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385053, 378713 (SFD)BUILDING PERMIT PERMIT NO: 335.053 DEPARTMENT OF,BUILDING & SAFETY COUNTY OF RIVERSIDE CONSTRUCTION ESTIMA. 'NO. ELECTRICAL FEES IST FL SQ, FT. $ 2ND. FL. SQ: FT.. C PDR GAR. SQ, FT, . OR P. SQ. FT. Q WALL SQ: FT. SQ: FT. Q ESTIMATED CONSTRUCTION VALUATION ,�.. UNITS MOBILEHOME SVC. POWER OUTLET NOTE: Not to be used as property tax valuation SWIM POOL, PVT MECHANICAL FEES SWIM POOL, COMM VENT SYSTEM FAN EVAP. COOL HOOD SIGN APPLIANCE DRYER Ufp rt -Parcel .�.T. FURNACE UNIT .WALL FLOOR SUSPENDED' - jUse/CoseN6, AIR HANDLING UNIT CFM IDLE METER ABSORPTION; SYSTEM B.T.U. TEMP USE PERMIT SVC COMPRESSOR HP POLE;TEMP/PERM HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT BOILER B. T. SQ. FT. ®' C tR SQ. FT. @ C SMI Fee j 4A SO. FT. RESID @11/4 4: Bond Amt. SO.. FT. GAR @ i; c Plan - cke Final Date Inspector PERMIT FEE rDbE Sp, Insp. Fee PERMIT FEE DBL. TOTAL FEES_ MOB.HM.FEE MICRO FEE -- MECH. FEE PL CK. FEE Ir CONST. .FEE EL PERMIT NO: 13850S31 Job Address AD Space Zip Own w Com Wiry Volu no E Dist. Off. JRCC'' MH. Permit Fee Is Micro Film .Fee Cop j Ufp rt -Parcel .�.T. No. - Y jUse/CoseN6, Gk. By Mech. Fee Dbl j PI. Ck. Fee j See t'8ocks lot Size Construction Fee Dbl j Legril'Description � F S S Electrical Fee Dbi j Zone Restrictions. tR Typa SMI Fee j 4A Plumbing Fee Bond Amt. Plan No. Plan - cke Final Date Inspector Unit rDbE Sp, Insp. Fee Derhol. Fee $ Const. Lander Branch - Supplimemal Permit NumBbrs r Registr. Fee S Mlleoge Fee j 'Address _ City Zip Witness Fee j Reinap. Fee j Owner/Agent Tet. ..Zip 7olal.Fees ddress City Zip M.O. N.r—O Cash CheckA Received by Ile Co or �^„_ Tel. (/ 51-6 V City, Zip f License# Trees.required Sewage System I A as IT District Form 184208 (Rev.8/78) THIS PERMIT SHALL BECOME VOID IF WORK, NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. Rt I HEREBY AGREE THAT ALL WORK IN CONNECTION WITHrTHIS PERMIT-WILLBE DONE IN ACCORDANCE -WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. ~' THEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN RDANCE WITH SECTION 5341 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. verified. by: . _ _T PERMIT NO. 385053 DEPARTMENT OF BUILDING & SAFETY COUNTY OF RIVERSIDE FIELD DST Fj CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ,� x UNITS Owne 2ND. FL. SQ. FT. @ YARD SPKLR SYSTEM FOR. @, MOBILEHOME SVC. BAR SINK GAR.= t SQ FT = , POWER OUTLET ROOF DRAINS CAR P. SQ. FT. F.C.C. DRAINAGE PIPING WALL SQ. FT. @ $ DRINKING FOUNTAIN SQ FT ® .Parcel URINAL ESTIMATED. CONSTRUCTION VALUATION $ Ck. By 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 Zone,Restrictions GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED 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 Branch SQ. FT. @ C WATER HEATER SQ: FT.. RESID @ 1 V. L SEWAGE DISPOSAL Mileage Fee s