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417848, 426627 (SFD)
BUILDING PERMIT PERMIT NO. 41I78*48 DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE DST COUNTY OF RIVERSIDE l� CONSTRUCTION ESTIMATE' NO. ELECTRICAL FEES NO. PLUMBING FEES Job Address IST FL: 2ND. FIL SQ. FT. @ UNITS Zip Owner to i SQ. FT. @ YARD SPKLR SYSTEM FOR. � GAR. CAR P. WALL SQ. FT. @ MOBILEHOME SVC. BAR SINK Dist. SQ. FT. @ :,,+• POWER OUTLET ROOF DRAINS ((F.C.C. DRAINAGE PIPING SQ. FT. @ Micro Film Fee Cop $�- SQ. FT. @ DRINKING FOUNTAIN �. SQ. FT. @ ESTIMATED CONSTRUCTION VALUATION c �� .Q.l,�- J:E ^ ftro6 URINAL WATER PIPING Use/Case No. NOTE: Not to be used as property tax valuation SWIM POOL, PVT FLOOR DRAIN L> MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER r''^y �i 1 ( !' L. VENT SrSTEM' FAN EVAP. COOL HOOD SIGN WASHER (AUTO)(DISH) Electrical Fee Dbl $ APPLIANCE DRYER Group - �-- GARBAGE DISPOSAL Type "" FURNACE UNIT WALL FLOOR SUSPENDED Plumbing Fee# bbl. $ LAUNDRY TRAY AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK Plan Checker 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. SQ. FT. @ t BATH TUB Mileage Fee $ Address - City Zip A SQ. FT. @ t WATER HEATER SQ. FT. RESID @ 1114 c SEWAGE DISPOSAL - - Tel. SQ. FT. GAR @ '/. C HOUSE SEWER Total Fees $ Address GAS PIPING PERMIT FEE 1 Zip , PERMIT FEE PERMIT FEE DBL. TOTAL F MOB.HM.FEE MICRO FEE MECH. FEE PL. CK. FE CONST. FEE ELECT. FEE SMI FEE FEE PLUMB. FEE PERMIT NO. 148 Job Address r- l V[ Space Zip Owner to i Community r Valuation $ Data /r',,�� ' � Dist. Off. ((F.C.C. MH.Permit Fee $ Micro Film Fee Cop $�- Use of Perm' rL u�' c �� .Q.l,�- J:E ^ ftro6 Parcel No. , r)F�-. 111 , o , Use/Case No. Ck. By Mech. Fee Dbl $ Pl. Ck. Fee $ .� Set BacksLot Size '4 D, Construction•Fee Dbl $ Legal Description / G-4 r''^y �i 1 ( !' L. � 1 PC) IF S S R) L Electrical Fee Dbl $ Zone Restrictions '✓ Group - �-- ` Type "" SMI Fee - $ Plumbing Fee# bbl. $ Bond Amt. $ Plan No. Plan Checker � .`-13 Final Date Inspector ';Unit lam Sp. Insp. Fee $ DemoL Fee E Const. Lender Branch Supplimentol Permit Numbers •• ~ Register Fee $ Mileage Fee $ Address - City Zip A Witness Fee $ Reinsp. Fee $ Owner/Agent - - Tel. - - Zip r Total Fees $ Address City Zip , M.O. .C. Cash Check Received Trees re u'r rontractor `? Tel. _Dq License# Sewage System Address C'tt� ip T LL P Sewer District Form 284-208 (Rev.8/78) ©s 1 -` THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK 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. CCO�E THA �I♦ INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN ION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. verified by: PERMIT NO. DEPARTMENT OF BUILDING & SAFETY DST n 1 78,4B Q n COUNTY OF RIVERSIDE FIE 4 U `F r CONSTRUCTION ESTIMATE p' .NO: '•ELECTRICAL FEES NO. PLUMBING FEES +,�j�-`� �L/'�,•�.e IST FL SQ.'FT. @ iv r� '� w� I P.. •t UNITS.. up SQ. FT. @ Valuotion i R : YARD SPKLR SYSTEM r2ND. FL. SQ. FT. @ IMOBILEHOME SVC. BAR SINK ,:' ` • '. FOR. GAR. / - SQ. FT. @• +\ t POWER OUTLET I ROOF. DRAINS. CAR P. SQ. FT. @ �� DRAINAGE PIPING WALL SQ. FT. @ Use o ermifa t+/ { r }+ '••��-1� .0 E ;)a" «�. P� a,"� tlj .:1 r . P•r 1 { t"`•1 S.' �r t �rt i �t DRINKING fOUNTAIN . SQ. FT. @ 1 URINAL ` ESTIMATED CONSTRUCTION VALUATION$^" - Set Bocks '~ WATER,PIPING NOTE: Not to be used as property tax valuation SWIM POOL, PVT FLOOR DRAIN MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER VENT SYSTEM FAN EVAP. COOL HOOD SIGN WASHER (AUTO)(DISH) APPLIANCE DRYER . Bond Amt. ' GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED Final Date : (` LAUNDRY TRAY AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR • HP POLE, TEMP/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER 601LER B.T.U.4 r." 'SQ. FT. @z jt BATHTUB �• FT:- @ c WATER: HEATER r . *-kSQ FT. RESID @1'/a< "% x:: SEWAGE DISPOSAL Tel. Zip SQ FT •GAR @.2/ c r ., t� s ., fi # HOUSE -SEWER ' g• ,..' ./kart; Address •- City Zip l t A5'PIPIN6 r rt11r _. s ...... _ e PERMITr,FEE, _ q PERMITIFEEt �' `tit. k iE '`r7:•k'111 i PERMIT FEE Dl k_ ��� <r.a' TOTAL FEES• a MOB:FIM FEE, I.- ,i MICRO°FEE -L�.Xa MECH.-,FEE FEE"i� ti PL: CK "FEE, - ' t CONST FEE ELECT.,FEE� s a`�;^ SMI FEE. �.r =��-t � ,�L l„ �,{ J i. " r °- r 't � � 'y+S^r 7;'4� (.� i ,d�tF•t •�, ��,FE♦i �' x PLl1MB. FEE �3•�'� tsj �' zT`j'1�'t li"' ;�� e , tr }i l'��Y�t + l i t. '•� s„ nCd � .t•"�{ H S y .i � y �u� ?'� i 0 ) t },.i4 .� G �. 1. r t 1� ;:�' .�* . fi x f/€"{„+ri � t.�-�-�' '.` r ➢"sX F r . ;i P ,• +• °-CL+ �::+�, � e. s .y f. ---tl ,s i�v .. iT: ' I`a w 'Y. °.,..�' a ,.3'.'i ��� p..;`/✓7+t;r s•+ - �'.ID tJt 3 - ��+� �.�.,r.:+1 .'.C',lTi.t' it .> .!. r.-.,.:.ttm1`4+„�,�� :�•L °. ,e 1'z'1 fir, .,r ,c., ,� .f .+, �� .. 1._�. , �? ;i - _ - -:.F r '.:Y•_.--T'r f!:IoA dress Y <r ,•i. r ,y I• PEe�,M1T NO.. 1�c��. a'.+ '" b :1"_ r'- F.A-3 , t f..r_ i r l{! ib cl+,�Space r •t c^'. iy-fFa yip; i wner O �� - +,�j�-`� �L/'�,•�.e ',' 1r �3 f�,. _ r v.' 1%+y ,,, ..� r /.. t S + up t, Valuotion Dote.'Dist Off. F.C.0 ,,{ H Pe mit Feez?.i ''=.lr. iv.� I �,- .rv`�',)rs$';rL+. .n_t -. >,jnr?. rv.J(.�.. 5+i $ Li�i.� •No. _ �/y,,`• �� .. } .{Jucywfilm Feeta �. rdi C P Fw-•�- f r Use o ermifa t+/ { r }+ '••��-1� .0 E ;)a" «�. P� a,"� tlj .:1 r . P•r 1 { t"`•1 S.' �r t �rt i �t - Parcel ! .`_ , l4!` ... Use/Cale No _. _.. ...c,.x.,... Ck. By, I P Y'� 3 Me`�h.' ' r. Pl. Ck. Fee 1 /~ $ •r „t - Set Bocks '~ Lot Size ti -<r) t , Construction Fee, • Dbl $ �. _. Leg tion al Description ''- {'' /} r 6". •!�- 7 i r �t _ 1 % 1 l F 5 5 R • {_:.,w i Electrical Fee Dbl $ ` Zone Restrictions ..- Group �1 Type\ J + SMI Fee $ _ Plumbing Fee Dbl $ Bond Amt. ' Plan No. '; Plan cke c �GS� Final Date : (` Inspector ' J,Unit , r $p. Insp. Fee $.$ Demol. Fee $ _ Const. Lender Branch Supplimental Permit Numbers Registr. Fee • Mileage Fee $ Address - City Zip t Witness Fee $ Reinsp. Fee $ Owner/Agent jt Tel. Zip Tocol Fees$ ��;^ Address •- City Zip M.O. 0N.C. 171 Cash-Check)[T] ' ` t0eceN6cl bX�a�• '' .. �`` ConlroEio�`' -' p .' ` ~ NA �A Tel. a License# .Trees re' ire - -.. Sewage System T' Address city''•---1'Zi T LL P Sewer District , tztnl Form 284-208 (Rev.8/78) •©si.t THIS PERMIT SHALL BECOME'VOI IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION.OF WORK verified by: FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. " I HEREBY AGREE THAT AUCWORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. 