00022706 GradingPERMIT APPLICATION
County of Riverside
Department of
Building and Safety
y� • 4080 Lemon St. 2nd Floor 135 N. Alessandro Rd. Rm, 203 880 N. State Street '
fir`?33; 227 North "D" Street 46.209 Oasis St. Rm. 310 160 N. Broadway ,
-
Riverside. CA.92501 Banning. CA 92220 Hemet. CA 92347
!
�
�.., Perris. CA 92370 Indio. CA 92201 Blythe. CA 92225 -
)+� Ph: 787.6146 Ph: 849.7312 Ph: 658.4464
'
}.1 , Ph: 657.3898 Ph: 342.8271 Ph: 922.2670
' t This permit becomes void it work not commenced within 180 days from date of issuance. OR. it work has Deer suspended or abandoned for a period of 180 days.
❑+ .
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be com-
LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (comment-
pleted if the permit is for one hundred ($100) or less. 1 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 not employ any person in any manner so as to become subject to the Workers' Compensa-
tion lion Laws of California.
-, y '•�Date
Applicant
OWNER -BUILDER DECLARATION: I hereby.affirm That I am exempt from the Contractor's License Law for the
- NOTICE TO APPLICANT: If. alter making this Certificate of Exemption, you should become subject to the Workers'
Compensation provisions of the Labor Code. you must lorthwilh comply with such provisions or Ihis 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-
01 hereby certify that no excavation five (5) or more feet in depth into which a 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-
h ,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 slruclure. scaffolding, lalsework:'
Qi I', as owner of the properly. or my employees with wages as their sole compensation, will.do the work, and the
or demolition or dismantling (hereof. 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 ollered for sale (Sec. 7044, Business and Professions Code: The Contractor's License
❑ As owner -builder. 1 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.
❑Division of Industrial Safely Permit No.
,.the building or improvement is sold within one year of completion, the owner -builder will have the burden of prov-
_
-mg that he did not build or improve for the purpose of sale.)
SI
OIs R'
.•
�). 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 properly who
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency lot the perfor-
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
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 inldrmation given is correct. I agree to comply with all slate laws and county ordinances relating to
WORKERS' COMPENSATION DECLARATION: I hereby allirm that I have a certificate of consent to self -insure. or a
building.construction, and authorize a representative of the County of Riverside. Department of Building and Safely
s� ceitilicate of Workers' Compensation Insurance. or a certified copy thereof (Sec. 3800. Lab. C.).
to enter upon the properly for which I have applied for this permit for the purpose of making inspections.
OCerlified copy is hereby furnished.
z"'
QCertified copy is tiled with the County Building Inspection Department or County Department.
Signature of Applicant or Agent Date
f
t
Print Applicant/Agenl Name
APPLICANT NAME (L, F, MI)
F LETCHER , DIANNE
ADDRESS
54283 AVE RUB:IO
CITY/COMMUNITY/STATE/ZIP
LA QUINTA CA 922 30000
JOB 54283RESSISPACE RUBIO
AVE,'9 6
CITYICOMMUNITYISTATEIZIP '
I A QUINTA CA 922530000
BOK
'7i4
PAG
234
PRC
016
C
4
TWN
0000
RING
SE
00
S
TRACTLOT
�iltD0g00 04�
MOD04M5SB
011
TRACT NAME
LUTS -4 � 5,
SClE�pV�-
k/LI�.LASQM��7�02�i�y��yi�.`.I(--263
��L.EEIf"\€AU D.YANNE
PHONE#
CONTRACTOR -FIRM NAME
ADDRESS
C ITYICOM M U N ITY ISTATEIZ I P
PHONE11
BLDG. INSPECTOR
FINAL DATE
ARCIENG FIRM NAME
LICNC #
ADDRESS
CITYICOMMUNITYISTATEIZIP -
PLAN #
P S EXAMINERG
G APPFOVE DATE
.USE OF PERMIT
GRADING—CUT ,175 CU.YDra,/FILL. •0
BL
00
ii1N
FS
02,
1 SSB I
014
SI
OIs R'
04e
FN
ZONE ORD#.
