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DEPARTMENT OF BUILDING & SAFETY" f
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PERMIT NO. P MIT , .COUNTY OF RIVERSIDE'
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dditional Information: Y >
•ACTORY BUILT HOUSING
MOBILE HOME INSTALLATION t
Manufacturer
MH Manuf.
New D
odel Designation 4
Size .. _ Relocated O ;
UnitSerial'No.
-
Total,Fees $
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P,.Ian Approval No. c
Insig.. Serial<No.
Moving
Sewage System:
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Permission is hereby granted to move the
structure, described below„in
$
„total„Fees
`
Width Length
Height
.GRADING
#1
r
Number. `
of #2
Sections
#3
,
!Cut-
ill ; ` '
rTotal Fees
Present Location
Community County
RELOCATION INSPECTION
Destination
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Rreserit location ;: ., . ,,-. _ . _ „ ~, .
Community -
County
Total Fees
$
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ota I Fees ^ ' $ - _
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SP #
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Comm nity
1
Valuation
Date; p
Dist
Off
P.C.
;Plan Check
t,.t a—� r°1$
$
-
Use of Permit
Parcel No. '0 LIM
Lot Size
°,Reinspection
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;Factory-
Set backs
Use Permit #
Legal Description t
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Bond . one Grp Type
Unrt :1�'b
Built
GradingZtl
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Engineer License
Final Date
Inspector
Env. Assmt.
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/Mobile home
#
Requirement
Escrow Company
Branch
:Relocations
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Address
City
Zip
Total Fees
..`. Cash
Check
MO
NC
Owner/Agent
Tel. . + -
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Rede vedy Date?
Addr
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City:'
Zip
Related Permit(s)
Contr cto IV`
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tFr' workers' Mmp.
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(.,certify that in the performance of the work. for .which .'this permit is This pe, ni s afl �ecome void if work is not commenced within 120 days. Cessation of work for 120 days
issued I sholl not employ any person in any manner so as to become sub- shall also c se permit t become void. _:,
[eci io the workers' compensation laws of California. I hereby ee tho . dll ork in connection with this 'permit will be done in accordance with the s of
> ; Riverside Jruy_a a to of California. I hereby certify that the individual who prepared the plons,, nd
Owner Signature- specification ne s I Ecco ce with Section 5541 of the Business'ond Professions Code of the
Builder Signature State of Colifo ' '
FORM 284.208A 5-77 (2)m
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Bock
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
t 7
Framing
40 Fire Damper
8
Vents
41 Smoke Detention Device
9
Garage Fire Wall
42 Commercial Hood
10
Fireplace
P.L.
43 Final
10A
Fireplace
T.O.
NON ADDITIONAL INFORMATION
T.
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SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Loth
12 Internal Loth
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Botts))
12B 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
PI
i
26 Power Pole
77Conduit
28 Service Entrance
29 Wiring '
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
i
STREET NAME
NOTICE: THIS IS NOT A BUILDING PERMIT
APPLICATION TO CONSTRUCT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
DISTRICT
Permit No
284 199 9/74
CANARY—FILE, PINK—APPLICANT
Owne a Architect Contractor_
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Addres w F%alt�� d�%n Address Address X/ Z/
City PL City City_ Lx
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 war- 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. N 'r
NOW, therefore, it is agreed that I(we) will' not occupy said .property and will not cause said property to be occu d until I (we) have
complied with all laws of theCountyof Riverside and the State of California governing said property.
�`� y Acca.
DATE SIGNATURE OF OWNER ANp1nR
Approval by Signature from the Following Departments Listed Below
Must Be Obtained Prior to the Issuing of a Construction Permit.
SPACE NO.
11� USE OF STRUCTURE
JOB ADDRESS - 6,�6�xV - SINGLE FAMILY DUPLE,X
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LEG D ' CRIPTION OF PROPERTY - - APARTMENTS AGRIC.
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�� J �COMiafERCIAL INDUSTRIAL Cj
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COMMUNITY.
ALTERATIONS ❑
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NO. OF SUBMITTED PLANS ---_ USE OF, PERMIT
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CASE NO. `
p ZN0.
OF P RKING SPACES REQUIRED BUILDINGS NOW EXISTING -
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ZON SETBACKS: FRONT SIDE REAR
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GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE
SETBACK ORDINANCE _— OF FEET REQUIRED ON - STREET
DATE _4=SIGNATURE OF LAND USE OFFICIAL -- -
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DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET--
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
CIMPROVEMENT?
YES ❑ NO ❑
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DATE _ - SIGNATURE OF ROAD DEPT. OFFICIAI
S
SWIMMING POOLS PUBLIC
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ISPOSAL
SEWAGE DISPOSAL-
FOOD ESTABLISHMENT _
FOOD
WATER POLLUTION REMARKS
FLOOD CONTROL
W AIR POLLUTION
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DIV OF HWY
c YOUR PROPERTY MAY. BE SUBJECT TO
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c FLOOD. RIVERSIDE COUNTY ASSUMES
NO RESPONSIBILITY IN EVENT OF FLOOD.
284 199 9/74
CANARY—FILE, PINK—APPLICANT