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SFD (A010820)FIELD � , DEPARTMENT OF BUILDING & SAFETY PERMIT NO. 1�PERMITTYPE COUNTY OF RI SIDEf Ao1e�-2t� ' ional Information: 'FACTORY BUILT HOUSING MOBILE HOME INSTALLATION `Manufacturer [Model Designation Z-'OQ Q MH Manuf. Size New 0 Relocated O Unit Serial No. Z„ 04 — I � Total Fees $ (Plan Approval No. '341 Insig. Serial No. {5©%' t(77 Moving Sewage System T 100 0 U 11 p 5 r Permission is hereby granted to move the structure, described below, in Width Length Height (Total Fees $ ©J GRADING #1 Number of #2 Sections _ #3 , [Cut Fill Total Fees $ t Present Location Community County RELOCATION INSPECTION Destination Present location 'Community County Total Fees Total Fees Permit No. A0108201 Job Address o o — -- - � � N G�t�v�A SP # ;Zip wner 5TAQ r •Mv Plan Check ICA ICA 1-T l� Valuation .- $ k bi ouo Date 2 • L.}- (,? Dist Off ►i P.C. F tReinspection Use of Permit A\Z, T T IL Parcel No. 77-3- Lott Size `'Factory -(A ;Built 75 Setbacks Use Permit f/ Legal Description ZP � f, / s ifN C AK#ACs-%TIS VW(C- . u1 7-0 -1>1 ;Grading Bond zone Grp Type Unit ckby Mobile home Engineer License # Final Date fl/ G -S- gp Insp cto Env. Assmt. ,( Requirement Relocations Escrow Company B nch- Total Fees $ Address City Zip E cash Check Mo NC Owner/Agent Tel. �Recejved y Date Address I O Cjtv Zip i Related Permit(s) f Contractor/ Mover t.Vsz-0�-t�-s Tel. �- �3 y 1�1.oL) workers' comp. I % yes no O Address /©FSC) too'), 040 City Zip � r CI 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 - t ject to the workers' compensation laws of California. Owner Signature er Signature FORM 284-20fTA 5-77 OM 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 Riverside County and the State of C'alifornio. 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. J� NO. OPERATION DATE INSPECTOR NO.- OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back _ 33 Ventilation System 2 Ftgs & Frms _ 34 Plenums & Ducts-�5266 2A Slab Grade _ _-�� L`r Ly /.��"�I 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 6- -U 22 Commercial Hood 10 Fireplace P.L. 43 Final - 10A Fireplace T.O. NON ADDITIONAL INFORMATION C� t r /� [� tm p j�T CJj J SEWAGE SYSTEM SIZE & LOCATION \ 11 Exterior Loth 12 Internal Lath 12 wall y 13 Finish Grade INSULATION Thick R Value 7A Walls IBottsl 128 Ceiling (Botts) 12C Ceiling IBlownl 14 Final - O PLUMBING APPROVALS 15 Ground Plumb 16 Water Piping 17 Rough Plumb 18 Vents 19 Sewage Disposal d 0 20 Sewer 21 Water Heater 22 Water Softener 23 Water Service _ 5 /\ v 24 Gas Test 25 Final - Tank Pit L. Line 26 27 28 29 29A 29B 30 31 32' ELECTRICAL APPROVALS Power Pole Conduit Service Entrance Wiring Grounding Wire Bonding Fixtures Service -S 'Final •. " G -s Alj • J J_ i REAR OF PROPERTY LINE P/L P/ p � � \ R�v'T1� STREET NAME _ DEPdTRENT OF. NG AND SAFETY COUNTY OF•RIVERSIDE NOTICE TO APPLICANT In conformity with the-pro.visions�of State,of California Labor Code Section, 3800, the applicant shall have on file or file with the Riverside County Department of Building and -Safety -a certificate as des.ignated•.in Items I"or II below, or shall indicate Item III, IV or V, whichever is applicable. CERTIFICATE OF APPLICANT' - Please mark the appropriate block: I. Certificate of Consent to self -insure issued by the Director'of -Industrial, Relations. Copy.' on :file Copy .submitted II... Certificate of -Workers' Compensation`Insurance issued by an admitted insurer -.-Copy on file Copy submitted III. The cost of the work .to .be performed is ,$100. or less. C-IV. `I certify that in the performance of the work for which kthis permit is•is_sued,._I=shall not -employ any person in any manner so' as to become'subject, .to the -Workers' Compensation laws of California. I further certify, that, in -the event I become subject,to the Workers' Compensation provisions of the Labor.' Code that I will.comply forthwith with the provisions of Labor,Code,Section.3700, et'seq., and understand' that, if I do not comply,•the permit shall be deemed revoked. F7 V..: I certify as the owner' (or the agent of the owner) that in' the performance of the work for which this permit is issued - I have' engaged contractor. (Contractor must have on file, or submit. certificate required by I or .II above.) Applicant's Signature Date '� — �=/ —. �y Permit No. Address and location °where work is to . be performed 284-141 Rev. -6/77 - r PERM IT NO, PERM IT TYPE A 01 0_ 82LO. Jitional'Information: DEPARTMENT OF BUILDING & SAFETY " OUNTY OF'RIVERSIDE FIELD OFFICE FACTORY BUILT HOUSING MOBILE HOME INSTALLATION Manufacturer MH•Monuf. New ❑ Model Designation Gam.: q. - Size Relocated ❑ Unit Serial No. Total Fees "$ Plan Approval No.32-1 1 Insig. Serial No. ` " Moving , Sewage System T 1000 1 1 �. p 57 *A (-2 Permission is hereby granted to move the structure, described below., in \ Width Length Height TotoI Fees $ Ac) 7 r GRADING #1 Number of #2 Sections y #3 . , t Cut Fill TotaLFees $ - , Present Location Community County RELOCATION. INSPECTION Destination Present location Community County Total Fees A" It=fd a P.20 J Job,A.ddress, a—?o a - SP 4Z OwnPr Plan Check Commune y 4 v, .' Valuation s- $ 46 (i%(� Date 2 - L+j �V Dist i�Off P. C. Reinspection Use of Permit 0V (.A k, ,409 Parcel No. %7 53-oc7 Lot Size Factory- Built 5 Set backs Use Permit N Legal Description l' X07 Z,�� �j�C•i+ 4�i � #*? � l� KAE i A 4) � L u Grading Bond $ zone Grp Type , Unit ckby Mobile home Engineer License # Fino'I-Dote Irtecto -- O Env. Assmt. . Requirement Relocations Escrow Company r B ch _ • Total Fees $ Address City' _ ` Zip Cash Check I MO F VC Owner/Agent Tel. _ _ _ Recejv d by Date Address City-,�Zip CA p Relo ed Permit(s) Contractor/Mover wocno T / �- Tel. -?3 y- iisoJ workers' comp. yes no ❑ Address loeb 1 O1►� / C�it^y� --� Ir-GY✓� �t Zip !?-ZD I certify that din the .performance of the work for which this permit is This permit shall 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 Colifdrnio. 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 Colifornio.'I hereby certify that the individual who prepared the plans and Owner Signature specifications has done so in occordonce vrth Section 5541 of.the Business and Professions Code of the Builder Signature State of California.. FORM 284.208A 5-77 0M ' .