , NO. OPERATION DATE INSPECTOR NO.' OFERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVAL% 1 Set Back 7 — 3—i 9 -Thr&ipi c 33' Ventilation System 2 2A Ftgs 8 Frms Slab Grade 7-3-73 34 Plenums 8 Ducts !O -/5-- -2A 35 Furnace Comport. 3 Steel _ 36 Inlets 8 Outlets 4 Grout Blocks 37 Combustion Air 5 Bond Beams 38 Compressor 6 Roof Deck / 7 _I' ' I, 39 Appl. Clearance 7 Framing o _�S = 9 40 Fire Damper } 8 Vents 41 Smoke Detection Device 9 " Garage Fire Wall 42 Commercial Hood 10t Fireplace P. L. 43 Final loA Fireplace T. 0. No ADDITIONAL INFORMATION 75-7 �l / NAL 0d,?LPgQ-(r0AC 9EP;t4- 100. _.----- -----------------T_- l 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) D o-- / —7- _12C 12CCeiling (Blown) 14 Final _ __ ——PLUM.01MGAPPR.CIVA_LS— __ 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 LQQ� Pit (// px lq L.Line REAR OF PROPERTY LINE P/L bl P/I 6' Z 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 (D -b Rk C, n.�� Kemneth.R. Kin Civil Engineer ,826 (714) 793-W-2 -gaite c Redlands, CA. 92373 Br60ksiide Ave.. Suite C ,May 8., 19`79. Model Enterprises. 6083 Ronald Circle Cypress, Calitornia.90630 Re: Residence in La Quinta (Save 11. jZystemi-)'.`I rispecti on Procedure Gentlemen: The Savell System involves the use of pre -cast concrete panels for the walls of your proposed house. -These*p.anels have-been,.designed for a "28 -day strength of 2000.psi,._ We, have 'ca.11e.d-'for a concrete mix, -.,rated at 3000psi.. This higher, strength gdhc.re--e, --'1>s_a-matter_ of -n choice,. not structural n6c-essa­ty--.,,,. !,�,Spec � %al nspect3 on. is not required. A do—planh_ r,7K, '.� —a We t0 6 conduct' e-f5r!5 sp e-ac6d-ure-: 1. Wall - panel's will be i-nspecte.d.by melfor proper steel p prior rior to pouring concrete. 2. John R. Byerly, Inc., will -obtain and test concrete cylinders to verify the strength .,of, I cloncrete.. 3. Panels will be. numbered -for field. identification.� 4. At the completion of'6r6ction,.and prior. .to covering connecti-ons,. I. will. inspect.the connections for structural. integrity. This procedure should insure a structurallyadequate'building. .. Very -.truly yours Kenneth R. king, 'Engineer RC,E,:,i 537 A -284 .199 9/74 �i y 'r CANARY—FILE, PINK—APPLICANT' l Architect - Contractor`` �1�!21) rt ° ryG .� I ^ •. • � /r - "f' '^ • �Z �-• a .e... i 1 // t 1_41. �• ^~`" s k F..,•� .irk t •d CE: • —. _ NO THISAS-NOT A BUILDING PERMIT`,` y DISTRICT - z Paving, and/tir Dedication of right -of way'is.required,;by the County of -:Riverside; -,the Riverside County Department,. of Building and ,Safety M 3 shall.not make a Final Inspectionuntilsaid'requirements have been_met. 1 am also awarc.that no work is to be done within the County R/W v O wittiout•an'en.roachment permit. APPLICATION' TO CONSTRUCT DEPARTMENT OF, BUILDING AND SAFETY Permit,No t F, DATE- + SIGNATURE OF OWNER;ANO/OR AGENI� COUNTY-,OF RIVERSIDE _ Approval by Signature from. the,. Following Departments Listed'Below " r - Must.Be Obtai ned' Prior to. the Issuing of a Construttion'Perm it.