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329766 (BLCK)spm piuvw y,3 :. 16 CONST 15t FL. SO- FT. _ 2ND FL. SO. FT. POR. $0. FT. 6'v GAR SO. FT. RIP. SG. FT, L 5Q. FT. SO. FT. ESTIMATED CONSTRUCTION -ALUATION It NOTE, Nov to be used us propeny tax valuotbn MECHANICAL FEES VET,11SYSTEM [] FAN iO EVAP. COOL ❑ HOOD APPLIANCE 0 DRYER FURNACE ❑ UNIT © WALL 0 FLOOR Q SUSPENDED AIR HANDLING UNIT ---1 i FM ABSORPTION SYSTE 4 B.T.U. COMPRESSOR HP HEATING SYSTEM O FORCED E) GRAVITY BOILER D S.T.U. PERMIT FEE 09L I i DOM MMOtIT OF BUWNG 8 SAFETY COUNTY OF IUVMDE ELECTRICAL F UNITS MOBILEHOME SVC. POWER OUTLET SWIM POOL, PVT SWIMPOOI COMM SIGN IDLE METER TEMP USE PERIAIT SVC POLE, TEMP/PERM AMPERES SERV ENT SO. FT. (a a 50. FT. fs c SQ. FT. RESID (a 1'.e $0. FT. GAR (s fie PERMIT FEE -- PL`CX.. FEE CONST. fEE T PLUMBING FEES:* YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING FLOOR DRAIN ' WATERSOFTENER WASHER IAUTO)IDISHI GARBAGE DISPOSAL LAUNDRY TRAY KITCHEN SINK WATERCLOSET , LAVATORY SHOWER BATH TUB WATER HEATER SEWAGE DISPOSAL 140WE SEWER GAS PIPING PERMIT FEE I FEE I PEE 97N� S+rpp•Petmil Job Address Space Zrp Ctwnet Cammvrwy ./,';L•-- Val a Rio. OH. F.0 AW Pem•. '•>e s Mlcm Fdro ftio '' Cep -5 Lh4 o1 Parma ltgol petcripYgn /(7'r / ` /7 S�Y/c� Parol No. l7sa No. Me& fvo ow f M. Cl- Fee S Construction Fye ot. S + tW S'ae R tkaltd fee obi S LWrr GrP Type Unit ^ SMI Plumbaq Fee DW ' i Bond Aml. f Port No. Plan Checker fma! pore lmptx;a Sp. Imp. fee S otmol. FM 1 Cow, Lender Branch l4wfily lhm at the PHfonnaxe of IM work for whkh $4 pamo Is bwed I slsp0 not employ an/ perwn it any manner so ame io becowbled 10 llte workman's wm- penwtgn laws a,culdo,nio.•' Address Gh Zrp Owner Slgrnatuq WIdu Signotwo fEeq Mr. Fye 3 won" $ Wanenfee S a;mP. f Avner/Agent - r Tel. Zip Tad Fees s Adam% J � - �/ d a� Az Coy Zip �� ��ii✓>yV MA. 0 N.C. p coth 0 Ilrcewed 17y Trees itWi,ed Contswor . Tel. Lkmw S Sewrrpe`ystem T LL P S", DMrn1 Form79A.20B IR*,,- 4.771 OF Address City Grp Wo" A'Camp. Yes Q noQ THIS PERMIT SHALL BECOME VOID IF WORK. 15 NOT COMMENCED WITHIN 127 DAYS. CESSATION OF willed by. WORK FOR 120 DAYS SHALL ALSO CAUSE PERMI T 10 BECOME VOID. I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE N 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 OF THE BUSINESS AND PROFESSION:, CODE OF THE STATE OF CALIFORNIA. NOTICE: THIS IS NOT A BUILDING PERMIT DISTRICT APPLICATION TO CONSTRUCT Permit No DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE 204 199A 9/74 CANARY—FILE, PINK --APPLICANT 101 Owne Architect _. Contractor �i1JC Addie ss �, Address�_...a llViJ')-3Ci�•s—Z— 1.l? .� — _ Q --• — .. .I I (we) the undersigned, t•eraby certify are: acknowledge that I (we) have read the application and agree that if Curb and Gutter, and ,°Cit Z Paving, and/or Dedication of right of way is requt ad by the County or 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, therefore, it is agreed that I (we) will not occupy said property end 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 g"arnutg said property. DATE/1El�/�i� SIGNATURE OF OWNER AND/OR AGEN _ p cul 19R� Approval by Slrnahoro from the following Departments Listed a S Mutt Be Obtained Prior to the Issuing of a Construction Permit. (SPACE NO, .-- _ 1 USE OF STRUCTURE 5 2- S/0 /�(/Ir/7/tl✓� / � JOB ADDRESS _ SINGLE FAMILY DUPLEY, >- LEGAL DESCRIPTION OF PROPERTY G - APARTMENTS (] AGRIC. L 2 Z f�% c� v ' ;Aa sit _ __ _`� �"�""' -"" -'—- COMMERCIAL O INDUSTRIAL [] G Z COMMUNITY NO. OF SUBMITTED PLANS �L^ USE OF PERMIT 4- A )�/S� G!<�Ca 41:— ALTERATIONS CASE PIO. "— fJC A 3 T r{ co C ? NO. OF PARKING SPACES REQUIRED _. —1--____ NO. OF BUILDINGS NOW EXISTING a ZONE "� SETBACKS: FRONT ' SIDE REAR " m GRADING PERMIT REQUIRED? YES :j1 NO C -r—_ LOT SIZE C7 SETBACK ORDINANCE A OF FEET REQUIRED ON .1 STREET DATE SIGNATURE OF LAND USE OFFICIAL DEDICATION REQUIRED: YES ❑ NO ❑ . NO, OF FEET.__ CURB AND GUTTER REQUIRED: YES ❑ NO ❑ — STREET - a W CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑ ' HAS AN ACCEPTAELE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET OIMPROVEMENT? YES ❑ NO ❑ 00 DATE SIGNATURE OF ROAD DEPT. OFFICIAL S SWIMMING POOLS. PUBLIC 1 = D SEWAGE DISPOSAL - FOOD ESTABLISHMENT WATER POLLUTIONREMARKS r�► FLOOD CONTROL a Wit AIR POLLUTION W DIV OF HWY c a _ YOUR' PROPERTY MAY BE SUBJECT TO , o — FLOOD. RIVERSIDE COUNTY ASSUMES10 ' NO RESPONSIBILITY IN EVENT OF FLOOD. 204 199A 9/74 CANARY—FILE, PINK --APPLICANT `y F. ._. ... ._. _�.Nk_4 eyi; .- DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE NOTICE TO APPLICANT In conformity with the provisions of State of California Labor Code Section 3800, the applicant shall have on file or file with the Riverside County Department of Building and Safety a certificate as designated in Items I or II below, or shall indicate'ltem III, IV or V, whichever is applicable. CERTIFICATE OF APPLICANT Please mark the appropriate block: �. I. Certificate of Consent to self -insure issued by the Director of Industrial Relations. [� Copy on file Copy submitted QII. Certificate of Workers' Compensation Insurance issued by an admitted insurer. Copy on file . Q Copy submitted (� III. The cost of the work to be performed it $100 or less. IV. I certify that in the performance of the work for which j this permit is issued, I shall not.employ any person in j any manner so as to become subject to the Workers' Compensation. laws of California. I further certify that-, in the event I become subject to the Workers' Compensation provisions of the Labor Code that I will comply forthwith with the provisions of Labor Code Section 3700, et seq.-, -=-- and understand that, if I do not comply, the permit shall be deemed revoked. V. I certify as the owner (or the agent of the owner) that in the performance of the work for which chi permit -is issued I have engaged�Lt.;c. contractor. (Contractor must have on f e or submit certificate required by I or 11 above.) Applicant's Signature Date L, .�f t No. Address and location where work is to be performed 284-141 Rev. 6/77 L