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00021896 (SFD)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 227 North •'D" Street 46409 Oasis SI. 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: 849.7312 Ph: 6584464 Ph: 657.3898 Ph: 342.8271 Ph: 922.2670 This permit becomes void it work not commenced within 180 days from date of issuance. OR, it work has beer suspended or abandoned for a period of 180 days. 0 LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commenc- ing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force a,iu effect. ❑ 4 OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5. Business and Professions Code: Any city or county which requires a permit to con- struct. alter, improve, demolish• or repair any structure, 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 (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is ex- empt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a per- mit subjects the applicant to a civil penalty of not more than five hunderd dollars ($500).): ❑ 1• as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of properly who builds or improves thereon, and who does such work himself or 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- ing that he did not build or improve lot the purpose of sale.) of, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044• Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the Con- tractor's License Law.) 01 am exempt under Sec. B.d P.C. (Attach Certificate). Date Owner WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell -insure, or a certificate of Workers' Compensation Insurance. or a certilied copy thereof (Sec. 3800, Lab. C.). ❑Certified copy is hereby furnished. _ ❑Certified copy is tiled with the County Building Inspection Department or County Department. •[erARNTJq J7E1W. MI) AODBE.SS l b3k3 PAL "'TA IrT CA 922600000 i E R f B I O I'lVIG 1\4JC iA i.i WrAloRESSISPACE AVE GGrd/TA �,Uii�yY� CTA CO (TAZIP 922539000 i 22539000 1 f3 a13 Ulb t Group N woo V lJ 17 _CI.En{/ S U U 0 0 0 0 TO P:. F:i 101 IVIS sB CA 16—tVATAIR0171 BLK--171 f- r7 f_V4.EDEBERT y DEV CONE# !V {.r 14.ff iN7fYrWlR I COUNTER B.I. ^"' >: 7l/71�AVfJJq N LIw►sJp 1.7� URS 16313 PTAV fU`%S9F.IFrt CA 922600000 Pl iN41— .l f, 8— 1 0 4 8 A l7 w� BLDG. INSPECTOR FINAL DATE ARC/ENG FIRM NAME LICNC N ADDRESS CITYICOM M UNITYISTATEIZIP PLAN If P N E I APPR VE DATE. DWLr.m' ATT GARAGE :4)0 1 RaTN 0210 0dIZ} 0`01.5 0` U I I rRD iii; W4.77 ZONE ORD M LOT SZ 0 1m tt 101 SIPFa CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be comi pleted if the permit is for one hundred ($100) or less. I certify that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensa- tion Laws of California. O Date Applicant _ NOTICE TO APPLICANT: II, after making this Certificate of Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: 01 hereby certify that no excavation live (5) or more feel in depth into which a person is required to descend. will be made in connection with work authorized by this permit. and that no building struclure. scaffolding. falsework. or demolition or dismantling thereol. will be more than thirty-six (36) feet high. (Chap. 3.2. Grp 2. Art 2. Sec 341. Title 8. C.A.C.). []As owner -builder. I will not employ anyone to do work which would require a permit from the Division of In- dustrial Safety. as noted above. unless such person has a permit to do such work from the division. E) Division of Industrial Safety Permit No. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the perfor- mance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name Lender's Address _ CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state that the information given is correct. I agree to comply with all slate laws and county ordinances relating to building construction, and authorize a representative of the County of Riverside. Department of Building and Safety to enter upon the properly for which I have applied for this permit for the purpose of making inspections. s� Signature of Applicant or Agent Date Print Applicant/Agent Name tYWITIL-185`6 � 07:1;�VT,3� 13-9 5N$:4 ESTIMATED PLAN REV t -LE +,11A .!01 (NOTEs Not to be used as property valuation) Description FCC Group Ty a Sq Ft Ratan Valuation PRIMARY DWLG 101 TOTALFEE V_ CA I C% NC I COUNTER B.I. ^"' >: COUNTER L.U.T. PERMIT FOR STRUCTURAL PLAN REVTCW TOTAL PERMIT COST IS $151.77 CONSTRUCTION ESTIMATE (NOTEs Not to be used as property valuation) Description FCC Group Ty a Sq Ft Ratan Valuation PRIMARY DWLG 101 R-3 V_ 1211 $27.60 $32423 SECNDRY AIRCON 900 Rw3 R 1211 $2.20 $2664 SEL''NDRY PRICAR 436 M WD 320 $9110 $2?12 Est Plant Rev Fere basad on Total Estim aced Val'tn of *3439??? iii; W4.77 FORM 284208111.81) INSPECTOR sj NO. OPERATION DATE INSPECTOR' NO. OPERATION DATE INSPECTOR'! BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Ftgs & Frms 34 Plenums 8 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. 0 43 Final 10A Fireplace T. 0. FI _ ADDITIONAL INFORMATION - r - • _ — � � V SEWAGE SYSTEM SIZE & LOCATION I - _. _ — _ 11 Exterior Lath 12 Internal Lath 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Walls (Batts) 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 PSL P/ 26 Power Pole �27 • Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 2913 Bonding 30 Fixtures 31 Service, 32 Final STREET NAME b PERMIT APPLICATION COU nIY Of Riverside Department of Building and Safety 4080 Lemon St. 2nd Floor 135 N. Alessandro Rd. Rm. 203 880 N. Slate Street 227 North -D•' Street 46-209 Oasis St. Rm. 310 160 N. Broadway Riverside, CA 92501 Banning. CA 92220 Hemel. CA 92343 Perris. CA 92370 Indio. CA 92201 Blythe. CA 92225 Ph: 787-6146 Ph: 849.7312 Ph: 658-4464 Ph: 6573898 Ph: 342-8271 Ph: 922.2670 11_11i permit becomes void if work not commenced within 180 days Irom date o1 issuance. OR, if work has beer suspended or abandoned for a period of 180 days. t F �,� El CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: 'This section need not be com- LICENSED CONTRACTORS DE6.LARATIDN: I hereby affirm that I am licensed under provisions of Chapter 9 (caStmenc- IFpleted if the permit is for one hundred ($100) or less. I ceilily that in the performance of the work lot which this Ing with Section 7000) of DiAion 3 of the Business and Professions Code, and my license is in full force and effect. permit issued: I shall not employ any person in any manner so as to become subject to the Workers' Compensa- S lwn Laws of California. I O - Date - Applicant - 0TI NOTICE TO APPLICANT: 11, alter makingthis Certificate of Exemption. you should become subject to the Workers' OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law for the 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 Code: Any city or county which requires a permit to con- deemed revoked. " struct, alter, improve. demolish, or repair any structure, 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 excavation live (5) or more leer to depth into which person is required to descend. will empt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a per- with made in connection with work authorized zetl by this permit. and that n building scaffolding. mit subjects the applicant to a civil penally of not more than live hunderd dollars ($500).): ' . or will or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2. Grp 2, Art 2. Sec 341. feet Chap.siruct3.2 2, Art . Sec 41. ❑ I, as owner of the properly, or my employees with wages as their sole compensation, will do the work, and the 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 Ar dusirial Safety. as noted above, unless such person has a perttiil to do such work from the division. through his own employees, provided'lhat 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 lot the purpose of sale.) - s Of, as'owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the perfor- 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of 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 contractor(s) licensed pursuant to the Con- Lender's Name ' tractor's License Law.) Lender's Address ❑I am exempt under Sec. . B.& P.C. (Attach Cerlilicale). 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 t0 comply with all slate laws and county ordinances relating to WORKERS' COMPENSATION DECLARATION: I hereby affirm Thal I have a certificate of consent tosell-insure. ora building construction, and authorize a representative of the County of Riverside, Department of Building and Safety to enter upon the properly for which I have applied for this permit for the purpose of making inspections. certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec.. 3800, Lab. C.). ❑Certified copy is hereby furnished. ❑Certified copy is filed with the County Building Inspection Department or County Departmepl. Signature of Applicant or Agent (late MPfAL NJW�4F, MI) WK 5 1638 FWLY-Pu'1 WERPt CA 922600000 .Ve(FRESSISPACE .RUBIO , Ur AVEI% v!�.I..COui6i ltl 1 Y'�IZIP COQ 922530000 /! t.7 1 •7 V i ! TWN '� V {l N 690 S fffo000 0020 1 0TI SB :Pf.VAJ!AQ*17 , BL�•K-171 f W' M 774=C: R 7 � DEV CO PHONE tt 4.1'I DWM%WRNMORN L3113.5436 FI9MI,i7f»G7f",.Eli l , CA 922600000 1NL 11- 5 L 8— 1 Q 48 w, 71N411-568-1Q48 BLDG. INSPECTOR - FINAL DATE ARC/ENG FIRM NAME - LICNC N ADDRESS - CITYICOMMUNITYISTATEIZIP. PLAN d PLANS EXAMINER APPROVE DATE VKW'6 ATT GARAGE 0-0 R 1°N . 020 0150 0 Ur 0150 I .PINll ZONEORDN L5TSZ 0VNIVO- 0.16`13 UP4,i "T896 896 39567 TOTAL . FEE' CA - CK NC I COUNTER ELL _COUNTER E'.U.T. APPLICATION FOR STRUCTURAL PLAN REVIEW T W 19 I S A N A P P L I C A T I 0 N u N L Y You Mint see the following Departments (if listed) for concurrence BEFORE a Permit can be issue4i Description �.. , «.... .. ..� ...« . _.,. .... »...:.. .w.. _. �„ r ,.. De -to See HOLD—ROAD.. HEALTH Z �r vLre� ov v�y:a/� MDt USE . I I - '�:,IZ`b Vis'p I . PENMIT APPLICATION County of Riverside Department of Building and Safety - 4080 Lemon St. 2nd Floor '. 135 N. Alessandro Rd. Rm- 203 880 N. Stale Street 227 North -D- Street"_ 46.209 Oasis St. Am. 310 - 160 N. Broadway - • Riverside. CA 92501. • Banning, CA 922.20 Hemet. CA 92343 ' • - Perris, CA 92370 _ friend. CA 92201 i Blythe. CA 92225 ` 1 , •. Ph: 787;6146 , Ph: 849:7312 Ph: 658.4464 . Ph 657.3898 Ph: 342.8271 - -,- Ph:'922 2670 - obis permit becomes'void. it work not commenced within 180 days from date of issuance. OR. it work has beer sospended p4 abandoned for a period of 180 days. ' ' EJ.,.; '+�� ,' . " '� `-' •. - CERTIFICATE OF EXEMPTION FROM WORKERS'. COMPENSATION INSURANCE:- This section need not be com- LICENSED CONTRACTORS t�iLARATION: I hereby aflirm that I am licensed under provisions of Chapter 9 (col-•lenc-: - pleled it the permit is for one hundred ($100) or less. I certify that in the performance of the work lot which this is issued, I ing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force anti�tiy;� -:.''� e - permit shall not employ any person in any manner so as to become subject to the Workers' Compensa• - tion laws of California. - - - .. -. ❑t - .: Date Applicant .. '• ' • .OWNER -BUILDER DECLARATION: I -hereby affirm that I am exempt from the Contractor's License Law for the `Any - NOTICE TO APPLICANT: If, after making this 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 Code: city or county which requires a permilto con- struct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such deemed revoked. - permit to life 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- therefrom basis for ,01 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend,"w111 empt and the the alleged exemption. Any violation of Section 7031.5 by any applicant for a per- mit 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 structure. scaffolding;: falsework: - K �� ❑ 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 Coder The Contractor's License C3 As owner builder. I will.not employ anyone to do Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or -through his own employees, provided that such improvements are not intended or offered fol sale. 11, however, work which would require a permit