�ii� -284 .199 9/74 �i y 'r CANARY—FILE, PINK—APPLICANT' l Architect - Contractor`` �1�!21) rt ° Addres,'' ' -' Address Arid ress_ r' i f! -n.-' °tet. b "iJ • City r i City- Cii - ` Fs.!' C'•''ii t _fir 1 �j. - • } s �.i i f �,�'�. . Phone •'' � Phone ,Phone is • 1 twe) the undersigned-.he"Y, certiN,and-acknowledge that,1.(we);have readethe application and agree that if Curb and�Gutter, and W - z Paving, and/tir Dedication of right -of way'is.required,;by the County of -:Riverside; -,the Riverside County Department,. of Building and ,Safety M 3 shall.not make a Final Inspectionuntilsaid'requirements have been_met. 1 am also awarc.that no work is to be done within the County R/W v O wittiout•an'en.roachment permit. t ' s._ NOW, therefore,'it is agreed.thaClAwe)�will not occupy said property 'and will not:cause`said property'to-be occu wd"ontil I-(wte) have complied w th all laws of the•County of Riverside and the State of ;California governing said.prope! .. � DATE- + SIGNATURE OF OWNER;ANO/OR AGENI� Cyt, ...__- ,R Approval by Signature from. the,. Following Departments Listed'Below " Must.Be Obtai ned' Prior to. the Issuing of a Construttion'Perm it.�ii� I SPACE NO. rr s -•r �✓ ;,���I�y�- r' �. USE OF STRUCTURE_• JOB ADDRESS i' I `' .' SINGLE FAMILY.,' DUPLEX, s" G^' , ar.• (� , . •APARTMENTS • Z W LEG L ESCRIP iON,OF P%p2(O�PERTY+ , M t AGRIC. -_ '•' ��COMMERCPAL _ N.Q H Y., /. V rr' C� ,reg f �, . r•� r x0 INDUSTRIAL JR ;'`i i %l,i✓' �.. k e �.. > C `O COMMUNITY . r �� t ALTERATIONS n PERMIT4� L, -�� z, NO. OF SUBMITTED'PLANS'__, USE sOF CASE N0. . , t , : �f• VW NO. OF PARKING SPACES REQUIRED < NO. OF BUILDINGS NOW EXISTING 0 Z Z Q /.+ , .`+.J! ''t:' t' 4. ,�+''• J -. �('-,� •J. ✓ / ,per+!.. r' �•% 'SETBACKS: f • Q J' ZONE FRONT SIDE REAR J m _ '❑ 'LOT GRADING PERMITREQUIRED? YES NO ❑ SIZE. J.rV T 'SETBACK- ETBACK ORDINANCE'# __ 'SOF FEET REQULRED ON ' STREa,$ , r �� DATE � f i>7 SIGNATURE OF LAND USE.OFFICIAL��" r `istst6•r"arte�ih`N:i�. �r L'�--- yy DEDICATION REQUIRED: YES ❑ NO ❑ ;NO. OF FEET-__-' � � �y .i W. �[i •-i .G CURB AND GUTTER'REQUIRED: YES D.,, -NO O k t r•. "'� STREET.i • � ♦ gyp.� - 4, W O CAN CURB' AND GUTTER FEASIBLY B_ E "IN_STALLED?' YES -40 tNO ❑ ' .. fid'` .s+ HAS AN ACCEPTABLE:. APPLICATION BEfN MADE FOR•IENCROACccHM,+FNT. PERMIT"FOR= DR1,,EWAY AND STREET O IMPROVEMENT? YES "'' [D� /DATE';;C _ :H; '.t.+SIGNATURE OF ROAD,'LDEPT. OFFICIAL � A •; t i ;{ ~ - _• � r-_ �. ��� + •,.A: � t ter_ �=+ i /:~' ,``. ,� SEWAGE DISPOSAL - t = C FOOD ESTABLISHMENT J •� • ..F t is / re A. WATER POLLUTION °e - REMARKS �rr FLOOD CONTROL r `z AIR POLLUTION = F -"DIV OF HWY . .. i c Q _ — '� ?'