391550 (PLBG)PERMIT NO. LPCrAKIMCNI Vr DW1LNIIgV OL
91550'COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
$
UNITS
Valuation
$-
IST FL. SQ. FT. @
Di t.%
1
Off.
2ND. FL. SQ. FT. @
MH.Permit Fee $
YARD SPKLR SYSTEM
Use of Permit-Parcel
(1)"C' "'�('� \ ��(„ S {
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. @
Mech. Fee Dbl $
PI. Cki Fee $
GAR. SQ. FT. @
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT. @
S S
_
DRAINAGE PIPING
WALL _ SQ. FT. @
Zone Rest(r(X�ions /
•�"' 1
DRINKING FOUNTAIN
Type
SMI Fee $
URINAL
SQ. FT. @
Plan No.
Plan Checker `.^�3
•+
ESTIMATED CONSTRUCTION VALUATION $
Inspe
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
Tel. Zip
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
Address _
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
d•�EATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. @ t
BATH TUB
SQ. FT. @ c
WATER HEATER
SQ. FT. RESID @I'V.c
SEWAGE DISPOSAL
S0. FT. GAR @ s/. c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL.
TO A�. F
MOB.HM.FEE
MICRO FEE
MECH. FEE PL. CK. FEE
CONST. FEE ELECT. FEE
SMI FEE
FEE PI,U B FEE
1PERMIT NO.
39155 Q '.
-
-
Job AddressSpace
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Zi Own
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Co t
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Valuation
$-
IDyf ,�^�.
Di t.%
1
Off.
F.C.C.
MH.Permit Fee $
Micro Film Fee Cop $
Use of Permit-Parcel
(1)"C' "'�('� \ ��(„ S {
No. / /'� /
/ '� 2-t` , i✓(�
Use/Case No.
r
Ck. By
r.
Mech. Fee Dbl $
PI. Cki Fee $
Set Backs
Lot Size,
Construction Fee Dbl $
Legal Description e.p,M
°
Vn
W ��...�.�
S S
_
R
Electrical Fee Dbl $
Zone Rest(r(X�ions /
•�"' 1
Group
Type
SMI Fee $
Plumbing Fee Dbl $
Bond Amt.
y'
Plan No.
Plan Checker `.^�3
•+
Final Dote
Inspe
Unit
Sp. Insp. Fee $
Demol. Fee $
Const. Lender Branch
%Supplimental Permit Numbers
t
Registr. Fee $
Mileage Fee $
Address City:.' - Zip
• 4'"'4!-„
Witness Fee $'
Reinsp. Fee $
Owner/Agent
Tel. Zip
Total Fees §
Address _
City Zip
M.O. N.C. Ashn Chec
Received by
Con -c or a t' w- 'yam 4•- -
7e� /
License,#
Trees required
Sewage System t
Add c
Ste'
it Z.p�
.
�b r�
T LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 D,&. CESSATION OF WORK verified by:
Sewer District FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
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. t
(016>1 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.
Form 284-208 (Rev.8/78) P s
A
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS '
1
Set Back
33 Ventilation System
2
Ftgs 8 Frms
34 Plenums 6 Ducts J
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. ❑
43 Final
10A
Fireplace T.O. Q
OP'N I
NO.
ADDITIONAL INFORMATION
y
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 4-
23 Water Service
24 Gas Test
25
Final �o
Tank Pit L.Line
REAR OF PROPERTY LINE '
ELECTRICAL APPROVALS
PSL
� G
(J'
% l0
/-7 / P)
0.T-
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
• N6. -
'IV Weighmaster's Certificate of -Weight.and Measure
t THIS IS TO CERTIFY that the 1,11owing described merchandise was wei9hed, measured or counted by a private weighmaster,
tl his signature is a Tec g;,imtl auttanity of accrrraey as prescribed by Chapter 7.3 (commencing with Section 12740) of
_ Divi , 5 of. the Cof tunia Rus nm and Professions Code, administered: by the'Division of Measurement Standards of the L
ift Depelment of Food and A96alture of the State. of California.
THOUSAND PALMS READY .MIXXORP. ''1'
P.O. BOX 221 •.. THOUSAND PALMS, CALIF. 92276 . PHONE (714)'343-341.1
WEIGHED AT: 72475 VARNER RD. • THOUSAND PALMS, CALIF. 92276
•
OR DER NO.JOt9 NO. ITEM DATE ..` �� `• •� �+
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SOLO TO
• CUSTOMER CODE
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MAILING AOORESS
r"
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r`T
Free Unloading Time: A maximum of 5 minutes p�r yard for Ready'Mix-or a maximum of 15'minutes'
per load ,for' dry material. ADDITIONAL unloadinTp+time will be -:charged at current"prevailing rates:
Claims for. credit or adjustments must be accompanied.by delivery tickets and"made within .5 -days. AW
bills payable net 10th of month following month of delivery. We are not responsible for sidewalks, curbs,
• or other property -when delivery•is requested on premises.
