00018126 GradingPERMIT, APPLICATION
County of
Riverside
Department of Building
and Safety
• 4080 Lemon St. 2nd From, 135 N. Alessandro Rd. Rm. 203 880 N. State Street
227 North "0' Street 46.209' -Oasis St. Rm. 310 160 N. Broadway
R!"'side, CA 92501 Banning, CA 92220 Hemet. CA 92343
Perris. CA 92370 India. CA 92201 Blythe. CA 92225
Ph: 787.6146 Ph: 849-7312 - 1ti Ph:, 6584464'
Ph: 657.3898 Ph: 342.8274 Ph: 922.2670
This permit becomes void it work not commenced within 180'days from omanci. 06. it waili'lias beer Suspended spendeddr
date of
a afdoneq fdr a period of 180 days.
S
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be cont,
LICENSED CONTRACTORS DECLARATION: I hereby affirm that barn lic ensed under provisions of Chapter 9 commenc-
pleled it. the permit is for one hundred ($100) or less. I certify that in the performance of the work for which .this
permit is issued. I shall not employ any,person in any manner so as to become subject to the Workers' Compensa-
Ing withSeclion:7000i of Division 3 of the Business and Professions Code, and my license is infull lorce and effect.
tion Laws of California. I
r
FJ
Date Applicant
OWNER-BUILDER DECLARATION: I hereby affirm that I am exempt Irom the'Conarktor's License Law for the
NOTICE TO APPLICANT: It, after makingthis Certificate of Exemption, you should become subject to the Workers'
Compensation provisions of The Labor Code:. you must forthwith comply with such provisions or this permit shall be
follo,king reason (Sec 7031�.5; Business and Professions Code: Any city or county -which requires a permitto con-
deemed revoked.
Mrucf. alter, improve, demolish, or repair any structure, prior to its issuance, also requires The applicant or such
CITY/COMMUNITYISTATEIZIP
permit to.file p signed statement that he is licensed pursuant to the provisions of the Contractor's License Law.
DIVISION OF INDUSTRIAL SAFETY PERMITCERTIFICATION:
(Chapter 9 (commencing with Section 7000) of Division'3 of We Business and Professions Code) or That he is ex-
01 hereby certify that no . excavation live (5) . or more.leet in depth'into which a person is required to descend, will
empt therefrom and the basis for the alleged exemption. Any yiolationof Section 7031.5 by any applicant for a per -
mit subjects the applicant to a civil penalty of not more than live hunderd dollars ($500).):,
be made in connection with work authorized by this permit. and that no building structure, scaffolding, talsework.
CITY/COMMUNITY/STATE/ZIP
or demolition or dismantling thereol. will be more Than thirty-six (36) feet high. (Chap. 3.2. Grp 2. Art 2. Sec 341,
0 1, as owner of the property, or my employies with wages as their sole 6orripensation. will do the work, and the
Title B. C.A.C.).
structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License
C3 As owner -builder, I will not employ anyone to do work which would require a permit from the Division of In -
Law does' not apply to an owner of property who builds or improves Thereon. and who does such work himself or
du5trial: Safely. as noted above. unless such person has a permit to do such work from The division.
Through his own employees, provided that such improvements are not intended or offered for sale. It* however
SSB
QQ 7-1
the building or improvement is sold within one year of complelion,'Ihe owner -builder will have the burden of prow :
C]Oivisiori of industrial Safely Permit No.
,ing that he did not build or improve for the purpose of, sale.)
Ell, as owner of the property, am exclusively contracting. with licensed,conlraclors to construct the project (Sic.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the perfor-
7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who
mance of the work for which this permit is issued (Sec. 3097. Civ. C.).
builds or improves thereon, and who contracts Tor such projects with a contractor(s) licensed,pursuanl to the Con-
Lender's .Namd-
tractor's License Law.)
Lender's Address
[DI am exempt under Sec. B.& P.C. (Attach Certificate).
Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state
—Owner
that th6* information given is correct. I agree to comply with all slate laws and county ordinances relating to
WORKERS' COMPENSATION DECLARATION: I hereby.allirm that I have a certificate of consent to -self -insure, or a
building construction, and authorize a representative of the County of Riverside. Department of Building and Safely
to enter uf�Sn$*propefly for which I have applied for this permit lot the purpose of makingjnspections.
certificate of Workers Compensation Insurance, or a certified copy Thereof (Sec. 3800, Lab. C.).
C)Certilled is hereby lurnished.
X
copy
Ocerlified copy is filed with the County Building Inspection Department or County Department.
Signature of Applicant or Agent Dale
Print Applicam/AgetNam,
APPLICANT. NAME (L, F, MI)
.A
E RAM TREZ
CITY/COMMUNITY/STATEIZIP
LrA- "GUXNTA -CA. '02253.0 0 0 6
,JOB SITE ADDRESS/SPACE "-
-5412,5 AVE RAMIREZ,
CITY/COMMUNITYISTATEIZIP
LA QUINTA CA 922530000'
BOKPR
'74
I PAG'
211
C;
010
C;
5
TWN
RNG
a, a 0
SE
.010
S
TRACT LOTM
A 0:0,0 o a 1-00,66.1
Do
01
I1
SB
I
,TRACT NAME
CV. LA Q-6,24, DLK-2'85
OWNER NAME LF MI)
:HORM, DAN" -
PHONE#
CONTRACTOR -FIRM NAME
LICNC If
ADDRESS
CITY/COMMUNITYISTATEIZIP
PHONE#
BL INSPECTOR
FINAL DATE
ARC/ENG FIRM NAME
LICNC 0
ADDRESS
CITY/COMMUNITY/STATE/ZIP
PLAN If 07�
N IN ER
F-
APPRO E DATE:`
USE OF PERMIT
GRADING
.BL
ZON
FSIII
1.1 SSB.
SSB
QQ 7-1
RSB
020-l'.
IJND-1:'
OFC
ZONE ORD#
LOT SZEND
SIDE
APPLIPPIMT I H
0 . 6.01 S 12 6
r*1,RA1)!NGr:-P.-LAN
S� DATE 34741
60 05/11/(42
.,R�WIEW FE' $10.00
TOTAL
FEE
$1 U ex
'CA'1-TER
---TNc
COUNT R
COUNTER L.U.T.
FOR"
-0A
ST -IS Q1
f La rte, V CLG'YDS,�;'Cuti .-6-8 BVI�Z as
Co arid. Filld-dl
Ge.ading'.''Plary R,Ovi .9 _'.0WA baqpd b
FORM 284208n1 EI) _,INSPECTOR
Moved: TO&
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs 8 Frms
34
Plenums & 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
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. E]
No
ADDITIONAL INFORMATION
-
SEWAGE SYSTEM SIZE & LOCATION
)I Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION
rThd Value '
7A Walls (Batts)
12B 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
ELECTRICAL APPROVALS
PSL
P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32. Final
STREET NAME
APPLICANT NAME:(L, F MI)
164
9, ..Avr_-*AHiRE7.-
i C!TYICOMMUNITYISTATE/ZIP
JOB SITE
5,4125' AW XAM Rt E27-
CITY/COMMUNITYISTATEIZIP
�LVIQINT4- ON. -924.530 .0-0.,..
j3OK
.,7 741]
�G
P�It
`2
PRC•
C
1
TWN
RNG.�,
SE
S.
TRACT LOT
�o olo Q,0 aaa
Mo.
1
S,
-TRACT NAME
OWNER NAME
,`HORN-�(L,F; -34N. PHON . E $1
'CONTRACTOR.
FIRM NAME LICNC #
ADDRESS
-PITYICOMMUNITY/STATE/ZIP
PRONE*# 7-77-7FNSPECTOR
FINAL DATE
ARC/ENG FIRM NAME
LICNC #,
ADDRESS
CITYICOMMUNITYISTATE/ZIP
PLAN #PLANS
j
EXAMINER
APPROVE DATE.