• YOURiPROP.ERTY MAY BE.SUBJECT TO .,. ,o TY.' FLOOD: 'RIVERSIDE COUNTY ASSUMES _ NO;RESPONSIBILITY IN EVENT - OF FLOOD. -284 .199 9/74 �i y 'r CANARY—FILE, PINK—APPLICANT' W Lu Z O 0 o W CZo 0 >- Z � LU C LL J Q N m ad v z z ILZa Lu IL J � a 0>- Z t - LU 7 LL JQ 3'A m df .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 No. 457, the applicant agrees to install said trees�riorto final inspection. It is understood that no final inspection will be given until said requirements have been met or exception'ho's 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 the County of Riverside shall assume no responsibility should trees have to be removed due to'lot'line errors. f�.(�� b 6 8g1 Owner's Name ���� �^+rrrctQ�C/SICS �- Building Permit No. t� Mailing Address g Aaw�••�*-'fid City,•/ Stgte Zip �G[�3o Job Address / / oy�'t �CrO w Community Legal Description ---C) Cell n p j Assessor's Map, Book, & Page Type Stru_ cture G 6— Type of Soil' s water,cvailable Road Dept. Plot Plan.No. Type of existing trees in road right-of-way ^-4P- Trees preferred by applicant (1) Mq F44% A�"� (2) 0 (j''� (3) �� �^re � Date _" `�— J Owner's Signature .., T �ll P�►ammng: Comm ission Case No. ROAD DEPARTMENT APPROVAL Approved species Washingonia robusta (Mexican fan palm) Number of trees -1 Spacing of trees Distance from'lot lines: Front 2' in R/W Side` Additional requirements Per plot plan on reverse. Date Building and Safety notified 6/79 Signature REQUEST FOR EXCEPTION Reason i (attach additional page if necessary) . Request for hearing: YES ❑ Owner's Signature rt (Forward application to Planning Dept. if exception requested) NO REQUEST FOR HEARING .w,. Planning Dept. .� . Concur ❑ Non -concur ❑ Explanation, Date Signature Road Dept. Concur ❑ Non -Concur *n 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 k t APPROVAL BY BUILDING INSPECTOR Final Date Inspector Job Address Requirements for tree planting complied with .— Remark s Building Permit No. ' Community t ' (Detach -and forward above information to Road Department Riverside) Y 284-230, REV. 1/74 ' _ 'i STATE OF CALIFORNIA DEPARTMENT OF FOOD AND AGRICULTURE DIVISION OF MEASUREMENT STANDARDS Weighmaster'i Certificate of Weight andtMeasure t THIS IS TO CERTIFY that the following described n&dandise was we ghed .sand or obunted by1 Priftz peighmasser /� ` /� d his signature is a recognized authority of accuracy as presaibed by Chapter h pt 7.3 ( ing w h Section 1 /QI of No.. ' V' "24913 j+ 4 A 1 3 Division 5 of the California Business and professions Code, administer d by 1R D vis,on 1 M sure t Standards of tM 1 , 0• ,`//1_ -,y/■ J ..i-» Department of Food and Agriculture of the State of California. THOUSAND 'PALMS', READY MIXCORP. - P.O. BOX 221 . THOUSAND-iPALMS, CALIF. 