368897 (BLCK)BUILDING PERMIT
PERMIT NO. DEPARTMENT OF BUILDING & SAFETY FIELD
11
368897COUNTY OF RIVERSIDE +�/
Dsr
CONSTRUCTION
ESTIMATE
NO.- ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL.
2ND. FL.
POR.
SQ. FT. @ $
UNITS
MH.Permit Fee Is
SQ. FT. @
YARD SPKLR SYSTEM
SQ. FT. @ MOBILEHOME SVC.
BAR SINK
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @
POWER OUTLET
ROOF DRAINS
_
SQ. FT. @
DRAINAGE PIPING
SQ. FT. @'
DRINKING FOUNTAIN
Construction Fee Dbl $
URINAL
VALUATION $
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
Plan No.
GARBAGE DISPOSAL,
FURNACE UNIT WALL FLOOR SUSPENDED
Inspector
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
$
SQ. FT. @ c
WATER HEATER
S0. FT. RESID @ 1 t/. c
SEWAGE DISPOSAL
SQ. FT. GAR @ I/. c
HOUSE SEWER
Address
City
GAS PIPING
PERMIT FEE
Received by
PERMIT FEE
PERMIT FEE
DBL.
TOTAL FEES
Q.•o
MOB. HM. FEE
MICRO FEE
MECH. FEE PL. CK. FEE
I CONST. FEE ELECT. FEE
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SMI FEE
FEE PLUMB. FEE"
PERMIT NO.
.368897
Job Address
Community ' + ]Valuation
7 $
Space Zip
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Date
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Owner
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Dist. OFf.
F.C.C.
MH.Permit Fee Is
Micro Film Fee
Cop $
Use o Permit '
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C.: �✓�%'•
Parcel No.
Use/Case No.
Ck. By
Mech. Fee Dbl $
Pl. Ck. Fee $
ldt Size
Construction Fee Dbl $
Legal Description
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F S
5
R
Electrical Fee Dbl$
Zone.Restrictions
Group
Type
SMI Fee $
Plumbing Fee
Dbl $
Bond Amt.
$
Plan No.
Plan Checker
Final Datlee
Inspector
Unit
Sp. Insp. Fee $
Demol. Fee
$
Const. Lender Branch
Supplime ermit Numbers
i
Registr. Fee $
Mileage Fee $
Address City Zip
Witness Fee $
Reinsp. Fee
$
Owner/Agent - ,
-Tel.
Zip
Total Fees
M.O. N.C.
$
01
Cash Check
Address
City
Zip
Received by
Contractor"'"
Tel.
LicenseM
Trees required
Sewage System
Address �''r f7475e .-
City V.r
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T U. P THIS PERMIT SHALL B OME VOID IF WORK ISNOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK
Sewer District FOR 120 DAYS 5HL ALSO CAUSE PERMIT TO BECOME VOID.
=r I HEREBY �NNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH
THE LAWS V RSID OUNHE STATE OF CALIFORNIA.
I HEREBYrCERTIF,Y THAT THE INDIVIDUAL WHO PREPARf D THE PLANS AND SPECIFICATIONS HAS DONE SO IN
F ACCORDANCE WITH SECTION 5541 OF THE BUS'IILESS AND PROFESSIONS CODE OFJTHE'STATE OF CALIFORNIA.
1, Form 284.208 (Re,8/78)
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verified by:
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE 1 INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs 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 6 a,'
L.
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.O.
NO
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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 _ f
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
e
P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Banding
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 CANARY—FILE, PINK—APPLICANT
OwnerArchitec4— —. —_—_ Contractora� __, AAA --0 Addressio
City ' City-- Cityl�Af�.�_s�.c�� t
_ _
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 Department 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
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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 to be occupied until I (we) have
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complied with all laws ofthe County of Riverside and the State of California. governing said property.
DATE �l.Y- `-!--- 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.
v� � I USE OF STRU TURE -
JOB ADDRESS C� SINGLE FAMILY DUPLEX El
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LEG DESCRIP NOF PR ERTY - - APARTMENTS AGRIC.Lu �-
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COMMERCIAL E] INDUSTRIAL - LJ
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COMMUNITY ❑
ALTERATIONS
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NO. OF SUBMITTED PLANS — USE OF PERMIT
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CASE NO.
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NO. OF PA (ING ACES REQUIRED -- — NO. OF BUILDINGS NOW EXISTING
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ZONE SETBA(fKS: FRONT SIDE RFAR
GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE ,00
SETBACKORD NAI CE # OF FEET REQUIRED ON STREET
DATE—6 SIGNATURE OF LAND USE OFFICIAL
DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET —
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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. OFFICIAL
_
SWIMMING POOLS PUBLIC
W
SEWAGE DISPOSAL
Q
_
FOOD ESTABLISHMENT
WATER POLLUTION REMARKS
H FLOOD CONTROL
- t-
AIR POLLUTION
.W
W DIV OF HWY
c Q• YOUR PROPERTY MAY BE SUBJECT TO
_
c FLOOD. RIVERSIDE COUNTY ASSUMES
NO RESPONSIBILITY IN EVENT OF FLOOD.
284 199A 9/74 CANARY—FILE, PINK—APPLICANT