USE OF PERMIT-�."
VM Roplwc
IBL,
ZON
FSB
I .SSB f
SSB.,'"RS77-
777
77
ZONE ORD
'LOT SZ
-:END'
`-SIDE.
0 H L Y.
FORM , 284;208 01-8% INSPECTOR
o-
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE 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
40
Fire Damper '
8
Vents
41
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L. E]
43
Final
10A
Fireplace T. 0. C3
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 (Botts)
12C Ceiling (Blown)
14 1 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
Flnal', •' - .••� -
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
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
3 . '". ...... .. .. .. PERMIT APPLICATION
County of. Riverside-
;�
Department of 8*uilding
and Safety
4080 Lemon SI. 2nd Floor 135 N. Alessandro Rd. Rm. zo 11 880 N. Slate Street
227 North "D" Street 46.209 Oasis SI. Rm. 310 160 N. Broadway
Riverside. CA 92501 Banning, CA 92220 +�� Hemet. CA 92343-
Perris. CA 92370 Indio. CA 92201 Blythe. CA 92225
Ph: 787.6146 Ph: 849.7312 Ph: 658.4464
Ph: 657.3898 Ph: 342.8271 Ph: 9222670
L
This permit becomes void it work not commenced within 180 days from date otoissuance. OR. it work has beer 4uspendefd
of abandoned lot a period of 180 days.
0EQ
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be com-
LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commenc-
pleted if the permit is for one hundred ($100) or less. -1 certify that in the performance of the work for which this
ing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and ellect.
permit is issued, I shall not employ any person in any manner so as to become subjecl to the Workers' Compensa-
SB
tion Laws of California.
❑
Date Applicant
PHONEJI
NOTICE TO APPLICANT: It. after making this Certificate of Exemption, you should become subject to the Workers''
OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law for the
Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be�
following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to con-
deemed revoked.
. struct. alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such
FINAL DATE
permit to file a signed statement that he is licensed pursuant 10 the provisions of the Contractor's License Law
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
(Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is ez-
❑I hereby certify -
excavation five (5) or more feet in depth into which person is to descend, will
empt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a per-
made in connection with w
do with ed by This permit. and that n ,
building structure. scaffolding,
scaffolding,
mil subjects the applicant to a civil penalty of not more than five hunderd dollars ($500).):
.
or enol. will
or demolition or dismantling Ihereal. will De more than thirty-six (36) feet high. (Chap. 3.2. Grp 2. Arl 2. Sec 341,
feet . Sec 41,
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the
,
Title 8. C.A.C. ).
structure is not intended or offered for sale (Sec. 7044. Business and Prolessions Code: The Contractor's License
❑ As owner -builder. I will not employ anyone to do work which would require a permit Irom the Division of In -
Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or
dustrial Safety. as noted above. unless such person has a permit to do such work from the division.
through his own employees, provided that such improvements are not intended or offered for sale. If, however,
[]Division Industrial Safety Permit No.
the building or improvement Is sold within one year of completion, the owner -builder will have the burden of prov-
of
Ing that he did not build or Improve lot the purpose of sale.)
❑l, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractor's License Law does not apply t0 an owner of property who
builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Con-
tractor's License Law.)
❑I am exempt under Sec. . B.& P.C. (Attach Certilicate).
Date Owner
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure, or a
certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800. Lab. C.).
❑Certilied copy is hereby furnished.
❑Certified copy is filed with the County Building Inspection Department or County Department.
APPLICANT NAME (L, F; MI)
HORN, DAN
x°37125 AVE RAMIREZ
{t��/f� Grp h.�yriH
L.1111 OIN�. AT1T�IZIP CA 922530000
����jSIaE��1Q�,-JRES(S�ISPA��C;;E AVEjR A M I R.w Z
6i p�'t 7:n929530000
1TWONU��1'�Tf�T_FIZIP ' �6
{r
jVC1
9�4
P -2.A i
.
