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PEPARTMpgrOf BUILDING & SAOtrlt
COUPITY OF RIVERSIDE
FIELD OFFICE
CONSTRUCTION
ESTIMAtE
NO,
ELECTRICAL FEES
NO. PLUMBING FEES
1ST
'2ND: L ;SQ,
-,POR.-,
GAR, ,.SQ•
CAO.P.
WAIL
ESTIMATED CONSTRUCTIC14VALL)ATION
18. 40
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UNITS
Mh.fermit Fee $
M! S.F_Q i I ro Fee
FT. @
YARD SPKL4 SYSTEM
M6BILEHOME SVC.
SQ. FT.@ 4. 04
BAR SINK
FT, ,@ 6 -SO POWER 6VTUT_
ROOF DRAINS
SO. ft„ @ — -------
DRAINAGE PIPING
SQ. FT., @,
DRINKING FOUNTAIN
SQ Ft:.(p3,
URINAL
Ag, am -ft-_
WATERYIPING
N6*.'Nbi io-be used'as property. tax -vIaluotion.
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Swim POOL, PVT
T.� No, -1.
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FLOOR DRAIN 2 1W
MECHANICAL FEES'
Unit
swfm pcibL, tCoMm-
'WATER SOFTENER
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• HOOD
7
Const. lender -
SIGN
SuPP! imentoLPermlr Numbers
WASHER (A'
APPLIANCE DRYER
Address
Zip
GARBAGE
FURNACE UNIT WAIL �,FLOOR SUSPENDED
L
LAUNDRY TRAY 2
AIR: HANDLINGUNIT"CFM
METER
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KITCHEN SINK
A9SORPTION!SYSTEM
TEMR, USE PERMIT SVC
WATER CLOSET 1 U
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4' HOUSE SEWER
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GAS PIPING
PERMIT PEE
FERMI fEE'PERMIT
FEE
AS I
DBL_
J�,
TOT
TOTAL
MOO. HWFEE
MICRO FEE
PL CK_ FEE
22A0
CONST. FEE
1,0640
-31.40
SMI FEE
12.08
EE I
F POW.M
PERMIT' NO
Zip Owner
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Lot Size
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SuPP! imentoLPermlr Numbers
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THIS PERMIT SHALL BECOME VOID I.F°WORK IS NOT COMMENCED
ITHIN 120 DAYS. CESSATION OF WORK verified by.
beWer t,;tSVtCj r%JK I NVP% L"
rc I U VV
U r
CM -9 'it
_7 W"j--j__ T'WiLL BE DONE IN ACCORDANCE WITH
I HEREBY;k(VREE T H S PER
ATE
THE LAWS RIVERSIDE �COUN 'ND THE- st OFCAdr-OkN�_:,'`'
R(V 6 SSID
I HEREBY CERTIFY THAT THE INDNIDUAL W'
'_ D
H&OREPARED THtPLAN6 AND SPECIFICATIONS HAS DONE SO IN
ACCORDANCE'WITH SECTION 5541 d TAE'5
UMNE!SS`-Ak PROFESSIONS CODE OF THE STATE OF CAUFORNW
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1_;�' ... .. - I
NOTICE: THIS IS NOT A BUILDING PERMIT
APPLICATION TO CONSTRUCT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
DISTRICT
Permit No
284 199 9/74
CANARY—FILE, PINK—APPLICANT
0"'.er Contractor -7/7 V
Ad&�"_ I/ Addre-- Address—
/_:V -s - 1
City City— _ City_ i ..sr r�
J
Phone Phone Phone -/
I (wej 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
shall not make a Final Inspection until said requirements have been met. I[ am also aware. thl-t no work is to be done within the County R/W
0
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
complied with all laws of 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
Must Be, Obtained Prior to the Issuing 'of i Construction Permit.
ISP
3 A c) USE OF STRUCTURE
>.
JOB ADDRESS
❑
'F Vie Lk F0 I L L E -X
z
LEGA 94 PROPiE��Y APAR IMENTS Lj AGRIC'.
0
CO MM'E RCIALINDUSTRIAL❑
5:N
COMMUNITY ALTERATIONS❑
Z
NO. OF SUBMITTED'PLANS USE OF PERMIT
7H
AL
CASE N.O.
in E
N0. OF SPACES REQUIRED NO.. OF BUILDINGS NOW E-XISTING
Z' to
jP�,AjRKING
.ZONE SETBACKS: FRONT SIDE REAR
_
GRADING PERMIT REQUIRED? YES 0 NO -0 LOT SIZE,,-
E # OF FEET REQUIRED ON ST ET
SETBACORDINANCE NANC
q1. - 11
7
DATE. SIGNATURE OF LAND USE OFFICIAL
DEDICATION REQUIRED: YES [3 NO El NO. OF FEET—
CURB AND GUTTER REQUIRED: YES.[].. NO [I STREET
IL
CAN CURB AND GUTTER FEASIBLY BE INSTALLED? 'YES ❑ NO El
HAS.XN ACCEPT -ABLE APPLICATION -:6EEN'MADE FORn-IENCROACHMENT PERMIT FOR DRIVEWAY AND STREET
IMPROV V9MEN ? YES &—NO C1'
DATE-Z SIGNAT.UR'E OF. ROAD DEPT. OFFICIXL_
_i 11 -
, pe
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SEWAGE Dlspbsw-'e
a A-10
Z
A"
T 42
f
jKAVe__1 G;V.
WATER POLLUTION C
FLOOD CONTROL —
_Z AIR POLLUTION —
Dly OF HWY
YOUR PROPERTY MAY BE SUBJECT TO
FLOOD. RIVERSIDE COUNTY ASSUMES
NO RESPONSIBILITY IN EVENT OF FLOOD.
284 199 9/74
CANARY—FILE, PINK—APPLICANT
s-
at. .
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10
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APPLICATION FOR -TREE PLANTING
I(we), the undersigned„ hereby certify and acknowledge that I (we) have read the application and agree that if trees are required under River-
side County Ordinance No. 457, the applicant agrees to install said trees prior to final inspection. It is understood that no final inspection
will be given until said requirements have been met or exception has been granted by the County. Now, therefore, it is a@reed that -the prop-
erty owner shall cause the property lines to be surveyed in the event no survey stakes can be found. Further, it is agreed that the County of
Riverside shall assume no responsibility should trees have to be removed due to lot line errors.
Owner's Name K 71'
Mailing Address D w City
Job Addressf1Gs't.i? C Z_
Legal Description STl
a 40
Assessor's Map, Book & Page 2 d
Type of Soil✓ Is water available Road Dept. Plot Plan No.
Type of existing trees in road right—of—way
Trees preferred by applicant (f) c (2)!
Date y % ` Owner's Signature
Planning Commission Case No.
[ding Permit No.
sl" X
/�y���
—State � Zip
ty
Type Structure
ROAD DEPARTMENT APPROVAL
Approved species Jacaranda acutifolia (Jacaranda) Number of trees_
Spacing of trees Distance from lot lines: Front 2l in RV -Side
Additional requirements Per plot plan on reverse_
Date Building and Safety notified 5/.79 Signature
REQUEST FOR EXCEPTION
Reason
Request for hearing:
Owner's Signature
YES ❑
(attach additional page if necessary)
(Forward application to Planning Dept. if exception requested)
NO REQUEST FOR HEARING
Planning Dept..
Concur ❑ Non -concur ❑ Explanation
Date Signature
Road Dept.
Concur ❑ Non -Concur F-1
Date Signature
.REQUEST FOR HEARING.AND COMMITTEE DECISION
Date hearing established Date hearing notice mailed to owner
Approved ❑ Disapproved n Date Owner notified of decision
Date Building & Safety notified Signature
S�
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