360176 (SATT)BUILDING PERMIT
PERMIT NO. DEPARTMENT OF BUILDING & SAFETY FIELD ~'" D`s
3 6.017 6 COUNTY OF RIVERSIDE I
CONSTRUCTION ESTIMATE
'
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. '+
2ND. FL.
yL . $
SCl. FT. @
• .
UNITS
YARD SPKLR SYSTEM
SQ. FT. @
7
POR. e _ ?
GAR. .. -
CAR P.
WALL .., ..,.
ESTIMATED CONSTRUCTION
SQ. FT. @ r i-
"� - atx
MOBILEHOME SVC.
BAR SINK
�
SQ. FT. @ POWER OUTLET. ROOF DRAINS
SQ. FT.. @ V DRAINAGE PIPING
� - DRINKING FOUNTAIN
SQ. FT.
Community
- Fi
@•
SQ.: FT. @ URINAL
�.
VALUATION $ WATER PIPING
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
F.C.C.
MECHANICAL FEES'-
Micro Film Fee
SWIM POOL, COMM
WATER SOFTENER
/ - -
VENT SYSTEM FAN ` EVAP. COOL HOOD
Use/Case No.
SIGN'
., WASHER (AUTO)(DISH)
PI. Ck. Fee $ -
7Z
APPLIANCE DRYER
Lot Size
GARBAGE DISPOSAL
f.W
FURNACE UNIT WALL FLOOR SUSPENDED
R
,7
74 10-
Construction Fee • Dbl E
LAUNDRY TRAY
,. «
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
Electrical Fee Dbl 8 y', J
ABSORPTION SYSTEM B.T.U.
Group
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
,3-
POLE,TEMP/PERM
LAVATORY
HEATING SYSTEM,Ole FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T:U: -
SQ. FT. @ c
BATH TUB
0
Plumbing Fee
SQ. FT." @ 'f
WATER HEATER
10,
Plan Checker
Final Dat sp or
SQ. FT. RESID @1'/.c
SEWAGE DISPOSAL
_ _ --•-
Sp. tnsp. Fee
E
a SQ. FT. GAR @ 'G cHOUSE
SEWER
, , �,2V
r
GAS PIPING
Demol. Fee
PERMIT FEE
Const. Lender
PERMIT FEE
PERMITFEE
Supplimentol Permit Numbers
DBL.
TOTAL FEES
D
MOB. HM. FEE
MICRO FEE
MF H. E'E'
.:-T
PL CK. FEE
<:r y�
CONST. FEE ELECT. EE'
?� ? pt✓ 7"1. lin/
SMI FEE
�
FEE
PLU B. fE
. 4'Z_
...
- PERMIT NO. -
'
Job Address
-
-•� �+ •: +" « z . > .:.' ti "
sSpbce Zip
Owner
,
3601116r
7
Community
- Fi
Voluatipn
E
Date
Al.
Dist.
Off.
F.C.C.
MH.Permit Fee E
Micro Film Fee
Cop 8
Use of Permit
r'"'�
/ - -
Parcel No.
-•
'Set
Use/Case No.
Ck. By
Mech. fee Dbl E ,r.
PI. Ck. Fee $ -
Boc7cs
Lot Size
FS
,,
S
R
,7
74 10-
Construction Fee • Dbl E
Legal Description
,. «
CC
_ _*
Electrical Fee Dbl 8 y', J
Zone Restrictions
Group
Ty e
,3-
.iJ� .✓�rly' .,;j
'
SMI Fee
E
Plumbing Fee
Dial 8 f
Bond Amt.
Plan No.-
Plan Checker
Final Dat sp or
Unit
_ _ --•-
Sp. tnsp. Fee
E
8
A -
, , �,2V
Demol. Fee
E
Const. Lender
-Branch
-
Supplimentol Permit Numbers
I
x
Regisir. Fee 8
Mileage Fee E
Address City Zip
Witness Fee E
Reinsp. Fee
E
Owner/Agent•,
.,`.y
rC'�„Y �,
Tel.
Zip
Total Fees
E G
Address
City
Zip
M.O.
N.C. Cash Check
Y
Received -by '
Contractor
r-
.r - "�
Tela
License#
�•�
Trees required
Sewage System
Address
-
City
Zip
. `
LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK
Sewer District FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THA WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH
W
THE LAWS OF RIVERSID ( TY R,THE STATE OF CALIFORNIA.
jG 0 ,1!,>4 (' l ' a 't! I HEREBY CERTIFY THAT THE INDIVIDUA(,'NHO 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}
verified by:
-n
NO.
Grout Blocks
OPERATION DATE
INSPECTOR I .NO.
OPERATION
DATE INSPECTOR
Combustion Air
5
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
_ 7 b
t 33
Ventilation System
2
Ftgs & Frms
_
CGCG ( 34
Plenums & Ducts _
2A
Slab Grade
35
Furnace Comport.
3
Steel
8
36
Inlets & Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
7 _ _
G
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
IDA
Fireplace
T. 0.
FI ADDITIONAL INFORMATION
-P/% RQ C+tlr--
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)
GI
'A
12C Ceiling (Blown)
14 Final
PLUMBING APPROVALS
15 Ground Plumb
16 Water Piping
17 Rough Plumb S.
18 Vents
19. Sewage Disposal 8—((D-1 L
20 Sewer
21 Water Heater
22 Water Softener
23 Water Service
24 Gas Test
25
Final
Tank `000 Pity L.Line
PSL
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
l Vt I P,
�Y
( Q
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring�y'
I„
29A Grounding Wire
29B Bonding
29B
30 Fixtures
31 Service
32 Final
STREET NAME
DEPARTMENT OF BUILDING AND SAFETY . COUNTY OF RIVERSIDE
OFFICE
DATE,
TIME
PERMIT NUMBER
j
t /
L v
INSPECTION
RFfIIIFCTFn
ADDRESS_ SPACE NO. FOR
Woe --'
QOWNER A.M.
COMMUNITY
BUILDING. PLUMBING ELECTRICAL MECHANICAL.
ktUN ',
` C? TUES
WED "
REMARKS:
a THUR
FRI
OWNER/CONTRACTOR TEL.NO.
284 75
DEPARTMENT OF BUILDING AND SAFETY . COUNTY OF RIVERSIDE
O�FFI•_CE
DATE
447-7�1
TIME
4)3.7
PERMIT NUMBER
INSPECTION
ADDRESS SPACE NO.
OWNER COMMUNITY
BUILDING PLUMBING ELECTRICAL MECHANICAL
REMARKS:
OWNER/CONTRACTOR TEL.NO
REUUESTED
FOR:
❑ A.M.
El P.M.
FIMON
TUES
wEt)
U THUR
FRI
2811 tIi75
h,
DEPARTMENT OF BUILDING'AND SAFETY. COUNTY OF RIVERSIDE
OFFICE
DATE'
X46`77
TIME
16 `30
PERMIT NUMBER
INSPECTION
ADDRESS
SPACE NO
OWNER COMMUNITY
BUILDING PLUMBING ELECTRICAL MECHANICAL
REMARKSOWNERS CONTRACTOk1�,.
-
I
FO
A.M.
P.M.
'WQN
vs
0- WED
THUR
FW
29444 1117S
NOTICE: THIS IS NOT A BUILDING PERMIT I{ \
_ DISTRICT
APPLICATION TO CONSTRUCT
Permit No
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
284 199 9/74
CANARY—FILE, PINK—APPLICANT ��
Owner� A �
Architect Contractor
�"(�° j`
�' cp '} to
Address�t' s" Address Address_
-City 1A AV4 i C44, City City_
,g.,
7�:�
Phone Ph o»P Phone
m
wej e unersr-
I ( the di geed,lrerPbY Certaty 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 9s required try 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 within 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 I (we) have
complied with all laws of the County of Riverside and the State of California governing said proper y. 4
t
DATE '`jy SIGNATURE OF OWNER AND/OR AGENT ;` C
Approval by Signature from the Following. Departmenti Liito Below
Must Be Obtained Prior to the Issuing of a Construction Permit.
SPACE NO.
y�I USE OF STRUCTURE
JOB 'ADDRESS/ I
7 I>_ — SINGLE FAMILY DUPLEX
y `fit �
y
Z W
LEGAL DESCRIPTION F PROP RTY
.��t7� �£ �� �� — APARTMENTS AGRIC.
O
N
. _ •7
k 14 `'` COMMERCIAL ❑ INDUSTRIAL
N
COMMUNITY r"'1
ALTERATIONS [j`
�� "
Z
NO. OF SUBMITTED PLAN SY_ USE OF PERMIT a�� `
4A
CASE NO.'
Z
NO. OFA/PARKING SPACES REQUIRED NO. OF BUILDINGS NOW EXISTING —
JZONE
` SETBACKS: FRONT 2 SIDE C;' REAR L-1
m
GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE `�"^ ;e,-2,7� '
SETBACK ORDINANCE # _— OF FEET REQUIRED ON STREET
., It
DATE
_ SIGNATURE OF LAND USE OFFICIA ---
DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET-_
W
CURB AND GUTTER,, REQUIRED: YES ❑ NO ❑ STREET
a t
IL
'
CAN CURB AND GUTTER FEASIBLY BE INSTADLED? YES ElNO ❑Ila
r HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET
IMPROVE M ` T? YES NO C3
_DATE `-� _ SIGNATURE OF ROAD DEPT." x
r
QW
SEWAGE DISPOSAL 1n r
W
x
Fon"; I A;k WSCSiI,E N T
i
WATER POLLUTION REMARKS
Vn FLOOD CONTROL
W AIR POLLUTION
DIV OF HWY
c < — - - YOUR PROPERTY MAY BE SUBJECT TO
FLOOD. RIVERSIDE COUNTY ASSUMES
NO RESPONSIBILITY IN EVtNT OF FLOOD.
284 199 9/74
CANARY—FILE, PINK—APPLICANT ��
RIVERS40E COUNTY DEPARTMENT OF BUILDING AND SAFETY
n�.► CpRRECTION NOTICE
To: , �'^' ��� Permit No.
Address: !-7Z V 0- Date:
FRAME INSPECTION - U.B.C., 1976 EDITION
1. Approved plans shall be on job for inspection. (302(b)] .
2• Changes from approved plans must be made on all plans and approved in Plan Check. [302(a)) .
3. Add shots where indicated per Research Recommendation Card.
4. Maximum spacing of studs 24" o.c. [2518(f)31.
5. Horizontal stabilizing blocks to be placed in all stud walls over 6' in height to conform to
Ordinance 457.
6. Double top plate joints at least 4' apart. [25181 .
7• Ceiling joist overspanned. (2518 (h)21 .
8. 3-8d nails joist to plate. Nail top plates together- 16d 16" o.c. [2518) Table 25-P.
9. 3-8d nails rafters to plate. [25181 . Table 25-P.
10. Nail corner studs 16d - 24" o.c. [25181 . Table 25-P.
11. Rafters overspanned at [2518 (h)21.
12. Purlin overspanned at (2518 (h)51.
a3. Slope of struts not to be less than a 45' angle from the horizontal. [2518(h)51 .
Add backing at =Aae� [4706(c)) .
��� Rafters do not fit ridge - fix. (2518(h)31.
16. Nail ceiling joist to rafters. Add cross ties, Max. 4' o.c. [2518(h4)) .
17. Add brace at [2518 & Ord. 457) .
18. Shim and nail trimmers. (2501(b)] .
19. Metal strap on studs and plate where pipes -are located. [2518(9)81 .
20. Install windows as per approved plan. [1404) .
Fasten post to concrete. Use "T" strap post to beam. [ 2310,(e)] .
Attic access minimum 22" x 30" 13205(a)).
All plywood exposed to weather to be exterior grade (3202) .
24. Replace short trimmers in [2518(g)71.
25• Foundation ventilation. (2517(c)61.
26. Install sway braces in garage. [ 2312(a)] .
27• Provide flashing and counter -flashing at junction of roof and vertical surface. (32081.
28. Secure chimney straps at ceiling line to frame [3704(c)) .
29• Install solid sheathing and 15 lb. felt between masonry and wood studs at planter. (2517(c)71.
Plumb all walls [:2309(0)1 .
GD Install screened attic ventilation rati to 150 [3205(c)] .
32 Bath requires vent to outside air.[1405 a
33. Provide adequate space for comfort heater.
INSPECTOR
CORRECT THE ABOVE CIRCLED ITEMS AND CALL FOR RE -INSPECTION.
284-231 REV. 3%77
RIVERSIDE COUNT
tY DEPARTMENT OF BUILDING AND SAFETY
.CORRECTION NOTICE
To: Permit No.
Address:601'���� P �Sel i Date: — fel"._ 7.F
GROUND PLUMBING — U.P.C., 1976 EDITION
proved plans shall be on job for inspection. [U.B.C. 302gAp
Toilet facilities s all be on job site. (Calif. Health & Safety Codes.
3. Post job card. [U.B.C. 304) .
4. Replace defective fitting at _[3091 .
5. Support soil pipe each joint ( ), continuous ( 1 [3161.
6. Closet bend to extend minimum floor level. [8051.
7. Off set plumbing out of bearing footing. [315] .
8. Fill soil pipe with water for testing. [3181 .
9• Stop leaks on line. [3181.
10. Unapproved fittings on line. [405 and 3101.
11. Minimum %<" per foot grade required on line. [4071.
12• Gas line not permitted under slab. [1213-b] .
13. Pipe shall not be installed in a strained position. (503] [ 12051 .
14 -All horizontal vents required to drain to fixture it serves. [505) .
15. Total vent area to be equal to largest required building sewer. (5041 .
16. Cleanouts to grade. [4061 .
FOOTING AND FORM INSPECTION — U.B.C., 1976 EDITION
1. Approved plans shall be on job for inspection. (3021 .
2. Provide legal lot stakes. [301 and 304) .
3• Foundation footing to be 12 inches — 18 inches into undisturbed soil and 12 inches — 15
inches wide. [Table 29-A1 I.
4. Regrade and compact fill, minimum thickness of concrete floor, 3% inches. [26231 .
5. Fireplace footing to be 12 inches larger each dimension than fireplace. (3707(b)1 .
6. Interior bearing footings to be 12 inches into undisturbed soil; width, minimum 12 inches.
[2907 (b)) .
7• Pier footings minimum 16 inches square. [Chapt. 291 .
8• Forms shall conform to plan; tied and braced. (2606(a)) .
9• Minimum foundation height 6 inches above finish grade. (2907(a)) .
10. Re -bar shall be tied in place. [2607(d)] .
11 -Provide footing for veneer. Brick ( ), Rock ( 1 [2006(b)I I.
12•Water piping on branch to too small. [1009 U.P.C.] .
13•Gas piping not permitted under slab. [1213-b U.P.C.] .
14. Mastic required on all metallic pipes where they come through slab or footings. [315 U.P.C.) .
15. Form shall be in place for tub trap recess. It shall be poured monolithic. (803 U.P.C.1 .
16.Post job card [U.B.C. 304(b)) .
17•Job not.ready for inspection.
`Tea Mar7-AOo /-_&_nT �. ee
Inspector
CORRECT THE ABOVE CIRCLED ITEMS AND CALL FOR RE -INSPECTION
284-233 REV 3/77
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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 agreed 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 assuumje no responsibility should -trees have too be removed due to lot line errors. /� �J�j
--
Owners NartTit ��' /� ��'� " r r'r>1 � Buildiinng Permit No. 7t)0 `"'
Mailing Addre,$: _y, "`tet _��_ City l� ,State C'` Zip
Job Address O Ayt= L,�frd Community L4—
Legal Description 72
Assessor's Map, Book & Page 7 d0 7 Type Structure ���L —'' ✓ C_
Type of Soil Is water available �� Road Dept. Plot Plan No.
Type of existing trees in road right—of—way n
Trees preferred by applicant (1ka4A— 45 ( �l iFl�/y (3 u%M JOW/3
Date n �r `
Planning Com mission Case No
ROAD DEPARTMENT APPROVAL
Approved species Jacaranda acutifolia (Jacaranda) Number of trees 1
Spacing of trees Distance from lot lines:. -Front 2' in R/W Side
Additional requirements Per plot plan on reverse.
Date Building and Safety notified 5/79 Signature
REQUEST FOR EXCEPTION
Reason
(attach additional page if necessary)
Request for hearing: YES F-1
Owner's Signature
Planning Dept.
Concur ❑
Date
(Forward application to Planning Dept. if exception requested)
NO REQUEST FOR HEARING
Non -concur ❑ Explanation
Signature
Road Dept.
Concur ❑ Non -Concur ❑
Date Signature
REQUEST FOR HEARING AND COMMITTEE DECISION
Date hearing established Date hearing notice mailed to owner
Approved ❑ Disapproved ❑ Date Owner notified of decision
Date Building & Safety notified Signature
Final Date Inspector
Job Address
Requirements for tree, planting complied with
Remarks
APPROVAL BY BUILDING INSPECTOR
Building Permit No.
Community
(Detach and forward above information to Road Department Riverside)
284-230, REV. 1/74 �1
i
� per;
t
W__UNTY `ft
1_CV1jERSI Tl epantimeit o f TUIRP19 aid Safety
Administrative Office Bldg. Room 310
Hall of Records, Room 114 Administrative Office Bldg: 46-209 Oasis'Street s
4080 Lemon Street 880 N. State Street Indio, California 92201
Riverside, California 92501 Hemet, CA 92343 (714) 347-8511
(,714) ;787,-6146 (714) 658-4464-,(714) 345-2521
December. 49j,-107:91
NOTICE•OF EXPIRATION
You were recently advised that we had.not receiveda request for,an inspection
do,your Building PermitNumber (s) 360176 .
for, r6lling'8 garage
Located at '514660 Avenida '=VdUsca'
You were also'given'•a copy of S'ec 302 (d), "Expiration", taken'from the
latest
edition of the Uniform Building'Code'. which we quote again'as follows:,.
(d) Expiration. Every permit issued by the, Building Official under
'the provisions of this Code shall expire by limitation and become null
and void, if, the building or `work authorized 'by such permit is not
,commenced within 120 clays from.the date of such permit, or: if the
building or xyork authorized by such permit is suspended or.abandoned
•at am• time after the work .is commenced for,a, period of 120•days.
' `Before such work can be recommenced' a new permit shall be first
obtained ',so to do, fee therefor shall be- one-half the amount :•
,and,the'
reyiiired for a new permit for succi work, provided no changes have
!
' been inade`or.will,be made in the original plans and specifications for
such work; and provided, further, that such suspension or abandon
meiit has•'not exceeded one near.'
Since.the'following,circumstances apply, your permit has expired and has
been
removed-fromtour active files.
Work not commenced within 120 days
' Work suspended for a period of 120 days
As indicated above, you may obtain a new permit by payment of one-half the
amount required for; a new permit,.provided there are no changes and that'the
`
suspension has not exceeded one year.
Very.•truly yours,
DEPARTMENT OF BUILDING AND SAFETY
46dio Office
284-189 8/74
PERMIT No. -7 DEPARTMENT' OF BUILDING & SAFETY FIELD OFFICE
3 6 01 1 6 COUNTY OF RIVERSIDE ,/
CONSTRUCTION
ESTIMATE
1ob Address
NO.
ELECTRICAL FEES
NO. PLUMBING FEES
IST FL.
2ND. FL.
POR.
cGAR.-
CAR P.
SQ. FT. @ µ $
360176
UNITS
aZ
SQ. FT. @
YARD SPKLR SYSTEM
SQ. FT. @ MOBILEHOME SVC.
BAR SINK
SQ. FT. @ �' - p^✓ POWER OUTLET
ROOF DRAINS
SQ. FT. @
DRAINAGE PIPING
WALL " +
j
Sq. FT.@ V -
" {
Off.
`
DRINKING FOUNTAIN
SQ. FT. @
URINAL
ESTIMATED CONSTRUCTION VALUATION
Use of Permit
•/ /
Parcel No.
WATER PIPING
'NOTE: Not to be used as property tax valuation
Ck. By
Mech. Fee D $ s
SWIM POOL, PVT
'
FLOOR DRAIN
MECHANICAL FEES`
PL Ck. Fee
$
SWIM POOL, COMM'
WATER SOFTENER
VENT SYSTEM FAN EVAP. COOL ;HOOD
et Backs
SIGN
WASHER (AUTO)(DISH)
APPLIANCE DRYER
S
R
R
ConstruUion Fee Dbl $ 7
Le al Description t
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
Electrical Fee
'
Pip -
n. • 0>
LAUNDRY TRAY '
AIR HANDLING UNIT ' : CFM
Group
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM r, B.T.U.
E
't
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR r HP
/[ 3
ix
POLE,TEMP/PERM
Plumbing Fee
LAVATORY
y
HEATING SYSTEM FORCED GRAVITY'
89nd Amt.
Plan No.
AMPERES SERV ENT
i
SHOWER
BOILER, B. T: U"
Unit
'
'Sp. Insp. Fee
BATH TUB
$
All,
SQ. FT. @ <
WATER HEATER
SQ. FT. RESID @I'V,c
Demol�Fee
SEWAGE DISPOSAL,
'
Const. LenderBranch
Q. FT. GAR @ %c
Permit Numbers
HOUSE SEWER
tRegist, Fee
$
GAS PIPING
PERMIT FEE
-
PERMIT FEE
`
PERMIT FEE
DBL.
TOTAL FEES
Lw
MOB. HM. FEE
MICRO FEE
MECH. F
PL CK.'FEE
CONST. FEE
EL T. FEE
13444n./
SMI FEE
�.�f!'
FEE PLU B. E
� JC
PERMIT NO.
1ob Address
r
Space
Zip
Owner
360176
aZ
Community :•
- " . ° w ° "
Vdluotion • » " +—
Date I
Dist
Off.
F.C.C.
r .«•.r w.,w. M,
MH.Permit Fee E
Micro Film Fee
Cop $
Use of Permit
•/ /
Parcel No.
T
Use/Case No.
Ck. By
Mech. Fee D $ s
PL Ck. Fee
$
,
et Backs
Lot Size
F
S
S
R
R
ConstruUion Fee Dbl $ 7
Le al Description t
Electrical Fee
Dbl
Pip -
�C'y" % `
.. ``
I,7L �/, 'y :.�Y� 5—/SMI
Zone Restrictions
Group
Type
Fee
E
c
/[ 3
Plumbing Fee
Dbl E
89nd Amt.
Plan No.
Pion Checker
Final Dat
Inspector
Unit
'
'Sp. Insp. Fee
$
$
All,
Demol�Fee
$
Const. LenderBranch
Supplimentol
Permit Numbers
tRegist, Fee
$
-
`
Mileage Fee $
Address - City Zip
Witn ss Fee $
Refnsp. Fee
$
Owner/Agent ,
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T LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK
Sewer District FOR 120 DAYS SHALL ALSO USE RMIT TO BECOME VOID.
• I HERESY AGREE THACOftfC WITH 1HIS PERMIT WILL BE DONE IN ACCORDANCE WITH
THE LAWS OF RIVERSID COUNTY ND THE STATE OF CALIFORNIA. i
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
Form 284-208 (Rev.8/78) ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
verified by: °