368773 (BLCK)BUILDING PERMIT'
PERMIT NO. DEPARTMENT OF BUILDING & SAFETY 7DST368773 COUNTY OF°RIVERSIDE FIELD
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES,
IST FL.
2ND. FL.
POR.
GAR.
CAR P.SQ.
WALL v r^
ESTIMATED CONSTRUCTION
SQ. FT. @ $
UNITS
Owner
SQ. FT. @
YARD SPKLR SYSTEM
SQ. FT. @ MOBILEHOME SVC.
BAR SINK "
POWER OUTLET
SQ. FT. @
ROOF DRAINS
FT. @
DRAINAGE PIPING
SQ. FT. @ v
DRINKING FOUNTAIN
SQ. FT. @
URINAL
VALUATION' $ / r
WATER PIPING
NOTE: Not to be used as.property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER r
VENT SYSTEM FAN EVAP. COOL HOOD
SIGN
WASHER (AUTO)(DISH)
APPLIANCE DRYER
Dbl E
Dbl $
GARBAGE DISPOSAL
FURNACE UNIT WALL - FLOOR SUSPENDED
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
BOILER B.T.U.
SQ. FT. @ c
BATHTUB
SQ. FT. @ c
WATER HEATER
$
SQ. FT. RESID @1 /.c
SEWAGE DISPOSAL
SQ. FT. GAR @ '/. c
HOUSE SEWER
Registr. Fee $
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL.
TOTAL FEES
MOB. HM. FEE
MICRO FEE
MECH. FEE PL. CK. FEE
CONST. FEE. ELECT.,FEE
SMI FEE
,r+ FEE PLUMB. FEE
. PERMIT NO.
368773
.
Job Address
,A'.
Space
Zip
Owner
omm riily
valuonon
$
Date
'
Dist.
F.C.C.
MH.Permit Fee $
Micro Film Fee
Cop $
Use of Permit
/^I „1,+7L /t„% C,161�91 .A —
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Porcel No.
y 1
Use/Case o.
Ck. By
Mech. Fee Dbl $
PI. Ck. Fee $
M'B' cks
Lot St�Iize
Construction Fee
Electrical Fee
Dbl E
Dbl $
N
L I escripti n F
,v ♦� y j ,�i /)
1-4)7-17
/ '✓V' 4C [„! 4e 56 V 4' ,,�- - '
S S R
Zone Restrictions Group
Type
..
SMI Fee $
Plumbing Fee
Dbl $
Bond Amt.
$
Plan No.
Plan Checker v
Fin Dote
..--
Insp or
Unit
Sp. Insp. Fee $
Demol. Fee
$
Const. Lender Branch
Supplirpe
I Permit Numbers
Registr. Fee $
Mileage Fee E
Address Cit Zi
y P
,,f
Witness Fee $
Reinsp, Fee
$
Owner/Agent
Tel.
Zip
Total Fees
$
y,++ -
AdA re (,
te
City
Zip-
M.O. N.C. n Cash Checkoeff
Received by -
Contra for
Tela
'- -
'
License
—
V,
Trees required
Sewage System
Address
Y
City
Zip
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.
k � I HEREBY AGREE THAT ALL WORK IN CONNECTI BE DONE IN ACCORDANCE WITH
THE LAWS OF RIVERSIDE COUNTY AND THE STATFUF NIA.
1 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)
verified by: •
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
_;W _ C�
QC/
33
Ventilation System
2
Figs 8 Frms
p _
rnQ��
34
Plenums 8 Ducts
2A
Slab Grade
35
Furnace Comport.
3
Steel
36
Inlets 6 Outlets
4
Grout Blocks
Z
37
Combustion Air
5
Bond Beams
7 , 3 , ��
d
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
10A
Fireplace
T. 0.
NO.
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
__ _ _._P,LUMB.ING.APP_ROVALS_
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
NOTICE: THIS IS NOT A' BUILDING PERMIT
APPLICATION TO CONSTRUCT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
DISTRICT
Permit No
284 199A 9/74
CAtJARY—FILE, PINK—APPLICANT
Owner L AArchitect —_ Contractor__ —
Address�7\ddress—__ Address--
ddress—Cit
Cit6.w_ty-- _ City___._— —
Phone Phone _ Phone—
r.
cc
W
I (we) the undersigned, hereby certify and acknowledge that I (we) have read the application and agree -:hat if Curb and Gutter, and
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Paving, and/or Dedication of,right of way is required by the County of Riverside, the Riverside County Depar-,ment 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
' 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 occupied until I (we) have
complied with all laws of .the Countv of Riverside and the State of California governing said property. '
SIGNATURE OF OWNER AND/OR AGENT
DATE o! ---—
Approval by Signature from the Following Departments Liste elow
Must Be Obtained Prior to the Issuing of a Construction P rmit.
I SPACE NO.
/ rr✓�3
1 USE OF STRUCTURE
JOB ADDRESS .— 1 �—t
SINGLE FAMILY � DUPLEX I—II
H
LEG DESCRIPTION OF PR — APARTMENTS AGRIC. [J
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/:-—/�C L_�YOMMERCIAL INDUSTRIAL
to Q
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GCOMMUNITY.
ALTERATIO S J
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NO. OF SUBMITTED PLANS — USE OF PE MIT t -
Fr
j
CASE NO.
C Z
NO. OF P KING PACES REQUIRED _— —_ NO. OF BUILDINGS NOW EXISTING
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ZON ETBACKS: FRONT SIDE REAR
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GRAD ING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE
SETBACK ORDINANCE # OF FEET REQUIRED ON STREET
DATE �_� ' G SIGNATURE OF LAND USE OFFICIO
DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET___
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CURB AND GUTTER REQUIRED: YES ❑ NO ❑ - STREET
d
CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑
HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET
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IMPROVEMENT? YES ❑ NO ❑
O
ce
DATE _ SIGNATURE OF ROAD DEPT. OFFICIAL
=
SWIMMING POOLS PUBLIC
QW
SEWAGE DISPOSAL
us Q
FOOD ESTABLISHMENT
WATER POLLUTION REMARKS
H FLOOD CONTROL
t—
W AIR POLLUTION
W
S f. DIV OF HWY
c a — YOUR PROPERTY MAY BE SUBJECT TO
o.
Lu FLOOD. RIVERSIDE COUNTY ASSUMES
NO RESPONSIBILITY IN EVENT OF FLOOD:
284 199A 9/74
CAtJARY—FILE, PINK—APPLICANT