348822, 353765, 398328, 00014837 (SFD)BUILDING PERMIT DEPARTMENTOF BUILDING & SAFETY= do& FIELD OFFICE '
PERMIT NO.
3488221'
4 8 8 2 2
PERMITNO.
134-88221
Job Address
sem- ��
a COUNTY OF RIVERSIDE
Space
Zip
Owner
DST
CONSTRUCTION ESTIMATE
Community
�./'if G?�t4/!✓%/4
NO. ELECTRICAL FEES
�vct:z
�3
NO. PLUMBING FEES
Dist..
�(
--1 ST FL. .3oa
2ND FL.
POR. 14040
GAR.. SQ.
'CAR P.
WALL
ESTIMATED CONSTRUCTION
$Q. FT. Ca} _ $ a3 — "�
UNITS
MH Permit Fee $
Micro Film Fee
SQ. FT. @ ' YARD SPKLR SYSTEM
SQ. FT. @ O�T' MOBILEHOMESVC. BARSINK
S"a POWER OUTLET_ ROOF DRAINS
FT. @,
Use No.
SQ. FT. @ DRAINAGE PIPING
Ck.by
5
DRINKING FOUNTAIN
Sb. FT, (a}
PL`Ck. Fee $
SQ. FT. URINAL
Lot Size
VALUATION $ 8O3 WATER PIPING
a
NOTE: Not to be used as property tox voluotion
SWIM POOL, PVT
dS'1
FLOOR DRAIN
7`X�v
Electrical Fee Dbl $ �
MECHANICAL FEES
3
SWIM POOL, COMM
WATER SOFTENER
SMI Fee E
Fee
VENT SYSTE/yj,X) FAN ❑ EVAP. COOL K HOOD
SIGN
Plan No.PIan.CheckerSp.Insp.
3� / /
WASHER lAUTOYbISHI
APPLIANCE DRYER
– 477
Fee $
GARBAGE DISPOSAL
t-7 O
.
FURNACE ❑ UNIT • ❑ WALL ❑ FLOOR ❑ SUSPENDED
Branch '� I certify that in the perfwmaPce of _ work for which this permit is issued I shoes
not employ any person -in any mann os to become subject to the workmen's com-
pensation laws of California." -
City Zip '
Owner SignoNre _
Builder Signature
kegistr. Fee $
Mileage Fee $
LAUNDRY TRAY
P.einsp. Fee
$
AIR HANDLING UNIT CFM
Owner/Agent
IDLE METER
Tel.
S3 -a
/ KITCHEN SINK
O.
total Fees -
ABSORPTION SYSTEM O B.T.U.
-' Jct
TEMP USE PERMIT SVC
/7/v.�ITtl37R /�Yl.�
WATER CLOSET
-34
M.O. (3N.C. ❑ Cash ❑ Ch ek�
COMPRESSOR 37_J__ 0 HP
7 Z7
POLE, TEMP/PERM
Contractor -
-
LAVATORY
Tel.
License #
HEATING SYSTEM FORCED ❑ GRAVITY
Trees required
ad AMPERES SERV ENT
'7 p p
SHOWER
a
-BOILER B.T.U.
Workers'
yes ❑
SQ. FT. 8 ¢
BATHTUB
SQ. FT. 6 4
WATER HEATER
3p2. SQ. FT. RESID 1'/.¢
G
SEWAGE DISPOSAL
A
SQ. FT. GAR C4 '/.¢
3 /
HOUSE SEWER
GAS PIPING
PERMIT FEE
�Q
PERMIT FEE
PERMIT FEE
DBL.
[_M;��FEES.
&17
MOB. HM. FEE
.MICRO FEE
MECH. FEE
PL. CK. FEE-[CONST.FEE
//,:jr
ELECT. FEE
SMLFEE
FEE
PLUMB. FEE'tt
PERMIT NO.
3488221'
4 8 8 2 2
Supp. Permit
Job Address
sem- ��
� �.��
Space
Zip
Owner
- -
Community
�./'if G?�t4/!✓%/4
�vct:z
�3
Dote -y
/jV� I
Dist..
