SPIN (403221)OVIwIIVu rCKMII
PERMIT N. DEPARTMENT OF BUILDING & SAFETY FIELD M//�
14032201 COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. @ $
2ND. FL. SO. FT. @
FOR. SO. FT. @
GAR. SO. FT. @
CAR P. SO. FT. @
WALL SO. FT. @
SO. FT. @
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM FAN EVAP. COOL HOOD
SIGN
WASHER (AUTO)(DISH)
APPLIANCE DRYER
Ck. By
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED,"
Set Backs
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
BOILER B.T.U.
SO. FT. @ a
BATH TUB
Sp. Insp. Fee $
SO. FT. @ a
WATER HEATER
Supplimentol Permit Numbers
SO. FT. RESID @ 1 t/aa
SEWAGE DISPOSAL
Address Y City Zip
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SO. FT. GAR @ 3/4a
HOUSE SEWER
O"er/AA6/F
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Tel. / Zip
GAS PIPING
PERMIT FEE
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PERMIT FEEE
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TOTAL FEF,!•,MOB.
HM. FEE
MICRO'FEE
MECH. FEE PL. CK. FEE
I CONST. FEE ELECT. FEE
SMI E
FEE PLUMB. FEE
PERMIT NO.
4032
Job Address _, Space
Zip - _. _...
Owner
Community
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Voluotion
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Dist.
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F.C.C. .
MH Permit Fee $
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Use of Permit
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Use/Case No. ��
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Pi. Ck. Fee $
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Construction Fee 061 $
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Electrical Fee Dbl $
Zone Restrictions
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Group
Type
SMI Fee S
Plumbing Fee Dbl $
Bond Amt.
$
Pion No.
Pion Checker
inolate
Inspector
Unit
Sp. Insp. Fee $
Demol. Fee S
Const. Lender Branch
Supplimentol Permit Numbers
Registr. Fee $
Mileage Fee $
Address Y City Zip
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Witness Fee $
Reinsp. Fee $
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Total Fees S �; �=%G
Address
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THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by:
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. t,
Y
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.
Sewer District
Form 284208 (Rev. 1/80)
NO.
OPERATION
DATE
INSPECTOR
NO. OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33 Ventilation System
2
Ftgs & Frms
34 Plenums & Ducts
2A
Slab 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 Detection Device
9
Garage Fire Wall
42 Commercial Hood -
10
Fireplace P. L.
43 Final
10A
Fireplace T. 0.
El°o
ADDITIONAL INFORMATION
see,
- - - - - - - .
SEWAGE SYSTEM SIZE & LOCATION
i�
..-
`
11 Exterior Loth
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts)
128 Ceiling (Botts)
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
22 Water Softener
23 Water Service
24 Gas Test
25 Final
Tank Pit L. Line
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
P/L
P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
NOTICE: THIS IS NOT A BUILDING PERMIT
APPLICATION TO CONSTRUCT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
w.
DISTRICT
Permit No
284 199A 9/74 CANARY—FILE, PINK—APPLICANT
Owner __. _ _+ ►0_ v_tP OD_
//�I�� �'IArchitect
Address, 5,. V f Uu t WAddress___ Addres3katk-W-1 Lite --
City City--- - City_I Lit
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Phone Phone _ Phone!
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I (we) the undersigned, hereby certify and .acknowledge that I (we) have read the application and agree that if Curb and Gutter, and
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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. I am also aware that no work is to be done within the County R/W
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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 occupied until I (we) have
complied with all laws of the County of Riverside and the State of California governing said property.
DATE SIGNATURE OF OWNER AND/OR AGENT-,
Approval by Signature from the Following Departments Listed B low
Must Be Obtained Prior to the Issuing of a Construction Permit.
ISPACE NO.
USE OF STRUCTURE
C� J
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JOB ADDRESS v ! L\v�- '��rW�'�/k�"E�1
jSINGLE FAMILY DUPLEX
LEGAL DESCRIPTION OF PROPE TY 11��� els X O
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St;'U �(��O/�� 3 Z APARTMENTS AGRIC.
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–i �–' COMMERCIAL E] INDUSTRIAL CJ
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COMMUNITY in ALTERATIONS ❑
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NO. OF SUBMITTED PLANS — USE OF PERMIT
Lu Q
CASE NO. t��P
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N0. OF PARKINGSPACES REQUIRED _ NO. OF BUILDINGS NOW EXISTING
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ZONE g. — SETBACKS: FRONT zd SIDE S REAR
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GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE
SETBACK ORDINANCE # OF FEET REQUIRED ON��� STREET
DATE 9 - ga SIGNATURE OF LAND USE OFFICIAL _
DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET
W
CURB AND GUTTER REQUIRED: YES ❑ NO ❑ —STREET
a
CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑
W
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HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET
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IMPROVEMENT? YES ❑ NO ❑
O
ce.
DATE SIGNATURE OF ROAD DEPT. OFFICIAI
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SWIMMING POOLS PUBLIC
QW
SEWAGE DISPOSAL
FOOD ESTABLISHMENT
_
WATER POLLUTION REMARKS
rn FLOOD CONTROL
t–
z AIR POLLUTION
_ DIV OF HWY
c a — YOUR PROPERTY MAY BE SUBJECT TO
d
c FLOOD. RIVERSIDE COUNTY ASSUMES
NO RESPONSIBILITY IN EVENT OF FLOOD.
