BLCK (398534)BUILDING PERMIT
PERMIT NO. DEPARTMENT OF' BUILDING & SAFETY
9 8 5 3 4 COUNTY OF RIVERSIDE FIELD osr
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT..@ $
2ND. FL. SQ. FT. @
FOR. SO. FT. @
GAR. SO. FT. @
CAR P. SQ. FT. @
WALL SO. FT. @ S ,r.
SQ. 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
R
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
Type
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
Reinsp. Fee E
SQ. FT. @ a
WATER HEATER
S0. FT. RESID @ 1 %a
SEWAGE DISPOSAL
City Zip
S0. FT. GAR @ 3/<a
HOUSE SEWER
I,
—.. C'
Licensee
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL.TOTAL
I
FEES
L�O
MOB. HM. FEE
MICRO'FEE MECH. FEE
PL. CK. FEE
I CONST. FEE ELECT. FEE
SMI FEE
FEE PLUMB. FEE
PERMIT NO.
3985 3 4
Job Address Space Zip Owner
mmu';Off. F.C.
MH Permit Fee
Micro Film Fee Cop E
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Size -
Construction Fee Del E
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Electrical Fee Dbl E
Legal Description
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F S S
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Zone Restrictions
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Group
Type
SMI Fee E
Plumbing Fee Del E
Bond Amt. TPIKI,Io!4—Pidir'thocAer
S
Fino Dote 4/�
5` Z 3 O V
[Ins cto
Unit
Sp. Insp. Fee E
Dental. Fee E
Const. Lender Branch
SupplimentaI ermit Numbers
Regist, Fee E
Mileage Fee b
Address City Zip
Witness Fee E
Reinsp. Fee E
Owner/Agent
Tel. Zip
Total Fees - E
M.O. N.C. ❑ Cash ' • Chec .
Address
City Zip
Received by - "'+--' r
Contractor "� �• /: " J'-
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Licensee
Trees required
Sewage System
VaVlf
Address
Gl.o:4 aL
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Sewer 7District
s Form 284-208 (Rev. 1/80)
THIS PERT SHECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAY
MIALL S.' a SATION OF WORK 'verilie 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.
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.
t:
T STREET NAME
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back w
33
Ventilation System
2
Figs 8. Frms
-57 • ? 51
34
35
36
Plenums 6 Ducts s\
Furnace Comport.
Inlets 8 Outlets
2A Slab Grade
3 SteelS2 G • Ab
—
4
Grout Blocks
✓
A^
37
38
Combustion Air
Compressor
5 Bond Beams
6
Roof Deck
39
Appl. Clearonce
7
Framing
s
40
Fire Damper
8
Vents
41
Smoke Detection Device
r9
Garage Fire Wall
w
42
Commercial Hood .
10
Fireplace P. L.
43
Final
10A
Fireplace T. O.
[�
°o ADDITIONAL INFORMATION
'
•
t
-
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Loth
12 Internal Loth
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
•7A Walls (Batts)
12B 'Ceiling (Batts)
12C Ceiling`(Blown) ,
Piz 14 Final'. 2�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
t
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
P/L
r
P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding '
30 Fixtures•
31 Service
32 Final
t:
T STREET NAME
NOTICE: THIS IS NOT A BUILDING PERMIT
APPLICATION TO CONSTRUCT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
DISTRICT
Permit No
284 199A 9/74 CANARY—FILE, PINK—APPLICANT
OwnerP"12114 kVwt01_ Architect —. _ Contractor ;e_' /_ZD/r
AddressAddress___ Address_
City L& Oil j:k4 City-- City—
Phone 3yPhone _ Phone-34ca—a;
W
I (we) the undersigned, hereby certify and acknowledge that I (we) have read the application and agree that if Curb and Gutter, and
Z
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
O
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 Li ted Below
Must Be Obtained Prior to the Issuing of a Construction Permit.
I SPACE NO.
USE OF STRUCTURE
JOB ADDRESS' -0 �l �-
/J SINGLE FAMILY DUPLEX
Z F
LEG DESCRIPTION OF PROP R Y — APARTMENTS Q AGRIC.
