369509 (RPL)BUILDING PERMIT
PERMIT NO. DEPARTMENT OF BUILDING & SAFETY FIELD
36 9 5 0 9 COUNTY OF RIVERSIDE
F�Dyr
CONSTRUCTION
ESTIMATE
NO.
ELECTRICAL FEES
NO.
PLUMBING FEES
IST FL.
2ND. FL.
FOR.
GAR.
CAR P.
WALL
r
ESTIMATED CONSTRUCTION
SQ. FT. @
SQ. FT. @
SQ. FT. @
SQ. FT. @
SQ. FT. @
SQ. FT. @
SQ. FT. @
VALUATION+
$
UNITS
YARD SPKLR SYSTEM
MOBILEHOME SVC.
BAR SINK
POWER OUTLET
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
r
f
FLOOR DRAIN
?
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
`
VEk SYSTEM FAN EVAR COOL HOOD
SIGN
WASHER (AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
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
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U_
SQ. FT. @ t
BATH TUB
SQ. FT. @ C
WATER HEATER
SQ. FT. RESID @ltht
SEWAGE DISPOSAL
SQ. FT. GAR @ '/. G
HOUSE SEWER
GAS PIPINGPERMIT
]PL
FEE
PERMIT FEE
PERMIT FEE
,DBL-
TOTAL FEES
MOB. HM. FEE
MICRO FEE
MECH. FEE
PL. CK. FEE
CONST. FEE
ELECT. I
SMI FEE
FEE
E
PERM17 NO. T
Job Address � Space Ezip �y
Owner
Community
1 _
V I w< f..
Va lvat ion
3
$ ..._i-% r, !, t f
Date
��•
' Dist.
,i�
Off. "
F-C-C.
J, 7
MH.Permir Fee
$+
Micro Film Fee
Cop
5
Use of Permit
% '�.> > S !.- f isJi
�� - I� T
Parcel No.
>~'
se/Cos. No.
Mech. Fee
061
5
PI. Ck- Fee
S
/
Sol Bbcks
Lot Size
Construction Fee
Dbt
5 L
Legal Description
—,;
/
F
S
S
R
Electrical Fee
Dbl
$ 7
Zone Restrictions
Group
Type
SMI Fee
S
/,
Plumbing Fee
Dbl
s
,.
Bond Amt.
$
Plan No.
Plan Checker
Final Date 1�l1
1 / (J
/
Inspector
Unit
Sp. Insp. Fee
s
Demol. Fee
S
Const. Lender Branch
Supplimvnta P it Numbers
J
Registr. Fee
s
Mileage Fee
$
Address Cily Zip
witness Fee
S
Reintp, Fee
$
Owner/Agent
Tel ZIP
Total Fees
:6
..
Address
Ciry Zip
M.O. Ej N.C.,-] C.,IhEl Check
/
Received by f
Conlractor
.•r f r• r� f.
Tel-
C f
License#
7 •' �/
Trees required
Sewage System
Addr - -
0 -• 7jp
-
T LL P THIS PERMIT SHALL BECOME V61D IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION 6F WORK
'SewaF District FOR-120 DAY$_SHALL ALSO CAUSE PERMIT TO BECOME' VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH TFPS PERMIT WILL BE DONE IN ACCORDANCE WITH
THE LAWS OF RIVERSIDE COUNTY AND THE STATE -OF CALIFORNIA.
I HEREBY CERTIFY THAT THE71NDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
�.rni 28A-2&.
I
verified by:
NO.
