391151 (BLCK)BUILDING PERMIT
PERMIT NO. DEPARTMENT OF BUILDING & SAFETY DST
3 91151 COUNTY OF RIVERSIDE FIELD ✓/
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
MH.Permit Fee E
1ST FL.
2ND. F.L.
POR.SQ.
SQ. FT. @ $
UNITS
'
Ck. By
/'�7
YARD SPKLR SYSTEM
SQ. FT. @
PI. Ck. Fee $
MOBILEHOME SVC. BAR SINK
FT. @
GAR. SQ. FT. @
CAR P. SQ. FT. @
WALL SQ. FT. @
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $
POWER OUTLET
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
F
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN '
Type
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
Plan No.
VENT SYSTEM FAN EVAP. COOL HOOD
SIGN
WASHER (AUTO)(DISH)
'
APPLIANCE DRYER
Const. Lender Branch
r GARBAGE DISPOSAL
Registr. Fee $
FURNACE UNIT WALL FLOOR SUSPENDED
Address City Zip
LAUNDRY TRAY
4
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
Total Fees,
ABSORPTION SYSTEM B.T.U. i
TEMP USE PERMIT SVC
WATER CLOSET
bees required 4,e
COMPRESSOR HP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER:
BOILER B.T.U.
SQ. FT. @ c
BATH TUB
SQ. FT. @ c
WATER HEATER
50. FT. RESID @1'/.c
SEWAGE DISPOSAL
SQ. FT. GAR @ '/. c
HOUSE SEWER
GAS PIPING .
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL.
TOTALFEES
MOB.HM.FEE
MICRO FEE
MECH. FEE PL. CK. FEE
CONST. FEE ELECT. FEE
G�
SMI FEE
FEE PLUMB. FEE
i v
PERMIT NO.
3.9
-
Job Address Space Zip 10-..r k
�.'• ,
Community/ Valuation Dote ist.V Off. F.C.C.
MH.Permit Fee E
Micro Film Fee Cop $
Use of Permit'Parcel
�� i / � fZ, 1)150
No.
A ��
Use/Cose'No.
Ck. By
/'�7
Mech. Fee Dbl $
PI. Ck. Fee $
. et ocks
Lot Size
Construction Fee Dbl E y
legal Description
(��^ �.,,�.�
/� p
F
Electrical Fee Dbl EL4'Trr
Zone Restrictions
Group
Type
SMI Fee - $
Plumbing Fee Dbl $
Bond Amt.
$
Plan No.
Plan Checker
Final Date
S
Inspe or Unit
Sp. Insp. Fee $
Dental. Fee $
Const. Lender Branch
upplime`�mit Numbers
i
Registr. Fee $
Mileage Fee $
Address City Zip
Witness Fee $
Reinsp. Fee $
Owner/Agent J(/ y I rfi�
Tel. Zip
Total Fees,
.Addresi y, /� .r
nIractor
r . Zip
! C
Tel. •~�� Lfce nseN
M.O. N.C. 'Cash Check
Received by
bees required 4,e
Sewage Syste 't
Address
City Zip
T LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified 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
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.
form 284-208 (Rev.8/78) as -
NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR
BUILDING APPROVALS MECHANICAL APPROVALS
1
Set Back
17
Rough Plumb
18
33 Ventilation System
2
Ftgs 8 Frms
20
s
yrrp�a�^
34 Plenums 8 Ducts
2A
Slab Grade
23
Water Service
24
35 Furnace Compart.
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.Woll
42 Commercial Hood
10
Fireplace P. L.
43 Final
10A
Fireplace T. 0.
0
NO ADDITIONAL INFORMATION
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 1 Final
15
16
Ground Plumb
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
1 Final
PLUMBING A
ALS
ELECTRICAL APPROVALS
26
Power Pole
27
Conduit
28
Service Entrance
29
Wiring
29A
Grounding Wire
29B
Bonding
30
Fixtures
31
Service
32
1 Final
SEWAGE SYSTEM SIZE & LOCATION [
Tank Pit L.Line /
REAR OF PROPERTY LINE
P/L P/L
STREET
NOTICE: T.HIS`IS-NOT.'.A BUILDING PERMIT.
` APPLICATION TO CONSTRUCT
DEPARTMENT OF, BUILDING >AND SAFETY -
-COUNTY OF RIVERSIDE
e
I
DISTRICT
Permit No
284 199A 9/74 CANARY—FILE, PIN K—APPLICAN
• - .. •i - _
Owner /✓1777 Architect CNS lee r1n _ Contractor --w11 L � L _.
ddress
Address LN 60100 Address-__ Address—
cityCity—_—City------ - ---
City ���N���,,--O--
AMJ��x�
Phone Phone 3`ie-4090 _ Phone— --------- -
(we) the undersigned, hereby certify and acknowledge -that I (w'e) have, read theapplication and ag-ree that if Curb and Gutter, and
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Z
Paving, and/or Dedication of right.of way is -required by the County of Riverside, ihe•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
0
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 Listed Below.
'Must Be Obtained Prior to the Issuing of: a Constiuction Pewmift.
SPACE NO.
! USE OF STRUCTURE
>
JOB ADDRESS -.-7 -w��� SINGLE FAMILY ,� DUPLEX
OF PROPERTY - �" ' D
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LEGAL DESCRIPTI N —773—
Lo� �� %D-5 ,Y� - APARTMENTS AGRIC.
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'- COMMERCIAL E] INDUSTRIAL 10
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COMMUNITY
, /�ALTERATIONS ❑
619PO ��+ �UUA L�
Z
N0. OF SUBMITTED PLANS' USE OF PERMIT _ —
N C
CASE NO.
--
Z
NO. OF PARKING SPACES REQUIRED _— NO. OF BUILDINGS NOW EXISTING -
Q
ZONE 2- L SETBACKS: FRONT SIDE REAR
J Co
GRADING PERMIT REQUIRED? YES. ❑ NO ❑ LOT SIZE
SETBACK ORDINA�N�C�E(# __— OF FEET REQUIRED ON STIR
DATE —J/--� SIGNATURE OF LAND USE OFFICIAL-" -
DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET_
H
W
CURB AND GUTTER REQUIRED: YES ❑ NO ❑ -STREET
i
d
CAN CURB AND GUTTER FEASIBLY BE INSTALLED? . YES. ❑ NO ❑
HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET
Q
IMPROVEMENT? YES ❑ NO ❑
0
ox
DATE SIGNATURE OF ROAD DEPT. ,OFFICIAL—
a
=
SWIMMING POOLS PUBLIC
QC
SEWAGE DISPOSAL '^`-
FOOD ESTABLISHMENT
WATER POLLUTION REMARKS-'
vt FLOOD CONTROL
W AIR POLLUTION
_ DIV OF HWY
c �. YOUR PROPERTY MAY BE SUBJECT TO
a —
FLOOD. RIVERSIDE COUNTY ASSUMES
NO RESPONSIBkL•ITY IN EVENT .OF, FLOOD.
284 199A 9/74 CANARY—FILE, PIN K—APPLICAN
• - .. •i - _