SQ. FT. GAR @ % C HOUSE SEWER Reinsp. Fee _ Owner/Agent GAS PIPING PERMIT FEE Tel. PERMIT FEE PERMIT FEE DBL. ,TOTAL fE+5� MOB. HM. MICRO FEE MECH. FEE PL CK. FEE .ELECT. FEE -SMI FEE FEE, PLUMB. FEE Zip Received by e. Co ro o`r _ .CONST. Tel. y"'rw. 5, - ,License# PERMIT NO. 0 Job Address /+r Space Zip Owne Community s Valu s � Data _ Dist. Off. F.C.C. MH.Permit Fee { Micro Film Fee $ Use ofPePerrmfi - - .Parcel No. ,• Use/Case No. Ck. By Mach. Fee i _-"'� rDb PI. Ck. Fee $ Set Backs -' Lot Size Construction Fee = legal Descriptio.f r� 1 (i ( 's''" `� S - e- tl 1 - F ` ., S S w R Electrical Fee Dbl S Zone,Restrictions Group Ty SMI Fee = Plumbing Fee Dbl $ Bond Amt. $ Plan No. 'PI C c Final Do,a Inspector Unit Sp.. Insp.. Fee s Dental. Fee i Const: Lender Branch Supplime' E rmirNumbers / Registr. Fee i Mileage Fee s Address City Zip Witness Fee $ Reinsp. Fee _ Owner/Agent Tel. Zip Total Fees 'M.O.11N.C. C..hEl Ch.ckj@ ddress �-. y;, t City Zip Received by e. Co ro o`r _ Tel. y"'rw. 5, - ,License# - Trees required Sewage'System Sewage AdJ..;-- I City Zip k T LL P S4•CverDistrict Form 284!!,(Rev:8/78) ©s 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. 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 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. _ _ ..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 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. 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 22 Water Softener 23 Water Service 24 Gas Test 25 FinGassl Tank Pit LLine 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 PERMIT NO. DEPARTMENT OF BUILDING & SAFETY '387 ..1 `a •41 COUNTY OF RIVERSIDE O fA:2�r70'12 FIELD CONSTRUCTION ESTIMATE PERMITNO. 387813 MH.Permit Fee NO. ELECTRICAL FEES NO. PLUMBING FEES A T FL, SQ. FT. Mech. Fee Dbl $ UNITS j 2N k. ,, SQ. FT. @ Dbl j Electrical Fee Dbl j YARD SPKLR SYSTEM o SQ. FT. @ r FOR. � �`� s. n Plumbing Fee Dbl $ MOBILEHOME SVC. BAR SINK. 'POWER GAR. d. SQ. FT. @ '�' 20 OUTLET - ROOF DRAINS CAR P.SQ. FT. @ Witness Fee j. Reinso. Fee DRAINAGE PIPING WALL SQ, FT,. @DRINKING FOUNTAIN SQ FT @ URINAL ESTIMATE '4 VALUATION $ i WATER PIPING r+ NOTE: Not to be used as property tax valuation SWIM, POOL, PVT FLOOR DRAIN MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER VENT SYSTEM 2 FAN EVAP. COOL HOOD 0 SIGN +• WASHER (AUTO)(DISH) APPLIANCE DRYER .7 GARBAGE DISPOSAL n• �o FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM IDLE'METER KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC •i WATER CLOSET COMPRESSOR W HP0 POLE,TEMP/PERM LAVATORY a. -J HEATING SYSTEM FORCED GRAVITY 4,IL 12 AMPERES SERV ENT 7010 SHOWER BOILER B.T.U. SQ. FT. @ C BATH TUB SQ. FT. @ C WATER HEATER r E ; S0. FT. RESID @11/.0 f SEWAGE DISPOSAL S0. FT. GAR @ '/4 C HOUSE SEWER. GAS PIPING PERMIT FEE f PERMIT FEE r PERMIT FEE DBL TOTAL FEES _ MOB.HM:FEE MICRO FEE