92276 . PHONE (714) 343-3411 a WEIGHED AT: 72475 VARNER RD: • THOUSAND PALMS, CALIF. 92276 BORDER NO. JOB NO' ITEM DATE, �. fI i SOLD TO+ r•w•.i f ! ,� ,.y"fir/ S '' ����:�� � � - MAILING ADDRESS,.•' A All") JOB ADDRESS' OWNER Weight? Load DISCOUNT IF Gross Lbs. �` ,� No. Tare• - Delivered - - PAID -BY 10TH Truck No. PROX Net , -�. :... r« _ - ..:�—. _ . -. - _ - _ PROX •�,� Truck License No. PREVIOUS CU. YDS.- i TIV!er License No. r t NLbment t �COMMODITYnd l `' " ' CU. YDS- THIS TICKET -THOUSAND PALMS READYo,kr.< Ys, MIX CORP. F + { PRIVATE WEIGH MASTER Lbs.+Rock 2 TOTAL CU- YDS. t { a Water Added : At Plant-Gal.I it / ,t _t� 1r Nater Adde ti �Y c, DEPUTY At-Job-Gal. � ., • M rwtaos Vns.- C"ss_ Ready-Mix/Other PRt CE AMOUNT { Mixer Drum Revolutions PlantJob Discha Rock rge *� t f s 4 Tons Sand Tons , Tons r ... Minimum Load Charge Yds: Tons Arrive 'i` .Startt Plant M Job y• •"�;* a M Pour . M Finish' '` Left a Return -Pour M Job �'M Plant, M , Oelay.Time �! Hrs.~ _ Rate Per Hr: Remarks SALES TAX ^ f�- P - Rec'd. by �d J s+ i tp TOTALmo- t Free Unloading Time: -A M6Ximum of;5 minutes per yard for Ready Mix or amaximum of 15 minutes N Pet load for, dry material. ADDITIONAL unloading time will be charged at current prevailing rates. Claims for credit or adjustments must be accompanied by delivery tickets and made within 5 days. All bills payable net 10th of month followth)9. month of delivery. We are not responsible for, sidewalks,curbs, or other property when delivery is requested on premises. CUSTOMER NC.-'-'PRODUCT NO. ZONE' , _ , .'fig: s I i .�:+�:'•'V, ♦ f - BUILDING PERMIT tr FIELD OFFICE, PERMIT NO. pp DEPARTMENT OF BUILDING &+'SAFETY . f DST 36 68 0 1 COUNTY OF RIVERSIDE ;,: t CONSTRUCTION ESTIMATE Job Address Space ��� - �� a >���: �..� 8.7� o- �i'sJ'.J+• ' rr +. t' NO. ELECTRICAL FEES NO. '. :-PLUMBING•FEES f IST FL. `� -72 2ND. FL. SQ. FT. @ [� ^ Date ..J UNITS ref—OjfV•f-. F. C. C. MH.Permit F9. SQ. FT. @ YARD SPKLR SYSTEM " of Permit •L ., C J��1�AC__ E - _ t ; ✓, . FOR. .GAR. Q^ SQ. FT. @ tp -%' MOBILEHOME SVC PI. Ck: Fee $ BAR SINK j® SQ, FT, @ (,a „r, POWER OUTLET ROOF DRAINS L Description - Sc >✓ �� 1 f2T �y!�/ W:�.".� CAR P. WALL SQ. FT. @ Zone Restrictions' Group Type DRAINAGE PIPING Plumbing Fee Dbl $ 49 seBond SQ. FT. @ - DRINKING FOUNTAIN Plan No. tD SQ. FT. @: r F•„'r.h �. r� z r».e`«. ,a„v , •URINAL , ql� /{�� � v : i L _/ • �.. ESTIMATED CONSTRUCTION VALUATION $ T4 C Sp. Insp. Fee $ Demol. Fee $ WATER PIPING Supplimental Permit Numbers' r ` - i NOTE: Not to be used as property tax valuation Mileage Fee $ SWIM POOL, PVT ��. ,r 4 's.