'`GENERAL CO NTRACTOR LENDER, • •ZONE
t• •
I nR'An nR F6$ ! '`
OWNER '
, •Ir
.
Weight" .
�.
Load
No. .
DISCOUNT. IAF'
Gross Lbs.
x
-
_
.
PAID BY:1'OTH
'
Tare
Delivered
By
+
Truck No. k _.
Net
t PROX"
-
•
:
Truck License No.,
_ r
PREVIOUS CU. YDS:•
PREVIOUS
? •
0
Trailer License•No.-
Lbs. Cement
Y
"
~.
".
COMMODITY
Lbs. Sande
CU. YDS. THIS TICKET
• %
PALMS READY
THOUSAND
P
Lbs. -.Rock
MIX CORP.
PRIVATE.WEIGH MASTER
TOTAL CU: YDS. ;
Lbs. Rock'
!•
Water Added,
'At Plant -Ga L,
,_
•, ,•.
gy_ ..••J!
'
Water Added `
�a,,.
., + .
DEPUTY
.,At Job -Gal.
"•"�"
YARDS- •CLASS -
Ready-Mix/Other
PRICE
AMOUNT.
Mixer Drum Revolutions
Plant + • Job Discharge
�. ..
Rocks. -N:.-;;Tons
Sand " Tons
Tons*
-
r
!LeffArrive
Minimum Load Charge -Yds. Tons
Start
Plant ,•rM
Job M
Pour • M
Finish
Left f
Return
Pour M
Job jvl
Plant M
I w
Delay Time Hrs. Rate Per Hr.
J•:
Remarks
r"
SALES TAX
Rec'd..
NOTICE: THIS IS NOT A BUILDING PERMIT / lr
DISTRICT
APPLICATION TO CONSTRUCT Permit No It
DEPARTMENT OF BUILDING AND SAFETY
+»...- COUNTY OF RIVERSIDE
199 9/74
CANARY—FIL+E, ,PINK—APPLICANT
Owner Architect Contractor-
ontractorAddress
AddressAddress Address- IAVI�0 "tJ-
/ fiJjf�Ss��
�rr.LLa.<'.
City ,/�- City City_
Phone _�,2 � Phone Phone `~'�G _411_ , -A
01W
I (we) the undersigned, hereby certify and acknowledge that I (we) have read the application and agree that if Curb and Gutter, and
Z
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 wi hin 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 1 (we) have
complied with all laws of the County of Riverside and the State of California governing said property. �. /7
l
'- -ri .y� t
DATE t�j SIGNATURE OF OWNER AND/OR AGENTT�� `
i
Approval by Signature from the Following Departments Listed Below
Must Be Obtained Prior to the Issuing of a Construction Permit.
SPACE NO.
I
USE OF STRUCTURE
.
JOB ADDRESS vvwry" -
SINGLE FAMILY �� DLPLEX
Z
®�
L AL DES IPTION Q� PROPERTY "' "a -
�f
APARTMENTS 0 AGRIC. []
Q
COMMERCIAL Ej INDUSTRIAL n
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COMMUNITY
AALTERATIONS
Z
❑
NO. OF SUBMITTED PLANS - _
USE OF PERMIT
A
CASE NO.
_. Y
M Z
_
NO. OF P IRKING SPACES REQUIRED NO OF BUILDINGS NOW EXISTING
j
4
ZONESETBACKS: FRONT SIDE REAR
.J
ado
GRADING PERMIT REQUIRED? YES `j NO ❑ LOT SIZE
SETBACK ORDINANCE I1 __— OF FEET REQUIRED ON /rte STREET
DATE SIGNATURE OF LAND USE OFFICIAL
DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET__
CURB AND GUTTER REQUIRED: YES ❑ NO ❑ STREET
of
CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑' NO ❑
HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET
'•O
C
IMPROVEMENT? YES ❑ NO ❑
°L
DATE _ SIGNAT,URE OF ROAD DEPT. OFFICIAL-
W
SEWAGE DISPOSAL )"il 774,41< Ci
r
FOSS T A J - %� r S�.�i4 -oOi%-
1 71a I Sr _14 �Gl ,t..41/
WATER POLLUTION REMARKS
FLOOD CONTROL
AIR POLLUTION
DIV OF HWY
0 - YOUR PROPERTY MAYBE SUBJECT TO
0
c FLOOD. RIVERSIDE COUN-Y ASSUMES
NO RESPONSIBILITY IN EV=NT OF FLOOD,;