360007, 368652 (SFD)PERMIT NO.
8U'01 0
DEP4RTME NT,OF,. BUILDING
.0 1 1
COUNTYF RIVERSIDE - ID'E,,j
FIELD
M// i
CONSTRUCTION
ESTIMATE
NO.
ILECT.RtCALAES
INO. PLUMBING.FEE8
ISTD FL';,:
;.r2ND FL
-GAR:--.
CAR P. 0Q..F.
WALL
�K"'E'ifIMAkDrC8-NiT.RUC'Tfo-"AL6
SQ
SQ. FT. @
UNITS
-'A
YARD SPKLR'SYSTEM
SQ-, +,T._,'e* MOWHP
;BAR SINK
POWER OUTLET
$Q. FT, 4—SWL
@
ROOF DRAINS
DRAINAGE PIPING
SQ: FT. ,@
DRINKING, FOUNTAIN
SO. FT.: @ tURINAL
�� � �� ' - —
-u'nity
60mmI
WATER PIPING
-0e 9 -,q��pEqp r, , ox a. to
Npl�E�,NRtqq wk V,fucii
q fy t_
`Mktliermit Fite$
SWid 06(�,i ��'4
FLOOR DRAIN
MECHANICAL FEES,
_4
Uzgof Permit
SWIM'PoOL, COMM
WATER SOFTENER
`w SYSTEM FAN EVAP:_CCOL HOOD
Ck. By
SIGN
WASHER (AUTO)(DISH)
APPLIANCE DRYER
J
J-10 ia ..Ig
a
GARBAGE DISPOSAL,
FURNACE UNIT WALL FLOOR' SUSPENDED
AZ 4
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDUE'METER
KITCHEN SINK
ABSORPTION SYSTEM
rt
TEMP,_USE PERMIT. SVC
WATER CLOSET
COMPRESSOR HP
-4)
I on
POLEJEMP/PERM-
LAVATORY
HEATING SYSTEM FORCED GRAVITY
Plumbing: Fee
_11AMPERES SERV,ENT
SHOWER'
BOILER B.T.U.,
Plan No,
SQ. FT. @.
BATH TUB
,Inspector
WATER HEATER
Sp,.',!nip. Fee
$
SEWAGE DISPOSAL
z
SO: FT.r,AR @ 4.; -Y
_. -
HOUSE SEWER
GAS. PIPING
PEWIT FEEP
$
ERMIT FEE.
PERMIT FEE
DBLv
ITOTAL.EEES
OB_4M;FEEj,
MICRO FEE
.MECk4 i. .11
1, _,'ELECT. FEE
SMI FEE
FEE PLUMB. FEE
J
PERMIT NO.
Job Address
r1le) Ae-�
Spoce Zip6 nor,
-0
3
W 4g— "
5 3 A
-
�� � �� ' - —
-u'nity
60mmI
\�Ion Date
"Dist. Off. F.C.C.
`Mktliermit Fite$
Micro Film Fee
Pop
_4
Uzgof Permit
Parcel tel No:
d
Use C-sN6
Ck. By
"Mach,
Fee
DbI
J
J-10 ia ..Ig
a
AZ 4
k &iFeel
S6t Socks
Lot Size
construction Fee DbI $
Legol�Descriptiqn
_-jt
r.D
b
rt
S
IR
Electilicif Fee DbI S
-4)
I on
SMI Fee $
Plumbing: Fee
dbl $
Bond'Amt;
Plan No,
046 Che6 r--,,
0,
..Fi,,noI,0otd
,Inspector
nit
Sp,.',!nip. Fee
$
z
..Demol. Fee
$
Const. lender ranch.
'Supplim tal Permit Numb4rs
Fee
j
MIIeq4a,F6e
Address city
,N!d I t no" Fee t $
Reinap_
6wriefreAgent•'Tel.
ddre-
Zip
M.O. ,wC':E1_CqjhEl.