�(
Off.
„Z
F.C.
�Q
MH Permit Fee $
Micro Film Fee
Cop $
Use of Permit /
�O j.a.� , _ai3..-air
Y� LV/ �+sG�S=Set
-
-
Use No.
'0
Ck.by
5
Mech. Fee Dbl $ �
PL`Ck. Fee $
Backs
Lot Size
:onstruction Fee Dbl $ / tJ
Legal Description
`TypeeUnit
/+.�
Y
dS'1
:R"%
7`X�v
Electrical Fee Dbl $ �
4P;ce�N
3
ARPlumbing
SMI Fee E
Fee
Dbl $
Bond Amt.
$
Plan No.PIan.CheckerSp.Insp.
3� / /
Fee $
I)emol. Fee -
$
.
Const. Lender
- -
Address
Branch '� I certify that in the perfwmaPce of _ work for which this permit is issued I shoes
not employ any person -in any mann os to become subject to the workmen's com-
pensation laws of California." -
City Zip '
Owner SignoNre _
Builder Signature
kegistr. Fee $
Mileage Fee $
Witness Fee $
P.einsp. Fee
$
Owner/Agent
Tel.
S3 -a
,.Zip
total Fees -
$
-' Jct
Address
.. .� �I / ..
/7/v.�ITtl37R /�Yl.�
City
-i✓ /'"6��,%Cp - �..
zip--.
. _
M.O. (3N.C. ❑ Cash ❑ Ch ek�
P.eceived by •
Contractor -
-
Tel.
License #
Trees required
Sewage Syst�eymy�
Address
City - Zip
Workers'
yes ❑
Comp.
no ❑.
T • LL ` P
District
Form 284-208 fRev. 4.771 Os
THIS PERMIT SHALL BECOME VOID IF WORK 15 NOT COMMENCED WITHIN 120 DAYS. CESSATION OF verified by:
WORK FOR 120 DAYS SHALL A CA PER TIyJ� TO BECOME VOID.
I HEREBY AGREE THAT 'Kiel I CO�Fj�NE,C`TI/ON WITH THIS 'PERMIT WILL BE DONE IN ACCORDANCE
WITH THE LAWS OF RIVERSIDE COUNTY ND THE STATE OF CALIFORNIA.
I HEREBY CERTIFY THAT THE, INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONSMAS DONE
50 IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF
CALIFORNIA.
1 jLumv rc�cmn r r "p + + -' FIELD
+r aeltMlr No. .. _ �• , ., :DEPARTMENT OF •BUILDING &SAFETY.. .,•, • �,, _ ., ,R �,• ,• •-i: DST - ,
COUNTY OF RIVERSIDE
X53765; '
CONSTRUCTION_ESTIMATE...,,.,„-.'4t
d : „,,, , ,NO. ELECTRICAL, FEES :..,, .
NO.-, . —PLUMBING -FEES'
• ZipV3
$”
I ST FL. SQ. FT. @
Comm yity� / , .� . •
UNITS
Date 4- /�
I�i�st.Tf.
2JD. FL. SQ. FT.,~@ 1" t y.•�`�t , rvFOJ +w • `+.• •,.c
...... _ ...ar.....c,�. yT .:: Y9RD SPKLR SYSTEM
JNH.Permit F.L ! s
/POR. SQ. F1..@
Use of Permit - *
, � '�
J
S
MOBILEHOME SVC.
BAR SINK ,
. C B
t -yr
GA R. SQ. FT.
PI. Ck. Fee 'Y / $
POWER OUTLET
ROOF DRAINS
i f'Y •:' Jn • -
Construction,Fe , Dbl $
1� CAR P. SQ. FT. @ '
J
_, S S R
Electrical Fee ;' Dbl $ Y•
DRAINAGE PIPING
Group
ytA�(r VyALI SQ. FT.
SMI Fee w f $
Plumbing Dbl $
DRINKING,F_OUNTAIN
Plan No.
t �
I I
x SQ. FT. @'
Final 'Dote 'Inspector.