LOT SZ
END
010 0 101
SIDE
0 W,,,
APPLIPRMT # -
000#22706f
- F—ps--F DATE � � � 9 ^ 1/aI'LA
IPG 07/20/8'
-L-GRADING PERMXT FCL $22,00
e
TOTAL .
FEE
COUN ER 1
COUNTER L.U.T.
1 397941
' t ��3 '•� '"' G R A A) .1 N G P 0.:i. R M I T
TOTAL, PERMIT C OST. JS $22.00
"-0 of Lots,. 0 CU M. -Cut c 17 5, 0 Total Moved t 175
_'L",efrtific atl on RCE 01 Certification Date:
ELF VATIUNS - ala%e t 0 Grind; 0 F i.nshd Fir t 0 Pail 0
,,Grading Frermi•t Fee (based on cubic,.Vdss Cutand Filled) ist $22,00
• � f
sl
FORM 284208 11181) INSPECTOR -
t
t
e
t
t
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION I
. . DATE'4 INSPECTOR
BUILDING APPROVALS
MECKANoeAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs 8 Frms
34 Plenums 8 Ducts
2A
Slob 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.
OP'N
NO.
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Loth
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts)
128 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
ELECTRICAL APPROVALS
P/L
P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
PERMIT APPLICATION
County of Riverside
Department of Building and Safety
4080 Lemon St. 2nd Floor 135 N. Alessandro Rd. Rm. 203 880 N. State Street 227 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 8tythe. CA 92225
Ph: 787.6146 Ph: 849-7312 Ph: 658.4464 Ph: 657.3898 Ph: 342.8271 Ph: 922.2670
This permit becomes void if work not commenced within 180 days from date of issuance. OR, it work has beer suspended or abandoned for a period of 180 days.
❑ CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be com-
LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter9 (comment• pleted if The permit is for one hundred ($100) or less. I certify that in the performance of the work for which this
ing with Section 7000) of Division 3 0l the Business and Professions Code, and my license is in lull force and effect. 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.
11
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 live hunderd dollars ($500).):
❑ I, 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 Conlraclor'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 for the purpose of sale.)
❑I, 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 properly who
builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Con-
tractor's License Law.)
❑I am exempt under Sec. . B.& P.C. (Attach Certificate).
WORKERS' COMPENSATION DECLARATION: I hereby allirm 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. C.).
❑Certified copy is hereby furnished.
❑Certified copy is lited with the County Building Inspection Department or County Department.
APPLICANTMit
CHFh�
FL1 DIANNE
641963 AVE RUBIO
Cl
LWCOjyJJJTY4SJA 1ZIP CA 922530000
0 W QpRESSISPACE AVE R UD I O
TF 47CA`J
,C WCO�I�Nj3i/eSMA�EIZiP
922530000
7�r{4
17..34��016
a
'"""
0000
0u
S
M000
ws
SB
°A�AG�2A�7BLiK�y-�-2b3 LOTSAI i
PTVOrf 0
'j DIA✓'iNE
PHONE#
CONTRACTOR -FIRM NAME
LICNC #
ADDRESS
CITYICOMMUN ITY/STATE/ZIP
PHONE#
BLDG. INSPECTOR
FINAL DATE
ARC/ENG FIRM NAME
LICNC #
ADDRESS
CITYICOM M UNITYISTATEIZIP
PLAN#
EXAMINER
APPROVE DATE
phAMIG—CUT1!JEXU.vTS./FILL M
L)
R°N
nO'VM
il.
OASw,
0A6
fib
ZONE ORD#
LOT SZEND0
01
SIDE
Ua1e _Applicant
NOTICE TO APPLICANT: ll, after making Ihis Certilicate of Exemption, you should become subject to the Workers'
Compensation provisions of the Labor Code. you must lorthwith 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 feet in depth info which a person is required 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 Ihirly-six (36) feet high. (Chap. 3.2. Grp 2, Art 2. Sec 341.
Title B. C.A.C.)..
0 A 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,
❑Division of Industrial Safety Permit No.