OPERATION DATE
INSPECTOR
NQ. OPERATION
DATE INSPKTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Bock
33 Ventilation System '
2
Ftgs & Frms
34 Plenums & Ducts
2A
Slab Grade
35 Furnace Comport.
3
Steel
'�_ �0' 7�
36 Inlets & Outlets
4
Grout Blocks
37 Combustion Air
5
Bond Beams
38 Compressor
6
Roof Deck
39 Appl. Clearance
7
Framing
40 Fire Dompei
8
Vents
41 Smoke Detection Device
9
Garage Fire Wall
42 Commercial Hood
10
Fireplace
P. L. 0
43 Final
10A
Fireplace
T.O.
oo ADDITIONAL INFORMATION
g�
E
- n
�
�(� 2s -toj p '}
er
Lj i
U�
PYC
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A DrywallF
13 Finish Grade
INSULATION
R
Thick
Value
7A Walls (Batts)
12B Ceiling (Batts)
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 7-44—Z?
25
Final
� /
Tank Pit L.Line
REAR OF PROPERTY LINE
1`
PSL P/
ELECTRICAL APPROVALS
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring g—/ -o -
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final D�
STREET NAME
BUILDING PERMIT DST
—
PERMIT No.DEPARTMENT OF BUILDING 8 SAFETY FIELD OFFICE �'�j
369509' COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE
NO.. ELECTRICAL FEES NO. PLUMBING FEES
IST Fl.
2ND. FL:'
SQ. FT. @
UNITS
Owner ,
S 1
YARD SPKLR SYSTEM
SQ. FT. @
T
POR.
SQ. FT. @
MOBILEHOME SVC.
BAR SINK
F.C.C.
? Q
GAR.
SQ. FT. @
POWER OUTLET'
ROOF DRAINS
Use of Permit
�'", �»
-
CALI/
1N/ j
q L! r SSQ. FT. @ Q. FT. @
%'�j` • r Q. FT. @
STE IMATED CONSTRUCTION VALUATION'
7
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
-
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
V(f / FLOOR DRAIN
Set Backs
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
Dbl $
Dbl $
VENT SYSTEM FAN EVAP. COOL HOOD .
SIGN
WASHER (AUTO)(DISH)
APPLIANCE DRYER
Zone Restrictions /
9 -
GARBAGE DISPOSAL
Type
FURNACE UNIT WALL FLOOR SUSPENDED
SMI Fee $ 43
LAUNDRY TRAY
Dbl $1
$
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
Plan Checker
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
Unit
COMPRESSOR HP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
Supplimental Permit Numbers
BOILER B.T.U.
SQ. FT. @ c
BATH TUB'
Address - City Zip
/
Witness Fee Is
SQ. FT. @ c
WATER HEATER
Owner Agent
SQ. FT. RESID @1'h<
SEWAGE DISPOSAL
Tel.
Zip
SQ. FT. GAR @ s/. c
HOUSE SEWER
$
Ca
�
C
Check
.Address
GAS PIPING
PERMIT FEEPERMIT
FEE
PERMIT FEE
`
DBL.
TOTAL FEES
[(?7 ��
MOB. HM. FEE
MICRO FEE
MECH. FEE PL. CK. FEE
CONST. FEE
-0
--ENET- TEE • SMI FEE
Z-
FEE
I. - i
PLUMB. FEE
/ rj%�AW
PERMIT NO.
369509
Job Address
G/
Space
�� -
Zip
Owner ,
S 1
Community /,)'
4� C/ r •!V
T
Valuation
$
F
�00 .,,,,....
Date . Dist.
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Off.
� / .
F.C.C.
? Q
MH.Permit Fee $
Micro Film Fee
Cop $
Use of Permit
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-
It
�`�
Parcel No.
• ,,. O�
Use/Case, No.
Ck.�
Mech. Fee' Dbl $��
PI. Ck. Fee $
Set Backs
Lot Size
Construction Fee
Electrical Fee
Dbl $
Dbl $
d
Legal Description
:�
G I,/ 1
._ �� �� / /�
F ,, — S ® S ' R
Zone Restrictions /
9 -
Group
Type
SMI Fee $ 43
Plumbing Fee
Sp. Insp. Fee
Dbl $1
$
Bond Amt.
$
Plan No.
Plan Checker
Fina(lA/ate
Inspector
Unit
Demol. Fee
$
Const. Lender
Branch
Supplimental Permit Numbers
Registr. Fee $
Mileage Fee $
Address - City Zip
/
Witness Fee Is
Reinsp. Fee
$
Owner Agent
/
Tel.
Zip
Total Fees
M.O. N. C,
Received by
$
Ca
�
C
Check
.Address
'
City -"y
-
Zip y
^ --
Contr t r
-,a _`j~
Tel. „"" _-• r--
wr�.�/�G�
`Clj
licenseN
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frees required
Sewage System
-
Address
^.,.- " -
'[�y�/} /�j• ,Zip
if .T LL , --•p-
!?Sewer District
,Form2842 �e 8) s t
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THIS PERMIT SHALL BECOME Vd1D IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK
FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. '
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN 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 PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
•
TAMs
verified by:
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ELECTRIC BY. y OT #PWN BY
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a visions ot, an the job until FILTER (SO. FT-.)., P(yq� 4._�rLIA -LIGff
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11DAT .4
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NOTICE: THIS IS NOT A BUILDING PERMIT
-'! DISTRICT
,_, APPLICATION TO CONSTRUCT Permit No
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE /j f
L'. " --�) wr / <, r f /
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284 199 9/74 CANARY—FILE, PINK—APPLICANT
I
I 61Y
Owner Architect Contractor •F
Addrss_�
l.g
Address 'f y,
" \: l u
City T t City City_C
Phone Phone Phone
I (we) the undersigned, hereby certify and acknowledge that I (we) have read the application and .agree that if Curb and Gutter, and
01W
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 bg done within the County R/W
O
without an encroachment permit. l
X(we
NOW, therefore, it is agreed that I (we) will not occupy said property and will not cause said property. be occupied u�,,til have
complied with II la sof the County of Riverside and the State of California governing said property.,f�ti`
DATE SIGNATURE OF OWNER AND/OR1AGEN
Approval by Signature from the Following Departments Listed Below
.xeMust Be Obtained Prior to the Issuing of a Construction Permit.
` SPACE NO.
USE OF STRUCTURE
JOB ADDRESS —40- ")X 74. ap if/l' — SINGLE FAMILY ❑ DUPLEX ED
Z W
LEGAL DES IPTI9 N�, OF Pf�OPERTY _
� '*4 ai APARTMENTS AGRIC. El
N
ONJM,ERCIAL INDUSTRIAL �J
'^COMMUNITY
G G
ALTERATIONS [j_.
Z
N0. OF SUBMITTED PLANS _-- USE OF PERMIT
CASE,t�;,—
p Z
NO. OF PARKING SPACES REQUIRED NO. OF BUILDINGS OW EXISTING
a
ZONE SETBACKS: -FRONT `S SIDE 3J RE
J m
GRADI/? RR !,REQUIRED? YES ❑ NO ❑ LOT SIZE xa
SETBACK ORDINACE # __ OF FEET REQUIRED ON _ STREET
DATE —_ SIGNATURE OF LAND USE OFFICIAL ---
DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET-_.
zCURB
AND GUTTER REQUIRED: YES ❑ NO ❑ —STREET,„
H
ac
d
CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑ .
W
HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET
D
IMPROVEMENT? YES ❑ NO ❑
°L
DATE __ SIGNATURE OF ROAD DEPT. OFFICIAL
S
SWIMMING POOLS PUBLIC
W'
SEWAGE DISPOSAL
_
FOOD ESTABLISHMENT
_
WATER POLLUTION REMARKS
�n FLOOD CONTROL—
ONTROLW
Z.AIR POLLUTION
W
DIV OF HWY
I.-
YOUR PROPERTY MAY BE SUBJECT TO
a _
d
c - FLOOD. RIVERSIDE COUNTY ASSUME;
NO RESPONSIBILITY IN EVENT OF FLOOD.
x-
284 199 9/74 CANARY—FILE, PINK—APPLICANT
I