C
TWN
V � i1
0EQ
S
T6A61 0 0 0 VT{7j
Q F7
M 1C
SB
�f1.411
'VATA 0 '026, SLK -2135
effl,l (L•bmAN
PHONEJI
CONTRACTOR -FIRM NAME
LICNC p
ADDRESS
CITYICOM M UNITYISTATE/ZI P
PHONE 7
BLDG. INSPECTOR
FINAL DATE
ARCIENG FIRM NAME
LICNC If
ADDRESS
CITYICOMMUN ITYISTATEIZI P "
PLA N d
PLANS EXAMINER
APPROVE DATE
St4O7N
WV
VF ,"h
V ot, l :nS411y
V_1 ,
• ZONEORDq
LOT SZ
0640o
0d%
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency lot the,perfor-:
mance of the work for which this permit is issued (Sec. 3097. Civ. C.).
Lender's Name _
Lender's Address
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certily I have read this application and state
that the information given is correct. I agree to comply with all state laws and county ordinances relating to
building construction, and authorize a representative of the County of Riverside. Department of Building and Safety
to enter upon the property for which I have applied for this permit lot the purpose of making inspections.
i
Signature of Applicant or Agent Date
- Print Applicant/Agent Name
V IS•if- 15:7 :t? i 06 ovinl/b2
GRADING PERMIT PEE
2 7 0 41:.
MICRUFXLM PEE
�f1.411
TOTAL
FEE
CA
CKur
NC
I COUNT Ef7 B.J
COUNTER L.U.T.
5 270
'DOTAL PERMIT COST , IS $15.4
0 of Lata: 0 CU YDS--Cu•t i 69 Fill i 40 Total Moved i tan
Certification RCE of � F�ertificaiion DaT t Pact: 0
ELEVATIONS IONS p Base: p Qr,c>+di
Grading Permij Fee (based an cubic yds fur and, Filled) ist $15.00
INSPECTOR
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS 'N
1
Set Back
33
Ventilation System
2
Ftgs & Frms
34
Plenums & Ducts
2A
Slab Grade
35
Furnace Comport.
3
Steel
36
r
Inlets & Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
39
Appl. Clearance
7
Framing
40
Fire'Domper
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 (Batts)
12B 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. h
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
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
PERMIT APPLICATION
'County of Riverside
Department of, Building and Safety
4080 Lemon St. 2nd Floor 135 N. Alessandro Rd. Rm. 203 880 N. Slate Street ..
, 227 North "D" Street 46.209 Oasis St. Am. 310. ,. . 160 N. Broadway
Riverside, CA 92501 Banning, CA 92220 Hemel. CA 92343.
,
Perris. CA 92370 - Indio. CA 92201 .Blythe. CA 92225
Ph: 787.6146 Ph: .849-7312 Ph: 6584464.
Ph: 657-3898 Ph:. 342.8271 Ph: 922.2670 + '
This permit becomes void it work not commenced within 180 days from date of issuance. OR, it work has beer suspended or abandoned Iof a period of 180 days. - l
-
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This.section need not be com-
LICENSED CONTRACTORS DECLARATION: 1 hereby affirm that I am licensed under provisions of Chapter 9 (comment -7
pleted it the permit is for one hundred ($100) Or less. I certify that in the performance Of the work for whin, this,
ing with Section 7000) of Division 3 of the Business and Professions Code, and my license. is in full lorce and effect.
permit is issued. I shall not employ any person in any manner so as to become subjei!!.to the Workers' Cornpensa-
tion Laws of California. .. ,
+
a -
Date Applicant -
0 6
NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should becokl. subject to the Workers'
OWNER -BUILDER DECLARATION: I hereby affirm that 1 am exempt from the Contractor's License Law for the
Compensation provisions of the Labor Code.. you must forlhwith.comply with such provisiollfs or this permit shall be
following reason (Sec. 7031.5, Business and Professions. Code: Any city or county.which requires a permit to con-
deemed revoked.