•./ FLOOR DRAIN m.L MECHANICAL FEES SWIM POOL, COMM t WATER SOFTENER M.O. N.C. Cash - Check VENT SYSTEM EVAP. COOL OOD 00 SIGN ` WASHER (AUTO)(DISH) 00 APPLIANCE tLER� 'Z Oq ' r r THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED;,WITHIN.120:DAYS. CESSATION OQ, WORK., v wer Pied by:E FOR 120 DAYS SHALL ALSO CAU ERMI TO BECOME VOID. - , i I HEREBY AGREE THAT ALL EC'Ff Mik'VML7FITHIS PERMIT WILL BE DONE IN ACCORDANCE WITHLy ' THE LAWS OF RIVERSIDE COUNTY AND T STATE OF CALIFORty1A. ; ! • GARBAGE DISPOSAL S FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM IDLE METER ( KITCHEN SINK p ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' `' Glp COMPRESSOR HP ' Fs POLE,TEMP/PERM LAVATORY jcJ HEATING SYSTEM FORCED GRAVITY 03 –&9P AMPERES SERV ENT Cita 'SHOWER BOILER B.T.U. SQ. FT. @ BATH TUB SQ. FT. @ t WATER HEATER�*� Z. SQ., FT. RESID'@l'� c� ''SEWAGE"DISPOSAL p ' SQ. FT. GAR @ % t . G% HOUSE. SEWER +i GAS PIPING PERMIT FEE ..5 PERMIT FEE t 3�jr p- 1 PERMIT FEE_ o DBL. j TOTAL (FEE�ES MOB. HM.FEE MICRO FEEp MECH. FEE PL. CK. FEE JCONS�T.. FEE ELECT.•FEE '. SMI FEE FEE PLUMB. FEE,+ '(, PERMIT NO. 3668811 r Job Address Space ��� - �� a >���: �..� 8.7� o- �i'sJ'.J+• ' rr +. t' Ziph d G�� Owner �• ` - +' _ ,�. ,,li/1 0 r Community) Valuation �. Date ..J Dsist.1 ref—OjfV•f-. F. C. C. MH.Permit F9. 'Use Micro Film Fee i' Cop $ '0 of Permit •L ., C J��1�AC__ E - _ t ; ✓, Pdicel No, r R.' ! 'fS" ©f� Use/Case No. fes, Ck. B Y. r S o. Mech. Fee Dbl $ PI. Ck: Fee $ 4 "` - Set Backs r�.. Lot Size . - /�•f Q ' Construction Fee Dbl $ L Description - Sc >✓ �� 1 f2T �y!�/ W:�.".� F S S [ R, L n♦ •. �• . 1 4r Electrical Fee Obl $ Zone Restrictions' Group Type SMI Fee $k Plumbing Fee Dbl $ 49 seBond Amt. E Plan No. tD PIan�F eckel I �.. �� t f/G/G/`/ �.I �`'"- ql� /{�� � v : i L _/ • �.. Insp ctbr' Unit., . Sp. Insp. Fee $ Demol. Fee $ Const. Lender Branch a' •q� Supplimental Permit Numbers' r ` - Regisir. Fee $ Mileage Fee $ Address. Cit Zi City P - . t.� Witness Fee $ Reinsp. Fee $ Owner/{(A�ggent �- Tel. .: � � - Zip, Total Fees E 2 3 Address ,� :!S/.;�}.�i., Y ICU City • ¢ r)' Zip �V� ��J �~ \i.f*� / p M.O. N.C. Cash - Check Received b y.. . -JM WA Kees. required '`.� Contractor , _ '" � ! :.i i �4 3 '.. - = u Tel. 1 ,-'.�e-J.F3;-.'.,.`i :�>vw ,• ... ,• ,y LicenseX - sta �, 1 • Sewage yst m ��r..�..� t T LL P ti AddressZip .. Cit -' r r THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED;,WITHIN.120:DAYS. CESSATION OQ, WORK., v wer Pied by:E FOR 120 DAYS SHALL ALSO CAU ERMI TO BECOME VOID. - , i I HEREBY AGREE THAT ALL EC'Ff Mik'VML7FITHIS PERMIT WILL BE DONE IN ACCORDANCE WITHLy ' THE LAWS OF RIVERSIDE COUNTY AND T STATE OF CALIFORty1A. ; Sewer Distract P -r v I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN ' ILORDANCE WITH SECTION 5541 OF TME BUSINESS AND PROFESSIONS CODE OF THE STATE OF. CALIFORNIA P ° Form 284-208 (Rev.8/78) s ILO -