MECH. FEE PL. CK. FEE CONST. FEE ELE . FEE SMI FEE FEE PLUD7`B. Total Fees I$ M.O\ N:C: ,. Cast Received by ,Trees required Sewage System .Job Address AlhNIYA CORTEZ Community Valuation QUINTA j Use of Permit 'v1SiLING AND ATT. GARAGE /B Legal Description • OT 21 BLK 1256 SCVLQ 924 Bond Amt. Plan No. plan /S/decker/% rr Const. Lender Branch Address .. •�. --City Zip Sewer P �� 040 � Form 284208 (Rev.8/78) P Space.ZIP Owner L ^ Pti 2 Date Parcel Set Backs. Zone, Restrictions Gr r, Finol,Dote Inspector 14 _6_ Supplimentol Permit Numbers RE0387613 W� H r iry d Dist. Of( P06C. Lot Size Type Unit a4 nier/Agent Tel Zip Address City Zip ZX 820 PATA D99RR'? Contractor • Tel. License# Address City Zip c ...t 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. I HEREBY AGREE THAT ALL WORK IN CONNF,CTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE SPATE OF CALIFORNIA:. REBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN k CCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. i�/ PERMITNO. 387813 MH.Permit Fee j Micro Film Fee Cop j Mech. Fee Dbl $ PI. Ck. Fee j Construction Fee Dbl j Electrical Fee Dbl j .SMI Fee $ Plumbing Fee Dbl $ Sp. Insp. Fee j Demol. Fee. j Registr. Fee j Mileage Fee j Witness Fee j. Reinso. Fee f Total Fees I$ M.O\ N:C: ,. Cast Received by ,Trees required Sewage System .Job Address AlhNIYA CORTEZ Community Valuation QUINTA j Use of Permit 'v1SiLING AND ATT. GARAGE /B Legal Description • OT 21 BLK 1256 SCVLQ 924 Bond Amt. Plan No. plan /S/decker/% rr Const. Lender Branch Address .. •�. --City Zip Sewer P �� 040 � Form 284208 (Rev.8/78) P Space.ZIP Owner L ^ Pti 2 Date Parcel Set Backs. Zone, Restrictions Gr r, Finol,Dote Inspector 14 _6_ Supplimentol Permit Numbers RE0387613 W� H r iry d Dist. Of( P06C. Lot Size Type Unit a4 nier/Agent Tel Zip Address City Zip ZX 820 PATA D99RR'? Contractor • Tel. License# Address City Zip c ...t 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. I HEREBY AGREE THAT ALL WORK IN CONNF,CTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE SPATE OF CALIFORNIA:. REBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN k CCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. i�/ NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTPR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Bock uS a33 Ventilation System . 2 Ftgs & Frms , Dc/ p 34 Plenums 6 Ducts 2A Slab Grade ,oAo,,�.T7" 7 35 Furnace Comport. 3 Steel 36 inlets & Outlets 4 Grout Blocks 37 Combustion Air 6 5 Bond Beams 38 Compressor b Roof Deck Z �j/ 39 Appl. Clearance -6 ,1-5- 7 Framing Q 40 Fire Domper 8 Vents 41 Smoke Detection Device fl� 9 Garage Fire Wall 10 -6 -ft 42 Commercial Hood 10 Fireplace P. L. 43 Final 0, 10A Fireplace T.O. 0 OP'N NO. ADDITIONAL INFORMATION SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath7 7- 12 Internal Loth 12A Drywall 13 Finish Grade 10 40 INSULATION Thick R Value 7A Walls (Batts) 3`/Z It I 14— 1 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 - ItO-80 21 Water Heater 0 - ra 22 Water Softener 23 Water Service O 24 25 Final 0 ��- a Tank 0 00 Pit L.Line P/L REAR OF PROPERTY LINE ELECTRICAL APPROVALS P/ 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring (rte Q�N 29A Grounding Wire /� �_ 29B Bonding /,D . 