Check61,1
Received by
Contractor
License# ;;;q ,-vN
,Trevi required
sis?vbgs System
Address t,
Zip
.Sewer Diitricl
2,
Form 284-208 (Rev.6/76)
THIS PERM!tSkA& BECOME*;KOlb IF WOR:WIS NOL COMMENDED WITHIN 12O DAYS. CESSATION -OF. WORK
FOR 120 DAYS: SHALL AM CAUSE PERMIT To BECOME VOID.,
I HEREBY AGREE THAT ALL WORK IN. CONNECTION W
WITH, THIS PERMITILL BE DONE IN ACCORDANCE,WITH
THE LAWS OF RIVERSIDE 'COUNTY AND THE STATE OF! 'CALIFO , RNIA*.
'I HEREBY CERTIFY THAT THE -INDIVIDUAL WHO PREPARED THE . P LANSAND SPECIFICATIONS HAS'DONE.SO IN
ACCORDANCE WITH -SECTION 5541 OF THE -BUSINESS AND PROFESSIONS CODE Of THE -STATE OF CALIFORNIA.
verified by:
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
SUOLDORIG APPROVALS
PAECHAMI(C&L 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 6 Outlets
4
Grout Blocks
37 Combustion Air
5
Bond Beams
38 Compressor
6
Roof Deck
39 11
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. 0.
OP'N
NO.
ADDITIONAL INFOO' MATOOM
S[tiMi AGa SYSTEM SOME LOCATOOM
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Wolts (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
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
Isr�>tr�r�wa,�rarcrhi
PERMIT NO.
368652
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
RIA nXgAA )
FIELD
DST
'gni
District V
r k
Form 284-208 (Rev.8/78)
FOR 120 DAYS SHALL ALSO -CAUSE PERMIT.19 BECOME VO.
VOID.
I HEREBY AGREE THAT ALL Willa IW14M,WOHIS PERMIT WILL BE DONE IN ACCORDANCE WITH '
THE LAWS OF RIVERSIDE COUNTY ANC THE. ATE OF CALIFORNIA.
�`-
I HEREBY 'CERTIFY THAT THE INDIVIDUA Vvi'Ab kiFA�ED'THE PLANS AND SPECIFICATIONS HAS DONE SO IN -
ACCORDANCE WITH SECTION 5541 OF'THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
,,._. is •,t. , ...,i t .,"a.. _ i-
CONSTRUCTION
ESTIMATE'
NO. ELECTRICAL FEES
NO:
PLUMBINGFEES.
IST FL. .1'231
2ND. FL.
POR. 198 _
GAR. 352
CAR P.
WALL.
ESTIMATED CONSTRUCTION
SQ. FT. a6.. 0 $ 2!G
p�
G7�,1F]ti►
UNITS
3'68652
YARD'SPKLR SYSTEM
SQ. FT. @ •
v
44 2 A0 MOBILEHOME SVC. BAR SINK
SQ. FT. @+ •00
9se-.40
e�
SQ. FT. 46.50 2 se-. @V POWER OUTLET ROOF DRAINS
DRAINAGE PIPING
SQ. FT.
Community.,
DRINKING FOUNTAIN
5a. FT. Q
SQ, FT, @ URINAL
Off.
VALUATION $ WATER PIPING
2
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
1-
5
MECHANICAL FEES
Micro Film Fee
SWIM POOL, COMM
Use of Permit -_
WATER SOFTENER
No. , Use/Case No.
'VENT SYSTEM
FAN EVAP. COOL 'HOOD
50
SIGN
JUL C A T T- 'G AAAA-
2
WASHER (AUTO)(DISH)
5
APPLIANCE
DRYER
306
Set Backs
'GARBAGE DISPOSAL
25
FURNACE
UNIT WALL FLOOR SUSPENDED
'Legdl.Description
05 �5 _ :,O
50 10.0 0001
LAUNDRY TRAY
Dbl S
AIR HANDLING UNIT CFM
�ry �s (�77 pp
Tt 8 BL 196 SOV V 1,4 #-19
IDLE ;METER . c
Zone Restrictions+
Group
KITCHEN SINK
25
ABSORPTION SYSTEM B.T.U..`TEMP
18, '
USE PERMIT SVC
��,
WATER CLOSET
F O
COMPRESSOR 300 HP
40
POLE,TEMP/PERM
Bond Amt.
2
LAVATORY
50 �
HEATING SYSTEM FORCED GRAVITY
4013
E go AMPERES SERV ENT
7H
S
SHOWER
=
BOILER
B.T.U: • t
SQ. FT. t
2
BATH TUB
503
$
SQ. FT. @ C
1
WATER HEATER
25.
- -
'�7,►� SQ. FT. RESID'@ltht�,
Mileage Fee
�,
SEWAGE DISPOSAL
1'(;g
Zip
-
Witness Fee.
32 SQ. FT. GAR Q '/rt.
2',
HOUSE -SEWER
Reinsp. Fee
s
'Owner/Agent
Tel. Zip
'GAS' PIPING
PERMIT FEE
off/f!/
S�
PERMIT FEE
��' j
UECTONIC
PERMIT FEE
+�
DBL
TOTAL FEES
MOB.HM.FEEr
• MICRO FEE"
MECH. FEE
- PUCK. FEE
CONST. FEE
ELECT. FEE
-SMI FEE`
...1.31
'L BEGONIA
PLUMB. FEE
44.
District V
r k
Form 284-208 (Rev.8/78)
FOR 120 DAYS SHALL ALSO -CAUSE PERMIT.19 BECOME VO.
VOID.
I HEREBY AGREE THAT ALL Willa IW14M,WOHIS PERMIT WILL BE DONE IN ACCORDANCE WITH '
THE LAWS OF RIVERSIDE COUNTY ANC THE. ATE OF CALIFORNIA.
�`-
I HEREBY 'CERTIFY THAT THE INDIVIDUA Vvi'Ab kiFA�ED'THE PLANS AND SPECIFICATIONS HAS DONE SO IN -
ACCORDANCE WITH SECTION 5541 OF'THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
,,._. is •,t. , ...,i t .,"a.. _ i-
r�.
�
PERMIT NO:
�
Job Address '.•5 1895
L
Space Zi
Pa P
Owner
3'68652
ASt. CORTU
0'
z.�
*1k
Community.,
Valuation
Dist.
Off.
F.C,C.
MH.Permit Fee
E
G I mq
1-
5
0
Micro Film Fee
Cop S
Use of Permit -_
'Parcel
No. , Use/Case No.
Ck.By
;. Mech. Fee
DbI :
�0
JUL C A T T- 'G AAAA-
74141019—
OLLI
PI. Ck. Fee
=
Set Backs
lot Size
Construction Fee
Dbl $
1150
'Legdl.Description
05 �5 _ :,O
50 10.0 0001
Electrimi'Fee'
Dbl S
231. L
�ry �s (�77 pp
Tt 8 BL 196 SOV V 1,4 #-19
-
Zone Restrictions+
Group
Type
SMI Fee
$
18, '
��,
'y
�.� P
,
N
t
,Plumbing Fee
Dbl f
� ..�
Bond Amt.
Plan No.
Plan Checker
-
Final Date
Inspector
nit
'. Sp. Insp. Fee
S
=
�yYy
04 ! (
per.
1
DemoL Fee
$
Const. Lender Branch
�Supplimental PermitNum
Registr. Fee
$
- -
R 0368652 -
Mileage Fee
s
-
Address _ city
Zip
-
Witness Fee.
:
Reinsp. Fee
s
'Owner/Agent
Tel. Zip
off/f!/
UECTONIC
,/�/.F'�
673 -432-9
Total Fees
Address ^"=�^ •
City Zip
' M.O. N.C.
Cosh
Cheek' 5
'L BEGONIA
�y y� DELMAR
GIONA -DEL MAR
Received by
Contractor
Tela y
License/
Trees required
Sewage Sy�sste�m..•,rf
AddressCity
Zip
J ,
T
LL.
P
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN -120 DAYS'. CESSATION OF WORK } verified by:
District V
r k
Form 284-208 (Rev.8/78)
FOR 120 DAYS SHALL ALSO -CAUSE PERMIT.19 BECOME VO.
VOID.
I HEREBY AGREE THAT ALL Willa IW14M,WOHIS PERMIT WILL BE DONE IN ACCORDANCE WITH '
THE LAWS OF RIVERSIDE COUNTY ANC THE. ATE OF CALIFORNIA.
�`-
I HEREBY 'CERTIFY THAT THE INDIVIDUA Vvi'Ab kiFA�ED'THE PLANS AND SPECIFICATIONS HAS DONE SO IN -
ACCORDANCE WITH SECTION 5541 OF'THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
,,._. is •,t. , ...,i t .,"a.. _ i-
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System '
2
Ftgs & Frms
29
QL
34 Plenums & Ducts
2A
Slab Grade
35 Furnace Comport.
3
Steel
36 Inlets & Outlets
4
Grout Blocks
37 Combustion Air
5
Bond Beams
38 Compressor Bp F,*,yA7
6
Roof Deck
' _
39
Appl. Clearance
7
Framing
_
40 Fire Damper
8
Vents
41 Smoke Detection Device
9
Garage Fire Wall
t
42 Commercial Hood
10
Fireplace P. L.
43 Final
10A
fireplace T. 0.
ONON ADDOTOOP1AL INF MATUCH
p F d k Q. 7- Y-
/ 1 1
X cQ�`1� ee;1'N
-------------•--------------
�
SEWAGE SYSTEM SIVE 8 LOCATION25
11 Exterior Lath - ..t
12 Internal Lath
12A. Drywall Z_2�.?9
13 Finish Grade Zi���� ,T�yyj •�
INSULATION Thick R
Value
7A Walls (Batts)
12B Ceiling (Batts)
12C Ceiling (Blown)
14 Final=y�/jyZ%
---------- PLUMBINGAP.PROVALS- -- - - -- -
15 Ground Plumb/�
16 Water Piping
17. Rough Plumb
18 VeAts
19 Sewage Disposal
20 Sewer
21 Water Heater P� %
22 Water Softener
23 Water Service -z.
24 Gas Test
Final
7rz�
y=!✓�T
Tank Pit L.Line
P/L
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
2.
-
P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring �� _ �.v
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final-�arOj.?r�'
STREET NAME J �6 6d� ,L
Z
NOTICE: THIS IS NOT A BUILDING PERMIT
'•i
APPLICATION TO CONSTRUCT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
DISTRICT
Permit No
284 1919. 9/Z4
CANARY—FILE, PINK—APPLICANT'
Owner Architect Contractor 11?e A::�IZ eS/xlg �..
Address i"2 ���` !��` A� �`6 'Address_ Address ZO fe
City -60vea >t City City *fV"i' r c
Phon% Phone Phone ly�'� �7 ' "+��Z '
19
1 (we) the uridersiyned, 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
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
O
without an encroachment permit.:, .. ..
' NOW, therefo_re,-it,,is agreed that I (we) will not occupy said property and will not cause said property to be occupied until I y%) have
complied. with all laws. f 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
Muit Be Obtained Prior to the Issain� of a Consbutlion Pemit.
4
ISPACE-N0:
y �r Jt,v '• s t r.l r/;- r' USE. OF STRUCTURE
/
y
JOB. ADDRESS" I — SINGLE FAMILY. Q/ DUPLEX
O �
LEGAL DESCRIPTION. OF P-ROPERTY
G£y,'" .� fit". �._/ �:. - �r '\ {� ! r ��.AP.ARTMEN.T.S' AGRIC.
Nf
( COMMERCIAL � •.INDUSTRIAL []
>
y
COMMUNITY FF ALTERATIONS
I�''
O Z
NO. OF SUBMITTEO'PLANS -- USE OF PERMIT `
CASE NO. .'_ 7 <_
:
p Z.
NO. OF PAVING SPACES REQUIRED NO: OF BUILDINGS NOW EXISTING - 7
_e
ZONE SETBACKS: FRONT SIDE REAR 1 -
m
6
GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT:SIZ,E
:
1
SETBACK ORDINANCE — OF ''FEET REQUIRED ON 1 STREET
-OFFICIAL `+
DATE SI,GNATURE OF.LAND USE
'
DEDICATION REQUIRED: YES.❑- NO ❑ NO. OF -FEET
W
CURB''AND GUTTER REQUIRED: -'YES ❑ N0. Elf/f f STREET'4.
oc
Jl
?CAN CURB AND GUTTER FEASIBLY BE INSTALLED? 'YES ❑ NO ❑
�.
HAS AN ACCEPTABLE -APPLICATION, BEEN MADE FOR ENCROACHMENT PERMIT FOR -DRIVEWAY AND STREET
IMPROVEMENT:' EYES Ef--NO ❑;
°t
FFICIAI
DATE SIGNATURE. OF ROAD DEPT. OFFICIAL-
SWIMMING
SWIMMING POOLS. PU8 Lj�'C"-
a
f
SEWAGE DISPOSAL /%!9• D/9/Y I At rr °� G �/ r i'�
W
= O
FOOD ESTABLISHMENT"
WATER POLLUTION REMARKS
e
�r► FLOOD CONTROL
;W AIR POLLUTION
W 2 DIV OF HWY
c < _ YOUR PROPERTY MAY BE SUBAtCT TO
81 -�—�' FLOOD. RIVERSIDE COUNTY
ASSUMES -NO
RESPONSIBILITY IN EVENT'OF FLOOD.
284 1919. 9/Z4
CANARY—FILE, PINK—APPLICANT'
BUILDING,PERMIT FIELD OFFICE
PERMIT NO: DEPARTMENT OF BUILDING & SAFETY FDST 368652 R COUNTY OF RIVERSIDE
PERMIT NO. -
CONSTRUCTION
ESTIMATE
Job Address 5U95
NO. ELECTRICAL FEES
NO.
PLUMBING FEES
1237 4.e 40 22
60.80
UNITS
x:11. CORTEZ
911,253 991TE
15T FL,
SQ. FT.
.
2ND. FL.
SQ. F.T. @
Community
YARD SPKLR SYSTEM
Off.
POR
9 SQFT 04A00
92,s> 0
MOBILEHOME SVC.
h' h
Q INT8.
BAR'SINK
//��LL,F.C.C:
5 01
GAR.
352 SQ.. FT. ®S • :70 2
818 i 00
POWER OUTLET
Use of Per
ROOF DRAINS
Parcel No.
CAR P.
'SQ. FT. ,@
Ck. By
Mech:Fee
Dbl.
DRAINAGE PIPING
AT. GARAGE��141R�19-o
WALL
,SQ FT.
Obi
PI. Ck. Fee
DRINKING. FOUNTAIN
FT.
Set Backs Lot Sim
20 05 0.5 . 20 50
01
100 000
URINAL
Electrical Fee
ESTIMATED CONSTRUCTION VALUATION. $ 2500.80
L
�t T
;f. W BIs 196 S V.V BL Q
1
WATER PIPING
25
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
}
FLOOR DRAIN
MECHANICAL FEES
SWIM. POOL, COMM
Plumbing Fee
WATER SOFTENER
VENT SYSTEMFAN
EVAP. COOL HOOD
Plan/�Noo..
SIGN
2
WASHER (AUTO)(DISH)J25
Unit
APPLIANCE'
DRYER. 1
'
?
; I
1
GARBAGE DISPOSAL
FURNACE
UNIT WALL FLOOR SUSPENDED
1
Demot. Fee
S
LAUNDRY TRAY
Const..lendar
AIR HANDLING UNIT CFM
IDLE METER
Reg str- Fee
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.,
TEMP' USE PERMIT SVC
2
WATER CLOSET
COMPRESSOR �Q10 HP
40
POLE,TEMP/PERM
2
' LAVATORY
HEATING SYSTEM FORCED GRAVITY
!�
00 AMPERES SERV ENT
70
SHOWER
'Owner/Agent r
BOILER.
B.T.U.
Tel.
SQ: FT: @. c
2
BATH TUB
aCTONIC�—
-�73-4329
SQ. FT: 0 C
1
WATER HEATER
2084
1
Address
12 7 W. FT. RESID @1144
5!�
1
SEWAGE.DISPOSAL
0 Cash
171 Ch -
0 BEGONIk.
3g2 50. FT. GAR @ -Vc
2f'j
DLL MAR
HOUSE SEWER
Received by
.Contractor
GAS PIPING
License#
PERMIT FEE
30
PERMIT FEE
D
PERMIT'FEE
DBL
TOTALFEES
MOB.HM.FEE
`MICRO FEE
MECH. FEE
PL. CK. FEE
CONST: FEE
ELECT. FEE _
SMI. FEE
- FEE
PLUMB. FEE
208.41
19..0
I 115.00
28.1 1
1. �1
a4.51a
PERMIT NO. -
Job Address 5U95
Space Zip Owner
x:11. CORTEZ
911,253 991TE
368652
1
.
Community
aluation Dale Dit.
Off.
MH,PermitFeei
tt
.L
h' h
Q INT8.
TSOI-11258,40.80V5-r21-79 11
//��LL,F.C.C:
5 01
Micro Film Fee
Cop
Use of Per
Parcel No.
Use/Case No.
Ck. By
Mech:Fee
Dbl.
DT,LIda
AT. GARAGE��141R�19-o
Obi
PI. Ck. Fee
Set Backs Lot Sim
20 05 0.5 . 20 50
01
100 000
Construction Fee Dbl L'elg�ol D�aj%Tlpallofri
g,445
Electrical Fee
Dbl
L
�t T
;f. W BIs 196 S V.V BL Q
t ,}�
#19
Zone'Restrictions
Group
'SMP Fee
}
{�T�11ype
Plumbing Fee
Dbl
Bond Amt.
Plan/�Noo..
;Plon'Checker
Final Date.
Id- c r
Unit
Sp. Imp. .Fee:
S
?
; I
�j
Ki7g7 f 4
�
1
Demot. Fee
S
Const..lendar
Branch
SSuppliimenttaalNumbers
Reg str- Fee
;
�Pwermit
B.036,0652
652
.Mileage Fee ; Address .City Zip
Witness Fee
=
'
Reinsp:'Fee
;
'Owner/Agent r
Tel.
Zip
aCTONIC�—
-�73-4329
Total Fees
2084
1
Address
city
Zip
M.O. N.C.
0 Cash
171 Ch -
0 BEGONIk.
C01tyOuuA
DLL MAR
Received by
.Contractor
Tel,
License#
Trees required_
'
Sewage System
Address
City Zip
/ y f
T LL P
.:Sewer District.
1�YBN_Y(Ju
Form 284208 (Rev:8/78) (E)s
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT_COMMENCED WITHIN 120 DAYS. CESSATION OF WORK
FOR 120 DAYS SHALL ALSO CAUSE IT TQ BECOME VOID.
1 HEREBY AGREE THAT ALL W ¢'�gW?MIS 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 5541.01F THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
verified by;