from. the Division �of In - dusirial Safety. as noted above, unless such person has a permit Io do such work from the division. the building or improvement is sold within one year of completion, the owner -builder will have.lfie burden of prov- []Division of Industrial Safely Permit No. Ing that he did not build or improve for the purpose of sale.) PLAN M - . ❑ ' r ' I, as owner of the property; am exclusively contracting with licensed contractors to construct the project (Sec. CONSTRUCTION LENDING AGENCY: I hereby affirm that (here is a construction lending agency for the perfor- `7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who mance o1 the work for which this permit is id (Sec. 3097, Ci " issued v. C.). , builds or improves thereon, and who contracts for such projects with a contractor(s) licensedpursuant•to the Con- Lender's Name ' tractor's License taw.) ' - 1 `f' -❑I Lender's Address " _ am exempt under Sec. , B.& P.C. (Attach Certificate). Date ' ' Owner • 1 - CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY- I certify I have read this applicallon and state -,- • that the information given is correct. I agree to comply with all slate laws and county ordinances relating to s WORKERS' COMPENSATION DECLARATION. I hereby affirm that I have a certificate of consent to self -insure, ora building construction, and authorize a representative of the County of Riverside. Department of Building and Safety . 'certificate of, Workers' Compensation Insurance. or a certified copy thereof (Sec. 3800, Lab. C.)..' to enferupon the property for which I have applied far this permit for the purpose of making inspections" - ' ❑Certified copy is -hereby furnished.- +c ,❑Certified copy is filed with the County Building Inspection Department dr County - Department. Signature ol. Applicant or Agent _` Date `' "A''•''4' - "z'- S 1• `• Print Applicant/Abenl Name - !4/PPIN I l V 1\1 F, MI) PAr--1 ,1[Jf-%T R'.1 CA 9t211"??b{7 0*000• t• RESSISPACE AVEG y RUBIO'.' r IO�•� JIG/R. V' • '.' EA°OC 1LJ''MAA'ZIP ". ,. C A.92L 3 0 0 0 0' 7'x'3 113 lr�11 '' ,"". 06,60 -ft- B . 0 0.0_ �Pb 26 0°e 1 SB 'B�L•K-'1ryil +•I @�Cg�''y",�'L�rAy,Qt*11•�7y •.,,•• fPIA'gL�1p.17'pAp��rlypGf�w�,yr•�wlp�)T • DEV --CO. PHONE p 5N'g 3 Wks 16381, CA 922600000 71"V-568-1 1"V„,5Lpyo,1 048 BLDG. INSPECTOR FINAL DATE ' ARCIENG FIRM NAME LICNC fI ADDRESS, CITYICOMMUNITYISTATEIZIP - .01 - PLAN M - . PLANS EXAMINER APPROVE DATE . ATT GARAGE 00 , "" R VN' 0 2!0 0 re, 0 W5 0 PO " I'ND I., r ZONE ORD q 1 r LOT SZ 0 f�0" 0 UPUI)`2T1"89b 0`1/11 J 516 I • -' fir. i7- J TOTAL i FEE a " i t QA.T ,t CK- NC 1.' COUNTER'B.I. - 3% A COU .U:T., y•••'y I +APPLICATION, F'OR "SI'RUCTURAL iPLAN REVIEW , Y T H µI `S I S A- N A P'• P L. 'I`. C A T NI U p;N'L Y 4 Y-ou Must 'See rthe* followtng,�,DepartMents (if listed) 'for .concur,r*ence BEFORE'. �;� a Per mi't 1can: be issued: , Description -�_ ___ .___.: -__� _ - - 'Dept t o Se ' ,HOLD -ROAD., HEALTH,- . lac, vv��ot� 4�i �,F� ..%� L..AWD-'USE. .74 MRA.IlIN1.Atr APPLICANT.. • ' - C' _,. -� I X X .. '. • y• Receipt No. 75 �- G C -v � Issued By j•v� r►f Sz �,r,� 7 District: Riverside ❑ Indio ❑ Hemet ❑ Date 2�- DISTRIBUTION: WHITE - Office File YELLOW - Applicant PINK - Building Dept. GOLDENROD - Attached to Plans DOH SAN 122 (New 10/81) i RIVERSIDE COUNTY 15EPARTMENT OF HEALTH APPLICATION FOR PERMIT TO INSTALL A RESIDENTIAL SUBSURFACE DISPOSAL SYSTEM Applicant: Submit this form with three copies of a scaled plot plan drawn to the specifications required on the attache check list. A non refundable filing fee of $15 is required when the application is submitted. Check must be made payable l County of Riverside. NNaamme` Mailing Address, C Q ' o City State Zip Code �% Phone /�cl f f �14_�- ll'– 'Property Ad^d7relss' *City or Community 'Legal Description of Property LU I *Assessors Parcel No. Water Serving Property From Sig'natureof'Akplicant� - - Date " 'The above information must be verified from Building Application Staff Use — Do Not Write Below This Line Initial Date