�•,
1am_ yQ
�/ �L
URINAL
]
Sp. Insp. Fet,e{ _ $
'u
ESTIMATED CONSTRUCTION VALU TION, ' . $
Const. . Lender Branch '
Supplimental F,ermit Numb^er�
��j•(' (7"
t
. • .' ,._ •
WATER PIPING
Mileage Fee $
J NOTE: Not to be used as property tax valuation -,
Witness Feel la- $
SWIM POOL, PVT
FLOOR DRAIN
Tel. Zip
•. .,„i �.x,.ra^aK,f,•P.. ✓.�.fi / ,f• •� •%tl'e•.a9
It ..MECHA,NiCAL FEES' '
r t_-
Total Fee $ "'r
SWIM POOL, COMM
WATER SOFTENER
O. N.C. ash heck
'YENT SYSTEM " C FAN EVAP. COOC'��"�= 'HOOD'.' „yt
Contractor +
SIGN
'p
WASHER{A 6P DISH)"
r
APPLIANCEDRYER„ Y ' "a
a`"".• �:
�
.City " , Zip
^GARBAGE DISPOSAL
FURNAWEt UNIT WALL !FLOOR SUSPENDED s+A
t
{
'LAUNDRY TRAY
AIR HANDLING UNITCFM ' yfs
.,
'_
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM B.T.0 _ w
+
TEMP USE PERMIT SVC
`
WATER CLOSET
COMPRESSOR HP
•
POLE,TEMP/PERM t
LAVATORY
'
HEATING SYSTEM FORCED + GRAVITY '• r
AMPERES SERV ENT
SHOWER
BOILER{ .f B.T.U. r"' '
?
SQ. FT. @ C
BATH TUB '
4 +
SQ. FT. @ c r
WATER HEATER
•-'
SQ., FT. RESID @1'/.c
SEWAGE DISPOSAL'
SQ. FT. GAR @ % c
HOUSE SEWER
z
GAS PIPING
'
PERMIT FEE �.. 11•a d •+.v. -i r.c`i.^ x' "�.+ t`a
PERMIT FEE r+. <... #t .., 1 ^
++�+ •RfRM14E(rir: 'e`er`•`
DBU /L,�TOTALFEES
MOB.HM.FEE
MICRO FEE
MECH. FEE
PL. CK. FEE
CONST. FEE. ELECT. FEE
SMI FEE•
FEE PLUMB:
FEE
I
PERMIT NO.
35j755
Job Ad� s , t1 •� j �•s�,�,✓ / r _ Spoce
�.
• ZipV3
Owns i
'
Comm yity� / , .� . •
Voluation l
Date 4- /�
I�i�st.Tf.
F.C.C. .
JNH.Permit F.L ! s
Micro Film Fqe �.� Cops
Use of Permit - *
, � '�
J
S
Parcel,No c -r
�
Use/Case No.
. C B
t -yr
Mech. Fee r Dbl $ '
PI. Ck. Fee 'Y / $
Set Bocks
- Lot Size
-.
i f'Y •:' Jn • -
Construction,Fe , Dbl $
Legal. Description F
_ / �+ '
or
a, _ r ,
_, S S R
Electrical Fee ;' Dbl $ Y•
Zone Restrictions
Group
Type
SMI Fee w f $
Plumbing Dbl $
Bond Amt. .
$
Plan No.
t �
Plan Checker t
1
Final 'Dote 'Inspector.
�•,
1am_ yQ
�/ �L
Unit
`
-
]
Sp. Insp. Fet,e{ _ $
'u
Demol. Fed ,i z t $
Const. . Lender Branch '
Supplimental F,ermit Numb^er�
��j•(' (7"
t
. • .' ,._ •
Registr. Feel[;'/
Mileage Fee $
Address r'j .. - ' City ,,;,.,,.••- Zip -,
+ tt f
-
Witness Feel la- $
'W
Reinsp. Fee $ •!