30 Fixtures �0- �- 31 Service t0 - 32 Final 0 — 6' STREET NAME `- 14- / i NOTICE: THIS IS. -NOT A BUILD* , -I iirm T APPLICATION TO CONSTRUCT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE DISTRICT Permit No 284 199 9/74 CANARY—FILE, PINK—APPLICANT J v ff•Owner A i n r,4 C At V Architect Contractor >>'.. AddresJ20O&[TtEW% ��. Address . Address��0 City. Y'4,44- 4111)t{c. , a City City Phoneme �� Phone Phone } V_ V9 W I (we) the undersigned, hereby certify and acknowledge that 1 (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. 1 am also aware that no work is to be done within the County R/W O without an encrochment permit. - NOW, iherefore, it is agreed that 1(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 M b -J i SIGNATURE OF OWNER -AND/OR AGENT .aJ° ,t'� � /J '� i AFL' G R Approval by Signature from the Following Departments Listed Below Must Be Obtained Prior to the Issuing of a Construction Permit. ( SPACE NO. USE OF STRUCTURE / �/ ,(� _ � % ` ? 19 �` ' �� r�.t C-` JOB ADDRESS _ _ SINGLE. FAMILY DUPLEX LEGAL DESCRIPTION .O j PROPERTY - APARTMENTS AGRIC. [l C .4 _ COMMERCIAL INDUSTRIAL [] G G Z COMMUNITY ALTERATIONS [� NO.. OF SUBMITTED'PLANS USE OF PERMIT 4 CASE NO. G = NO. OF P RKING SPACES REQUIRED NO, OF BUIL (NGS NOW (STING _ Q ZONE ETBACKS: FRONT �n SIDE - REAR m GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SI �dJ SETBACK ORDINANCE ___ OF FEET REQUIRED ON. STREET DATESIGNATURE OF LAND USE OFFICIAL _ DEDICATION REQUIRED;- �Y,ES p NO_fT NO. OFL FEET CURB AND GUTTER REQUIRED:+ YES ❑ NO ,B" STREET H a CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES '❑ NO ❑ W 0 HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET IMPROVEMENT? YES ;2- NO ❑ " DATE_1s? " 7r 2 - SIGNATURE OF, ROAD DEPT. OFFICIALt 7hz I / c. onnl c Pub 7`7 7-....., IC C s = 0 SEWAGE DISPOSAL F ~ 1,14k x WATER POLLUTION REMARKS �r FLOOD CONTROL— z AIR POLLUTION W DIV OF HWY o a — YOUR PROPERTY MAY BE SUBJECT TO c FLOOD. RIVERSIDE COUNTY ASSUMES A NO RESPONSIBILITY IN EVENT OF FLOOD. 284 199 9/74 CANARY—FILE, PINK—APPLICANT J v BUILDING PERMIT PERMIT NO: - 387813 DEPARTMENT OF .BU.ILDING & SAFETY FIELD OFFICE �" COUNTY OF RIVERSIDE A A ihEi7'f'i , 4 CONSTRUCTION ESTIMATE` NO." ELECTRICAL FEES NO, PLUMBING FEES .y 1201 0 $ fil0 0 UNITS IAT. FL. SQ,. FT. 0 e G 4�I « SQ. FT. 2Nk:v (B Communiityi Valuation YARD SPKLR SYSTEM POR. 192,SQ. FT. @ 4 e 00 7_ a 00 MOBILEHOME SVC- BAR SINK GAR. 496 SQ. FT. ® 6 0,50 -3224,09 POWER OUTLET ROOF DRAINS T Use of Perrmiiit. Pjorrcel No --{- — - - - DRAINAGE PIPIMG CAR P. SQ. FT. 0 Mach. Fee Dbl $ _ 'WALL 'SQ: FT. ®. 