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 NO. OPERATION DATE INSPECTOR R 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 Compart. 3 Steel 36 Inlets 6 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. E] 43 Final IDA Fireplace T. 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 23 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 29B Bonding ..30 Fxtuies- 31 -. Service 32 Final � o STREET NAME BUILDING PLKMIT PERMIT NO. 426627 DEPARTMENT OF BUILDING & SAFETY COUNTY OF RIVERSIDE FIELD CONSTRUCTION ESTIMATE �� NO. ELECTRICAL FEES NO. PLUMBING FEES IST Fl. 1211 2ND. FL. POR. GAR. 1 CAR P. WALL SQ. FT. 023 140 2 4 '7( UNITS 426627 SQ. FT. @ YARD SPKLR SYSTEM MOBILEHOME SVC. SQ. FT. @ BAR SINK SQ. FT. @ 7.70 ?4 94 01, POWER OUTLET ROOF DRAINS SQ. FT. @ DRAINAGE PIPING SQ. FT. @ DRINKING FOUNTAIN SQ. FT. @' 3 -53 2ESTIMATED CONSTRUCTION VALUATION . Community URINAL WATER PIPING NOTE: Not to be used as property tax valuation Dote SWIM POOL, PVT FLOOR DRAIN MECHANICAL FEES $ SWIM POOL, COMM WATER SOFTENER VENT SYSTEM FAN EVAP. COOL HOOD SIGN WASHER (AUTO)(DISH) APPLIANCE DRYER 1 *Jt Micro Film Fee GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED Use of Permit• LAUNDRY TRAY AIR HANDLING UNIT CFM Parcel No. se/Case No. IDLE METER j KITCHEN SINK ABSORPTION SYSTEM B.T.U. �4Se O MONO TEMP USE PERMIT. SVC WATER CLOSET COMPRESSOR HP r - POLE•TEMP/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT ;^ SHOWER BOILER B.T.U. SQ. FT. @ C BATH TUB Lot Size 050 100 [Type 0090 SQ. FT. @ C WATER HEATER Electrical Fee Dbl $ SQ. FT. RESID @1'/.0 t SEWAGE DISPOSAL 10 52 i �� 7 SQ. FT. GAR @ %. C PERHOUSE SEWER GAS PIPING PERMIT FEE G PERMIT FEE PERMIT FEE DBL. TOTAL FEES MOB.HM.FEE MICRO FEE MECH. FEE P, td PL. CK. FEE i CONST. FEE ELECT. FEE �.. SMI FEE 7 FEE PLUMB. FEE Lt PERMIT NO. �� Job Address v2�4� `--} —_�— — �lSpace Zip Owner .. 426627 , ,� r * BAN Room Community Valuation Dote Dist. Off. F.C.C. MH.Permit Fee $ i• O V $ - 02— � Micro Film Fee Cop $ Use of Permit• Parcel No. se/Case No. Ck. By Mech. Fee Dbl $ �4Se O MONO m �g w O F31t A d T G,�:[7AG 77'x;3 2 7— IRS PI. Ck. Fee $ S Set Backs Lot Size 050 100 [Type 0090 Construction Fee Dbl $ 211-30 Legal Description 6203 10 Electrical Fee Dbl $ .� i �� 7 Zone Restrictions Group SMI Fee E G P vN Plumbing Fee Dbl E 44 Bond Amt. Plan No. Plan CheckerY,,,d1ns]"ate Unit Sp. Insp. Fee $ $ e Demol. Fee E Const. Lender Branch Supplimental Permit Numbers Registr. Fee $ 1 B`21426627 'Mileage Fee $ Address City Zip Witness Fee $ Reinsp. Fee $ Owner/Agentd, 1 Tel. Zip MN Iv V�> Total Fees $ G Address - V r City' Zip M.O. Q N.C. Cash Check = 0 3 r r. Received rC&rrt ct Tel. License# Trees required ✓j '"f f •' Y Sewage System Address^ City Zip y 1 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 ALSO CAUSE PERMIT TO BECOME VOID. r 1 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 C.ALIFQRNIA. C, -11 .g � � 1 HEREBY CERTIFY THAT THL INDIVIDUAL WHO'REPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN Form 284-208 (Rev.8/78) @5 1 ACCORDANCE WITH SECTIOAII OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. verified by: NO. OPERATION f DATE INSPECT(A ,NO. OPERATION DATE INSPECTOR 1 Set Back BUILDING APP OV LS MECHANICAL APPROVALS 33 Ventilation System 7 2 Ftgs & Frms 34 Plenums & Ducts 2A Slab Grade I i 35 Furnace Comport. (_3 Steel 36 Inlets & Outlets 4 Grout Blocks 37 Combustion Air 5 Bond Beams I 38 Compressor 6 Roof Deck 39 Appl. Clearance — 7 Framing/s �% 40 Fire Damper 14 8 Vents - 41 Smoke Detection Device 9 Garage Fire Wall 42 Commercial Hood 10 Fireplace P. L. C] 43'. Final �8 10A Fireplace T. 0. No ADDITIONAL (INFORMATION ! IG�1�%'�_ C Q �5 Czz)e%f kE7- A R(v-U r •---- - ----- --= r t -• ---------- t r y SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath a �� 12 Internal Lath 12A Drywall ;7A. q/ 13 Finish Grade INSULATION Thick Value 7A Walls (Batts) 12B Ceiling (Botts) t; ?�_ 12C Ceiling (Blown) 14 Final - PLUMBING APPROVALS 15 Ground Plumb --. -- - - - -- 16 Water Piping 17 Rough Plumb 7�s 18 Vents 19 Sewage Disposal S� 20 Sewer 21 Water Heater 22 Water Softener 23 Water Service 24 Gas Test 25 Final AA / Tank l%�(/ Pit i L.Line PSL REAR OF PROPERTY LINE R r _ �B P/ Gl ar. ELECTRICAL APPROVALS 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 7-%S 29B Bonding 30 Fixtures 31 Service g 32 Final - STREET NAME `���� + +' DEPARTMENT OF BUILDING AND SAFETY y APPLICATION CERTIFICATE �- COUNTY' -0F RIVERSIDE PERMIT•# L Effective July 1, 1980, Chapter 1301 Section 19825of the Health and Safety Code requires the execu- - '-� tion of'the following applicable declarations prior to the issuance of a building permit. Please. • print or type.and sign,below:• , [� LICENSED CONTRACTORS DECLARATION - t I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000), of Division 3 of the Business and Professions Code and my license is in full force and effect. License Class License No. Date Contractor Q OWNER -BUILDER DECLARATION =t I hereby affirm that I amexempt from the Contractor's License Law for the following reasons: - 0 I, as owner of the property, or my employees with wages•as their sole compensation,.wi_ll do the work, and the structure is not intended or offered for sale. •If I sell within one-- p " year of completion, I understand I will have the burden of proving I did not.build or, improve for.the purpose of sale (Sec. 7031.5;"8.&P.C.). c [� I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, B.&P.C.). r I am exempt under Section B.&P.C. for this reason: Date Owner , [] WORKERS' COMPENSATION DECLARATION .--I hereby affirm that I have a certificate of consent to self -insure, or a Certificate_ of'Workers'. Compensation Insurance, or a certified copy thereof`(Sec. 3800, Lab. Code). Policy No. Insurance - :r - 0 . Certified copy is hereby furnished. Certified copy is filed with the County of Riverside, Department.of Building `and Safety. Date Applicant ' a CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE , (This section need'not'be completed if -permit valuation -is for'$100:00•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',Compensation laws of California.