284 199A 9/74 CANARY—FILE, PINK—APPLICANT
TO
SUBJECT
REFERENCE
REQUEST FOR CERTIFICATION
Date
County of Riverside
Local governing authority
Request for certification of acceptability of property under applicable
local building-code(s).-
Location
uilding code(s)..Location of dwelling:5;?_
Community:
1 hereby request an inspection of the above located dwelling for a determination of the
following, as well as a Certification of Acceptability (or Nonacceptability as the situation
warrants):
❑ 1. Compliance with local building code(s) applicable to the existing dwelling.
❑ 2. Compliance with applicable local codels) on room addition.
❑ 3. Compliance with applicable local code(s) on garage conversion.
❑ 4. Compliance with applicable local code(s) on sewage disposal system.
❑ 5. Compliance with applicable local codels) on other special construction.
(describe)��
Signed:' /
((Ot)
Owner/Agent) // / /it/ y
Address: Vr �K �/! (e f /
Zip:
284-49 8/76
i,
CERTIFICATE OF ACCEPTABILITY/NONACCEPTABILITY
Daf Ins awn`'
Owner:
Location of Dwelling:-/�T���Lp±---
moo= ��- Bui dot e'r�m"ttitJa.
Community: loa n o4
I certify that as a part of my official duties as building inspector, I have oil ,the date indicated,
inspected the above located dwelling as requested, and have noted the following violationls) of
the applicable building code(s):
❑ None. There is no violation of the applicable building code(s).
❑ The following nonacceptable conditions exist:
❑ Sanitary inadequacy:
❑ Structural hazard:
❑ Hazardous wiring:
❑ Hazardous plumbing:
❑ Faulty weather protection:
❑ Fire hazard:
❑ Faulty materials of construction:
❑ Additional details are noted on reverse side of this form.
Remarks:
❑ Conforms to other applicable ordinances.
❑ 1 further certify that a record is available indicating proper completion:
Reinspection/
New Permit
Required
(Building Permit No.) (Completion Date)
❑ The building permit completion record is not available. Records indicate age of this structure
has led to destruction of the completion record.
}
Xhere is no record available of the construction involved. However, the cons tructiaqoppeors
�h
to meet code.
JYL
Signed:
(Typed or Printed Name of
Building Inspector)
County of Riverside
a
City Date of Certificate
BUILDING PERMIT
'. PERMIT NO.
403221
DEPARTMENT OF BUILDING . & SAFETY FIELD OFFICE
COUNTY OF RIVERSIDE j�
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING .FEES
1ST FL.
2ND. Fl.
FOR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @ $
UNITS
Date
SQ. FT. @
YARD SPKLR SYSTEM
SQ. FT. @ MOBILEHOME SVC.,
BAR SINK ,
SQ. FT. @ POWER OUTLET
ROOF DRAINS
SQ. FT. @
DRAINAGE PIPING
SO. FT. @
DRINKING FOUNTAIN
SO. FT. @
URINAL
VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
_
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM FAN EVAP. COOL HOOD
SIGN
WASHER (AUTO)(DISH)
APPLIANCE DRYER
Const. Lender Branch
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED,
Mileage Fee S
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
BOILER B.T.U.
SQ. FT. @ a
BATH TUB
Address
SO. FT. @ a
WATER HEATER
S0. FT. RESID @ 1 I/4a
SEWAGE DISPOSAL '
S0. FT. GAR @ 3/4 t:
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
E p
DBL.
TOTALFEFj+�
MOB. HM. FEE
MICRO FEE
MECH. FEE PL. CK. FEE
CONST. FEE ELECT. FEE
SMI
FEE PLUMB. FEE
PERMIT NO.%
403221
_
Job Address Space
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Zip - Owner
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i
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Valuation
5
Date
Dist.
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MH Permit Fee S -
Micro Film Fee Cap S
Use of Permit ,
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Parcel No.Use/
—�. ?-
Ck. By
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Mech. Fee Dbl 5
PI. Ck.- Fee $
- Set Backs , Lot Size
F 5
Zone RestrictionsGroup Type
Construction Fee Dist S
Legal Description// �(//'' -
/G,j /✓ '.�`��� `�
Electrical Fee Dbl S
SMI 'Fee S
Plumbing Fee Dbl $
Bond Amt.
S
Plan No.
-
Plan Checker
ina ate -
�-l0 — �0
Inspector
Unit
Sp. Insp. Fee S ..-
Demol. Fee S
Const. Lender Branch
Supplimental Permit Numbers -
Registr. Fee $
Mileage Fee S
Address City Zip
Witness Fe4'
Re'up. Fee S
�OwirerT 9�nt
Tel. - Zip
Notal Fees S 00
Address
City Zip
M.O. [3 N.C. Cash Check
Receive y
Contrac or
Tel.
Licenselr
Trees
Sawa System •
Address
City Zip
T LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK
$ewer District 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.
1 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO JN
Form 284208 (Rev. I/80) ANCE WITH•SEtTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
verified by: