A009043 (GRD)FIELD
DEPARTMENT OF BUILDING & SAFETY.
PERMIT NO. PERMIT
,TYPE COUNTY OF RIVERSIDE
A00904
ditional Information:
,,ACTe RY BUILT HOUSING
uM
MOBILE HOME INSTALLATION
anufacturer
MH Manuf.
New ❑
/Model Designation
Size Relocated ❑
Pnit Serial No.
Total Fees $
4flon Approval No. E.
insig. Serial No.
Moving
ewoge System
w" T 1 1
p
Permission is hereby granted to move the
structure, described below, in
Width Length
Height
Total Fees $
'+r
'GRADING
#1
Number
of #2
Sections
#3
'Cvt
'Fill 'J"
7ofal Fees $
0
Present Location
Community County
RELOCATION INSPECTION
Destination
Present location
Community
County
Total Fees
$
otol Fees $
Per it No.
_A.D�'904 �3-
Job Address
��d 47>
SP # Zip
.�
Owner
"24
Plan Check
cro
Communit .-
100— / 7W
Valuation
$
Date
j0--916>
Dist
Off
P.C.
"
.Reinspectione/�/
Ude of Permit
�#y . mi-, `7
Legal Description
Par el No.
b9 2 /at ._���
Set backs
Bond Zone Grp Type
'°� yl $ A
Lot Size
Use Permit #
Unit ckby.
Factory-
Built
;,Grading
Mobile home
Engineer License
#
Fi al Date I ector
��—
Env. Assmt.
e u' nt
Relocations
Escrow Company
rant
f
�,Tota I Fees
$
Address
City
Zip
.!r ash
Check
Mo
rvc
Owner/Agent
Tel.
R - eived by Date
dresst
Zip
PReloted Perit�lysl
Contractor/Mover
Tel.
work'ens' comp.
yes ` \,, no ❑ N,
Address ��
I
City
I
Zip
certify that in th pe7fo mane o the work for which thi permit is This permit shall become void if work is not commenced within 120 days. Cessation of work for 120 days
,isuecl I shall not eIn an`y pe `son n manner so as to b come sub- sholl also cause permit to become void.
ct to the workers' comp otio to Col' or io. p ' 'Riverside
agree that oil work in connection with this permit will be done in accordance with the laws of
..j Riverside County and the State of California. I hereby certify that the individual who prepared the pians and
Owner Signatur specifications has done so in accordance with Section 5541 of the Business and Professions Code of the
Y; Builder signature Stote of California.
FORM 284.208A 5-77 (Dr
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
- Ventilation System
2
Ftgs & Frms
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
6
Roof Deck
39
Appl. Clearance
7
Framing
40
Fire Damper
8
Vents
41
Smoke Detention Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P.L.
43
Final
1oA
Fireplace T.O. Ej
NON
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
1 1 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls IBattsl
12B Ceiling IBattsl
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
REAR OF PROPERTY LINE
PSL P/
t
A
ELECTRICAL APPROVALS
26 Power Pole
27" Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
2c13 Bonding
3 Fixtures
31 Service
32 Final
r
STREET NAME _
FIELD OFFICE
DEPARTMENT OF BUILDING 8 SAFETY
PERMIT NO. I PERMIT TYPE COUNTY OF RIVERSIDE
AO090436e.
Additional Intormation:
FACTORY BUILT HOUSING
Manufacturer
MOBILE HOME INSTALLATION
MH Manuf.
New ❑
(Model Designation
Size
Relocated ❑
(Unit Serial No.
Total Fees $
Plan Approval No.
Insig. Serial No.
Moving
Sewoge System
li T 1 1
p
Permission is hereby granted to move the
structure, described below, in
Width Length
Height
;Total Fees $
I
GRADING
I.
#1
Number
of #2
Sections
#3
!Cut
!Fill
jTotal Fees $
' /J
Present Location
Community County
RELOCATION INSPECTION
Destination
location
iPresent
Community
County
Total Fees
$
Notal Fees $
r o}--- 11e7mrf..No
�. 09043
b63-o-�
'Job Address _ - _ ------ -- -- -- -- --- - - - -
SP # ..
' dip
Ovvrier'
AkeLle's-rJ111
Co/munit��`j ,
Valuation
Date
Dist
Off
P. C.
'i
Use of Permit
��AA11 e,-/�' '��
Parcel No.
69-1�
Lot Size
((Reinspection
Factory-
(Built
Set backs
Use Permit #
Legal Descripticn
besf—/4r-C I t d
+
'Grading
Bondzone
$
Grp
Type
Unit ckby
;'Mobile home
Engineer License
#
Fin I D to
����
In ct
Env. Assmt.
Requirement
I.
Relocations
Escrow Comparyanch
?Total Fees
$
Address
City '+
`
Zip
;i ash
Check
MO
Nc
Owner/Agent
Tel.
eawe'd by Date
r, J O�7
A res, LL
/./
C Zip
Rel ted Permitl 1VContractor
i
/Move r
Tel.
work6'�Scomp.
I` yes no ❑
r
Address Z
City
Zip
' certify that in e p rman the work for which th' permit is This permit shall become void if work is not commenced within 120 days. Cessation of work for 120 days
issued I shall not em oy a so in y manner so as to tome sub- shall also cause permit to become void.
Eject to the workers' tom nsatio s a o nio. I heredoe that olf work in connection with this permit will be done in accordance with the lows of
Riversmy an he Store California. I hereby certify that the individual who prepared the plans and
Owner Signatu specif e c a with Section 5541 of the Business and Professions Code of the
Builder Signat re Sta
FORM 284.208A 5-77 (E)m