/l
3
Q C.—
COMMERCIAL INDUSTRIAL ❑
COMMUNITY ALTERATIONS n
CNO.
Z
OF SUBMITTED PLANS -- USE OF PE MIT —
CASE NO. _
p Z
NO. OFING SPACES REQUIRED .— —_ NO. OF BUILDINGS NOW (STING
Q
;P
ZONE SETBA(fKS: FRONT SIDE REAR
J
m
GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE
SETBACK ORDINANCE OF FEET REQUIRED ON STREET
DATE j SIGNATURE OF LAND USE OFFICI - --
DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET--_ _
W
CURB AND GUTTER REQUIRED: YES ❑ NO ❑ STREET
i
t-
d
CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑
W
HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET
Q
IMPROVEMENT? YES ❑ NO ❑
O
°C
DATE SIGNATURE OF ROAD DEPT. OFFICIAL—
x
SWIMMING POOLS PUBLIC
A W
SEWAGE DISPOSAL
_
FOOD ESTABLISHMENT
WATER POLLUTION REMARKS
rn FLOOD CONTROL
H
Z AIR POLLUTION
e W
W l
DIV OF HWY
c a ,, — YOUR PROPERTY MAY BE SUBJECT TO
CL
c FLOOD. RIVERSIDE COUNTY ASSUMES
NO RESPONSIBILITY IN EVENT OF FLOOD.
284 199A 9/74 CANARY—FILE, PINK—APPLICANT
DVILUMw rmmll
1PERMIT NO.
398534
DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE 71T
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL.
2ND. FL.
FOR.
-PAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SO. FT. .@ $
UNITS
MH Permit Fee $
Micro Film Fee Cop S
SQ.. FT. @
YARD SPKLR SYSTEM
SQ. FT. @ - - MOBILEHOME SVC.
BAR SINK
SO. FT. @ POWER OUTLET
ROOF DRAINS
SQ. FT. @
DRAINAGE PIPING
SQ. FT. @-r
DRINKING FOUNTAIN
SO. FT. @
URINAL
VALUATION $
WATER PIPING
NOTE: Not to be used as property tax voluotion
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM FAN EVAP. COOL HOOD
SIGN
WASHER (AUTO)(DISH)
APPLIANCE DRYER
Address City Zip
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
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
SQ. FT. ' @ a
WATER HEATER
S0. FT. RESID @11/.c
SEWAGE DISPOSAL
Zip
S0. FT. GAR @ 3/4
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL.
TOTALLFFEEEESMOB.
V
HM. FEE
MICRO FEE
MECH. FEE PL. CK, FEE
CONST. FEE ELECT. FEE
�v
SMI FEE
FEE PLUMB. FEE
PERMIT NO.
3 9 8 5 34
lob Address
mmunity� '.'.07r.n
g
Use of Permit /
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v ✓ fes( �"-4.
Legal Description
/Qwy.. / ` i./
G•• r 1r T'
Space Zip One,
to
*r;t ,—
Parcel No.
et
F S S
Zone Restrictions
Dist. I Off.
Use/Case No.
lot Size
R
Group Type
F.C.C.
Ck. By
MH Permit Fee $
Micro Film Fee Cop S
Mech. Fee Dbl g
PI. Ck. Fee 'g
Construction Fee Dbl S
Electrical Fee D61 S
SMI Fee g
Plumbing Fee Dbl $
Bond Amt.
g
PI n No.
P1_.n_Ch.7.r _
Fina Date -
�2_ (,}
Insp
-
Unit
Sp. Insp. Fee S
Demol. Fee S
Const Lender Branch6
Supplimentof al Permit Numbers
Registr, Fee S
Mileage Fee $
Address City Zip
Witness Fee $
Reinsp. Fee S
Owner/Agent s
T.I.-
Zip
Total Fees. S
M.O. Q N.C. C] Cash Cflec 0
Address
�
City
Zip
Received by
Contra or C' �' "•� ��� "
- R
e,^ -
.Licensee
Trees required
Sewa e System
9 Y
Address
ty
Zip
T LL THIS PERMIT SHALL fiEdME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORKverified by:
Sewer 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.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
(Form 28x•208 (Rev. 1/801 ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.