387231 (BLCK)BUILDING PERMIT
PERMIT NO. DEPARTMENT OF BUILDING & SAFETY MIT,
3872.3 1 1COUNTY OF RIVERSIDE FIELD
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. @ $
UNITS
Zip
2ND. FL. SQ. FT. @
YARD SPKLR SYSTEM
POR. SQ. FT. @
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. @
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT. @
F.C.C.
DRAINAGE PIPING
WALL SQ. FT. @
Cop $
DRINKING FOUNTAIN
SQ. FT. @
Parcel No.
URINAL
ESTIMATED. CONSTRUCTION VALUATION $
Pio.
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 $
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
Plan No.
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 s
Address '""�`�t City Zip
SQ. FT. @ c
WATER HEATER
$
SQ. FT. RESID @1'/.0
SEWAGE DISPOSAL
/- I
SQ. FT. GAR @ '/. c
HOUSE SEWER
Zip
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL.
TOTAL FEES
MOB. HM. FEE
MICRO FEE
MECH. FEE` t PL. CK. FEE
CONST. FEE t ELECT. FEE
7
SMI FEE
FEE PLUMB. FEE
Contractor
Tel._
License#
Trees required
Sewage System
PERMIT NO.
387 231 �
Job Address
s `
�.�_'
Space
Zip
Owner
Community
-
Valuation
$
Date
�- M
Dist.
Off.•
F.C.C.
MH.Permit Fee $
Micro Film Fee
Cop $
Use of Permi '
tyA7,• J•....0 l.'i.J G�
Parcel No.
se/Case
Pio.
Ck. By
Mech. Fee Dbl $
PI. Ck. Fee $
e Backs
F S
Zone Restrictions
112 1
S R
Group
/ I /)
Lot Size
Type .
. •�
Construction Fee Dbl $ -
Legal Description
g /�
L. / 7 ,d3 L�� �,,..���`,�
Electrical Fee Dbl $
SMI Fee $
Plumbing Fee
Dbl $
Bond Amt.
$-r
Plan No.
Plan Checker
Fina) Date
-; ��
Inspector
Unit
Sp. Insp. Fee $
Demol. Fee
$
Const. Lender
Branch
Supplimental Per it Numbers
J
Regisir. Fee $
Mileage Fee $
Address '""�`�t City Zip
Witness Fee 1 1$4-
Reinsp. Fee
$
Owney//Agent
,
/- I
Tel.
Zip
Tocol Fees
$
��
Address
)
,..q (.!"
City _
/ _
�. !"0
Zip
�/•
M.O. N.C. Cash Check
Received by
Contractor
Tel._
License#
Trees required
Sewage System
Address
City
Zip
T LL P
`Sewer District
Form 284-208 Rev.8/78) (0s
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by:
FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. % `A4
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. I
I 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
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System ,.
2
Figs 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. Clearance
7
Framing �/ �J
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.O. ❑
NO
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Botts)
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
r
Y
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
r
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- CANARY—FILE, PINK—APPLICANT
Owner Architect -- _ Contracto �V_e_nS —
Q
Add leQK----
Address —_—_ Address___ resjjsn
City
City
Phone
Phone
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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 Depadment 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 I_ 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 with all laws of 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.
S e� I SPACE NO.
3 J I USE OF STRUCTURE
JOB ADDRESS- _ SINGLE FAMILYA DUPLEX
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F
LEGAL DESCRIPTION OF PROPERTY ��
^ -7 —-- APARTMENTS AGRIC.
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. COMMERCIAL � INDUSTRIAL L,
ALTERATIONS
COMMUNITYPERMIT
U�SEtZ�
NO. OF SUBMITTED PLANS �/ �< %Q n
H Q
CASE NO.
-- --
Z
NO. OF ARKING SPACES REQUIRED - NO. OF BUILDINGS NOW EXAM
Q
ZONE''ETBACKS: FRONT SIDE REAR
J m
GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE
SETBACK 0 DINANCE OF FEET REQUIRED ON STREET
DATE _ SIGNATURE OF LAND USE OFFICI -
DEDICATION REQUIRED: ES ❑ NO ❑ NO. OF FEET--
W
CURB AND GUTTER REQUIRED: YES E3 NO ❑ —STREET
cc
oe
a
CAN CURB AND GUTTER FEASIBLY BE INSTALLED?. YES ❑ NO ❑
W
HAS AN ACCEPTABLE APPLICATION BEEN, MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET
OIMPROVEMENT?
YES ❑ NO ❑
°L
DATE SIGNATURE OF ROAD DEPT. OFFICIAL
=
SWIMMING POOLS PUBLIC
QW
SEWAGE DISPOSAL
au
FOOD ESTABLISHMENT 1
WATER POLLUTION REMARKS
vt FLOOD CONTROL
F=
Z AIR POLLUTION
� W -
= F DIV OF HWY t'
c a - YOUR PROPERTY MAY BE SUBJECT TO
c FLOOD. RIVERSIDE COUNTY ASSUMES
. NO RESPONS;BILITY IN EVENT OF FLOOD.
284 199A 9/74- CANARY—FILE, PINK—APPLICANT