~- I further understand that if after making this Certificate of Exemption, I should become subject to. . the Workers' Compensation provisions of the labor code, I must forthwith.comply with such provisions . • or this permit shall'be deemed .revoked. Date Applicant CONSTRUCTION LENDING AGENCY - I hereby affirm that there is a construction lending agency.for-the performance,of.the work fora ` r which this permit is Issued (Sec. 3097, Civ. Code). , Lender's Name ' Lender's Address + `+. DIVISION OF INDUSTRIAL'SAFETY PERMIT CERTIFICATION �. Ot •I hereby certify that no excavation five (5) or more feet in depth into which a person is re- quired to descend, will be made in connection with work authorized by this permit, -and that no building, structure, scaffolding, falsework, 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.) �* [� As owner -builder, I'will not employ anyone'to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do I. such work from that division. Q Division of Industrial Safety Permit No. Date Applicant 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 state 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 pro- ' perty or which I have applied for this permit for the purpose of making inspections. nature%o pp scant qy t Date Print PPlicant/ gent Name' 284--2000 7/80 _ .. f' NOTICE: THIS IS NOTA BUILDING PERMIT APPLICATION TO CONSTRUCT DEPARTMENT OF BUILDING AND, SAFETY COUNTY OF -RIVERSIDE Ili 46 6 - DI STIR ICT DISTRICT v Permit No �- � `•-° - /yam �. 284 199. 9/74 _ CANARY — FILE, `.PINK APPLICANT h Owner DAN HORN Ar hitect w Contractor BOX 16M - Address Address Address_ City I)81m DeWrt City City_ x Phone Phone Phone W I (we) the undersigned, hereby certify and acknowledge that I (we) have read the application and agree that if Curb and Gutter, and • Z Paving, and/or Dedication of right of way is requiredby the County of Riverside, the Riverside County Department of Building and Safety 's. 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 O 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 wf 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 Construction Permit. SPACE NO. wa 1 .:.Am—.��USE OF STRUCTURE ryr►-�j JOB ADDRESS—� �. — SINGLE FAMILY ,1 DUPLE•Xw LEG L DES IPTION OF PROPERTY ! .*� i APARTMENTTS AGRIC. p JCOMMERCYAL -INDUSTRIA COMMUNITY,`' _> Z s ALTERATION NO .0 OF•SUBMITTED'PLANS --- .USE OF PERMITIdWall g :t.." "" t ...i 't i'�`- ..+ `J".•3 '%i j 1• .`4 ;-� ,� CASE NO. N0 OF•PARKING SPACES REQUIRED s ANO OF BU1`LDINGS1 OXISTING `Z y. a .jw..ZONE� SETBACKS FRONT�t'SI.O x/i REAR m GRADING PERMIT REQUIRED.) YES, c] !NO a LOT,.Sf_!E + ,,--.SETBACK ORDINA CE b '_ OF ' 'T'' FEET REQUIRED�ON s`''ue — STREET '- . �26;� DATE SIGNATURE OF LAND USE OFFICIAL ~+ DEDICATION REQUIRED: -YES ❑ NO ❑ NO. OF FEET _= r Am CURB AND GUTTER REQUIRED: YES ❑ NO ❑ 4 _STREET <IL CAN CURBiAND GUTTER FEASIBLY BE INSTALLED? YES ElNO ❑ U "" HAS AN ACCEPTABLEAPP ATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY. AND STREET IMPROVEMENT? YES NO ❑- °C DATE ZL_ SIGNATURE OF ROAD .DEPT. OFFICIAL 3 - _ SEWAGE DISPOSAI_kh �L ^�T WATER POLLUTION " REMARKS — �n FLOOD CONTROL— x AIR POLLUTION _ DIV OF HWY c < —� YOUR PROPERTY MAY BE SUBJECT TO d - c t' FLOOD. RIVERSIDE COUNTY ASSUMES NO RESPONSIBILITY IN EVENT OF FLOOD. 284 199. 9/74 _ CANARY — FILE, `.PINK APPLICANT h APPLICATIOWFOR.TREE PLANTINGt I (we), -the undersigned,'hereby^certify grid acknowledge that, (we) have read: the application'and.agree that if.trees ore required under River side County Ordinance No 457, the apPplicant agrees to`install said trees prior•to final inspection. lt,is"unda�3tood that,no'final:insg'ection:-'•tN. will'be given'until,said requirements have been met or exception has been granted by the County Now„therefore,,it is'agreed that the prop ' erty owner, shall cause the property'lines.to be surveyed.in,the event. no survey stakes can -be found Further it. is agreed that the -County of,. Riverside shall assume -no responsibility should trees have to be removed due �to�lot �lin e errors: L _^/ _# .I r '� •-� ,}_ r'''ya [ �?}� r�xt, i2 `fit _'.�4�V RY. i Owner's Name - DANN HORN � fBuildingtPermit ,. ) .o t...; , Mailing Address` `i -BOX 16 ' ” r'• City �$],QLD2$P.>' State-��'A��Zi;Q7 n - - ' rJob`Address s' Community L1? 1 Descriptions t_ � F' Assessor's Mcp,�Book & Page '^`' .`-� �0� Type Structure --dwelling Type of Soil 8 dlswater cvmlable yes'-" Road,Dept. Plot P16n No:'n i�r. A .� '3- :.� i it •:i ^.,. r, L,. �`"r'T.:~; Y:^•� F Type of existing treesinroad righi,, f -t ay C none%.�� •+ -„' s' �_.' Trees preferred by `applicant Datez�-��� t ; Owners Signatu e" Planni'ng;Commission Case No.' S w: _ROAD'DEPARTMENT APPROVAL Approved species'p nus haIaperiaia(A1P+9no ne) =_` x:15ga1`:sizeo Nulnber'of trees 1 t Spacing :of trees Distance •,from lot' lines: 'Front r-4,' Side` Additional requirements' '1' .': " r treat tree sheuld`'be'2' inside right of way and a miniinum`nf -1 f)' frt»n drivJr." 'tµ 'j - •1 Date Building and'.Safety notified' 22/R1• - Signature V, D_M. -► -REQUEST FOR EXCEPTION -! Reason f#tt: } ^• e. i" y":"'t- r. (attach additional page if necessary) Request for hearing: YES ❑,,�_ Owner's Signature ���•3;�t. �` (Forward application to Planning Dept. if exception requested) 15 "s NO REQUEST FOR HEARING , :Planning Dept:` r _ +t �4 a Concur ❑r - Non'-concur~^M "* Explandti nLU t Z a Date -Signature Z z' M a; Q Q Road Dept. J O " a C Concur ❑ .Non -Concur, ❑ �. '+� 1 Dara . YV Signatu a '� + tj 4 . REQUEST FOR HEARING AND COMMITTEE DECISIONf Z aDate hearing established 'Date Hearing notice mailed to owner r. a p - Approved •❑ iii Disapproved ❑ Data Owner notified of decision a aDate Building 8'Safety notified 1i irSignature�;3: ° Lr l APP VAL-BYCBUILDING'INSP.ECTOR Final -Date In�sp-actor " " L ' .-'Building Permit No. Lu JobAddress r Communit ((//�t(/l pec !w� 0 LL �. J Q Requirements for,tree planting complied with <• y �' an d Remarks * }i (Detach and forward above information,to Road Department�Riverside). 284-230,; REV. 1/74 �,, {v= JUC 1Za4 r f ^ Rr � h . � �,. i ..;rr. rt', l „{ tf - g • � w.•r.'�'o .a i�+5 �.t. x,,rr ,... � . - f � ; 7^� .fu'a ,=r ti, yt }` #' a ,. i- r „1„� •` 1.r{ -.,.Y t,,..n r�t1 •.`-' - r'"'•. �...