774,19:2694-4 i ( 4,19'1+694 DRINKING FOUNTAIN PI. Ck. Fee E URINAL SQ. FT. @ lot Size 05-0- 10 000 Construction Fee Dbl S 118 .�yy Le^^gal DesuiPtlon ESTIMATED CONSTRUCTION VALUATION $ k7- Electrical Fee WATER PIPING NOTE: Not to be used os propertyta* voludflon r1 -rC • L� �1 �,l.LA �icr;.��Q ��+Q'f/�'iE SWIM POOL, ,PVT FLOOR DRAIN MECHANICAL FEES E SWIM POOL, COMM WATER SOFTENER VENT SYSTEM 2 . FAN EVAP. COOL I HOOD SIGN ' WASHER (AUTO)(DISH) APPLIANCE DRYER 1 3N4 '0 PIon No.. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED I dor. LAUNDRY TRAY AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR 350 HP 7 POLE TEM. P/ ERMLAVATORY E HEATING SYSTEM FORCED GRAVITY2-' Const. under' : -Brandt AMPERES'SERV ENT f 0 SHOWER BOILER B.T.U. E SQ. FT. @ o BATHTUB 2 �Sujp�pltmreervtol ktEJVD r fi�1 �7 SQ• FT. (g� C WATER HEATER E` SQ .)FT. RESID @'1 I/.c SEWAGE DISPOSAL Reinsp. Fee 4g 15 SQ. FT: 'GAR ®"" 3 2 I, HOUSE SEWER IF Wer/Agent - Tel. Zip GAS PIPING. PERMIT FEE 3130 PERMIT AE PERMIT FEE DBL. TOTAL FEES MOB.HM FEE MICRO FEE MECH.-FEE 'Ft. CK.'FEE CONST: FEE ELECT. FEE SMI FEE FEE PLUMB. FEE Check 12291-0 �City S` DIRSERT Received by { •v Contractor Tel. - PERMIT NO. Job Address 54t0,f3o Space Zip Owner 38•7813 ` AVRNIDA CORTEZ 225 Communiityi Valuation Date D41. Off.. F.C.C. MH.Permit Fee E t ' - J Si34. GEyq -01-21-80 0 1 Micro Film Fee' Cop E Use of Perrmiiit. Pjorrcel No --{- — - - - Use/rat. N. ,_ CCk. ffy Mach. Fee Dbl $ 24' �y ,p„ tnE 1�; /�l q� {� _: WILLING AND A ii 4 t \EOAGE.., 774,19:2694-4 i ( 4,19'1+694 7J�i PI. Ck. Fee E Ser Mcks lot Size 05-0- 10 000 Construction Fee Dbl S 118 .�yy Le^^gal DesuiPtlon ho 0015 005. k7- Electrical Fee �Dbl E' r��, �yy 'Gia r1 -rC • L� �1 �,l.LA �icr;.��Q ��+Q'f/�'iE Zona Restricti�+s 'Group '� Type SMI Fee E 1 R1, ', -Plumbing Fee D_ bl $ 47 ja' Bond Anti. PIon No.. Plan:cckerrr Firwl' Dara I dor. Unit Sp. Insp. Fee S6 Demol. Fee E Const. under' : -Brandt Permit: Numbers fiegistr. Fee E �Sujp�pltmreervtol ktEJVD r fi�1 �7 MileageFee ; Addressr:.+, ��rJy� .r"€ity Zip' . �� Witness Fee. E` _ _ /� ICc7/'r✓"!� - -+ _ Reinsp. Fee E IF Wer/Agent - Tel. Zip 07 P. DU'r ' SRA " Total Fees _ �y 22_,0'�y _ r Add— Zip M -O - _N,C.. -. Cash_ Check (� OX '$20 �City S` DIRSERT Received by { Contractor Tel. - License# Trees required Sewage System Address " _ City Zip , P THIS PERMIT SHALL BECOME:VOID IF WORK IS NOT COMMENCED WITHIN 120:DAYS. CESSATION OF WORK ,Sewer DMr d FOR 120 DAYS SHALL ALSO CAUSE PERMTT 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. REBY CERTIFY THAT THE- INDIVIDUAL WHO PREPARED THE PLANS AND' SPECIFICATIONS HAS DONE SO IN CORDANCE WITH SECTLON5541:OF'THE'BUSINESS AND PROFESSIONS CODE'OF THE STATE OF CALIFORNIA. Form 284--208 (key.") P s verified by: