GRD (A012509)77310 Calle Madrid
A012509
FIELD
DEPARTMENT OF BUILDING & SAFETY
PERMIT No. I PERMITTYPE I COUNTY OF RIVERSIDE
A012509 r, J '
':Additional Information:
OX
(FACTORY BUILT HOUSING
MOBILE HOME INSTALLATION
•.Manufacturer
MH Manuf.
New ❑
'Model Designation
Size
Relocated ❑
Unit Serial No.
Total Fees
$
:'Plan Approval No.
I lnsig. Serial No.
Moving
I Sewage System
t
Permission is hereby granted to move the
i T 1 1 p
,Total Fees $
structure, described
below, in
l
Width Length Height
GRADING
#1
Number
;Cut
of #2
Sections
#3
,Fill
Total Fees $
t ' X,7 p4
Present
I
Location
Community
County
1IRELOCATION INSPECTION
Destination
i•
!;Present location
+Community
County
Total Fees
$
,_Total Fees $
! Permit No.
` 0
54-
Job Address
77—,.514261411e
I9z s
SP #
zip Own r
s:5
1 Plan
Communi t 1
Valuation
Date p O
Di t
71
lel
P.C.
Check
iG T
$
/'O
I.
I
U_se of Permit
x '_
Parcel No.
Lot Size
[Reinspectian
^ / %
Factory-
Set backs
Use Permit #
:Built
Legal Description -
/ v
Bond z
e Grp
Type
Unit k
(''Grading
Engineer License
Final Didie I
for Env. Assmt.
Mobile home
#
—
Requirement
Escrow Company
Bran
Relocations
(Notal
Address
City Zip
Fees
$
., Cash
I Check
MO
NC
Owner/Agent )
Tel
iR ceiv d y Date
Addre• ' _. ! //
City Zip
`Rela e8'Permitlsl
Cortr r%Move'
Tel.
I'
S3: $
r3
. 7
workers' comp.
yes ❑ vno ❑
Addre s
— Jl}
Cit/ ; zip
l5L gr. 0
j
rl certify that in the performance of the work for which this permit is This permit sholl become void if work is not commenced within: 120 days. Cessation of work for 120 days
;issued I shall not employ any person in any manner so as to become sub- shall also cause permit to become void.
ject to the workers' compensation laws of California. I hereby agree that all work in connection with this permit will be done in accordance with the lows of
Riverside County and the State of California. I hereby certify that the individual who prepared the plans and
t Owner Signature specificonons has done so in accordance with Section 5541 of the Business and Professions Code of the
Builder Signature State of California.
FORM 284-208A 5-77 QPM
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Bock
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 Detention Device
9
Garage Fire Wall
42 Commercial Hood
10
Fireplace P. L.
43
Final
10A
Fireplace T.O.
NON
ADDITIONAL INFORMATION
_
t
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Wolls tBotts) '
12B Ceiling (Botts)
12C Ceiling (Blown)
e
14 Final
PLUMBING APPROVALS
15 Ground Plumb
16 Water Piping i
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
PSL
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
r
Pi
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 final
STREET NAME _
FIELD OFFICE
DEPARTMENT OF BUILDING & SAFETY
PERMIT NO. F PERMITTYP; COUNTY OF RIVERSIDE
A012509r .d, E,
Additional Information:
FACTORY BUILT HOUSING
MOBILE HOME INSTALLATION
Manufacturer
MH Manuf.
New ❑
Model Designation
Size
Relocated ❑
Unit Serial No.
Total Fees $
Plan Approval No.
Insig. Serial No.
Moving
Sewage System
T 1 1
p
Permission is hereby granted to move the
structure, described below, in
Width Length
Height
Total Fees $
GRADING
#1
Number
of #2
Sections
#3
Cut
Fill
Total Fees $C QQ
._..
Present Location
Community County
RELOCATION INSPECTION
Destination
Present location
Community
County
to Fees
Z
TotaLFees
rermit
No.
A 6 12 5 0 9
5c.-
Job Address r
Z C
-zzs
f_
o: r ,
Z;
Plan Check
Communit ,
Valuation
$
Date
9
Dist
01
P.. C.
Reinspection
Use of Per it /
Parcel No.
j _I/J .
Lot Size
Factory-
Built
Set backs
Use Permit #
Legal Description
/
6` j,L
Grading
Bond A
$
Grp
Type
Unit ck b
Mobile home
Engineer Licens
#
Final Date
_ / (
Ins ector
I
Env. Assmt.
Requirement
Relocations
Escrow Company
Branch
Tota I Fees
$
Address
City
Zip
Cash
I Check
MO 1I
Owner/Agent
Tel.
'
R ceiv Date
Addre
City
Zip
Rp-lo 'd Permit(s)
C r Move
,,,r g
Tel.
56 o
workers' compgt,
yes ❑ no ❑
Address
1 30(
CSMA
City fin[
'w t
RL
Zip
Oda
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 sub-
ject to the workers' compensotiorl laws of California.
Owner Signature
Builder Signature
FORM 284.208A 5-77 QP M
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 lows of
River County and the State of California. I hereby certify that the individual who prepared the plans and
Idaa on e s t tordance with Section 5541 of the Business and Professions Code of the
a'