368769 (BLCK)BUILDING PERMIT. ,
PERMIT NO. DEPARTMENT OF BUILDING & SAFETY
3 6 8 7 6 COUNTY OF RIVERSIDE
FIELDDs-1T
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CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL.
2ND. FL.
FOR.
GAR.
CAR P.
WALL "'
SQ. FT. @ $
UNITS ,
Owner
SQ. FT. @
YARD SPKLR SYSTEM
MOBILEHOME SVC.
SQ. FT. @
BAR SINK
POWER OUTLET
SQ. FT. @
ROOF DRAINS
SQ. FT. @
DRAINAGE PIPING
SQ. FT. @
DRINKING FOUNTAIN
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $
Use i5f Per it•
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URINAL
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
Dbl $
Dbl $
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
a PL A,
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
BATH TUB
Inspect
SQ. FT. @ c
WATER HEATER
Sp. Insp. Fee $
SQ. FT. RESID @1'/.c
SEWAGE DISPOSAL
SQ. FT. GAR @ s/. c
HOUSE SEWER
Branch
Supplime Irmit Numbers
10
_
v GAS PIPING
PERMIT FEE
Address City Zip
PERMIT FEE
PERMIT FEE r
DBL.
TOTAL FEES
MOB. HM. FEE
.MICRO FEE
MECH. FEE PL. CK. FEE
FCONST. FEE ELECT. FEE
SMI FEE
FEE PLUMB. FEE
PERMIT NO.
368769
Job Address
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Space
Zip
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Owner
Communi
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20
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Date (—^1347 ~�
rye. . ..x
F.C.C.
MH.Permit Fee $
Micro Film Fee
Cop $
Use i5f Per it•
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arcel No.
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se/Cas o.
Ck. By
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Mech. Fee Dbl $
PI. Ck. Fee$
'S�rEdcks
Lot Size
Construction Fee
Electrical Fee
Dbl $
Dbl $
Legal Description
a PL A,
F S
5 R
Zone Restrictions Group
Type
SMI Fee E
Plumbing Fee
Dbl $
Bond Amt.
$
Plan No.
Plan Checker .,-
Final Date
y/•'
Inspect
Unit
Sp. Insp. Fee $
Demol. Fee
$
Const. Lender
Branch
Supplime Irmit Numbers
10
_
.Registr. Fee $
Mileage Fee $
Address City Zip
Witness Fee $
Reinsp. Fee
$
Owner/Agent
/ //'
Tel.
_
Zip
Total Fees
M.O.
$ -
N.C. Cash Check
Ad —re —ss `..`
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City "� '
Zip
Received by
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CantrVctor
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Trees required
Sewage System
Address
r
,
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.
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I HEREBY AGREE THAT ALL WORK IN CONNECTION WIT IAUIN ACCORDANCE WITH
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF COR IA.
' I ) HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
Form 284-208 (Rev. B/78)
ACCORDANCE WItH � SECTION 5541 OF THE BUSINESS -AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
'-
verified by:
NO.
�— OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back Z(J-7
33
Ventilation System
2
Figs & Frms _,W -79
34
Plenums & Ducts
2A
Slab Grade
35
Furnace Comport.
3
Steel :Zd X79
36
Inlets 8 Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beams �. /j '�
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. a
43
Final
10A
Fireplace T.O.
No
ADDITIONAL INFORMATION
-
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A I Drywall
13 Finish Grade
jI
INSULATION Thick
I
R
Value
7A Walls (Batts)
12B Ceiling (Botts)
0C Ceiling (Blown)
14 Final
_P1UMB.I-N.G. 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
1
P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
NOTICE: THIS IS NOT A BUILDING PERMIT
DISTRICT �L
APPLICATION TO CONSTRUCT Permit N-3—
DEPARTMENT
uDEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
284 199A 9/74 CANARY—FILE, PINK—APPLICANT
Owne, effjCHd9 LldL Architect_.— _. __—_ Contractor— Q
Addres "oAddress___ Address — ---
City _ City-- City__ --- —
Phone Phone _ Phone— -- —.---
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I (we) the undersigned, hereby certify and acknowledge that. I (we) have read the application and agree that 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 De"�artment 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 tc be done within the County R/W
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without an encroachment permit.
NOW, therefore, it is agreed that I (we) will not occupy said property and will not cause said property -o be occupied until I (we) have
complied withall laws of the County of Riverside and the State of California, governing said property.
2
DATE —�__� __ SIGNATURE OF OWNER AND/OR AGENTPermit.
Approval by Signature from the Following Departments Listow
Must Be Obtained Prior to the Issuing of a Construction
I SPACE NO.
USE OF STRUCTURE
_
JOB ADDRESS 4661k U
SINGLE FAMIL" DUPLEX ❑
LEG DESCRIPTION O; 'R/OPPERTY - APARTMENTS E]AGRIC. El
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COMMERCIAL ❑ INDUSTRIAL ❑
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COMMUNITY ALTERATIONS ❑
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NO. OF SUBMITTED PLANS — USE OF PERMIT
jCASE
NO.
O Z
NO. OFP KING SPACES REQUIRED NO. OF BUILDINGS NOW EXISTING
Q
ZONE ETBA(fKS: FRONT SIDE REAR
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GRA ING PERMIT REQUIRED? YES ❑• NO ❑ LOT SIZE
SETBACK 0 DINANCE # OF FEET REQUIRED ON ET
DATES SIGNATURE OF LAND USE OFFICIAL -
DEDICATION REQUIRED: YES ❑ NO ❑, NO. OF FEET__
W
CURB AND GUTTER REQUIRED: YES ❑ NO ❑ STREET
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CAN.CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑
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HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET
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IMPROVEMENT? YES ❑ NO ❑
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DATE SIGNATURE OF ROAD DEPT. OFFICIAI
S
SWIMMING POOLS PUBLIC
QW
SEWAGE DISPOSAL
_
FOOD ESTABLISHMENT
WATER POLLUTION REMARKS
H FLOOD CONTROL
t -
Z AIR POLLUTION
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_DIV OF HWY
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c a — YOUR PROPERTY MiNY BE SUBJECT TO
a
c FLOOD. RIVERSIDE COUNTY ASSUMES
NO RESPONSIBILITY IN EVENT OF FLOOD.
284 199A 9/74 CANARY—FILE, PINK—APPLICANT