struct, alter, improve, demolish, or repair any structure, prior to its Issuance, also requires the applicant for such
PHONE N
permit. to file a signed statement that he is licensed pursuant to the proyisions,ol the Contractor's License -Law
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
(Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is ex-
_❑1 hereby certily that no excavation five (5) or more feet in depth into which a person is required to descend, will
empt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a per-
mit subjects the applicant to a civil of not more than five hunderd dollars ($500).):
be made in connection with work authorized by this permit. and that no building structure, scaffolding, falsework.
penalty
or demolition or -dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2. Arl 2: Sec 391,
❑ I. as owner of the property, Or my employees with wages as their sole compensation, will d0 the work, and the.
Title 8. C.A.C.).
structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License
❑ As owner- builder,I will not employ anyone to do work which would require a permit Irom the Division of In -
Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or
- dustrial Safety. as noted above.. unless such person has apermit to do such work from the division.
through his own employees, provided that such improvements are not intended or offered for sale. If, however,
- — .-
❑ Division Industrial Safety Permit No,
the building or -improvement Is sold within one year of completion, the owner -builder will have the burden of prdv-
; of _
-
ing that he did not build or improve for the purpose of sale.) • •
- - ,
❑I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the perfor-
7044. Business and Professions Code: The Contractor's License Law does not apply to an owner of property who
mance 0f the work for which this permit is issued (Sec. 3097. Civ. C.). ,
builds or improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the Con-
Lender's Name
tractor's License Law.)
Lender's Address
01 am exempt under Sec. - , BA P.C. (Attach Certificate).
0UP'S0 1
Date Owner "'
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:.I certify I have read this application and state
'
that the information given is correct. I agree to comply, with all state laws and county Ordinances relating to
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell -insure. ora
- building construction, and authorize a representative of the County of Riverside. Department of Building and Safety
tXenter upon the property for which I have applied for This permit for the purpose of making inspections:
certificateof Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800. Lab. C.).
❑Certified copy is hereby furnished.. - -
❑Certified copy is filed with the County Building Inspection Department or County Department.
Signature of Applicant or, Agent - Date
'
- Print Applicant/Agent Name
APPLICANT NAME (L• F. MI) I
� AN
ADDpRERy �Njp1�s /�, �9 A y �y � ryr -
t+�^13G..S. AVE �RAMIR52
�C�COMM�N111' tTEyIZIP ;CA 92253000-0
�'(_
;�14IJE(�WESSISPACE AVE 'RAMIREx •
CrITYCOMWN�1, I TgT iI21P .:
''CA4 �"92253.0 H V W
j�
7f4
P9Gl1
POSC
le
C
5
TWN.
Mo0
V0
S
TING 0 Q 0 LOT
ii}} VV V H
0 6
A��O1
u
SB
F
TMCT NAME '
SCV LA 0,02(2o DIX--285
190 E (L VAk
PHONE N
CONTRACTOR -FIRM NAME
LICNC M
ADDRESS - -
CITYICOMMUNITY/STATE/ZIP
t
PHONE p •BLDG.
INSPECTOR
FINAL DATE
ARC/ENG FIRM NAME '
LICNC 9
-ADDRESS -
CITY/COMMUNITY/STATE/ZIP
P�LvAE�N #
PIANS EXAMINER �
APPROVE DATE
�71� f'4d/ NG o
eb O
RN
0".2YO
0109 1
OVi
0210
1
ND
ZONEORDtl
LOT SZ
0UP'S0 1
+1Sub
APPUPRMTN - PS Q0 0 18126 F4, Fer-- DATE 27034. 7O3
r
TOTAL .
FEE
CA, CK NC COUNTER B.I. COUNTER L.U.T.
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE 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
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.
P'
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 FI al
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
PSL
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME