359670 (BLCK)BUILDING PERMIT
PERMIT No.DEPARTMENT OF BUILDING & SAFETY FIELD [DST
35967 COUNTY OF RIVERSIDE
//
CONSTRUCTION
ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
I ST FL.
2ND. FL.
SQ. FT. @' $
UNITS -
Community
a
�F
SQ. FT. @
YARD SPKLR SYSTEM
"POR. (r.... ;:. . ,SQ:,'FT.a@
:. c ..,
a . ,(VOBILEHOME-SVGA.
K'!
BAR SINK
' GAR.
CAR P.
WALL
SQY FT. @
POWER OUTLET
Use of ermit
/tl
ROOF DRAINS
SQ. FT. @
DRAINAGE PIPING
SQ. FT. @ '
DRINKING FOUNTAIN
/71'--1' `.." SO. FT. @
ESTIMATED CONSTRUCTION`VALUATION $
Bd`ck3'' �✓
Lot Size
URINAL
WATER PIPING
NOT;E:. No1_(o be used,as. property taz valuation'
_ . f. SWIM.POOL," PVT
+
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
Group
WATER SOFTENER
VENT SYSTEM FAN EVAP. COOL HOOD
SIGN
Plumbing Fee'
WASHER (AUTO)(DISH)
AP:LIANCE DRYER
Plan
No. -
-
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
Inspector
Unit
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
Witness Fee E
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
r •------�..
- -
SHOWER
BOILER B.T.U.
SQ. FT. @ C
Total Fees ""
BATH TUB
Address r s.
SQ. FT. @ t
.City :k,. .'' r,
WATER HEATER
M.O. C3 N. C. Cash EI Check
SQ. FT. RESID @1'/.c
SEWAGE DISPOSAL
SQ. FT. GAR @ s/. t
LicenseY
HOUSE SEWER
Trees required•`
Sewage System
Address -
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL. ..rTOTAL-FEES
:
ala.
MOB.HM.FEE
.r „ MICRO FEE
MECH. FEE . PL. CK. FEE; -
,CONST, .fEE ;y' ..
�y
ELECT. FEE
SMI FEE
FEE PLUMB. FEE
PERMIT NO.
359670
..
Job Address
-
. Space
Zip
Owner
Community
a
-
_ _ ! -
Valuation
E
-
-
Date
Dist.,
Off.
F.C.C.
MH.Permit Fee$
Micro Film FeeCop
$ -
Use of ermit
/tl
' ` -
(' t;,"r ✓,d'y.�—
Parcel No.
`
Use/Cose No.
Ck. By
Meth. Fee Dbl E
PI. Ck. Fee _ y/�1.1
Bd`ck3'' �✓
Lot Size
Construction Fee Dbl- $
Legal Description
- '
- _
yy'%'
F S S R
Electrical Fee Dbl $
Zone Restrictions
Group
Type
SMI Fee $
Plumbing Fee'
DbI S
Bond Amt.
y -,
Plan
No. -
-
Plan Checker -
. '
Fino Date Z
Inspector
Unit
Sp. Insp.'Fee •- E '' , -
Demol. Fee
$
Const. Lender
Branch
SupPlimental Permit Number
'6
Regisir. Fee y
Mileage Fee g
Address - City. Zip
Witness Fee E
Reinsp. Fee
$
. �.,.
Or;r/Agent
r •------�..
- -
Tel.
Zip
Total Fees ""
- . .... $ _
Address r s.
4 ,/ �•r ! 4 ., j
.City :k,. .'' r,
Zip
M.O. C3 N. C. Cash EI Check
Received by\
Contractor.Tel:
:;-41'C;;' C
LicenseY
Trees required•`
Sewage System
Address -
-
Ciry Zip
Tl'—'`„ LLP F THIS PERMIT'SHALL-BECOME1 VOID! IF WORK' IS, NOT COMMENCED -W4THIN 120 DAYS. CESSATION OF WORK
1Sewer District FOR 120 DAYS SHALL ALSOE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT R jE/ITH THIS PERMIT WILL BE DONE IWACCORDANCE WITH
THE LAWS OF RIVERSIDE COUNTY AND r
E STATE OF CALIFORNIA.
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:
n
NO.
OPERATION DATE
INSPECTOR NO.
OPERATION
DATE INSPECTOR
PLUMBING APPROVALS
BUILDING APPROVALS
Ground Plumb
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Figs 8 Frms
34
Plenums 8 Ducts
2A
Slab Grade
35
=urnace Comport.
3
Steel
36
nlets 8 Outlets
4
Grout Blocks
37
=ombustion Air
5
Bond Beams
38
:ompressor
6
Roof Deck
39
Appl. Clearance
7
8
Framing ���_�9
Vents
i 40
41
=ire Damper
"smoke Detection Device
9
Garage Fire Wall
42
commercial Hood
10
Fireplace P. L.
43
Final
10A
11
12
12A
13
Fireplace T. 0.
Exterior Lath
Internal Lath
Drywall
1 Finish Grade
No
t
ADDITIONAL INFORMATION
INSULATION Thick
R i
Value
7A Walls (Batts)
12B Ceiling (Botts)
PLUMBING APPROVALS
12C Ceiling (Blown)
Ground Plumb
14
I 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
26
27
28
29
29A
29B
30
31
32
ELECTRICAL APPROVALS
SEWAGE SYSTEM SIZE & LOCATION
Tank Pit L.Line
REAR OF PROPERTY LINE
ti
P/L �/L
STREET NAME
NOTICE: THIS IS NOT A BUILDING PERMIT
APPLICATION TO CONSTRUCT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
Owner )�i�%Y iGdM,CIL-
Address Nom__-_
Cityg
Architect--
Address
rchitect— Address
City_
.r
DISTRICT
Permit No
Contractor----
Address-
City
ontractor__-_Address-City-
Phone— _
W
I (we) 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
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 property.
DATE ----- SIGNATURE OF OWNER AND/OR AGENC/ n
Approval by Signature from the Following Departments Listed Below
Must Be Obtained Prior to the Issuing of a Construction Permit.
)S--? ISPACE N0.
2
.JLu
H
Q W
Z
JOB ADDRESS
LEG�rL DESCRIPTION OF P6 a,ROPERTY
COMMUNITY S(Z
NO. OF SUBMITTED PLANS USE OF PERMIT
CASE NO.
USE OF STRUCTURE
SINGLE FAMILY
DUPLEX
APARTMENTS
AGRIC.
El
COMMERCIAL
INDUSTRIAL
ALTERATIONS
"n
NO. OF PARKING SPACES REQUIRED . NO. OF BUILDINGS NOW EXISTING -
ZONE�,�SETBACKS: FRONT SIDE REAR
GRADING PERMIT REQUIRED? YES ❑ NO M LOT SIZE
SETBACK ORDINANCE N OF FEET REQUIRED ON
DATE -�1�:M__7/ SIGNATURE OF LAND USE OFFICIAL _
REET
DEDICATION REQUIRED:. YES ❑ NO ❑ NO. OF FEET__
CURB AND GUTTER REQUIRED: YES ❑ NO ❑ STREET
CAN_ CURB AND GUTTER FEASIBLY BE "INSTALLED? YES ❑ NO ❑
HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET
IMPROVEMENT? YES ❑ ' NO ❑
DATE SIGNATURE OF ROAD DEPT. OFFICIAL
SWIMMING POOLS PUBLIC
SEWAGE DISPOSAL
FOOD ESTABLISHMENT ..
WATER POLLUTION REMARKS
FLOOD CONTROL
AIR. POLLUTLON
DI•V-OF-HWY-
YOUR PROPERTY MAY BE SUBJECT TO
FLOOD. RIVERSIDE COUNTY ASSUMES
--NO RESPONSIBILITY IN EVENT OF FLOOD.
284 199A 9/74 CANARY—FILE, PINK. APPLICANT