... •
Owner/Agent
/�'�' �� !
r'•1r j\[,i `ae•.t i..l i/-...•+.G�!llf+'.. t y y ..
Tel. Zip
•. .,„i �.x,.ra^aK,f,•P.. ✓.�.fi / ,f• •� •%tl'e•.a9
A , a. .,
Total Fee $ "'r
AddressCity
?
Zip _
r r
O. N.C. ash heck
Recei` d by l.•• i'..,`
Contractor +
Tel.
License# -
Treq(required-
Se, , age System
Address - f i 1
S
.City " , Zip
T U. P THIS PERMIT SHALL BECOM ID IF OR NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by:
Sewer,District FOR 120 DAYS SHALL ALSO ET VOID.
e; • I HEREBY,, AGREE,.THAT;.ALL,WORK.IN CONNECTION WITH'THIS PERMIT:WILL`$E DONE IN ACCORDANCE WITM`:4,- -' ^' "
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
S ICCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
Form 284-208 (Rev.8/78) _ +.'�
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.
NO ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
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
PSL
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
P/
26 Power Pole '
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service .
32 Final l
STREET NAME
BUILDING PERMIT
PERMIT NO. DEPARTMENT OF BUILDING & SAFETY FIELD oST
98328 COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL.
2ND. FL.
FOR.
GAR.
CAR P..
WALL
ESTIMATED CONSTRUCTION
SO. FT. .@ $
UNITS
MN Permit Fee f
SO. FT. @ r s
YARD SPKLR SYSTEM
SO. FT. @ MOBILEHOME SVC.
BAR SINK '
SO. FT. @ POWER OUTLET
ROOF DRAINS
SO. FT. @
DRAINAGE PIPING
SO. FT. @
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
—��
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
Supplimentol Permit Numbers ,
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.
SO. FT. @ a
BATH TUB
�--
SO. FT. @ a
WATER HEATER
Licenselt
50. FT. RESID @ 1 t/<a
SEWAGE DISPOSAL
50. FT. GAR @ a/44
HOUSE SEWER
'
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
.RX.-
Ase
TOTAL FEES nn
�J
MOB. HM. FEE
MICRO'FEE
MECH. FEE PL. CK. FEE
-�/
CONST. FEE P
C �)
SMI FEE
FEE PLUMB. FEE
PERMIT NO.
398328
Job Address • Space Zip Owner y*
- - s
�" '
Sewer District
b dy � al oti is . � F.C.C.
$
e
MN Permit Fee f
Micro Film Fee Cap $
U o Per tA-11 -¢/-•
!
'
Parcel No.
se/Cas No.
Ck. By ,
Mech. Fee �, Db
PI. Ck. Fee f6.1
ck - IF Lot Size
F S S V
•/ g ,,,,,,
type ,
Construction Fee D f
ego Description , / /'y
�
Electrical Fee
SMI Fee f
Plumbing Fee Dbl f„,�.
Bond Amt.
rP n o.
Plan Checker
Fina t pect r
Sp. Insp. Fee $
$
—��
Demol. Fee f
Const. Lender Branch
Supplimentol Permit Numbers ,
s
Registr. Fee S
Mileage Fee f
Address City Zip
Witness Fee $
Reinsp. Fee f
Owner/Agent �' `rr
..•Y ✓ f � f!„ac•.w.. .-:.--.-
Tel. Zip
Imo”
l„
Total Fees SZ117 ,'Address
City Zip ,
M.O. ❑ N.C. ❑ Cosh Che
f -�
�--
Received by
n octpf� i r
Licenselt
Trees requ
'
Sewage System
Address
City Zip
T 'LLP
THIS PERMIT SHALL' BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK
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.
EBY CERTIFY THAT. THE INDIVIDUAL WHO PREPARED•THE PLANS AND SPECIFICATIONS HAS DONE SO IN 4
Form 284.208 (Re,'1/80).
ACCORDANCE WITH SECTION 5541. OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
verified by:
W
NO.
OPERATION
PATE
INSPECTOR
NO.
OPERATION
J
DATE
INSPECTOR
1
BUILDING APPROVALS
MECHANICAL APPROVALS. k
1
Set Bock
33
'Ventilation System
2
F.tgs 8 Frms •t
34
Plenums 8 Ducts i
` 2A
Slab Grade
35
Furnace Comport. '
3
heel ,-
44
36
Inlets 8 Outlets t
4
Grout Blocks
1
37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
39
Appl. Clearance '
7 ••.Framing
t -
40 .Fire
'Domper
8
Vents
41
Smoke Detection Device ' - •
9
Garage Fire Wall
42
Commercial Hood t • i
I - --
10
Fireplace P. L.
43 .
Final t
10A
Fireplace T.O.
,'[j
°o ADDITIONAL INFORMATION'
j
>
i
s
L
4 • -
F
r
I
t
'
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior. Loth
12' Internal Lath
12A Drywall. _
t
13 Finish Grade �•�-J
INSULATION Thick R
Value
7A Walls (Batts)
12B Ceiling (Batts)
12C Ceiling (Blown)
E1
14 ! Final
PLUMBING APPROVALS
15 Ground Plumb `
16 _ Water,Piping 4
1,7 RoughFPlumb
18 4 Vents
19 Sewage Disposal
20 j Sewer
21 Water Heater
22 Water Softener
23 , i . Wcoer. Sny. ice
77 Gas Teit'
25
Final '
Tank Pit L. Line
_
4
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
P
f
• '
t
f L r
t
P/
26 Power Pole
27 Conduit
20 Service Entrance
29 Wiring
29A Grounding Wire
296 'Bonding
30 •,Fixtures
31 Service I
32 Final f
t
:.,:. ., ....,...... _ .. PERMIT APPLICATION . ..
County of
Riverside
Department of Building
and Safety
4080 Lemon St. 2nd Floor 135 N. Alessandro Rd. Rm. 203 880 N. Slate Street
221 North "D" Street 46.209 Oasis St. Rm. 310 160 N. Broadway
Riverside. CA 92501 Banning, CA 92220 Hemet. CA 92343
- Perris. CA 92370 Indio. CA 92201 Blythe. CA 92225
Ph: 787.6146 Ph: 8497312 Ph: 658.4464
Ph: 657.3898 Ph: 342.8271 Ph: 922-2670
' This permit becomes void It work not Commenced within 180 days Irom date of issuance. OR. it work has beer Suspended or abandoned lot a period of 180 days.
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be com-.'
1
LICENSED CONTRACTORS DECLARATION: 1 hereby affirm That I am licensed under provisions of Chapter 9 (commenc- "
pleted.if the permit is for one hundred ($100) or less. f certify that in the performance of the work for which this
ing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.
permit is issued. I shall ilot employ any person in any manner so as to become subject to the Workers' Compensa--
tion Laws of California.
Date Applicant
OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law for the
NOTICE TO APPLICANT: If. after makingthis Certificate of Exemption, you should become subject to the Workers'
Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be
following reason (Sec. 7031.5. Business and Professions Cade: Any city or county which requires a permit to con-
deemed revoked.
slrucl, after, improve, demolish, or repair any struclure, prior to its issuance; also, requires the applicant for such
permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's. License Law
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
(Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is ex-
❑I hereby certify that no excavation five (5) or more leer in depth into which a person is required to descend. will
empl therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a per-
mil subjects the applicant to a civil penalty of not more than five hunderd dollars ($500).):
be made in connection with work authorized by this permit, and That no building struclure, scaffolding, falsework,'
❑ I. as owner of the property, or my employees with wages as their sole Compensation, will do the work, and the
.or demolition or dismantling thereof. will be more than thirty-six (36) feet high. (Chap. 3.2. Grp 2. Art 2. Sec 341.
Title 8. C.A.C.). '
structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License
❑As owner -builder. I will not employ anyone to do work which would require a permit from the Division of In.
Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or
dustrial Safety. as noted above, unless such person has a permit to do such work from the division. '
through his own employees, provided that such improvements are not intended or offered for sale. If, however,
the building or improvement is sold within one year of completion, the owner -builder will have the burden of prov-
❑Division of Industrial Safety Permit No.
ing that he did not build or improve for the purpose of sale.)
❑l, as owner of the properly, am exclusively contracting with licensed contractors to construct the
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the perfor-
project (Sec.
7044, Business and Professions Code: The Contraclor's License Law does not apply to an owner,ol properly who
mance of the work for which this permit is issued (Sec. 3097. Civ. C.).
builds or improves thereon, and who contracts for such projects with a contraclor(s) licensed pursuant to the Con-
Lender's Name
tractor's License Law.)
Lender's Address
01 am exempt under Sec. B.8 P.C. (Attach Certificate).
Date Owner
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state
that the information given is correct. I agree to comply with all slate laws and county ordinances relating to
WORKERS' COMPENSATION DECLARATION: I hereby affirm That t have a Certificate of consent to sell insure, ora
certificate dl Workers' Compensation Insurance. or a certified copy Thereof (Sec. 3800, Lab. C.).
building construction, and authorize a representative of the County of Riverside. Department of Building and Safety
to enter upon the property lot which I have applied,lor This' a mit the purpose of making inspections.
,or
❑Cerlilied copy is hereby furnished.
❑Cerlilied copy is tiled with the County Building Inspection Department or County Department.
Signature of Applicant or Agent """' Date
Print_Applicant/Agent Name
APPLICANT NAME (L, F, MI) APPL/PRMT N PS ' DATE
WATTS-? CHRIS 00014837 e 0 ������¢�� 26006
, f°°Cf$V1 YPZIP CA 922530000
�OBSS�,TFd'ADORESSISPACE At 11_ NI 4'�,ta R B'i'. Prf�(�� k� ty �y n
is 6. i�FCO EVJ UU "1V 1lW/ZIP 1iV7:. AUCA +..7✓<9?A2'`GJiJ30000
3, P—n �:2 011 i YY TWIN
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00 660 S
iiQs��b000 g' t Julboa a°Yl IS-
M V 4w FEW �q FINAL
4p� M
p1 A.r Tb1E;,F,_b1'W!?1 ry• PHONEg SPECIAL TO �f�r �I:NAL 0.0q,
CONTRACTOR -FIRM NAME A• LICNC p
ADDRESS
C I TY I CO M M U N I TY I STA TE/ Z I P
i
PHONE p BLW. INSPECTOR FINAL DATE
.,3 -�2
ARCIENG FIRM NAME - LICNC N
I ADDRESS
I CITYICOMMUNITY/STATE/ZIP
PLAN N I PLANS EXAMINER I APPROVE DATE I
3g3Si4%NSPIECTI?I! TO FINAL
` tlNALDWLG SPECIAL MP "M FEE $30.00
"o FSB ]OW sTOTAL on ��0. $30.
_00t •)1•$— FEE •
ZONE ORD p LOT SZ END 0 0 STD4 CAV I CK NC ' COUNTER 8.1. COUNTER L.U.T.Uf
'TOTAL.. PERMIT COST is X30.00
$t"ef lft TO FINAL
I
INSPECTOR
OR
FORM 284.208 (11.81) -
$0,100
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs 6 Frms
34
Plenums 8 Ducts
2A
Slab Grade
35
Furnace Comport.
3
Steel
36
Inlets 8 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.
No
ADDITIONAL INFORMATION
{
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f
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
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/
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
DEPARTMENT.OF BUILDING AND SAFETY . COUNTY OF RIVERSIDE
OFFICE DATE TIME PERMIT NUMBER
,-:V- s -18 1. 31, -Z7? (��) I IINSPECTION
ADDRESS SPACE NO.
Sz -Ze:) C) AV J-0
OWNER
BUILDING
PLUMBING
REMARKS: _
OWNER/ RACTOR TEL.NO,
ELECTRICAL
ITY
MECHANICAIL
REQUESTED
FOR:
A.M. .
P.M.
MONI
r
TUE S6
WE
THUR
29446 ►1/!S