Soils feasibility report required Yes ❑ No ® r �� 7 S l Detailed boring report required Yes ❑ No LIJ Detailed contour plot required Yes ❑" No W Z Soils or boring report by Date O V Approved by Date LU y Soils Map Page Soil Type Tract File No. Other �- 41- 7 Number of Bedrooms Septic Tank Size (gallons) Rate Required (sq. ft./100 gal or gal. sq. ft./day) Leach line sq. ft. of bottom area trench .. Leach bed (sq. ft. of bottom area bed) I Seepage Pit Diameter Seepage Pit Vertical Feet Number of Seepage Pits Maximum Depth of Pit r,. Location of System 4^ 1 Additional Requirements V A permit wapp ed/denied for the installation of a subsurface disposal system as indicated on the accompanied Z plot plan using the -requirements set forth in Section C above. O W U) Signature of Health Official Date I Receipt No. 75 �- G C -v � Issued By j•v� r►f Sz �,r,� 7 District: Riverside ❑ Indio ❑ Hemet ❑ Date 2�- DISTRIBUTION: WHITE - Office File YELLOW - Applicant PINK - Building Dept. GOLDENROD - Attached to Plans DOH SAN 122 (New 10/81) i - .A/P'1RNTf'tilRl` . M1i .. - ►44 °�'r�" �t' i CRS 922, 1'G 41?PESSISPACE ry!* -1'1 U1� W ... . J� qqty �y uuq �ty� -'�i'tl '77��++�� yyssTTyy��i� //yy f'1.T COW,"4.TT ZIP. .. P�. - !�J z �.7;d' 3: l7 .1 iG TWN .000 j(y(' n 7i {/ e! la {3 Iwo S . . UT q U o IV 2& I. pypp V A: a SB pyyJygq p v�� y�ryry� g��+'� j �ry " �t' Ab14MEiJ1G:: wjG�it T' orv.- �.iM PHONE# J9t3HAVjaja.NMR-N L 54.36 .' . PID 9 5 163 TALOKUWs Ert CA - 922,160 0 a QA ..:, �,PI1aN E11��,,,E.fi 4 fi./i.IJ" BLDG. INSPECTOR - FINAL DATE, . ARCIENG FIRM NAME LICNC t ADDRESS ., �CITYICOMMUNITYISTATEIZIP PTAH t • PLANS EXAMINER APPROVE DATE nY . ZONE ORD # . - LOT SZ �t'e arid a t) ,'if ft ,S'9 SIDa 11.f 'i7 Y . n f f &� } irk C 9 � � � � ' � �Nt r5.y� �+ r a tib' t • a . � iFORM� 284.208(11'81)! INSPECTOR- ...... ... �,., �._.., ... .,..z. .-s .r.._ .�.. _ .:., . .� ..: At ... ._. a. .:��:.s ..., �A-. { .1 F tE :.,:-+s `�,+.aa.�'- Y. .:.e. �•. x'. .r`.^_ NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Ftgs 8 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. Cleorance 7 Framing 40 Fire Damper 8 Vents 41 Smoke Detection Device 9 Garage Fire Wall 42 Commercial Hood 10 Fireplace P. L. E] 43 Final IDA Fireplace T.O. FIN 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 298 Bonding 30 Fixtures 31 Service 32 Final STREET NAME "Lr.w TA ,so, d7�.” . XIA 39567 i J "I ll,; TOTAL . .s` FEE CA . ` = CK NC •• COUNTER B.I. - COUNZER L.U.T. tvu'. .+.. . yq,.1Wy UpF. PLAN RIE JpW . ALp "t'M'P.L1C'.Ar� U'N 0KLY � {t ., • `' .r' �Y�- :. a ^.:.. - ' ,Yp;u stiuiK st iltq fUlXa¢Dart.r►er►ts 0f.liaYtt3 f or concurrence BEFORE, a Pes°e-i t can:.be�us9 s x5 gins RRTF'i1.::ftUl/.C:,.7C:��'(�'•l,�Yl�4:f.:+�,�NN:�gy't7.F,' 'I AVE ' P� U�BI 494�pY /ngpy-.:�93k�'y-.. ,�• . �1�Q�t1{jJRy7E�SySgISAP'AFC�E. eeJ77L•' • My.UTf oJAY@'�ftpZl�P WA 2,1 0 N X60, TWN. o q(yCJ� ll a . , S 513 1wVA6wA001`7'�`;S�K .g1 YYy y� y� r P141fiME.(I,G.�iJ DEVPHONEq y4 .per p. A., v " ��App2��;h��TT�Rpp..((��gqpp��'MM �7� /y g. y LI�:l�7.tri .APR • . /ilf4NAVfAq�N a. 6 PMQf1CttL_B[R..f.�}„�•j„ff:Al t+l; BLDG: INSPECTOR - FINAL DATE -. �"V(7 '14 Y•• fs�4 is sli C•7 ARCIENG FIRM NAME LICNC q , t•) ADDRESS CITYICOMMUNITYISTATEIZIP PLAN N .. . PLANS EXAMINER 'APPROVE DATE h° MW4+{.J-MI,:{"1T 1a Pt�ti Pf 6il ID - �.. •� ggpp ry�y ZpN '•.. �p 6 9ggry •,Qid �y g�g� V: -V 1 ,,, `il y�ggg.�� `-li'8 �9 p�g� ii .. '• �� .IFf 4 p� gI ' y 'ZONE ORD# - LOT S2 `, tfiMIIA l7:wi4 A,4 fJ I.t-J' . "Lr.w TA ,so, d7�.” . XIA 39567 i J "I ll,; TOTAL . .s` FEE CA . ` = CK NC •• COUNTER B.I. - COUNZER L.U.T. tvu'. .+.. . yq,.1Wy UpF. PLAN RIE JpW . ALp "t'M'P.L1C'.Ar� U'N 0KLY � {t ., • `' .r' �Y�- :. a ^.:.. - ' ,Yp;u stiuiK st iltq fUlXa¢Dart.r►er►ts 0f.liaYtt3 f or concurrence BEFORE, a Pes°e-i t can:.be�us9 s NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS I 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. 0 P' 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 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