BLCK (354415)BNILDIPIG PERMIT
PERMIT NO. DEPARTMENT OF BUILDING & SAFETY FIELD .. DsTT,.
3544 1 5 COUNTY OF RIVERSIDE
CONSTRUCTION
ESTIMATE
Job Address t Space
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NO. ELECTRICAL FEES
NO. PLUMBING FEES =
IST FL.
2ND. FL.
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POR.
GAR.
CAR P.
WALL
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SQ. FT. @ P
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UNITS , _-
- F.C.C.
SQ. FT, @ . --..
.- . . YARD SPKLR SYSTEM
MOBILEHOME SVC.
SQ. FT. @
BAR SINK
SQ. FT. @ POWER OUTLET
ROOF DRAINS
SQ. FT. @
DRAINAGE PIPING
f,X4'9
SQ. FT. @/ `
DRINKING FOUNTAIN
C . SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $
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5 S R
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
Group
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
Bond
$
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM FAN EVAP,COOL, _,,,_,,,_;,HOOD_
Inspector
SIGN
WASHER,(AUTO)(DISH)
APPLIANCE DRYER
Const. Lender, Branch
Supplimantal PeUit Number '
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GARBAGE DISPOSAL
FURNACEUNIT WALL FLOOR ' SUSPENDED
Address City Zip
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Witness Fee E -
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
M.O. ,+N.C. Cos Check
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
License#
POLE,TEMP/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY I
City Zip
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. @ c
BATH TUB
SQ. FT. @ ' C
WATER HEATER
SQ. FT. RESID @1'/.c
SEWAGE DISPOSAL
SQ. FT. GAR @ s/. c
HOUSE SEWER
GAS PIPING
PERMIT FEEPERMIT
FEE -
• PERMIT FEE
DBL. -
TOT L FEES
MOB. HM. FEE
MICRO FEE
MECH. FEE
PL. CK. FEE
CONST. FEE ELECT. -FEE
SMI FEE
- FEE .PLUMB. FEE
T PERMIT NO.
3544151
Job Address t Space
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Zip
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Owner }
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Valuation'
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MH.Permit Fee E
Micro Film Fee Cop E
Use of Permit
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Parcel No. - '
Use/Cose No.
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Mech. Fee Dbl $
PL Ck. Fee $
Set Backs
Lot Size
Construction Fee Dbl E
Legal Description - F
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5 S R
Electrical Fee Dbl $
Zon lost tions
Group
Type _.
SMI Fee $
Fee Dbl E
Bond
$
Plan No. .^ "�•
-Plan �Checker
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Final Date
Inspector
Unit '
Sp. Insp. Fee $
Demol. Fee b
Const. Lender, Branch
Supplimantal PeUit Number '
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Registr. Fee $
Mileage Fee $
Address City Zip
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Witness Fee E -
Reinsp. Fee E a .t. a.
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To(dl Fees $
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M.O. ,+N.C. Cos Check
Received by /
Contractor
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Tel.
License#
Trees required
Sewage System
Address
.s.
City Zip
T LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK
Sewer District FOR 120 DAYS SHALL ALS R O BECOME VOID.
I HEREBY AGREE THAT R� ONN ION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH
C .THE LAWS OF RIVERSIDE COUNTY ND THE STATE OF CALIFORNIA!', .,'.... • _ * -^ ��+ • ' -
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
Form 284-208 (Rev.8/78)
ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
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verified by:
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE INSPECTOR.,
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs 8 Frms
34
Plenums & Ducts
2A
Slab Grade
35
Furnace Comport.
3
Steel —4-1 az-
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
IDA
F.ireplace T.O.
NO
ADDITIONAL INFORMATION
_
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Loth
12A Drywall
13 Finish Grade
INSULATION Thick
R
Value
7A Walls (Batts)
12B Ceiling (Batts)
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
PSL P/
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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
NOTICE: THIS IS NOT A BUILDING PERMIT
APPLICATION TO CONSTRUCT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
DISTRICT
Permit No
I
284 199A 9/74 CANARY—FILE, PINK—APPLICANT
Owner Architect _ ___—_ Contractor--__ _
Address, 7-%t 7 Address
DA*Vress___ — -----
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Cit yQ{'!— City-- City_—_ —
Phone V 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. 1 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 propert 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 G. —_— SIGNATURE OF OWNER AND/OR AGENT
Approval by Signature from the Following Departments Listed Below
Must Be Obtained Prior to the Issuing of a Construction Permit.
/ a a 1 SPACE NO.
//�� USE OF STRUCTURE
JOB ADDRESS 9! �/� ' �� ?saLE
- FAMILY, DUPLEX ❑
LEG SCR1PT1013 OF PROPERTY !2 v� ��
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COMMUNITY ALTERATIONS ❑
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NO. OF SUBMITTED PLANS USE OF PERMIT --
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CASE NO.
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NO. OF P RKING SPACES REQUIRED"— N0. OF BUILDINGS NOW EXISTING
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ZONE SETBACKS: FRONT SIDE REAR
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GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE
SETBACK ORDINANCE # OF FEET REQUIRED ON — STREET
DATE —_—,174 --EZ SIGNATURE OF LAND USE OFFICIA
DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET—
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CURB AND GUTTER REQUIRED: YES ❑ NO ❑ —STREET
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CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑
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HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET
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IMPROVEMENT? YES ❑ NO ❑
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DATE SIGNATURE OF ROAD DEPT. OFFICIAL
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SWIMMING POOLS PUBLIC
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SEWAGE DISPOSAL
_
FOOD ESTABLISHMENT
WATER POLLUTION REMARKS
&A FLOOD CONTROL
F-
W AIR POLLUTION
_ t- DIV OF HWY
0 a — YOUR PROPERTY MAY BE SUBJECT TO
a
LU FLOOD. RIVERSIDE COUNTY ASSUMES
.
NO RESPONSIBILITY IN EVENT OF FLOOD. -
284 199A 9/74 CANARY—FILE, PINK—APPLICANT