CONSTRUCTION LENDING AGENCY: I hereby allirm 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 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 property for which I have applied for this permit for the purpose of making inspections.
X
Signature of Applicant or Agent Date
Print Applicant/Agent Name
0 0RMT # PS DATE - 39792
� 1"J ^ ^
000 06
C� i12F3/f32 l9 I/ t92
TOTAL .
FEE
CA CK NC I COUNTER B.I. COUNTER L.U.T.
APPLICATION FOR GRADING PERMIT
T H I S I S A N A P P L I C A T I 0 N 0 N L Y
FORM 284.208 (1181) ASSESSOR
aWgONI
!I1Qd,M
a
■■■■■■■■■■■■■
■■■■■■■■■■■■■
■■■■■■■■■■■■■
■■■■■■■■■■■■■
■■
■■■■w! ICb-wsiFM oM
■■■malunNNIF, as
OEM ■IMEW
■s■■e.rr■■:■ta
■..■■■■■■■■■
-v
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be com-
PERMIT APPLICATION
pleted it the permit is for one hundred ($100) or less. I certify that in the performance of the work for which this
permit issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensa-
Ing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.
tion Laws of California.
IA�Date
❑
County of Riverside
'1
OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law lot the
NOTICE TO APPLICANT: IL alter makingthis Certilicate of Exemption, you should become subject to the Workers'
Compensation provisions of the Labor Code. you must lorlhwith 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.
Department of Building and Safety
CA 922530000 922530000
tpermit to life a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law
4080 Lemon St. 2nd Floor
135 N. Alessandro Rd. Rm. 203
880 N. Slate Street 227 North "D" Street
46.209 Oasis Sl. 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: 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 for a period of 180 days
PHONE#
-v
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be com-
LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter9 (comment-
pleted it the permit is for one hundred ($100) or less. I certify that in the performance of the work for which this
permit issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensa-
Ing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.
tion Laws of California.
IA�Date
❑
Applicant
'1
OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law lot the
NOTICE TO APPLICANT: IL alter makingthis Certilicate of Exemption, you should become subject to the Workers'
Compensation provisions of the Labor Code. you must lorlhwith 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
CA 922530000 922530000
tpermit 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 01 the Business and Professions Code) or that he is ex-
❑I hereby Certify that n0 excavation live (5) or more feel in depth into which a 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-
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, scalfolding, falsework.
TWN
1 0000
or demolition or dismantling thereof. will be more than Ihirly-six (36) feet high. (Chap. 3.2, Grp 2. Art 2. Sec 341,
❑ 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 lot 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 Safely, as noted above. unless such person has a permit to do such work from the division.
his own employees, provided that such improvements are not intended or offered lot sale. II, however.
;he
i 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.
j ing that he did not build or improve for the purpose of sale.)
❑I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
I 7044, Business and Prolessions Code: The Contractor's License Law does not apply to an owner of property who
1r builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Con-
tractor's License Law.)
(r ❑1 am exempt under Sec. . B.& P.C. (Attach Certificate).
Dale Owner
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell -insure, ora
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 Department
APPLICANT NAME It., F, MI)
FLETCHER DIANNE
54283 AVE RUBTO
CITYICOMMUN ITYISTATEIZI P
LA QUINTA
CA 922530000
IB 62E�D,QRESSISPACE AVE`� UB I O
V t
LA AOQUINTA2IP
CA 922530000 922530000
BOK
774
I PAG
234
PRC
016
C
4
TWN
1 0000
PING
SE
00
S
TRACT
000000
LOTOD
04&5
111
SB
TRACT NAME
SCVNyp-ILAIiWM�y4244p/E�taLK-2b3
LOTS 4 &5
PEEL / WEI�1�(� , D.T.97NNE
PHONE#
CONTRACTOR -FIRM NAME
I LICNC If
ADDRESS -J
CITYICO M M UN ITYISTATEIZI P
PHONE# BLDG. INSPECTOR FINAL DATE
ARC/ENG FIRM NAME LICNC #
ADDRESS
CITY/COMMUNITY/STATE/ZIP i
PLAN IfPL S EXAMINER /3 /_7 6 APPROVE DATE
/>-� 17-Z1?
USE OF PERMIT
GRADING --CUT 175 CU.YDS./FILL 0
OL 00 RT 04�� JOY84 �i l�'' 0 1F�
ZONEORDM LOT SZ 0 fV0 01 106
a= -
CONSTRUCTION LENDING AGENCY: I hereby alfirm that there is a construction lending agency for the perfor-
mance of the work lot which this permit is issued (Sec. 3097. Civ. C.).
Lender's Name
Lender's Address
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certily I have read this application and state
that the information given is correct. I agree 10 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 property for which I have applied for this permit lot the purpose of making inspections.
X
Signature of Applicant or Agent
Print Applicant/Agent Name
Date
PERMIT FOR GRADING FLAN REVIEW
TOTAL PERMIT COST IS $15.00
* of Lotez 0 CU YD9 -Cut 1 175 F illi 0 Total Moved i 175
Grading Plan Review Fee (based on cubic yds Cut and Filled) tai $15.00
Z -
T,
FORM 284.208 (11.81) INSPECTOR
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL At'OPROVALS
I
Set Back
33
Ventilation System
2
Ftgs 8 Frms
34
Plenums 8 Ducts
2A
Slab Grade
35
Furnace Comport.
3
Steel
36
Inlets & Outlets 1
4
Grout Blocks
37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
39
Appl. Clearance
7
Framing
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L.
43
Final
IDA
Fireplace T. 0.
FI
ADDITIONAL INFORMATION
T
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts)
12B Ceiling (Botts)
12C Ceiling (Blown)
14 Final
PLUMBING APPROVALS
15 Ground Plumb
16 Water Piping
17 Rough Plumb
18 Vents
19 Sewage Disposal
20 Sewer
21 Water Heater
22 Water Softener
23 Water Service
24 Gas Test
25
Final
Tank Pit L.Line
REAR OF PROPERTY LINE
PSL P/
ELECTRICAL APPROVALS
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
AY UAN I NAMt (L, l-, MI)
FLETCHER, DIANNE
ADDRESS
a5,428'43 'AVE RUBIO
oiTlyfdf;kzlp
CITY/Fac CA ' .922530000
9 Wild I RESSiSPACE AVE NUBIO
BCOMMUZIP
CA
BOK
774
I PAG
234
JPRC
016
C
4
ITWN
8000
FING1
,
SE
001
S
TRACT -LOT
Q,40000 0445.
1
IMOD,
01
JSB
-
TRACT NAME
PCV LAQ 0244� 263 LOTS 4 & 5
PUTWO, DIANWE
PHONE N
CONTRACTOR -FIRM NAME
ADDRESS
CITYICOMMUNITYISTATE/ZIP_
I P , HO I NE#
r.INSPECTOR
FINAL DATE
ARC/ENG FIRM NAME
LICNC #
ADDRESS
CITYICOMMUNITYISTATE/ZIP
PLAN N t
PLANS EXAMINER
APPROVE DATE
USE OF PERMIT
GRADING—CUT 175 Gla. YD8,/FlLL`0
BL
00
RT"
0
3 TlA
Oft
TT 46,
ZONEORD$L
T SZ
0 JN6 eft
0 1 UD6
APPLIPRMT #
0 ID 0 227 0 6
ps
JXG
DATE
107/28/82 39789
TOTAL
FEE
F
CA
I CK
INC
I COUNTER B.I.
COUNTER L.U.T.
APPLICATION FOR -RADING PLAN REVIEW
'T H I'S- X S A.M. A P PLICAT'ION 0 N L Y
ti
FORM 284.208(ii.81) NSPECTOR
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33 Ventilation System
2
Ftgs 8 Firms
34 Plenums & 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. C]
43 Final
IDA
Fireplace T. 0.
NO
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Loth `
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
ELECTRICAL APPROVALS
PSL
P)
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A , Grounding Wire
29B Bonding,
30 Fixtures
31 Service
32 Final
STREET NAME